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Benmarhnia, T, Oulhote Y, Petit C, Lapostolle A, Chauvin P, Zmirou-Navier D, Deguen S.  2014.  Chronic air pollution and social deprivation as modifiers of the association between high temperature and daily mortality. Environmental Health. 13   Artn 5310.1186/1476-069x-13-53   AbstractWebsite

Background: Heat and air pollution are both associated with increases in mortality. However, the interactive effect of temperature and air pollution on mortality remains unsettled. Similarly, the relationship between air pollution, air temperature, and social deprivation has never been explored.Methods: We used daily mortality data from 2004 to 2009, daily mean temperature variables and relative humidity, for Paris, France. Estimates of chronic exposure to air pollution and social deprivation at a small spatial scale were calculated and split into three strata. We developed a stratified Poisson regression models to assess daily temperature and mortality associations, and tested the heterogeneity of the regression coefficients of the different strata. Deaths due to ambient temperature were calculated from attributable fractions and mortality rates were estimated.Results: We found that chronic air pollution exposure and social deprivation are effect modifiers of the association between daily temperature and mortality. We found a potential interactive effect between social deprivation and chronic exposure with regards to air pollution in the mortality-temperature relationship.Conclusion: Our results may have implications in considering chronically polluted areas as vulnerable in heat action plans and in the long-term measures to reduce the burden of heat stress especially in the context of climate change.

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Beck, F, Richard JB, Deutsch A, Benmarhnia T, Pirard P, Roudier C, Peretti-Watel P.  2013.  Knowledge about radon and its associated risk perception in France. Cancer Radiotherapie. 17:744-749.   10.1016/j.canrad.2013.06.044   AbstractWebsite

Purpose. - Radon exposure is a major environmental risk in health. It remains badly known by the general population. It is the second cause of lung cancer, after tobacco smoking. The aim of this cross-sectional general population survey was to describe radon exposure risk knowledge and the socioeconomic factors related to this knowledge.Materials and methods. - The Cancer Barometer survey 2010 questioned the French population about its knowledge of radon as such and as health risk factor. This survey was a two-stage random sampling with computer-assisted telephone interview that was performed from April 3, 2010 to August 7, 2010 on a sample of 3,359 people aged 15 to 75 years old.Results. - Among people aged 15 to 75 years old, only one in five knows that radon is a natural gas coming from the ground. This knowledge is more frequent among people living in an area that is directly concerned by radon, among men and increases with age, with the level of education and the level of income. Radon risk remains still widely underestimated by the general public, including in areas concerned by this risk. When people were confronted with radon exposure, few intended to remedy by improving their home.Conclusion. - The success of prevention initiatives implies the support and the collaboration of various national and local actors. To improve their impact for the prevention of lung cancers, it could be more effective to couple these actions with prevention messages on tobacco. (C) 2013 Societe francaise de radiotherapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.

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Bailey, J, Gerasopoulos E, Rojas-Rueda D, Benmarhnia T.  2019.  Potential health and equity co-benefits related to the mitigation policies reducing air pollution from residential wood burning in Athens, Greece. Journal of Environmental Science and Health Part a-Toxic/Hazardous Substances & Environmental Engineering.   10.1080/10934529.2019.1629211   AbstractWebsite

Athens, Greece has been in economic and social crises after the 2008 global recession, resulting in an increase in wood burning as a cheaper method of residential heating in the winter. Reducing wood burning emissions is a source-specific method to address air quality degradation, and indirectly climate change, through instituting policies aimed at human health co-benefits. In this work, we investigate and quantify the potential health co-benefits from policies reducing outdoor particulate matter (PM) pollution from residential wood burning by assessing the pollution conditions during the 2015 calendar year in Athens, Greece, emphasizing vulnerable populations. We conducted a systematic literature search to extract data regarding effective improvements to outdoor PM due to wood burning interventions, and get a range of potential ambient PM reduction estimates regarding realistic benefits from different interventions. We applied a health impact assessment methodology and used existing Athens specific data to calculate the preventable daily average non-accidental deaths associated with reducing PM, additionally considering low and high socioeconomic status (SES) groups. We found that the reduction in outdoor PM concentration showed the potential to benefit lower SES groups as much as 13.5 times more than the high SES group, representing an opportunity for policies to improve not only the health of the total population but also improve environmental equity and health disparities.

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Benmarhnia, T, Grenier P, Brand A, Fournier M, Deguen S, Smargiassi A.  2015.  Quantifying Vulnerability to Extreme Heat in Time Series Analyses: A Novel Approach Applied to Neighborhood Social Disparities under Climate Change. International Journal of Environmental Research and Public Health. 12:11869-11879.   10.3390/ijerph120911869   AbstractWebsite

Objectives: We propose a novel approach to examine vulnerability in the relationship between heat and years of life lost and apply to neighborhood social disparities in Montreal and Paris. Methods: We used historical data from the summers of 1990 through 2007 for Montreal and from 2004 through 2009 for Paris to estimate daily years of life lost social disparities (DYLLD), summarizing social inequalities across groups. We used Generalized Linear Models to separately estimate relative risks (RR) for DYLLD in association with daily mean temperatures in both cities. We used 30 climate scenarios of daily mean temperature to estimate future temperature distributions (2021-2050). We performed random effect meta-analyses to assess the impact of climate change by climate scenario for each city and compared the impact of climate change for the two cities using a meta-regression analysis. Results: We show that an increase in ambient temperature leads to an increase in social disparities in daily years of life lost. The impact of climate change on DYLLD attributable to temperature was of 2.06 (95% CI: 1.90, 2.25) in Montreal and 1.77 (95% CI: 1.61, 1.94) in Paris. The city explained a difference of 0.31 (95% CI: 0.14, 0.49) on the impact of climate change. Conclusion: We propose a new analytical approach for estimating vulnerability in the relationship between heat and health. Our results suggest that in Paris and Montreal, health disparities related to heat impacts exist today and will increase in the future.

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Heo, S, Nori-Sarma A, Lee K, Benmarhnia T, Dominici F, Bell ML.  2019.  The use of a quasi-experimental study on the mortality effect of a heat wave warning system in Korea. International Journal of Environmental Research and Public Health. 16   10.3390/ijerph16122245   AbstractWebsite

Many cities and countries have implemented heat wave warning systems to combat the health effects of extreme heat. Little is known about whether these systems actually reduce heat-related morbidity and mortality. We examined the effectiveness of heat wave alerts and health plans in reducing the mortality risk of heat waves in Korea by utilizing the discrepancy between the alerts and the monitored temperature. A difference-in-differences analysis combined with propensity score weighting was used. Mortality, weather monitoring, and heat wave alert announcement data were collected for 7 major cities during 2009-2014. Results showed evidence of risk reduction among people aged 19-64 without education (-0.144 deaths/1,000,000 people, 95% CI: -0.227, -0.061) and children aged 0-19 (-0.555 deaths/1,000,000 people, 95% CI: -0.993, -0.117). Decreased cardiovascular and respiratory mortality was found in several subgroups including single persons, widowed people, blue-collar workers, people with no education or the highest level of education (university or higher). No evidence was found for decreased all-cause mortality in the population (1.687 deaths/1,000,000 people per day; 95% CI: 1.118, 2.255). In conclusion, heat wave alerts may reduce mortality for several causes and subpopulations of age and socio-economic status. Further work needs to examine the pathways through which the alerts impact subpopulations differently.