Nadine Fréry

Gold-mining activities and mercury contamination of native amerindian communities in French Guiana: key role of fish in dietary uptake.

In 1994, the French National Public Health Network reported significant mercury exposure of native Amerindians in French Guiana. In 1997, a study was conducted in the Wayana community to quantify the dietary intake and to identify the fish species contributing the most to the contamination. The study was completed by an impregnation analysis based on Hg determination in hair samples. The methodology used was a detailed familial dietary study associated with Hg measurements in fish and some game. The study was conducted over 7 days in two different seasons in the four most populated Wayana villages on the upper part of the Maroni River (521 people; 70% of the Wayana population in French Guiana). Analysis was based on data on consumption obtained from 165 people in a 1-14 day period (i.e., 940 persons [times] days) and involved 270 fish samples from 48 species. Total Hg and monomethylmercury (MMHg) were also determined in hair samples (235 samples for total Hg). The results confirm mercury exposure of the Wayana population related to a diet rich in fish, which are relatively highly contaminated for certain species (up to 1.62 mg/kg fresh weight or 8.1 mg/kg dry weight in skeletal muscle). Results from hair samples showed that 57% of the Amerindians had Hg levels above the World Health Organization (WHO) safety limit (10 microg/g); all those over 1 year of age had a Hg intake greater than the WHO safety limit (200 microg MMHg/week for a 60-kg male). Hg concentrations in fish muscle were closely linked to the feeding regime and position of fish in the food webs. Overall, 14.5% of the fish collected exceeded the 0.5 mg/kg (fresh weight) safety limit. Four carnivorous species accounted for no less than 72% of the metal ingested by the Wayana families, although these represented only 28% of the consumed fish biomass. In conclusion, this study revealed excessive exposure to mercury in the Wayana population in French Guiana related to the consumption of contaminated fish.

Blood lead levels in the adult population living in France the French Nutrition and Health Survey (ENNS 2006-2007)

BACKGROUND The French Nutrition and Health Survey (ENNS) was conducted in order to describe food consumption and levels of various biomarkers in the general population. In this paper, we aimed to assess the distribution of blood lead levels (BLL) in the adult population living in France. METHOD ENNS was a cross-sectional survey carried out in the general population. Participants (18-74years of age) were sampled using a three-stage probability design stratified by geographical areas and degrees of urbanization. Collected data included biochemical samples, anthropometric measurements, socio-demographic characteristics, and environmental and occupational exposure. RESULTS In 2006/2007, 2029 adults were included in the survey on lead. The blood lead geometric mean (GM) in the population living in France was 25.7μg/L [24.9-26.5]. The overall prevalence of elevated BLL (>100μg/L) was 1.7% [1.1-2.3%]. Levels were significantly higher in males than in females, and increased with age, smoking status and alcohol consumption. Other factors significantly associated with BLL were leisure activities, occupational category, age of housing unit, birth place and shellfish/crustacean consumption. CONCLUSION For the first time a survey provides national estimates of BLL for the adult population in France. Comparison with results from a previous study among men aged 18-28years showed that the GM dropped more than 60% in the last 10years. The distribution of BLL in France was quite similar to that observed in other European countries.

Urinary arsenic levels in the French adult population: The French National Nutrition and Health Study, 2006–2007

The French Nutrition and Health Survey (ENNS) was conducted to describe dietary intakes, nutritional status, physical activity, and levels of various biomarkers for environmental chemicals (heavy metals and pesticides) in the French population (adults aged 18-74 years and children aged 3-17 years living in continental France in 2006-2007). The aim of this paper was to describe the distributions of total arsenic and the sum of iAs+MMA+DMA in the general adult population, and to present their main risk factors. In the arsenic study, 1500 and 1515 adults (requested to avoid seafood intake in the previous 3 days preceding urine collection) were included respectively for the analysis of the sum of inorganic arsenic (iAs) and its two metabolites, monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA), and for the total arsenic. Results were presented as geometric means and selected percentiles of urinary arsenic concentrations (μg/L) and creatinine-adjusted urinary arsenic (μg/g of creatinine) for total arsenic, and the sum of inorganic arsenic and metabolites (iAs+MMA+DMA). The geometric mean concentration of the sum of iAs+MMA+DMA in the adult population living in France was 3.34 μg/g of creatinine [3.23-3.45] (3.75 μg/L [3.61-3.90]) with a 95th percentile of 8.9 μg/g of creatinine (10.68 μg/L). The geometric mean concentration of total arsenic was 11.96 μg/g of creatinine [11.41-12.53] (13.42 μg/L [12.77-14.09]) with a 95th percentile of 61.29 μg/g of creatinine (72.75 μg/L). Urinary concentrations of total arsenic and iAS+MMA+DMA were influenced by sociodemographic and economic factors, and by risk factors such as consumption of seafood products and of wine. In our study, covariate-adjusted geometric means demonstrated several slight differences, due to consumption of fish, shellfish/crustaceans or wine. This study provides the first reference value for arsenic in a representative sample of the French population not particularly exposed to high levels of arsenic (10 μg/g of creatinine). It shows that urinary arsenic concentrations in the French adult population (in particular concentrations of iAs+MMA+DMA) were relatively low compared with foreign data.

Levels of polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans and polychlorinated biphenyls in human milk from different regions of France

We report on the pilot study carried out before the start of the Elfe project (French longitudinal study from childhood). A total of 44 samples of mature human milk were collected at home 8 weeks after delivery. A total of 7 polychlorinated dibenzo-p-dioxins (PCDDs), 10 polychlorinated dibenzofurans (PCDFs), 12 dioxin-like (DL) polychlorinated biphenyls (PCBs), and 6 non dioxin-like (NDL)-PCBs were measured. For total TEQ (PCDD/Fs and DL-PCBs), the geometric mean concentration was 17.81 pg TEQ(WHO05)/g lipids. Relative PCDD, PCDF, and DL-PCB contributions to the arithmetic mean TEQ(WHO05) were 38%, 18%, and 44%, respectively. The use of TEF(WHO05) instead of TEF(WHO98) resulted in a 27% reduction of the total TEQ value. Although PCDD levels did not significantly change (less than 0.5% increase), PCDF and DL-PCB levels both decreased by 35% and 38%, respectively. Levels have been compared to data obtained during a previous non-reported national study conducted in 1998 (TEF(WHO98)) in French lactaria (n=244). The mean of PCDD/Fs has decreased about 39.4% (18.8 pg TEQ(WHO98)/g lipids in 1998 vs 11.4 pg TEQ(WHO98)/g lipids in pilot study), respectively 41.5% for PCDDs (10.6 pg TEQ(WHO98)/g lipids in 1998 vs 6.2 pg TEQ(WHO98)/g lipids in pilot study) and 36.7% for PCDFs (7.9 pg TEQ(WHO98)/g lipids in 1998 vs 5.0 pg TEQ(WHO98)/g lipids in pilot study). For the sum of the 6 NDL-PCBs, the 2007 geometric mean concentration in milk was 176.3 ng/g lipids. The arithmetic mean lipid concentration in 2007 breast milk was 26.4 g/l (range from 6.0 to 46.7 g/l). A PCDD/F and DL-PCB daily intake was estimated to be 62.3 pg TEQ(WHO05)/kg body weight per day (85.0 pg TEQ(WHO98)/kg body weight per day) for a baby of 5 kg of body weight fed daily with 700 ml of maternal milk containing 25 g/l of lipids.

Economic evaluation of health consequences of prenatal methylmercury exposure in France

BackgroundEvidence of a dose–response relationship between prenatal exposure to methylmercury (MeHg) and neurodevelopmental consequences in terms of IQ reduction, makes it possible to evaluate the economic consequences of MeHg exposures.ObjectiveTo perform an economic evaluation of annual national benefits of reduction of the prenatal MeHg exposure in France.MethodsWe used data on hair-Hg concentrations in French women of childbearing age (18–45 years) from a national sample of 126 women and from two studies conducted in coastal regions (n = 161and n = 503). A linear dose response function with a slope of 0.465 IQ point reduction per μg/g increase in hair-Hg concentration was used, along with a log transformation of the exposure scale, where a doubling of exposure was associated with a loss of 1.5 IQ points. The costs calculations utilized an updated estimate of €2008 17,363 per IQ point decrement, with three hypothetical exposure cut-off points (hair-Hg of 0.58, 1.0, and 2.5 μg/g).ResultsBecause of higher exposure levels of women in coastal communities, the annual economic impacts based on these data were greater than those using the national data, i.e. € 1.62 billion (national), and € 3.02 billion and € 2.51 billion (regional), respectively, with the linear model, and € 5.46 billion (national), and € 9.13 billion and € 8.17 billion (regional), with the log model, for exposures above 0.58 μg/g.ConclusionsThese results emphasize that efforts to reduce MeHg exposures would have high social benefits by preventing the serious and lifelong consequences of neurodevelopmental deficits in children.

Association of Parkinson’s disease with industry sectors: a French nationwide incidence study

In order to identify working environments at risk for Parkinson’s disease (PD), we investigated the relation between the importance of industry sectors, used as a surrogate for occupational exposures, and PD incidence in French cantons. The number of incident PD cases (2010–2014) in 3689 cantons of metropolitan France was determined using drug claims from French National Health Insurance databases. The proportions of workers in 38 industry sectors in 2006 were calculated for each canton. Associations between the proportions of workers in industry sectors and PD age/sex-standardized incidence ratios were examined using incidence rate ratios (IRR) and 95% confidence intervals (CI) estimated with multilevel negative binomial regressions with a random intercept at the canton-level and adjusted for smoking, deprivation index, and density of neurologists. We then used two-step semi-Bayes hierarchical regression (HR) to include prior information about exposure to pesticides, metals, and solvents in each industry sector. We identified 112,625 incident cases. PD incidence was higher in areas characterized by high proportions of workers in “Agriculture, forestry and fishing” (IRRHR = 1.042; CI 95% = 1.014–1.070; p-TrendHR = 0.004), “Manufacture of textiles, wearing apparel, leather and related products” (IRRHR = 1.024; CI 95% = 1.005–1.044; p-TrendHR = 0.010), and “Manufacture of basic metals and fabricated metal products, except machinery and equipment” (IRRHR = 1.024; CI 95% = 1.003–1.046; p-TrendHR = 0.071). This nationwide study, based on a comprehensive analysis of industry sectors, shows significant associations between high proportions of workers in specific industry sectors (agriculture, metallurgy, textile) and PD incidence that may be targeted in further epidemiological studies to replicate and better understand these associations.

P100 Occupational exposure of salaried workers to carcinogenic agents, france 2010

Objectives This study aims to estimate at a national level the frequency of occupational multiple exposure to carcinogenic agents and to identify economic activities and occupations with the highest frequency of exposure, for prioritisation of preventive measures. Methods New analyses of the data from the SUMER 2009–2010 survey relative to exposure of French salaried workers (sample of 48 000 individuals) to carcinogenic agents were performed. The selected carcinogenic agents were: the 24 most often used chemicals with carcinogenic properties, ionising radiation, and night work for women (≥45 nights/year). The proportions of workers exposed to a particular set of hazards were obtained by cumulative binary exposure indices, defined for each carcinogen (present/absent, according to the occupational physician). Results In 2009–2010, 12.0% of French salaried workers (∼2.6 million, 2 million men and 600 000 women) were potentially exposed to at least one carcinogenic agent from whom 757 000 had at least a double exposure. Exposed men were mainly construction workers, skilled maintenance, transport and metal workers. Exposed women worked principally in health occupations (nurses, midwives, nurses-aids) or in process industries, or were hairdressers and beauticians. Occupational exposure of men to carcinogens was the highest for skilled workers in automobile repair (79.2% exposed to at least one chemical carcinogen). For women, nurses and midwives constituted the group with the most frequent exposure (30.3%; due in particular to night work, but also to chemical carcinogens and/or ionising radiation). Nearly 1.58 million salaried workers (7.3%) were exposed to at least one lung carcinogen and 914 200 (4.2%) to at least one ENT carcinogen. Conclusions This study shows that workers’ exposure to carcinogenic agents remains relatively frequent in France, especially among men, and particularly in specific economic activities and occupational groups where preventive actions have to be implemented in priority.

Chapter 2C:Examples of Ongoing International Surveys: France

Human biomonitoring (HBM) studies have been conducted in populations in France since the 1980s in order to understand better the exposure to environmental chemicals and to help regulators to reduce exposure and to monitor existing policies. Until recently, French HBM studies focused on specific populations or pollutants, but an integrated, multipollutant approach has begun with a recent national population-based biomonitoring survey and will be extended through the current national HBM strategy.This chapter describes different relevant and successful approaches of French HBM activities in responding to specific and more general public health concerns. There are: 1) studies focused on a specific pollutant or population, illustrated by a multicentre study on dioxins and incinerators, on PCBs in river fishermen and a national lead survey in children, and 2) integrated national multipollutant HBM surveys, illustrated by the ENNS study and the current national HBM strategy including the national survey of people aged between 6 and 74 years completed for the neonatal period and childhood by the ELFE project. France also contributes to the harmonization of HBM in Europe through participation in European HBM projects.