[Study of self-reported health of people living near point sources of environmental pollution: a review. First part: health indicators]. / Étude de la santé déclarée par les personnes riveraines de sources locales de pollution environnementale : une revue de la littérature. Première partie : les indicateurs de santé déclarée.

BACKGROUND: Epidemiological studies have investigated the health impacts of local sources of environmental pollution using as an outcome variable self-reported health, reflecting the overall perception interviewed people have of their own health. This work aims at analyzing the advantages and the results of this approach. A first step focused on describing the indicators. METHODS: The literature on indicators of self-reported health was reviewed, leading to a discussion on data collection, selection of health effects, data processing, and construction of indicators. RESULTS: The literature review concerned 51 articles. The use of self-reported health indicators allowed the studies to take into account the health concerns and complaints of populations exposed to environmental pollution. Various indicators of self-reported health were used in the studies. They measured physical, psychological and general dimensions of health. Standardized questionnaires were used less often than ad hoc questionnaires (78% of studies) developed to fit the needs of a given study. Three standardized questionnaires were used more frequently: the MOS Short-Form Health Survey (SF-36) to measure general health perceptions, the General Health Questionnaire (GHQ), and the Symptoms Checklist (SCL-90) to measure psychological distress. CONCLUSION: The choice of self-reported health indicators is a compromise between specificity of the studied health issues within a given environment and standardization of the questionnaires used to measure them. Such standardization is necessary to ensure the validity and the reliability of the information collected across time and situations. The psychometric properties of the measuring questionnaires are rarely estimated or verified when they are used.

[Study of self-reported health of people living near point sources of environmental pollution: a review. Second part: analysis of results and perspectives]. / Étude de la santé déclarée par les personnes riveraines de sources locales de pollution environnementale : une revue de la littérature. Seconde partie : analyse des résultats et perspectives.

BACKGROUND: Epidemiological studies have investigated the health impacts of local sources of environmental pollution using as an outcome variable self-reported health, reflecting the overall perception interviewed people have of their own health. This work aims at analyzing the advantages and the results of this approach. This second part presents the results of the studies. METHODS: Based on a literature review (51 papers), this article presents an analysis of the contribution of self-reported health to epidemiological studies investigating local sources of environmental pollution. It discusses the associations between self-reported health and exposure variables, and other risk factors that can influence health reporting. RESULTS: Studies using self-reported health showed that local sources can be associated with a wide range of health outcomes, including an impact on mental health and well-being. The perception of pollution, especially sensory information such as odors, affects self-reported health. Attitudes referring to beliefs, worries and personal behaviors concerning the source of pollution have a striking influence on reported health. Attitudes can be used to estimate the reporting bias in a biomedical approach, and also constitute the main explanatory factors in biopsychosocial studies taking into account not only the biological, physical, and chemical factors but also the psychological and social factors at stake in a situation of environmental exposure. CONCLUSION: Studying self-reported health enables a multifactorial approach to health in a context of environmental exposure. This approach is most relevant when conducted within a multidisciplinary framework involving human and social sciences to better understand psychosocial factors. The relevance of this type of approach used as an epidemiological surveillance tool to monitor local situations should be assessed with regard to needs for public health management of these situations.

[Pneumococcal vaccination: expected benefits in adults]. / Vaccination antipneumococcique: bénéfices attendus chez l'adulte.

PURPOSE: Streptococcus pneumoniae is one of the leading causes of bacterial pneumonia, meningitis and acute otitis media in children and adults worldwide. Polysaccharide pneumococcal vaccines have been available for approximately 50 years and conjugate vaccines, which generate immunological memory even at an early age but have limited serotype coverage, have recently been developed. CURRENT KNOWLEDGE AND KEY POINTS: Although the polysaccharide vaccine is considered effective in preventing invasive pneumococcal disease (IPD) in adults, its efficacy against pneumonia and among older or immunocompromised individuals is still controversial. On the other hand, the conjugate vaccine for children allows a large reduction in the incidence of IPD and in the rate of pneumococcal colonization in the general population through herd immunity, but its serotype coverage remains low in adults and serotype replacement may be expected in the long-term. FUTURE PROSPECTS: In the present context of widespread antibiotic resistance, it is of the utmost importance to assess the expected benefits of pneumococcal vaccination, in order to be able to use it optimally in all population parts.

Personal exposure of workers to atmospheric PAHs on gasworks sites--The SOLEX study.

The aim of the SOLEX study was to estimate the personal exposure of workers to atmospheric polycyclic aromatic hydrocarbons (PAHs) on former gasworks sites in the Paris metropolitan area. Devices to sample gas and particulate phases for 9 PAHs were carried during one working day of a study week in November 1997 by 24 workers and in June 1998 by 19 workers with contrasted job profiles involving different opportunities for contact with the soil; among these volunteers, some were active in the process of contaminated soil remediation during the November study period. PAH concentrations were measured by high-performance liquid chromatography. Subjects working on the site under remediation were clearly more exposed (684.1 ng/m3 for total PAHs in November 1997) than workers, without close contact with soil, whose PAH exposure was similar to that measured by fixed monitors in the ambient air in Paris. The contrasts were weaker in June 1998, when soil remediation had nearly been completed. Only subjects involved in activities with close contact with the ground were found with exposures exceeding background levels. Further investigations are needed to improve our understanding of the influence of the pollutants present in the soil.