Cindy PADILLA - Academia.edu (original) (raw)

Papers by Cindy PADILLA

Research paper thumbnail of Data analysis techniques: a tool for cumulative exposure assessment

Background: Everyone is subject to environmental exposures from various sources, with negative he... more Background: Everyone is subject to environmental exposures from various sources, with negative health impacts (air, water and soil contamination, noise ...) or with positive effects (e.g. green space). Studies considering such complex environmental settings in a global manner are rare. We propose to use statistical factor and cluster analyses to create a composite exposure index with a data-driven approach, in view to assess the environmental burden experienced by populations. We illustrate this approach in a large French metropolitan area. Methods: The study was carried out in the Great Lyon area (France, 1.2M inhabitants) at the census block group (BG) scale. We used as environmental indicators ambient air NO 2 annual concentrations, noise levels, proximity to green spaces, to industrial plants, to polluted sites and to road traffic. They were synthesized using Multiple Factor Analysis (MFA), a data driven technique without a priori modeling, followed by a hierarchical clustering to create BG classes. Results: The first components of the MFA explained respectively 30, 14, 11 and 9% of the total variance. Clustering in 5 classes group: 1) A particular type of large BGs without population; 2) BGs of green residential areas, with less negative exposures than average;3) BGs of residential areas near midtown; 4) BGs close to industries; 5) midtown urban BGs, with higher negative exposures than average and less green spaces. Other numbers of classes were tested in order to assess a variety of clustering. Conclusions: We present an approach using statistical factor and cluster analyses techniques which seem overlooked to assess cumulative exposure in complex environmental settings. Although it cannot be applied directly for risk or health effect assessment, the resulting index

Research paper thumbnail of Absence of intrafamilial transmission of hepatitis C virus and low risk for sexual transmission in rural central Africa indicate a cohort effect

Journal of Clinical Virology, Aug 1, 2009

Background: Intrafamilial and sexual transmission of hepatitis C virus (HCV) are still being deba... more Background: Intrafamilial and sexual transmission of hepatitis C virus (HCV) are still being debated, and little is known about such transmission in central Africa. Objective: To examine the rate of intrafamilial transmission of HCV between patients and their household members. Study design: A cross-sectional study was conducted in Dienga, a remote village in Gabon, involving 195 household members of 14 index cases of HCV infection. After a questionnaire on the risk factors for parenteral exposure, blood samples were obtained and tested for antibody to HCV by an enzyme immunoassay (Monolisa anti-HCV plus version 2). Positive samples were tested for HCV RNA and genotyped by amplification and phylogenetic analysis of a fragment of the NS5B gene. Results: HCV antibody was found in 13/195 (6.7%) household contacts, comprising 5/14 (35.7%) sexual partners and 8/114 (7%) relatives. None of the children of index patients tested positive. HCV RNA was detected in only five household members with HCV antibody. The same genotypes were found in only two of five couples, both couples being sexual partners. Parenteral risk factors were not more likely to be reported by people positive for HCV antibody than by those who were negative. Age over 50 years was the only independent predictor of positivity for HCV antibody. Conclusions: This study indicates, as previously suggested, that the spread of HCV in central Africa is due to a cohort effect, with previous, possibly iatrogenic, transmission rather than intrafamilial or sexual transmission.

Research paper thumbnail of Geographical Ambulatory Endovascular Revascularisation Disparities in France From 2015 to 2019

European Journal of Vascular and Endovascular Surgery, Jun 1, 2022

This study is the first to report on the geographical space and time disparities of the developme... more This study is the first to report on the geographical space and time disparities of the development of ambulatory endovascular revascularisation in France. Between 2015 and 2019, the ambulatory activity increased slowly but with significant geographical disparities. In 2019, the ambulatory activity in the French departments ranged from 0% to 39%. From both population health and health services perspectives, the clusters of departments with a significant ambulatory activity differed from the others by the burden of lower extremity arterial diseases, some form of social isolation, and the poverty of their elderly population. Therefore, research is needed to improve health care ressources and access to ambulatory endovascular revascularisation.

Research paper thumbnail of Urban rural paradox -when easy access to mammography services does not mean active participation

European journal of public health, Sep 1, 2020

Research paper thumbnail of NO2 ambient air levels differently affect life expectancy according to social deprivation: an analysis across census blocks in Paris

Environmental health perspectives, Sep 19, 2013

Research paper thumbnail of City Specific Spatio-Temporal Trend of Infant and Neonatal Mortality Clusters. Links with Socioeconomic and Air Pollution Spatial Patterns in France

Environmental health perspectives, Oct 20, 2014

Research paper thumbnail of La question du lien entre défaveur sociale, pollution de l’air et morbidité/mortalité infantile : applications aux villes de Lyon et de Nice

HAL (Le Centre pour la Communication Scientifique Directe), Oct 17, 2014

National audienc

Research paper thumbnail of Accounting for complex environmental exposure situations: a classification approach

Environmental health perspectives, Sep 19, 2013

Research paper thumbnail of Impact de la crise sanitaire de la Covid-19 sur la santé mentale des étudiants à Rennes

HAL (Le Centre pour la Communication Scientifique Directe), Feb 25, 2021

Research paper thumbnail of Geographic differences in relationship between socioeconomic, clinical, urban-rural factors and stroke incidence in France

Research Square (Research Square), Dec 17, 2019

Background: Stroke remains a devastating disease in Europe and geographic disparities persist. Ma... more Background: Stroke remains a devastating disease in Europe and geographic disparities persist. Mapping spatial distributions of disease occurrence can serve as a useful tool for identifying exposures of public health concern. The purpose of this study was to investigate geographic differences in relationship between socioeconomic, clinical, urban-rural factors and stroke incidence in Pays de Brest (Western France) between 2008 and 2013. Methods: We used cases and patient's characteristics from the Brest stroke registry, and sociodemographic, urban-rural indicators constructed at the census blocks level. We generated maps using Poisson geographic weighted regression models, smoothing on longitude and latitude while adjusting for covariates. Results: Women living in more deprived census blocks evidenced a significantly higher age standardized stroke incidence risk 1.24, [95%CI 1.09-1.39] and 1.21, [95%CI 1.04-1.49], in rural and urban census blocks respectively. For men, three clusters of census blocks with high stroke incidence risk were detected, one in rural and deprived and two in urban and low deprived census bocks. Conclusions: Understand whether and how neighborhood and patient's characteristics influence stroke risk, may be useful for both epidemiological research and health services planning. Background Stroke remains a devastating disease in Europe despite major improvements in management over recent decades. At the beginning of the 21st century, the age standardized stroke incidence in Europe ranged from 95 to 290 per 100 000 inhabitants-year. Because of the ageing population, the expected number of patients who will suffer a stroke each year will inevitably continue to rise over the next decades (1). In France, stroke constitute the first cause of mortality among women, with 18,343 deaths in 2013, the third among men, with 13,003 deaths, and is a leading cause of serious disability. Analysis of the French national health insurance database suggests that in 2013 the cost of stroke care amounted to 3.5 billion € (2). The burden of stroke varies according to demographic, socioeconomic status (SES), and geographic factors. Past efforts have investigated the association between contextual SES position alone or after

Research paper thumbnail of Systematic Literature Review Of Reproductive Outcomes Associated With Residential Proximity To Polluted Sites

Environmental health perspectives, Aug 20, 2015

This study aims to assess the evidence on adverse pregnancy outcome associated with living close ... more 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.

Research paper thumbnail of Plausible cumulative effect of air pollution exposure and neighborhood deprivation on the risk of congenital malformations

Environmental health perspectives, Aug 17, 2016

Introduction Congenital anomalies are the main causes of preterm and neonatal mortality and morbi... more Introduction Congenital anomalies are the main causes of preterm and neonatal mortality and morbidity. The determinants of half of all major malformations are multifactorial including air pollution...

Research paper thumbnail of Variations géographiques du démarrage en urgence de la dialyse chronique en Bretagne

Nephrologie & Therapeutique, Sep 1, 2018

(IC) à 95 % 0,54-0,9, et sub distribution-hazard ratio 0,7, IC 95 % 0,54-0,91). Le risque d'échec... more (IC) à 95 % 0,54-0,9, et sub distribution-hazard ratio 0,7, IC 95 % 0,54-0,91). Le risque d'échec technique secondaire à une péritonite était significativement plus élevé dans le deuxième cluster de centres (cause-specifique hazard ratio 2,37 IC 95 % 1,23-4,59, et sub distribution-hazard ratio 2,48 IC 95 % 1,29-4,78). Dans le modèle de Cox multi-niveau, la variance de l'effet centre diminuait de 5,33 % après ajustement sur les variables individuelles, et de 25,9 % après ajustement sur les variables individuelles et les clusters. Discussion Cette étude propose l'originalité d'étudier des clusters de centres aux pratiques similaires. L'effet de l'ensemble des variables liées aux centres est ainsi évalué. L'avantage de cette approche est que les centres issus des clusters à risques pourraient ainsi être identifier pour y mener prioritairement des actions ciblées d'amélioration de la qualité. Conclusion Cinq clusters de centres aux pratiques de soins de la DP similaires ont été identifiés en France. Ces clusters étaient associés à des survies techniques différentes. Déclaration de liens d'intérêts Les auteurs n'ont pas précisé leurs éventuels liens d'intérêts.

Research paper thumbnail of Spatial Planning of Green Space as a Local Intervention Aimed at Tackling Social Health Inequalities: Adverse Pregnancy Issues

Geoinformatics & geostatistics, 2016

Empirical support for the potential of green space to play a role in reducing the risk of adverse... more Empirical support for the potential of green space to play a role in reducing the risk of adverse pregnancy outcomes (including infant mortality) has now been documented. Uneven proximity and/ or access to green space thus contribute to health inequalities. Therefore, each intervention or strategy performed by local policy and aimed at promoting universal access to (and/or use of) green space regardless of social group could promote birth health-and thus tackle social health inequalities. To orient local programs or initiatives targeting health inequalities by acting on the equitable distribution of green spaces, today's geospatial tools may be of assistance to the policy maker. Our above discussion describes the evidence of the health benefit of urban green space, and how this factor contributes to health inequalities in pregnancy issues. Given that birth health is recognized as a key indicator of the health status of a population as well as a predictor of long-term outcomes, this suggestive evidence should encourage the planning and evaluation of local green space intervention aimed at promoting health and tackling health inequalities.

Research paper thumbnail of Impact of the COVID-19 health crisis on the mental health of students in Rennes, France

HAL (Le Centre pour la Communication Scientifique Directe), Mar 17, 2021

Pour lutter contre la pandémie de Covid-19, la France, comme de nombreux pays dans le monde, a dû... more Pour lutter contre la pandémie de Covid-19, la France, comme de nombreux pays dans le monde, a dû mettre en place des mesures de contrôle pour ralentir la propagation du SARS-CoV-2. Ces mesures, qui ont un impact direct sur la vie quotidienne des Français, ne sont pas sans conséquences sur leur santé mentale, notamment pour la population des étudiants. Ainsi, lors du premier confinement en avril 2020 près d'un tiers des étudiants présentait des signes de détresse psychologique d'après une étude nationale. Cependant, aucune donnée n'existe, à notre connaissance, concernant la santé mentale des étudiants suite au second confinement du mois de novembre 2020. Cette étude a pour objectif d'évaluer l'impact de la crise sanitaire de la COVID-19 jusqu'au mois de novembre 2020 en France sur la santé mentale des étudiants au travers de divers indicateurs : détresse psychologique, soutien social, solitude, symptômes de dépression et symptômes d'anxiété. Elle se base sur les données recueillies dans le cadre de l'enquête longitudinale COVER portant plus largement sur les facteurs de risque et les comportements des étudiants de Rennes face à l'épidémie de Covid-19. Dans le cadre de cette enquête, 4261 étudiants Rennais issus de l'EHESP (Ecole des Hautes Etudes en Santé Publique), la Rennes School of Business et Sciences Po Rennes ont été invités en décembre 2020 à répondre à un auto-questionnaire en ligne visant, pour partie, à évaluer leur santé mentale. Parmi les étudiants interrogés, 784 ont répondu au questionnaire (taux de participation de 18.4%). Les résultats ont été redressé pour être représentatifs de la distribution par sexe des étudiants. Les signes d'une détresse psychologique ont été retrouvés chez 60.3% des étudiants interrogés (Intervalle de confiance à 95% (IC95%) [57.0%; 64.1%]). Un étudiant sur cinq présentait des symptômes de dépression (IC95% [20.3%; 26.4%]) et 37.7% des symptômes d'anxiété (IC95% [34.3%; 41.1%]). Plus d'un étudiant sur deux présentait des signes de solitude (IC95% [47.9%; 52.1%]) et près d'un quart bénéficiait d'un faible soutien social (IC95% [19.8%; 25.9%]). Les femmes étaient davantage à risque de détresse psychologique et de symptômes d'anxiété comparativement aux hommes. Par ailleurs, les étudiants qui présentaient des difficultés financières, qui bénéficiaient d'un faible soutien social, qui se déclaraient en mauvaise santé ou qui avaient un sentiment de solitude étaient plus à risque de présenter

Research paper thumbnail of NO2 ambient air levels differently affect life expectancy according to social deprivation: an analysis across census blocks in Paris

ISEE Conference Abstracts

Research paper thumbnail of Impact de la crise sanitaire de la COVID-19 sur la santé mentale des étudiants à Rennes, France

Pour lutter contre la pandémie de Covid-19, la France, comme de nombreux pays dans le monde, a dû... more Pour lutter contre la pandémie de Covid-19, la France, comme de nombreux pays dans le monde, a dû mettre en place des mesures de contrôle pour ralentir la propagation du SARS-CoV-2. Ces mesures, qui ont un impact direct sur la vie quotidienne des Français, ne sont pas sans conséquences sur leur santé mentale, notamment pour la population des étudiants. Ainsi, lors du premier confinement en avril 2020 près d'un tiers des étudiants présentait des signes de détresse psychologique d'après une étude nationale. Cependant, aucune donnée n'existe, à notre connaissance, concernant la santé mentale des étudiants suite au second confinement du mois de novembre 2020. Cette étude a pour objectif d'évaluer l'impact de la crise sanitaire de la COVID-19 jusqu'au mois de novembre 2020 en France sur la santé mentale des étudiants au travers de divers indicateurs : détresse psychologique, soutien social, solitude, symptômes de dépression et symptômes d'anxiété. Elle se base sur les données recueillies dans le cadre de l'enquête longitudinale COVER portant plus largement sur les facteurs de risque et les comportements des étudiants de Rennes face à l'épidémie de Covid-19. Dans le cadre de cette enquête, 4261 étudiants Rennais issus de l'EHESP (Ecole des Hautes Etudes en Santé Publique), la Rennes School of Business et Sciences Po Rennes ont été invités en décembre 2020 à répondre à un auto-questionnaire en ligne visant, pour partie, à évaluer leur santé mentale. Parmi les étudiants interrogés, 784 ont répondu au questionnaire (taux de participation de 18.4%). Les résultats ont été redressé pour être représentatifs de la distribution par sexe des étudiants. Les signes d'une détresse psychologique ont été retrouvés chez 60.3% des étudiants interrogés (Intervalle de confiance à 95% (IC95%) [57.0%; 64.1%]). Un étudiant sur cinq présentait des symptômes de dépression (IC95% [20.3%; 26.4%]) et 37.7% des symptômes d'anxiété (IC95% [34.3%; 41.1%]). Plus d'un étudiant sur deux présentait des signes de solitude (IC95% [47.9%; 52.1%]) et près d'un quart bénéficiait d'un faible soutien social (IC95% [19.8%; 25.9%]). Les femmes étaient davantage à risque de détresse psychologique et de symptômes d'anxiété comparativement aux hommes. Par ailleurs, les étudiants qui présentaient des difficultés financières, qui bénéficiaient d'un faible soutien social, qui se déclaraient en mauvaise santé ou qui avaient un sentiment de solitude étaient plus à risque de présenter

Research paper thumbnail of RESEARCH Open Access

A statistical procedure to create a neighborhood socioeconomic index for health inequalities anal... more A statistical procedure to create a neighborhood socioeconomic index for health inequalities analysis

Research paper thumbnail of Proximity to Industrial Plants, Neighbourhood Socio-Economic Characteristics and the Risk of Infant Mortality – a Bayesian Analysis in Lyon, France

ISEE Conference Abstracts, 2011

Cindy Padilla, EHESP School of Public Health–Rennes-France Benoit Lalloué, EHESP School of Public... more Cindy Padilla, EHESP School of Public Health–Rennes-France Benoit Lalloué, EHESP School of Public Health–Rennes-France; IRSET – Research Institute of environmental and occupational health-France Whahida Kihal , EHESP School of Public Health–Rennes-France; LIVE Laboratoire Image, Ville et Environnement, (CNRS/UdS) Department of Geography, Strasbourg University, France Grégoire Rey, INSERM-CépiDc-le Vésinet-France Denis Zmirou-Navier , EHESP School of Public Health–Rennes-France; IRSET – Research Institute of environmental and occupational health-France; INSERM U954–Vandoeuvre-les-Nancy-France ; ancy University Medical School–Vandoeuvre-lesNancy-France Séverine Deguen , EHESP School of Public Health–Rennes-France; IRSET – Research Institute of environmental and occupational health-France

Research paper thumbnail of Neonatal Mortality, Outdoor Air Pollution and Social Inequalities– a Spatial Analysis Conducted at a Small Geographical Level in Three French Metropolitan Areas

ISEE Conference Abstracts, 2013

Research paper thumbnail of Data analysis techniques: a tool for cumulative exposure assessment

Background: Everyone is subject to environmental exposures from various sources, with negative he... more Background: Everyone is subject to environmental exposures from various sources, with negative health impacts (air, water and soil contamination, noise ...) or with positive effects (e.g. green space). Studies considering such complex environmental settings in a global manner are rare. We propose to use statistical factor and cluster analyses to create a composite exposure index with a data-driven approach, in view to assess the environmental burden experienced by populations. We illustrate this approach in a large French metropolitan area. Methods: The study was carried out in the Great Lyon area (France, 1.2M inhabitants) at the census block group (BG) scale. We used as environmental indicators ambient air NO 2 annual concentrations, noise levels, proximity to green spaces, to industrial plants, to polluted sites and to road traffic. They were synthesized using Multiple Factor Analysis (MFA), a data driven technique without a priori modeling, followed by a hierarchical clustering to create BG classes. Results: The first components of the MFA explained respectively 30, 14, 11 and 9% of the total variance. Clustering in 5 classes group: 1) A particular type of large BGs without population; 2) BGs of green residential areas, with less negative exposures than average;3) BGs of residential areas near midtown; 4) BGs close to industries; 5) midtown urban BGs, with higher negative exposures than average and less green spaces. Other numbers of classes were tested in order to assess a variety of clustering. Conclusions: We present an approach using statistical factor and cluster analyses techniques which seem overlooked to assess cumulative exposure in complex environmental settings. Although it cannot be applied directly for risk or health effect assessment, the resulting index

Research paper thumbnail of Absence of intrafamilial transmission of hepatitis C virus and low risk for sexual transmission in rural central Africa indicate a cohort effect

Journal of Clinical Virology, Aug 1, 2009

Background: Intrafamilial and sexual transmission of hepatitis C virus (HCV) are still being deba... more Background: Intrafamilial and sexual transmission of hepatitis C virus (HCV) are still being debated, and little is known about such transmission in central Africa. Objective: To examine the rate of intrafamilial transmission of HCV between patients and their household members. Study design: A cross-sectional study was conducted in Dienga, a remote village in Gabon, involving 195 household members of 14 index cases of HCV infection. After a questionnaire on the risk factors for parenteral exposure, blood samples were obtained and tested for antibody to HCV by an enzyme immunoassay (Monolisa anti-HCV plus version 2). Positive samples were tested for HCV RNA and genotyped by amplification and phylogenetic analysis of a fragment of the NS5B gene. Results: HCV antibody was found in 13/195 (6.7%) household contacts, comprising 5/14 (35.7%) sexual partners and 8/114 (7%) relatives. None of the children of index patients tested positive. HCV RNA was detected in only five household members with HCV antibody. The same genotypes were found in only two of five couples, both couples being sexual partners. Parenteral risk factors were not more likely to be reported by people positive for HCV antibody than by those who were negative. Age over 50 years was the only independent predictor of positivity for HCV antibody. Conclusions: This study indicates, as previously suggested, that the spread of HCV in central Africa is due to a cohort effect, with previous, possibly iatrogenic, transmission rather than intrafamilial or sexual transmission.

Research paper thumbnail of Geographical Ambulatory Endovascular Revascularisation Disparities in France From 2015 to 2019

European Journal of Vascular and Endovascular Surgery, Jun 1, 2022

This study is the first to report on the geographical space and time disparities of the developme... more This study is the first to report on the geographical space and time disparities of the development of ambulatory endovascular revascularisation in France. Between 2015 and 2019, the ambulatory activity increased slowly but with significant geographical disparities. In 2019, the ambulatory activity in the French departments ranged from 0% to 39%. From both population health and health services perspectives, the clusters of departments with a significant ambulatory activity differed from the others by the burden of lower extremity arterial diseases, some form of social isolation, and the poverty of their elderly population. Therefore, research is needed to improve health care ressources and access to ambulatory endovascular revascularisation.

Research paper thumbnail of Urban rural paradox -when easy access to mammography services does not mean active participation

European journal of public health, Sep 1, 2020

Research paper thumbnail of NO2 ambient air levels differently affect life expectancy according to social deprivation: an analysis across census blocks in Paris

Environmental health perspectives, Sep 19, 2013

Research paper thumbnail of City Specific Spatio-Temporal Trend of Infant and Neonatal Mortality Clusters. Links with Socioeconomic and Air Pollution Spatial Patterns in France

Environmental health perspectives, Oct 20, 2014

Research paper thumbnail of La question du lien entre défaveur sociale, pollution de l’air et morbidité/mortalité infantile : applications aux villes de Lyon et de Nice

HAL (Le Centre pour la Communication Scientifique Directe), Oct 17, 2014

National audienc

Research paper thumbnail of Accounting for complex environmental exposure situations: a classification approach

Environmental health perspectives, Sep 19, 2013

Research paper thumbnail of Impact de la crise sanitaire de la Covid-19 sur la santé mentale des étudiants à Rennes

HAL (Le Centre pour la Communication Scientifique Directe), Feb 25, 2021

Research paper thumbnail of Geographic differences in relationship between socioeconomic, clinical, urban-rural factors and stroke incidence in France

Research Square (Research Square), Dec 17, 2019

Background: Stroke remains a devastating disease in Europe and geographic disparities persist. Ma... more Background: Stroke remains a devastating disease in Europe and geographic disparities persist. Mapping spatial distributions of disease occurrence can serve as a useful tool for identifying exposures of public health concern. The purpose of this study was to investigate geographic differences in relationship between socioeconomic, clinical, urban-rural factors and stroke incidence in Pays de Brest (Western France) between 2008 and 2013. Methods: We used cases and patient's characteristics from the Brest stroke registry, and sociodemographic, urban-rural indicators constructed at the census blocks level. We generated maps using Poisson geographic weighted regression models, smoothing on longitude and latitude while adjusting for covariates. Results: Women living in more deprived census blocks evidenced a significantly higher age standardized stroke incidence risk 1.24, [95%CI 1.09-1.39] and 1.21, [95%CI 1.04-1.49], in rural and urban census blocks respectively. For men, three clusters of census blocks with high stroke incidence risk were detected, one in rural and deprived and two in urban and low deprived census bocks. Conclusions: Understand whether and how neighborhood and patient's characteristics influence stroke risk, may be useful for both epidemiological research and health services planning. Background Stroke remains a devastating disease in Europe despite major improvements in management over recent decades. At the beginning of the 21st century, the age standardized stroke incidence in Europe ranged from 95 to 290 per 100 000 inhabitants-year. Because of the ageing population, the expected number of patients who will suffer a stroke each year will inevitably continue to rise over the next decades (1). In France, stroke constitute the first cause of mortality among women, with 18,343 deaths in 2013, the third among men, with 13,003 deaths, and is a leading cause of serious disability. Analysis of the French national health insurance database suggests that in 2013 the cost of stroke care amounted to 3.5 billion € (2). The burden of stroke varies according to demographic, socioeconomic status (SES), and geographic factors. Past efforts have investigated the association between contextual SES position alone or after

Research paper thumbnail of Systematic Literature Review Of Reproductive Outcomes Associated With Residential Proximity To Polluted Sites

Environmental health perspectives, Aug 20, 2015

This study aims to assess the evidence on adverse pregnancy outcome associated with living close ... more 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.

Research paper thumbnail of Plausible cumulative effect of air pollution exposure and neighborhood deprivation on the risk of congenital malformations

Environmental health perspectives, Aug 17, 2016

Introduction Congenital anomalies are the main causes of preterm and neonatal mortality and morbi... more Introduction Congenital anomalies are the main causes of preterm and neonatal mortality and morbidity. The determinants of half of all major malformations are multifactorial including air pollution...

Research paper thumbnail of Variations géographiques du démarrage en urgence de la dialyse chronique en Bretagne

Nephrologie & Therapeutique, Sep 1, 2018

(IC) à 95 % 0,54-0,9, et sub distribution-hazard ratio 0,7, IC 95 % 0,54-0,91). Le risque d'échec... more (IC) à 95 % 0,54-0,9, et sub distribution-hazard ratio 0,7, IC 95 % 0,54-0,91). Le risque d'échec technique secondaire à une péritonite était significativement plus élevé dans le deuxième cluster de centres (cause-specifique hazard ratio 2,37 IC 95 % 1,23-4,59, et sub distribution-hazard ratio 2,48 IC 95 % 1,29-4,78). Dans le modèle de Cox multi-niveau, la variance de l'effet centre diminuait de 5,33 % après ajustement sur les variables individuelles, et de 25,9 % après ajustement sur les variables individuelles et les clusters. Discussion Cette étude propose l'originalité d'étudier des clusters de centres aux pratiques similaires. L'effet de l'ensemble des variables liées aux centres est ainsi évalué. L'avantage de cette approche est que les centres issus des clusters à risques pourraient ainsi être identifier pour y mener prioritairement des actions ciblées d'amélioration de la qualité. Conclusion Cinq clusters de centres aux pratiques de soins de la DP similaires ont été identifiés en France. Ces clusters étaient associés à des survies techniques différentes. Déclaration de liens d'intérêts Les auteurs n'ont pas précisé leurs éventuels liens d'intérêts.

Research paper thumbnail of Spatial Planning of Green Space as a Local Intervention Aimed at Tackling Social Health Inequalities: Adverse Pregnancy Issues

Geoinformatics & geostatistics, 2016

Empirical support for the potential of green space to play a role in reducing the risk of adverse... more Empirical support for the potential of green space to play a role in reducing the risk of adverse pregnancy outcomes (including infant mortality) has now been documented. Uneven proximity and/ or access to green space thus contribute to health inequalities. Therefore, each intervention or strategy performed by local policy and aimed at promoting universal access to (and/or use of) green space regardless of social group could promote birth health-and thus tackle social health inequalities. To orient local programs or initiatives targeting health inequalities by acting on the equitable distribution of green spaces, today's geospatial tools may be of assistance to the policy maker. Our above discussion describes the evidence of the health benefit of urban green space, and how this factor contributes to health inequalities in pregnancy issues. Given that birth health is recognized as a key indicator of the health status of a population as well as a predictor of long-term outcomes, this suggestive evidence should encourage the planning and evaluation of local green space intervention aimed at promoting health and tackling health inequalities.

Research paper thumbnail of Impact of the COVID-19 health crisis on the mental health of students in Rennes, France

HAL (Le Centre pour la Communication Scientifique Directe), Mar 17, 2021

Pour lutter contre la pandémie de Covid-19, la France, comme de nombreux pays dans le monde, a dû... more Pour lutter contre la pandémie de Covid-19, la France, comme de nombreux pays dans le monde, a dû mettre en place des mesures de contrôle pour ralentir la propagation du SARS-CoV-2. Ces mesures, qui ont un impact direct sur la vie quotidienne des Français, ne sont pas sans conséquences sur leur santé mentale, notamment pour la population des étudiants. Ainsi, lors du premier confinement en avril 2020 près d'un tiers des étudiants présentait des signes de détresse psychologique d'après une étude nationale. Cependant, aucune donnée n'existe, à notre connaissance, concernant la santé mentale des étudiants suite au second confinement du mois de novembre 2020. Cette étude a pour objectif d'évaluer l'impact de la crise sanitaire de la COVID-19 jusqu'au mois de novembre 2020 en France sur la santé mentale des étudiants au travers de divers indicateurs : détresse psychologique, soutien social, solitude, symptômes de dépression et symptômes d'anxiété. Elle se base sur les données recueillies dans le cadre de l'enquête longitudinale COVER portant plus largement sur les facteurs de risque et les comportements des étudiants de Rennes face à l'épidémie de Covid-19. Dans le cadre de cette enquête, 4261 étudiants Rennais issus de l'EHESP (Ecole des Hautes Etudes en Santé Publique), la Rennes School of Business et Sciences Po Rennes ont été invités en décembre 2020 à répondre à un auto-questionnaire en ligne visant, pour partie, à évaluer leur santé mentale. Parmi les étudiants interrogés, 784 ont répondu au questionnaire (taux de participation de 18.4%). Les résultats ont été redressé pour être représentatifs de la distribution par sexe des étudiants. Les signes d'une détresse psychologique ont été retrouvés chez 60.3% des étudiants interrogés (Intervalle de confiance à 95% (IC95%) [57.0%; 64.1%]). Un étudiant sur cinq présentait des symptômes de dépression (IC95% [20.3%; 26.4%]) et 37.7% des symptômes d'anxiété (IC95% [34.3%; 41.1%]). Plus d'un étudiant sur deux présentait des signes de solitude (IC95% [47.9%; 52.1%]) et près d'un quart bénéficiait d'un faible soutien social (IC95% [19.8%; 25.9%]). Les femmes étaient davantage à risque de détresse psychologique et de symptômes d'anxiété comparativement aux hommes. Par ailleurs, les étudiants qui présentaient des difficultés financières, qui bénéficiaient d'un faible soutien social, qui se déclaraient en mauvaise santé ou qui avaient un sentiment de solitude étaient plus à risque de présenter

Research paper thumbnail of NO2 ambient air levels differently affect life expectancy according to social deprivation: an analysis across census blocks in Paris

ISEE Conference Abstracts

Research paper thumbnail of Impact de la crise sanitaire de la COVID-19 sur la santé mentale des étudiants à Rennes, France

Pour lutter contre la pandémie de Covid-19, la France, comme de nombreux pays dans le monde, a dû... more Pour lutter contre la pandémie de Covid-19, la France, comme de nombreux pays dans le monde, a dû mettre en place des mesures de contrôle pour ralentir la propagation du SARS-CoV-2. Ces mesures, qui ont un impact direct sur la vie quotidienne des Français, ne sont pas sans conséquences sur leur santé mentale, notamment pour la population des étudiants. Ainsi, lors du premier confinement en avril 2020 près d'un tiers des étudiants présentait des signes de détresse psychologique d'après une étude nationale. Cependant, aucune donnée n'existe, à notre connaissance, concernant la santé mentale des étudiants suite au second confinement du mois de novembre 2020. Cette étude a pour objectif d'évaluer l'impact de la crise sanitaire de la COVID-19 jusqu'au mois de novembre 2020 en France sur la santé mentale des étudiants au travers de divers indicateurs : détresse psychologique, soutien social, solitude, symptômes de dépression et symptômes d'anxiété. Elle se base sur les données recueillies dans le cadre de l'enquête longitudinale COVER portant plus largement sur les facteurs de risque et les comportements des étudiants de Rennes face à l'épidémie de Covid-19. Dans le cadre de cette enquête, 4261 étudiants Rennais issus de l'EHESP (Ecole des Hautes Etudes en Santé Publique), la Rennes School of Business et Sciences Po Rennes ont été invités en décembre 2020 à répondre à un auto-questionnaire en ligne visant, pour partie, à évaluer leur santé mentale. Parmi les étudiants interrogés, 784 ont répondu au questionnaire (taux de participation de 18.4%). Les résultats ont été redressé pour être représentatifs de la distribution par sexe des étudiants. Les signes d'une détresse psychologique ont été retrouvés chez 60.3% des étudiants interrogés (Intervalle de confiance à 95% (IC95%) [57.0%; 64.1%]). Un étudiant sur cinq présentait des symptômes de dépression (IC95% [20.3%; 26.4%]) et 37.7% des symptômes d'anxiété (IC95% [34.3%; 41.1%]). Plus d'un étudiant sur deux présentait des signes de solitude (IC95% [47.9%; 52.1%]) et près d'un quart bénéficiait d'un faible soutien social (IC95% [19.8%; 25.9%]). Les femmes étaient davantage à risque de détresse psychologique et de symptômes d'anxiété comparativement aux hommes. Par ailleurs, les étudiants qui présentaient des difficultés financières, qui bénéficiaient d'un faible soutien social, qui se déclaraient en mauvaise santé ou qui avaient un sentiment de solitude étaient plus à risque de présenter

Research paper thumbnail of RESEARCH Open Access

A statistical procedure to create a neighborhood socioeconomic index for health inequalities anal... more A statistical procedure to create a neighborhood socioeconomic index for health inequalities analysis

Research paper thumbnail of Proximity to Industrial Plants, Neighbourhood Socio-Economic Characteristics and the Risk of Infant Mortality – a Bayesian Analysis in Lyon, France

ISEE Conference Abstracts, 2011

Cindy Padilla, EHESP School of Public Health–Rennes-France Benoit Lalloué, EHESP School of Public... more Cindy Padilla, EHESP School of Public Health–Rennes-France Benoit Lalloué, EHESP School of Public Health–Rennes-France; IRSET – Research Institute of environmental and occupational health-France Whahida Kihal , EHESP School of Public Health–Rennes-France; LIVE Laboratoire Image, Ville et Environnement, (CNRS/UdS) Department of Geography, Strasbourg University, France Grégoire Rey, INSERM-CépiDc-le Vésinet-France Denis Zmirou-Navier , EHESP School of Public Health–Rennes-France; IRSET – Research Institute of environmental and occupational health-France; INSERM U954–Vandoeuvre-les-Nancy-France ; ancy University Medical School–Vandoeuvre-lesNancy-France Séverine Deguen , EHESP School of Public Health–Rennes-France; IRSET – Research Institute of environmental and occupational health-France

Research paper thumbnail of Neonatal Mortality, Outdoor Air Pollution and Social Inequalities– a Spatial Analysis Conducted at a Small Geographical Level in Three French Metropolitan Areas

ISEE Conference Abstracts, 2013