A Study of Spatiotemporal Variations in Childhood Asthma and Its Determinants in France from 2015 to 2021
Asthma is a chronic, multifactorial respiratory disease with a genetic and hereditary component that depends on the individual’s age and sex, as well as on external factors that can trigger the disease or cause it to flare up through asthma attacks. The objective of this study is to assess the association between the incidence of treated asthma in children and exposure to environmental risk factors—including industrial areas—through a geographic ecological correlation study at the municipal level. A selection of the main known risk factors was made based on the scientific literature. Exposure indicators for these risk factors—including exposure to industrial areas—were collected or constructed at the municipal level, which also corresponds to the unit of health indicators derived from the National Health Data System (SNDS) analyzed for this study. All of these indicators were then incorporated into spatial analyses to examine their associations with health indicators of treated childhood asthma. The associations between the municipal incidence of treated childhood asthma and municipal characteristics (including exposure to industrial areas) were examined using Poisson regressions and hierarchical Bayesian models. In total, 1,386,578 new cases of treated childhood asthma were identified throughout France between 2015 and 2021 (incidence rate = 14.3 per 1,000 children over the period). Spatial heterogeneity in the risk of treated asthma was observed across the country, with higher-risk areas in the southwestern departments, particularly Tarn-et-Garonne, Tarn, and Haute-Garonne, as well as a positive association between the municipal incidence of treated asthma and proximity to a facility classified for environmental protection (ICPE), levels of air pollution (nitrogen dioxide), low temperatures, humidity, pollen, obstetric and perinatal factors (excluding the mother’s age at delivery), and acute respiratory infections. An increased risk of treated asthma in children was observed in municipalities located near an industrial area, compared to those that are not. However, the results should be interpreted with caution given the identified limitations of the databases used and the study design itself, which does not allow for the establishment of a causal link between exposure and disease. Municipal levels of other environmental factors, such as pesticides, were not associated with the incidence of treated asthma. This study demonstrates the value of ecological approaches for integrating health and environmental data in the context of complex, multifactorial diseases, where risk factors—both environmental and sociodemographic—may be highly correlated with one another.
Author(s): Morel Pauline, Goria Sarah, Stempfelet Morgane, Ben Raies Jébraïel, Serra Delphine, Hardy Perrine, Kairo Cécile, Roudier Candice, Guldner Laurence
Publishing year: 2026
Pages: 149 p.
Collection: Current State of Knowledge
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