Résumé : En Guadeloupe, la prévalence du diabète est deux fois plus élevée qu'en France hexagonale, avec une prédominance féminine. En dehors des facteurs environnementaux, la vitamine D et certains polymorphismes de gènes impliqués dans son métabolisme seraient associés à un risque de pathologies métaboliques. Les androgènes sont également associés aux anomalies du métabolisme glucidique, soit directement, soit via leur transporteur SHBG (Sex Hormone Binding Protein). Nous avons émis les hypothèses de recherche suivantes: 11 le statut en vitamine D et les polymorphismes des gènes impliqués dans son métabolisme pourraient être associés aux paramètres métaboliques chez des sujets Afro-Caribéens (AC). Ils expliqueraient l'importance des pathologies cardiométaboliques en Guadeloupe. 2/ la SHBG pourrait être associée aux anomalies du métabolisme glucidique, indépendamment des stéroïdes sexuels. Nos travaux sont présentés dans 4 études. Nous avons mis en évidence une prévalence élevée du déficit en vitamine D chez les sujets AC diabétiques de type 2. Nous avons trouvé une association significative entre le statut vitaminique D et le risque cardiométabolique chez ces sujets, mais aussi dans une population de sujets en hémodialyse chronique. Les polymorphismes des gènes impliqués dans le métabolisme de la vitamine D sont aussi associés à ce risque. Chez les sujets dysmétaboliques, une relation entre la SHBG, la graisse intra-hépatique, les hépatokines et les paramètres métaboliques a été mise en évidence, indépendamment des stéroïdes sexuels. En conclusion, la vitamine D et la SHBG pourraient être des marqueurs d'intérêt pour le dépistage des sujets à haut risque cardiométabolique.
In Guadeloupe, the prevalence of diabetes is two times higher than in Metropolitan France, with a female predominance. Apart from environmental factors, vitamin D and polymorphisms of genes involved in vitamin D metabolism would be associated with increased risk of metabolic diseases. Androgens are also associated with abnormal glucose metabolism, directly or through the Sex Hormone Binding Protein (SHBG). Our main hypotheses were: 11 Vitamin D status and polymorphisms of genes involved in its metabolism may be associated with metabolic pammeters in Afro-Caribbean (AC). They could explain the importance of cardiometabolic diseases in Guadeloupe. 2/ SHBG may be associated with abnormal glucose metabolism, independently of sex steroids. Our research is presente
http://www.theses.fr/2012AGUY0536/document

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
BACKGROUND: The insecticide chlordecone was extensively used in the French West Indies to control banana root borer. Its persistence in soils has led to the widespread pollution of the environment, and human beings are still exposed to this chemical. Chlordecone has been shown to impair neurological and behavioural functions in rodents when exposed gestationally or neonatally. OBJECTIVES: The aim of the study was to evaluate the impact of prenatal and postnatal exposure to chlordecone on the cognitive, visual, and motor development of 7-month-old infants from Guadeloupe. METHODS: Infants were tested at 7 months (n=153). Visual recognition memory and processing speed were assessed with the Fagan Tests of Infant Intelligence (FTII), visual acuity with the Teller Acuity Card, and fine motor development with the Brunet-Lezine. Samples of cord blood and breast milk at 3 months (n=88) were analyzed for chlordecone concentrations. Postnatal exposure was determined through breast feeding and frequency of contaminated food consumption by the infants. RESULTS: Cord chlordecone concentrations in tertiles were associated with reduced novelty preference on the FTII in the highly exposed group (β=-0.19, p=0.02). Postnatal exposure through contaminated food consumption was marginally related to reduced novelty preference (β=-0.14, p=0.07), and longer processing speed (β=0.16, p=0.07). Detectable levels of chlordecone in cord blood were associated with higher risk of obtaining low scores on the fine motor development scale (OR=1.25, p<0.01). CONCLUSION: These results suggest that pre- and postnatal low chronic exposure to chlordecone is associated with negative effects on cognitive and motor development during infancy.
ISSN: 0013-9351

hal-00875939
https://hal.archives-ouvertes.fr/hal-00875939
DOI : 10.1016/j.envres.2012.07.006
PUBMED : 22910562

Éditeur(s) : HAL CCSD
Résumé : International audience
Increasingly, health risk assessment is addressing multiple pathway exposures to multiple contaminants. We reviewed aggregated exposure and cumulative risk approaches for contemporary and ubiquitous semivolatile organic compounds (SVOC). We identified 22 studies aggregating exposure pathways, and 31 cumulating risk. Exposure aggregation is based on the addition of pathway-specific doses, using kinetic modeling where it exists, and classic external dose equations otherwise. In most cases, exposure is dominated by a single route or source of exposure - mainly the oral pathway - via dietary or non-dietary exposure. Preferential routes and sources of exposure are influenced by SVOC physical-chemical properties such as vapor pressure. The cumulative risk approach for contaminants is based on dose addition. Simple sum of hazard quotient (Hazard Index: HI) is the most commonly used cumulative risk assessment approach, while Relative Potency Factor (RPF) appeared to the best suited - although this calls for a level of toxicological information that limits the number of compounds that can be studied simultaneously. Where both were performed, moving from HI to more refined approach produced similar results. In conclusion, both approaches - exposure aggregation and cumulative risk - rely on simple assumptions. Nevertheless, they allow uncertainty to be reduced, in comparison with source-by-source or chemical-by-chemical approaches.
Environmental Research

hal-01579608
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01579608
DOI : 10.1016/j.envres.2017.06.022
PUBMED : 28732321

Éditeur(s) : Pêche thonière et dispositifs de concentration de poissons, Caribbean-Martinique, 15-19 Oct 1999 15-19 octobre 1999
Résumé : The development of the FAD gave rise to technical problems owing to their conception, their setting spot and of their utilisation. Failings generated by the unreliability of components or the uncertain repair precariousness, those can prove to be here more and more expensive with the progression of the ageing of devices and reasons of their loss. For as various domains that aerospace or the fishing deck layout, the engineering has functional analysis tools that permit to reduce conception uncertainties of systems by the mean of a hierarchical classification of function values of components. The application of one of these techniques, the FMEA, Failure Mode and Effects Analysis, to the study of reasons of FAD loss in La Reunion describes perfectly everything that this type of method can bring to the appraisal in fishing technology. This preventive analysis method assess the potential risks integrates perfectly in the mind of a precaution approach as it would agree to see to apply to the FADs and to their exploitation.Original Abstract: Le developpement des DCP a entraine l'apparition de problemes techniques, issus tant de leur conception, de leur lieu d'implantation que de leur utilisation. Defaillances generees par le manque de fiabilite des composants ou la precarite de reparations aleatoires, celles-ci peuvent s'averer de plus en plus couteuses au fur et a mesure du vieillissement des systemes et cause a terme de leur perte. Pour des domaines aussi divers que l'aerospatiale ou l'amenagement de pont de peche, l'ingenierie dispose d'outils d'analyse fonctionnelle qui, par le biais d'une hierarchisation des valeurs des fonctions de chaque element des systemes etudies, permettent de reduire les incertitudes de la conception. L'application d'une de ces techniques, l'Amdec, analyse des modes de defaillance et de criticite, a l'etude des causes des pertes de DCP a La Reunion illustre parfaitement tout ce que ce type de methode peut apporter a l'expertise en technologie des peches. Cette methode d'analyse preventive qui recense et met en evidence les risques potentiels s'integre parfaitement dans l'esprit d'une approche de precaution telle que celle qu'il conviendrait de voir appliquer aux DCP et a leur exploitation.

Droits : Ifremer
http://archimer.ifremer.fr/doc/00042/15289/12675.pdf
http://archimer.ifremer.fr/doc/00042/15289/

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Voting rules relying on k-nearest neighbors (k-NN) are an effective tool in countless many machine learning techniques. Thanks to its simplicity, k-NN classification is very attractive to practitioners, as it enables very good performances in several practical applications. However, it suffers from various drawbacks, like sensitivity to "noisy" instances and poor generalization properties when dealing with sparse high-dimensional data. In this paper, we tackle the k-NN classification problem at its core by providing a novel k-NN boosting approach. Namely, we propose a supervised learning algorithm, called Universal Nearest Neighbors (UNN), that induces a leveraged k-NN rule by globally minimizing a surrogate risk upper bounding the empirical misclassification rate over training data. Interestingly, this surrogate risk can be arbitrary chosen from a class of Bregman loss functions, including the familiar exponential, logistic and squared losses. Furthermore, we show that UNN allows to efficiently filter a dataset of instances by keeping only a small fraction of data. Experimental results on the synthetic Ripley's dataset show that such a filtering strategy is able to reject "noisy" examples, and yields a classification error close to the optimal Bayes error. Experiments on standard UCI datasets show significant improvements over the current state of the art.
ISSN: 0925-2312

hal-00664462
https://hal.inria.fr/hal-00664462

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
This study aims to assess the evidence on adverse pregnancy outcome associated with living close to polluted industrial sites, and identify the strengths and weaknesses of published epidemiological studies. A systematic literature search has been performed on all epidemiological studies published in developed countries since 1990, on the association between residential proximity to industrial sites (hazardous waste sites, industrial facilities and landfill sites) and adverse pregnancy outcome (low birth weight, preterm birth, small for gestational age, intrauterine growth retardation, infant mortality, congenital malformation). Based on 41 papers, our review reveals an excess risk of reproductive morbidity. However, no studies show significant excess risk of mortality including fetal death, neonatal or infant mortality and stillbirth. All published studies tend to show an increased risk of congenital abnormalities, yet not all are statistically significant. All but two of these studies revealed an excess risk of low birth weight. Results for preterm birth, small for gestational age and intrauterine growth retardation show the same pattern. There is suggestive evidence from the post-1990 literature that residential proximity to polluted sites (including landfills, hazardous waste sites and industrial facilities) might contribute to adverse reproductive outcomes, especially congenital malformations and low birth weight—though not mortality. This body of evidence has limitations that impede the formulation of firm conclusions, and new, well-focused studies are called for. The review findings suggest that continued strengthening of rules governing industrial emissions as well as industrial waste management and improved land use planning are needed.
ISSN: 1476-072X

Droits : http://creativecommons.org/licenses/by/
hal-01547817
http://hal.upmc.fr/hal-01547817
http://hal.upmc.fr/hal-01547817/document
http://hal.upmc.fr/hal-01547817/file/s12942-017-0091-y.pdf
DOI : 10.1186/s12942-017-0091-y

Éditeur(s) : HAL CCSD BioMed Central
Résumé : International audience
Urinary tract infections are bacterial infections most commonly encountered in the community. The resistance rate of uropathogens to commonly prescribed antibiotics has increased worldwide but there are no published data concerning the resistance of strains isolated from community-acquired UTI in Guadeloupe. To assess the susceptibility patterns of Enterobacteriaceae strains isolated from outpatients in Guadeloupe we conducted a prospective study from December 2012 to May 2014 among outpatients consulting at private and public laboratories for urine analysis. Risk factors for E. coli resistance to amoxicillin, third-generation cephalosporin, and ciprofloxacin were also determined. To study the trends of E. coli resistance rates over the past 10 years, data on the susceptibility patterns of E. coli from 2003 to 2014 were also collected from three major laboratories for a retrospective study. During the prospective study, we isolated 1293 bacterial strains from the urine of outpatients presenting for urine analysis. The most commonly isolated bacteria were E. coli (57 %) and Klebsiella pneumoniae (15.5 %). Thirty seven per cent of the E. coli strains were resistant to amoxicillin. Resistance rates to third generation cephalosporin were low for E. coli and other Enterobacteriaceae (3.1 and 12.2 % respectively) and mostly due to the presence of an Extended Spectrum Beta-lactamase. Resistance to cotrimoxazole and ciprofloxacin was moderate (17.8 and 15.6 % respectively). However, the resistance rate of E. coli to ciprofloxacin has significantly increased during the last 10 years. Risk factors were consistent with previously reported data, especially for the increasing ciprofloxacin resistance with age. General practitioners in Guadeloupe need to be better informed to favor the prescription of fosfomycin-trometamol to reduce the risk of resistance to fluoroquinolones.
ISSN: 1471-2180

Droits : http://creativecommons.org/licenses/by/
pasteur-01351191
https://hal-riip.archives-ouvertes.fr/pasteur-01351191
https://hal-riip.archives-ouvertes.fr/pasteur-01351191/document
https://hal-riip.archives-ouvertes.fr/pasteur-01351191/file/art%253A10.1186%252Fs12866-016-0749-9.pdf
PUBMED : 27342199

Éditeur(s) : HAL CCSD SAGE Publications
Résumé : International audience
: French Guiana is the French territory that is most affected by HIV. AIDS incidence is much higher than in mainland France and sex work seems to be an important driver of the epidemic. The objective of this study was to describe consistent condom use among female sex workers with their clients and their intimate partners and to identify determinants of non-use of condoms. An HIV/AIDS Knowledge, Attitudes, Behaviours and Practices survey was conducted in 2009-2010 among sex workers in French Guiana. A total of 477 sex workers were interviewed. Female sex workers were more likely to use condoms with their clients (97%) than with their intimate partners (45%). The factors associated with non-consistent condom use with the intimate partner were having had an abortion, feeling at risk for HIV, not evaluating one's own risk for HIV, living as a couple, being Dominican, not feeling comfortable asking intimate partners to use condoms. Although a high proportion of female sex workers declared using condoms with commercial partners, there is still room for improvement in the prevention of transmission with both commercial and intimate partners.
ISSN: 0956-4624

inserm-01065111
http://www.hal.inserm.fr/inserm-01065111
http://www.hal.inserm.fr/inserm-01065111/document
http://www.hal.inserm.fr/inserm-01065111/file/Table_III_IJSA.pdf
http://www.hal.inserm.fr/inserm-01065111/file/2014_Parriault_-_Predictive_factorssur unprotected_sex_for_female_sex_workers.pdf

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Long-term exposure to air pollution (AP) has been shown to have an impact on mortality in numerous countries, but since 2005 no data exists for France. We analyzed the association between long-term exposure to air pollution and mortality at the individual level in a large French cohort followed from 1989 to 2013. The study sample consisted of 20,327 adults working at the French national electricity and gas company EDF-GDF. Annual exposure to PM10, PM10–2.5, PM2.5, NO2, O3, SO2, and benzene was assessed for the place of residence of participants using a chemistry-transport model and taking residential history into account. Hazard ratios were estimated using a Cox proportional-hazards regression model, adjusted for selected individual and contextual risk factors. Hazard ratios were computed for an interquartile range (IQR) increase in air pollutant concentrations. The cohort recorded 1967 non-accidental deaths. Long-term exposures to baseline PM2.5, PM10-25, NO2 and benzene were associated with an increase in non-accidental mortality (Hazard Ratio, HR = 1.09; 95% CI: 0.99, 1.20 per 5.9 μg/m3, PM10-25; HR = 1.09; 95% CI: 1.04, 1.15 per 2.2 μg/m3, NO2: HR = 1.14; 95% CI: 0.99, 1.31 per 19.3 μg/m3 and benzene: HR = 1.10; 95% CI: 1.00, 1.22 per 1.7 μg/m3).The strongest association was found for PM10: HR = 1.14; 95% CI: 1.05, 1.25 per 7.8 μg/m3. PM10, PM10-25 and SO2 were associated with non-accidental mortality when using time varying exposure. No significant associations were observed between air pollution and cardiovascular and respiratory mortality. Long-term exposure to fine particles, nitrogen dioxide, sulfur dioxide and benzene is associated with an increased risk of non-accidental mortality in France. Our results strengthen existing evidence that outdoor air pollution is a significant environmental risk factor for mortality. Due to the limited sample size and the nature of our study (occupational), further investigations are needed in France with a larger representative population sample.
ISSN: 0160-4120

hal-01187145
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01187145
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01187145/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01187145/file/Association%20between%20long-term%20exposure%20to%20air%20pollution%20and%20mortality_accepted.pdf
DOI : 10.1016/j.envint.2015.08.006

Résumé : Penaeus stylirostris shrimp imported from Hawaii for a genetic program and kept at the Saint-Vincent research facility had progressively developed a high sensitivity to IHHNV, the etiological agent of the Infectious, Hypodermic, and Hematopoietic Necrosis. Fears were that the virus could not only be transferred to their offspring, but also that the New Caledonian strain of Penaeus stylirostris, so far considered as resistant, could become sensitive by an off balance of its hosts/pathogen equilibrium. In October 2008, a joint decision between Uprac (shimp owner), Davar (New Caledonian Animal Health Authority) and Ifremer (scientific partner) was taken to terminate all pure breed and hybrid Hawaiian populations remaining in the ponds, and to implement an intensive fallowing protocol, and controlled restocking. IHHNV was also suspected to trouble experiments carried out in the research facility (mortalities, deformities, slow growth), thus affecting research programs. Difficulties pointed out by IHHNV have triggered since 2008 some awareness on biosecurity issues at some level of the New Caledonian shrimp industry. At the St-Vincent research station, it led to a risk assessment and implementation of biosecurity procedures (fallowing, propagation, grow out and use of screened animals) which minimizes the risk of expression of IHHNV. The use of a brand new hatchery building on site also helped in resetting routine hygiene procedures during production and in controlling incoming and outgoing items (shrimp, water, feed, personnel, equipment, pests and wastes). IHHNV has not been detected on analysed samples since then nor have any symptoms been found during experimental or broodstock growout. Keeping this control alive is considered as a useful tool to lower the risk of potential health threats, to get a better understanding in case of an outbreak, and to increase the reliability of experimental results.
Les crevettes originaires d’Hawaii et conservées au LEAD St-Vincent, dans le cadre du programme d’introduction de variabilité génétique dans le cheptel Calédonien, ont progressivement montré une sensibilité importante au virus IHHNV, agent de la Nécrose Hypodermale et Hématopoïétique Infectieuse (mortalité, croissance ralentie, déformations). Les risques d’une transmission génétique de cette sensibilité à leur descendance à moyen terme, et de son développement par rupture de l’équilibre hôte/pathogène sur la souche dite « Calédonienne » jusqu’alors considérée comme résistante à l’IHHN, ont conduit à partir d’octobre 2008, avec l’accord et l’appui de l’UPRAC et de la DAVAR, à la suppression des animaux hawaiiens ou hybrides encore présents dans les bassins de terre du LEAD St-Vincent, au vide sanitaire de ces derniers, et au repeuplement contrôlé du site. D’autre part, le virus IHHN est soupçonné d’avoir pu affecter les animaux utilisés dans les expérimentations menées au LEAD-St-Vincent (mortalités, déformations, croissance réduite), influençant donc potentiellement leur bon déroulement et celui des programmes de recherches. Les obstacles soulevés par l’expression du virus IHHN ont donc initié depuis 2008 une prise de conscience et la mise en place de démarches de biosécurité dans certains points de la filière. A la station de St-Vincent, cette démarche s’est traduite par une identification/évaluation des risques et l’application de mesures (vide sanitaire, reproduction, élevage et utilisation des animaux contrôlés) chacune dotée de procédures qui regroupées, minimisent le risque d’introduction et de dissémination de l’IHHNV. La prise en main de la nouvelle structure d’écloserie sur le site de la SASV a également été mise à profit pour revoir les procédures d’hygiène de routine dans la conduite des productions et dans le contrôle des flux intrants et sortants (animaux, eau, aliments, personnel, équipement, nuisibles, déchets). Aucune détection d’IHHNV sur les échantillons prélevés n’a depuis été observée, de même qu’aucun symptôme de l’expression de cette maladie sur les animaux en élevage sur le site de Saint-Vincent. La poursuite de ces mesures est envisagée comme un outil d’aide à la minimisation des problèmes potentiels, à leur compréhension en cas d’apparition, et à la fiabilisation des résultats.

Droits : 2010 Ifremer
http://archimer.ifremer.fr/doc/00118/22949/20776.pdf
http://archimer.ifremer.fr/doc/00118/22949/

Éditeur(s) : HAL CCSD Elsevier
Résumé : International audience
Introduction Evidence has accumulated that exposure to ambient air pollution during pregnancy may influence preterm birth (PTB) in urban settings. Conversely, this relation has barely been investigated in rural areas where individual characteristics (demographic, socioeconomic, and psychosocial factors) and environmental co-exposures may differ. Objective We examined the association between prenatal exposure to traffic-related air pollution and PTB among pregnant women from the PELAGIE mother–child cohort (Brittany, France, 2002–2006) living in urban (n=1550) and rural (n=959) settings. Methods Women’s residences were classified as either urban or rural according to the French census bureau rural–urban definitions. Nitrogen dioxide (NO2) concentrations at home addresses were estimated from adjusted land-use regression models as a marker of traffic-related pollution. Associations between NO2 concentrations and PTB were assessed with logistic regression models. Results Prevalence of PTB was similar among women living in urban (3.2%) and in rural (3.5%) settings. More positive socioeconomic characteristics and health behaviors but more single-parent families were observed among urban women. NO2 exposure averaged 20.8±6.6 µg m−3 for women residing in urban areas and 18.8±5.6 µg m−3 for their rural counterparts. A statistically significant increased risk of PTB was observed among women exposed to NO2 concentrations ≥16.4 µg m−3 and residing in urban areas but not among their rural counterparts. Discussion The results of this study, conducted in a region with interspersed urban–rural areas, are in line with previous findings suggesting an increased risk of PTB associated with higher NO2 concentrations for women living in urban areas. The absence of association among their rural counterparts for whom exposure levels were similar suggests that environmental mixtures and psychosocial inequalities might play a role in this heterogeneity
ISSN: 0013-9351

hal-01165108
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01165108
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01165108/document
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01165108/file/Air%20pollution%20%26%20preterm%20birth%20PELAGIE_HAL-accepted.pdf
PUBMED : 26092808

Éditeur(s) : HAL CCSD International Medical Press
Résumé : International audience
BACKGROUND: Psychiatric disorders are relatively common among HIV-infected patients. However, there are few studies about their potential risk factors. This analysis aimed to measure the incidence of severe psychiatric events (PE) among patients receiving combination antiretroviral therapy (cART) of the French APROCO-COPILOTE (ANRS CO8) cohort, and to identify the medical and socio-behavioural correlates of their first episode of depression, suicide or suicide attempt (D/S/SA). METHODS: APROCO-COPILOTE is a cohort of patients started on a protease inhibitor regimen between 1997 and 1999, with prospective medical standardized records and self-administered questionnaires collecting socio-demographic and socio-behavioural data. This analysis included all 11-year follow-up visits for 1,095 patients having completed baseline self-administered questionnaires. A proportional hazard Cox model was used to identify the correlates of a first D/S/SA event. RESULTS: The overall prevalence of severe PE remained low: 50 patients experienced 67 events (incidence rate [95% CI] =1.04 [0.82, 1.32] per 100 person-years). Depression (n=16), suicides (n=5) and suicide attempts (n=14) were the most frequently diagnosed PE (0.54 [0.39, 0.76] per 100 person-years) among 25 patients. Multivariate results showed that unemployment, unstable housing, detectable viral load and smoking more than 20 cigarettes/day were independently associated with D/S/SA. CONCLUSIONS: Although the incidence of severe PE remained relatively low among the patients of APROCO-COPILOTE cohort, this study's results underline a clinically important problem in HIV-infected patients receiving cART. Furthermore, our findings not only emphasize the importance of comprehensive care, especially for socially vulnerable patients, but may also help future studies designed to assess the effectiveness of interventions in reducing the risk of PE during cART.
ISSN: 1359-6535

hal-00875183
https://hal.archives-ouvertes.fr/hal-00875183
DOI : 10.3851/IMP2102
PUBMED : 22544079

Éditeur(s) : HAL CCSD
Résumé : International audience
OBJECTIVE: Contemporary pesticides, such as triazines or organophosphates, possess immunotoxic properties. We aimed to determine whether prenatal environmental exposure to these current-use pesticides was associated with otitis media (OM) during the first 2 years of life among children from the PELAGIE mother-child cohort. METHODS: The PELAGIE cohort enrolled 3421 women at the beginning of pregnancy in Brittany (France). At the 2-year follow-up, 1505 families completed a self-administered questionnaire, including the domestic use of pesticides and consumption of organic diet during pregnancy and occurrences of OM in the child. Two health outcomes were considered: at least one OM and recurrent OM (at least three). Multivariate logistic regression models that adjusted for known risk factors of OM were performed. Metabolites of triazine herbicides and organophosphate insecticides measured in urine collected before the 19th week of gestation (248 mothers) were considered in a subgroup analysis. Multiple imputation was used to handle missing values for the covariates. RESULTS: Children whose mothers reported an organic diet during pregnancy had a reduced risk of OM (at least one episode, p trend=0.01). No association was found between any outcome and residential proximity to crops. The presence in maternal urine of dealkylated triazine metabolites (OR=2.12 (1.01 to 4.47)) was positively associated with recurrent OM. CONCLUSIONS: To the best of our knowledge, this is the first work to suggest a positive association between prenatal exposure to current-use pesticides and the occurrence of parent-reported OM in young children
Occupational and Environmental Medicine

hal-01201944
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01201944
DOI : 10.1136/oemed-2015-103039
PUBMED : 26347056

Éditeur(s) : Université des Antilles Études caribéennes
Résumé : Cet article souligne la particularité des politiques locales menées récemment en Martinique et en Guadeloupe en matière de gestion du risque sismique. Ces Départements français des Amériques, fortement exposés à la menace sismique, s’impliquent depuis peu dans une véritable dynamique préventive soutenue par l’action des Collectivités. Des stratégies locales de réduction de la vulnérabilité humaine et technique sont expérimentées au bénéfice de la population. Elles viennent renforcer ou compléter les efforts étatiques visant une plus grande implication du citoyen à son information et à sa sécurité face aux séismes.
This article underlines the characteristic of the local policies followed recently in Martinique and Guadeloupe as regards seismic risk management. These French Departments of Americas, strongly exposed to the seismic threat, imply themselves recently in a true preventive dynamics supported by the action of the Communities. Local strategies of reduction of the human and technical vulnerability are tested for the benefit of the population. They come to reinforce or supplement the official efforts of French State aiming a greater implication of the citizen to his information and its safety against the earthquakes.
Guadeloupe
Martinique

Droits : info:eu-repo/semantics/openAccess
urn:doi:10.4000/etudescaribeennes.289
http://journals.openedition.org/etudescaribeennes/289

Éditeur(s) : HAL CCSD BMJ Publishing Group
Résumé : International audience
OBJECTIVES: The time from the prenatal period through early childhood is an important window of vulnerability for the developing immune and respiratory systems, both sensitive to environmental chemicals such as solvents. This study sought to examine the effects of solvent exposure during the prenatal and postnatal periods on wheezing, eczema and food allergies in early childhood. METHODS: This study, based on the PELAGIE cohort, included 1505 mother-child pairs with measurements of prenatal and postnatal solvent exposures and data on wheezing, eczema or food allergies. The maternal occupation reported at inclusion, in early pregnancy allowed us to define prenatal occupational solvent exposure (by three specific job-exposure matrices). Data on prenatal and postnatal domestic solvent exposure, that is exposure to products that contain solvents, were obtained from self-administered questionnaires, once at inclusion and again when the child was 2 years old. Outcome data was collected at the 2-year follow-up. Associations between exposures and outcomes were estimated by logistic regression models, after adjustment for potential confounders. RESULTS: No association was observed between prenatal exposure to solvents and the outcomes studied. Postnatal exposure was associated with an increased risk of wheezing (OR=1.80 (95% CI 1.25 to 2.59)) which persisted after adjustment for prenatal exposure. No significant association was observed with eczema or food allergies. CONCLUSIONS: Postnatal exposure to solvent-containing products in the home may increase the risk of wheezing in early childhood. Follow-up studies are needed to determine if the health effects observed at age 2 persist at later ages.
ISSN: 1351-0711

hal-01063913
https://hal.archives-ouvertes.fr/hal-01063913
DOI : 10.1136/oemed-2013-102036
PUBMED : 24996679

Résumé : Cette thèse explore les relations entre histoire et archéologie sous-marine pour étudier le risque de perte en mer aux Petites Antilles à travers l' exemple de la Guadeloupe. Le phénomène du naufrage est envisagé comme un prisme pour aborder les aspects maritimes de l'histoire de la Guadeloupe à l' époque de la marine à voile, entre la fin du XVIIe siècle et la première moitié du XIXe siècle. L' étude repose sur un dépouillement exhaustif de la correspondance administrative et des sondages ciblés dans les archives de la Marine et de quelques-uns des principaux ports du royaume de France liés aux Antilles (Nantes, Bordeaux, Le Havre, Marseille). Le naufrage est défini à travers une étude quantitative des pertes en mer : nombre, fréquence, localisation, répartition chronologique. Cette perspective conduit à qualifier le phénomène de sériel mais marginal en comparaison avec la fréquentation maritime, ce qui n' ôte pas de son intérêt en tant que clé de lecture d'une colonie française d' Amérique et de son économie et de sa société si part iculières , entre cultures d'exportation et esclavage. Environ 550 naufrages son répertoriés en archives entre la fin du XVIIe siècle et le début du XIXe siècle, ce qui représente moins de 1 % de la fréquentation maritime de la colonie. Il s' agit d'un phénomène essentiellement côtier et portuaire lié à la survenue d'événements climatiques exceptionnels (coups de vent et ouragans). Mais, ponctuellement, d'autres causes sont mises en évidence. L'objectif est de dresser une typologie des pertes en mer s'intéressant aussi bien aux différents types de navires perdus qu'à leur fonction , leur cargaison et leur équipage. La question de la perception des risques de pertes (conditions de navigation, dangers d'échouage, aléas climatiques) est envisagée pour analyser les relations entre risques et les moyens mis en oeuvre pour en réduire l'impact. Les différentes pistes allant des premières missions à caractère hydrographique au XVIIIe siècle, aux premiers aménagements portuaires au XIXe siècle, sont étudiées pour voir si elles répondent aux risques de pertes en mer. L'étude des documents d'archives trouve une application dans l'évaluation du potentiel archéologique sous-marin de la Guadeloupe. Celui-ci est évalué à une fourchette entre 50 et 120 sites d'épaves. La lecture critique des sources propose par ailleurs des hypothèses d'identification de 5 sites sur les 15 sites d' épaves anciennes connus, permettant ainsi une vision différente de la question des risques maritimes.
This Ph D explores relationships between history and underwater archaeology in order to study the martime risks in West Indies through the example of Guadeloupe. Shipwreck phenomenon is presented as a prism to analyze maritime aspect of Guadeloupe history during the time of sailing, from the end of 17th to first half of 19th century. The study is based on a archivaI analysis of administrative correspondence and surveys in marine archives and French kingdom main ports linked with West Indies. Shipwreck is defined through an quantitative study of losses : quantity, frequency, localization, chronological spread. This point of view permits to qualify the this phenomenon as serial but low regarding to the maritime activity, This fact is not a lack in order to use this event as a reading key of an American French colony, its economy and society. About 550 shipwrecks have been recorded from the end of 17th to first half of 19th century, thi represents less than 1% of maritime activity of the colony .. This phenomenon is mainly a coastal and a port event, linked with climatic hazard as hurricanes, but the study focused also on others causes . The objective is to set up a losses' typology dealing with ships types, functions, cargos, and crews. The perception of losses risks (seafaring conditions, wrecks dangers and climatic hazards) is presented in order to analyze relationships between risks and means in order to prevent them or reduce their consequences. Different projects from first hydrographical missions during 18th century to first ports building projects at the beginning of 19th century have been studied in order to establish if they answer the losses risks.

http://www.theses.fr/2013AGUY0607

Éditeur(s) : HAL CCSD National Institute of Environmental Health Sciences
Résumé : International audience
Safe drinking water is essential for well-being. Although microbiological contamination remains the largest cause of water-related morbidity and mortality globally, chemicals in water supplies may also cause disease, and evidence of the human health consequences is limited or lacking for many of them. We aimed to summarize the state of knowledge, identify gaps in understanding, and provide recommendations for epidemiological research relating to chemicals occurring in drinking water. Assessing exposure and the health consequences of chemicals in drinking water is challenging. Exposures are typically at low concentrations, measurements in water are frequently insufficient, chemicals are present in mixtures, exposure periods are usually long, multiple exposure routes may be involved, and valid biomarkers reflecting the relevant exposure period are scarce. In addition, the magnitude of the relative risks tends to be small. Research should include well-designed epidemiological studies covering regions with contrasting contaminant levels and sufficient sample size; comprehensive evaluation of contaminant occurrence in combination with bioassays integrating the effect of complex mixtures; sufficient numbers of measurements in water to evaluate geographical and temporal variability; detailed information on personal habits resulting in exposure (e.g., ingestion, showering, swimming, diet); collection of biological samples to measure relevant biomarkers; and advanced statistical models to estimate exposure and relative risks, considering methods to address measurement error. Last, the incorporation of molecular markers of early biological effects and genetic susceptibility is essential to understand the mechanisms of action. There is a particular knowledge gap and need to evaluate human exposure and the risks of a wide range of emerging contaminants.
ISSN: 0091-6765

hal-01118530
https://hal-univ-rennes1.archives-ouvertes.fr/hal-01118530
PUBMED : 24380896
DOI : 10.1289/ehp.1206229
PUBMEDCENTRAL : PMC3948022

Éditeur(s) : HAL CCSD Elsevier Masson
Résumé : International audience
Construction works in healthcare establishments produce airborne fungal spores and considerably increase the risk of exposure of immunosuppressed patients. It is necessary to reinforce protective measures, or even to implement specific precautions, during this critical phase. The aim of these precautions is to protect both those areas, which are susceptible to dust, and patients at risk of a fungal infection particularly invasive aspergillosis. When construction works are planned in healthcare establishments, the first step consists in the characterisation of the environmental fungal risk and the second one in proposing risk management methods. It is then essential to establish impact indicators in order to evaluate the risk management precautions applied. The working group promoted by the French societies of medical mycology and hospital hygiene (SFMM & SF2H) details here both environmental and epidemiological impact indicators that can be used.
ISSN: 1156-5233

hal-00759179
https://hal.archives-ouvertes.fr/hal-00759179
DOI : 10.1016/j.mycmed.2012.01.003
PUBMED : 23177816

Éditeur(s) : HAL CCSD Lippincott, Williams & Wilkins
Résumé : International audience
BACKGROUND:Fever in infants younger than 3 months is generally a cause for concern because of the risk for a serious bacterial infection. The aim of this study was to describe clinical and biological features of Chikungunya infection in infants < 3 months of age hospitalized in Cayenne Hospital during the 2014-2015 outbreak.METHODS:We performed a preliminary retrospective study followed by a prospective study from March 2014 to February 2015. All infants younger than 3 months presenting with fever and hospitalized in Cayenne Hospital were included. The main diagnostic criteria were fever and positive Chikungunya PCR.RESULTS:One hundred and twenty infants were hospitalized with fever. The mean age was 46 days (SD± 22 days). The mean hospitalization duration was 7.4 days (SD± 6.1 days). Chikungunya infection was diagnosed in 26 children. The most important clinical findings were high (80.8% [77.5-84]) and prolonged fever (76.9%, [73.4-80.4]), irritability (96.2% [94.5-97.7]) and skin rash. (69.2%, [65.4-73]). Half of the infants presented edema of the extremities (hands and feet principally). However, in 15 %, Chikungunya infection was associated with a serious bacterial infection. Infants who presented with irritability, high fever and elevated PCT were at high risk for Chikungunya: OR 39, [9.2-243] (p < 0.001), with a specificity of 96.7 % and a negative predictive value of 89.4%. The area of the ROC curve was 0.96 CONCLUSIONS:: Our results confirm that Chikunguyna infection is a cause of high fever in infants younger than 3 months. Our data should be confirmed by larger studies.
ISSN: 0891-3668

inserm-01476019
http://www.hal.inserm.fr/inserm-01476019
http://www.hal.inserm.fr/inserm-01476019/document
http://www.hal.inserm.fr/inserm-01476019/file/2017%2C%20Elenga%20-%20Chikungunya%20Infection%20in%20hospitalized%20febrile%20infants.pdf
DOI : 10.1097/INF.0000000000001541

Éditeur(s) : HAL CCSD Elsevier [Commercial Publisher]
Résumé : International audience
BACKGROUND: Pneumocystis jiroveci pneumonia in HIV-negative immunocompromised patients is associated with high mortality rates. Although trimethoprim-sulfamethoxazole (TMP-SMX) provides a very effective prophylaxis, pneumocystosis still occurs and may even be emerging, due to sub-optimal characterization of patients most at risk, hence precluding targeted prophylaxis. METHODS: We retrospectively analyzed all cases of documented pneumocystosis in HIV-negative patients admitted in our institution, a referral center in the area, from January 1990 to June 2010, and extracted data on their underlying condition(s). To estimate incidence rates within each condition, we estimated the number of patients followed-up in our area for each condition, by measuring the number of patients admitted with the corresponding international classification diagnostic code, through the national hospital discharge database (PMSI). RESULTS: From 1990 to 2010, 293 cases of pneumocystosis were documented, of whom 154 (52.6%) tested negative for HIV. The main underlying conditions were hematological malignancies (32.5%), solid tumors (18.2%), inflammatory diseases (14.9%), solid organ transplant (12.3%), and vasculitis (9.7%). Estimated incidence rates could be ranked in three categories: i) high risk (incidence rates extgreater 45 cases per 100,000 patient-year): polyarteritis nodosa, granulomatosis with polyangiitis, polymyositis/dermatopolymyositis, acute leukemia, chronic lymphocytic leukemia, and non-Hodgkin lymphoma; ii) intermediate risk (25-45 cases per 100,000 patient-year): Waldenström macroglobulinemia, multiple myeloma, and central nervous system cancer; and iii) low risk ( extless 25 cases per 100,000 patient-year): other solid tumors, inflammatory diseases, and Hodgkin lymphoma. CONCLUSIONS: These estimates may be used as a guide to better target pneumocystosis prophylaxis in the groups most at risk.
ISSN: 0002-9343

hal-01063911
https://hal.archives-ouvertes.fr/hal-01063911
https://hal.archives-ouvertes.fr/hal-01063911/document
https://hal.archives-ouvertes.fr/hal-01063911/file/1-s2.0-S0002934314005907-main.pdf
DOI : 10.1016/j.amjmed.2014.07.010