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Substantial knowledge is available on the association of the indoor school environment and its effect among schoolchildren. In the same context, the SINPHONIE (School indoor pollution and health: Observatory network in Europe) conducted a study to collect data and determine the distribution of several indoor air pollutants (IAPs), physical and thermal parameters and their association with eye, skin, upper-, lower respiratory and systemic disorder symptoms during the previous three months. Finally, data from 115 schools in 54 European cities from 23 countries were collected and included 5175 schoolchildren using a harmonized and standardized protocol. The association between exposures and the health outcomes were examined using logistic regression models on the environmental stressors assessed in classroom while adjusting for several confounding factors; a VOC (volatile organic compound) score defined as the sum of the number of pollutants to which the children were highly exposed (concentration > median of the distribution) in classroom was also introduced to evaluate the mul tiexposu re - outcome association. Schoolchildren while adjusting for several confounding factors. Schoolchildren exposed to above or equal median concentration of PM2.5, benzene, limonene, ozone and radon were at significantly higher odds of suffering from upper, lower airways, eye and systemic disorders. Increased odds were also observed for any symptom (sick school syndrome) among schoolchildren exposed to concentrations of limonene and ozone above median values. Furthermore, the risks for upper and lower airways and systemic disorders significantly increased with the VOCs score. Results also showed that increased ventilation rate was significantly associated with decreased odds of suffering from eye and skin disorders whereas similar association was observed between temperature and upper airways symptoms. The present study provides evidence that exposure to IAPs in schools is associated with various health problems in children. Further investigations are needed to confirm our findings. (C) 2020 Elsevier B.V. All rights reserved.

Introduction Few investigations have related objective assessments of indoor air pollutants to respiratory health in farmers, in spite of the many rural environmental hazards to which they are exposed. Chemical air pollution has been particularly neglected. Objective We investigated the relationships of indoor exposure to particulate matter (PM) and volatile organic compounds (VOCs) to respiratory health in farmers. Methods Nineteen VOCs (5 families) and PM (from ultrafine to total suspended particles (TSP)) were objectively assessed in dwellings and workplaces in 109 French farmers during a week. To take into account multiple exposures, scores of exposure were computed for total VOCs and VOCs families. Individuals filled a standardized questionnaire and underwent spirometry with bronchodilation test. Results On average, VOCs concentrations were higher in dwellings than in workplaces. The reverse was observed for PM. When considering the mean concentrations of air pollutants for the whole farm (dwellings + workplaces), asthma (9.3%) was positively associated with elevated exposure to benzene (adjusted odds-ratio (ORa) = 6.64, 95%CI: 1.56–28.27), trichloroethylene (4.80, 1.00–23.30) and halogenated hydrocarbons score (2.9, 95% 1.3–6.8). Early airway obstruction (FEF25–75

Backgroud Evidence about the relationship between prenatal maternal depression and the development of childhood asthma and allergies in early life is scarce. We aimed to examine this relationship by using data set of EDEN mother-child cohort study. A total of 1139 children were followed-up until the age of 5 years. Methods Prenatal maternal depression was self-reported by using the Centre for Epidemiological Studies-Depression scale (CES-D) questionnaire and was classified into binary variable (maternal depression [CES-D score of≥16] and no maternal depression [CES-D score of Results In our study population, 13.67 % of the mothers had clinical significant depression (the total scores for CES-D ≥16) during pregnancy. For children ages 5 years, the prevalence of wheezing, physician-diagnosed asthma, physician-diagnosed eczema and allergic rhinoconjunctivitis were 46.78, 20.99, 29.17, and 22.54%, respectively. Prenatal maternal depression was associated with ever allergic rhinoconjunctivitis (aOR 1.87 [95% confidence interval {CI}, 1.33–2.62]). No significant relationships were found between prenatal maternal depression and wheezing, physician-diagnosed asthma and physician-diagnosed eczema (aOR 1.12 [95% CI, 0.91–1.39], aOR 1.23 [95% CI, 0.81–1.85] and aOR 1.17 [95% CI, 0.86–1.61], respecitvely). Conclusion Prenatal maternal depression was related to ever allergic rhinoconjunctivitis in the first 5 years of life in children of EDEN mother-child cohort study.

International audience; BACKGROUND: Galaxolide (HHCB) is used for fragrance in many consumer products. The aim of the current study was to use objective assessments of HHCB to build a predictive model in order to estimate indoor-measured HHCB concentrations from questionnaire-based data on dwelling characteristics and occupants' habits and activities. METHODS: Environmental assessments of indoor HHCB, dwelling characteristics were carried out in 150 dwellings in Brittany (France). Among the various models that were tested, the best predictive model for the reduced set of characteristics was identified on the basis of the coefficient of determination (R2) criterion. RESULTS: Linear regression model showed among the best performances (R2 = 0.48), together with some more complex models. According to the estimated results, the main variables that significantly increased HHCB concentrations were: living in rural area, drying clothes inside dwellings, painted walls, chipboard furniture, double glazing, damaged floors and duration of bathroom door being kept open. Laminated floors and presence of indoor plants were found to significantly decrease HHCB concentrations. DISCUSSION: The linear model based on objective assessments and questionnaire-derived data about dwelling characteristics and occupants' activities constituted an easy method for predicting indoor air HHCB concentrations. For studies including a large number of dwellings, modeling of HHCB concentrations is cheaper than measuring it in every location. Our methodological procedure can be applied to other indoor air pollutants.

A wildfire is an uncontrolled fire in an area of combustible vegetation that occurs in the countryside or a wilderness area. The United Nation International Strategy for Disaster Reduction estimates that between 3 and 4 million km2 are affected by wildfire annually, with 18 000 km2 occurring in Europe. The Mediterranean region is one of the most affected regions by wildfires in Europe. Nearly 500 000 ha, on average, are burned annually by 50 000 wildfires in the countries of southern Europe bordering the Mediterranean Sea. Wildfires or biomass burning seriously damage ecosystems and affect public health. A major difficulty related to the assessment of health impact of wildfire emissions derives from the complexity of wildfire exposure assessments. Based on the literature, several methods, including satellite data, chemical transport models and, less often, personal exposure monitoring are available. However, few investigations have used methods allowing separating wildfires emissions from air pollutants emissions from urban sources having the same components. An inventory of wildfires occurred in Europe between 2006 and 2010 was obtained in terms of burnt areas, duration and related emissions of major air pollutants (black carbon, particulate matter), as obtained using a hybrid model that allows excluding anthropic sources of air pollution.

Good indoor air quality in schools is important to provide a safe, healthy, productive, and comfortable environment for students, teachers, and other school staff. However, existing studies demonstrated that various air pollutants are found in classrooms, sometimes at elevated concentrations. Data also indicated that poor air quality may impact children's health, in particular respiratory health, attendance, and academic performance. Nevertheless, it should be noted that there are other adverse health effects that are less documented. Few data exist for teachers and other adults that work in schools. Allergic individuals seem to be at a higher risk for adverse respiratory health consequences. Air quality improvement represents an important measure for prevention of adverse health consequences in children and adults in schools.

We investigated the relationships of behavioural problems as assessed using the standardized Strengths and Difficulties Questionnaire (SDQ) to asthma in view of improving asthma management. Six thousand eight hundred and eighty children (mean age 10.4 years, male: 49%) were recruited in the French 6 Cities Study. Children with abnormal or borderline emotional symptoms (internalizing problems) or conduct problems (externalizing problems) were more asthmatic than others (P < 0.01). Compared to being normal, abnormal emotional symptoms or conduct problems were found to be related to mild-to-moderate persistent asthma (logistic model adjusted odds ratio = 1.55 (95% CI = 1.26-1.90) and 1.42 (95% CI = 1.17-1.71), respectively) and to early-onset asthma (Cox's model Adjusted Hazard Risk = 1.60 (95% CI = 1.27-2.01) and 1.34 (95% CI = 1.05-1.70). Borderline conduct problems were found to be negatively related to parents' knowledge on how to prevent asthma attacks, compared to normal conduct problems [adjusted OR = 0.51 (95% CI = 0.31-0.85)]. Further data are needed to better understand the involvement of behavioural problems in childhood asthma according to phenotypes.

The measurement of indoor air pollutants and their health effects are less often studied due to the costs of collection of such data. We have analysed the variability in the measurement of five indoor school air pollutants: fine particulate matter of size ≤2.5 μm (PM 2.5 ), nitrogen dioxide (NO 2 ), and three Volatile Organic Compounds (VOC), namely formaldehyde, acetaldehyde and acrolein, objectively measured over five days of a week at representative points in more than 400 classrooms of 109 schools and courtyards in six French cities spread out over the year. Separate 3-stage multilevel models were fitted to partition the different nested variance components ( i.e. , classroom, school and city levels), and intra-class correlation (ICC) coefficients were computed to bring out the similarities of pollutants' concentrations among these spatial units. The indoor PM 2.5 and NO 2 concentrations showed a high degree of similarity (ICC coefficients equal to 76% and 81%, respectively) between the classrooms of a school (and city), whereas the formaldehyde, acetaldehyde and acrolein concentrations showed low to moderate degree of similarity (ICC coefficients equal to 25%, 36% and 57%, respectively) between the classrooms. We conclude that to investigate the impact of indoor air pollutants, a multilevel approach taking into account the full design of the study would be the most appropriate.

The safety profiles of once-daily adjunctive levetiracetam (LEV) extended release (XR) (1000mg/day) and adjunctive LEV immediate release (IR) (500mg twice daily) were compared using data from three randomized, placebo (PBO)-controlled phase III clinical trials in patients with partial-onset seizures. MedDRA 9.0 treatment-emergent adverse events (TEAEs) were indirectly compared using meta-analytic techniques, including calculation of risk difference (RD) and mixed-effects analysis. Statistical significance was set at 10% alpha risk, the normative value for these analyses. Data from 555 patients older than 16 (204 LEV IR, 70 LEV XR, 281 PBO) were analyzed. Following adjustment for incidence of placebo TEAEs, LEV XR showed statistically significantly lower rates of TEAEs than LEV IR across nervous system disorders (RD=-18%, P=0.03), psychiatric disorders (RD=-11%, P=0.08), and metabolism and nutrition disorders (RD=-3%, P=0.08). Among nervous system disorders, the RD for headache favored LEV XR (RD=-11%, P=0.08). These results suggest that adjunctive LEV XR may be associated with a lower incidence of nervous system, psychiatric, and nutritional and metabolic TEAEs as compared with LEV IR. However, this difference was observed at a broad scale and not at a specific TEAE level except for headache.

We have developed an automated surveillance system based on passive infra-red sensors. Eight sensors were installed in a hospital room. A computer automatically captured data from the sensors every night from 21:00 until 06:00 the following morning. The sensors were polled twice per second and when a sensor was activated by movement, the event and time were recorded in a data file. At the end of the surveillance period the program analysed the data and generated a report showing the activities taking place in the room and their times. Four elderly patients were observed for a total of 97 nights. A total of 1637 possible sequences of movements by the patient and the hospital staff were detected. The computer was able to identify 1450 sequences (89%) correctly, in comparison with manual analysis. Only 10 movements (0.6%) were undetected by the system; all were very short sequences (five or six activations of the sensors). The system was generally capable of detecting and classifying all major movements in the room.

International audience; Wildfires take a heavy toll on human health worldwide. Climate change may increase the risk of wildfire frequency. Therefore, in view of adapted preventive actions, there is an urgent need to further understand the health effects and public awareness of wildfires. We conducted a systematic review of non-accidental health impacts of wildfire and incorporated lessons learned from recent experiences. Based on the literature, various studies have established the relationship between one of the major components of wildfire, particulate matter (particles with diameter less than 10 µm (PM 10) and less than 2.5 µm (PM 2.5)) and cardiorespiratory symptoms in terms of Emergency Rooms visits and hospital admissions. Associations between wildfire emissions and various subclinical effects have also been established. However, few relationships between wildfire emissions and mortality have been observed. Certain segments of the population may be particularly vulnerable to smoke-related health risks. Among them, people with pre-existing cardiopulmonary conditions, the elderly, smokers and, for professional reasons, firefighters. Potential action mechanisms have been highlighted. Overall, more research is needed to better understand health impact of wildfire exposure.

Background Exercise-induced bronchospasm (EIB) is frequent among asthmatic children. However, opinions differ on the relation between EIB and rhinitis in the absence of asthma. Objectives We assessed the relationship between EIB and various phenotypes of rhinitis according to asthmatic status at the general population level in the Six Cities Study. Methods Of 7781 schoolchildren with a mean age of 10 years underwent an EIB test and skin prick test to assess allergic sensitization. Their parents completed a standardized questionnaire recording asthma-like symptoms and past-year rhinoconjunctivitis, ever hay fever (EHF), and a score for allergic rhinitis (SFAR) ≥7 as a marker of 'past-year allergic rhinitis'. Exercise-induced bronchospasm was defined as a fall in peak expiratory flow rate ≥15% after exercise. Results Of the 6813 schoolchildren retained for analysis, 227 (3.33%) experienced EIB after exercise. Odds ratios [95% confidence intervals] between EIB and allergic rhinitis phenotypes in the absence of asthma were 1.56 [0.92-2.63] for EHF, 1.97 [1.16-3.35] for past-year rhinoconjunctivitis, and 1.84 [1.16-2.91] for a SFAR ≥7. Results were unchanged after adjustment for confounders. Multiple correspondence analysis showed that EIB, although related to asthma, constitutes a separate entity. Exercise-induced bronchospasm was not significantly related to familial history of asthma. Conclusion In our large population-based sample of children, different phenotypes of atopic rhinitis were associated with EIB, independently of asthma. Exercise-induced bronchospasm, although related to asthma, seems to constitute a separate entity. Clinical relevance In this large (6813) sample of 10-year children drawn from the general population, EIB is associated with rhinitis phenotypes in the absence of asthma. Furthermore, it constitutes an entity independent from asthma and is not related to a familial history of asthma. Thus, investigating these symptoms could be important in this disease, as a specific nasal treatment might improve EIB in these children.

Demented elderly patients in the hospital need continuous follow-up. For this reason, we created a system of continuous telesurveillance with the help of eight passive infrared sensors and installed it in an experimental hospital bedroom to analyse patients’ motor activity. Patients were continuously monitored by the system from 21:00 until 6:00 the next morning. We monitored patients’ motor activity and correlated it with his or her illness as well as patient management. We present here three Alzheimer’s patients, which included 147 nights of observation. The first, otherwise stable patient, presented an acutely confused state. In the second patient, chronic sleep disturbance was noted. In the third patient, a superimposed episode of nocturnal agitation on chronically prevailing sleep disturbance was found. Thus, the preliminary results show that this method of monitoring patients’ motor activity could be a useful adjunct to patient diagnosis and management for the clinician.

We have developed a method for remote wound assessment in the elderly. Wound images were taken with a digital camera at a resolution of 640×480 pixels. JPEG compression was then used to produce images of about 100 kByte. Selected clinical data were transmitted by email, together with standardized digital images of wounds. The remote physician then read the clinical data and viewed the digital images on a 38 cm colour display monitor, at a resolution of 800×600 pixels, in 16-bit colour, using standard software. Three elderly inpatients with pressure sores or leg ulcers had both bedside and remote examinations, by different physicians. The diagnosis and therapeutic recommendations proposed after each of the two examinations were compared qualitatively. There was reasonable agreement between the two physicians in the assessment of wound size, anatomical classification, wound bed and status of infection. However, the lack of palpation represented a major limitation to remote wound assessment, despite the use of probes to delineate the depth of any opening in the wound bed.

This study examined the hypothesis that emotion and conduct problems (ECPs) may modify the relationships between ambient air pollutants and childhood asthma and eczema.In the cross-sectional study, 4209 French schoolchildren (aged 10e12 years) were investigated between March 1999 and October 2000. Ambient air pollutants exposures were estimated with dispersion modeling. Health outcomes and ECPs were evaluated by validated questionnaires, completed by the parents. Marginal models were used to analyze the relationships of exposures to ambient air pollutants and/or ECPs to asthma phenotypes and current eczema, adjusting for potential confounders.In our population, interactions were found between ECPs and exposures to ambient air pollutants (benzene, carbon monoxide, nitrogen dioxide, nitrogen oxides, particulate matter with an aerodynamic diameter below 10 mm, volatile organic compounds) (P.20). In addition, ECPs were related to current wheezing (adjusted prevalence odds ratio [aOR], 2.35; 95% confidence interval [CI], 1.59e3.47), current doctor-diagnosed asthma (aOR, 1.82; 95% CI, 1.25e2.66), and current eczema (aOR, 2.21; 95% CI, 1.61e3.02). Children with ECPs had 1.17e1.51 times higher aORs for the associations between ambient air pollutants and asthma phenotypes and current eczema than those without ECPs.ECPs may modify the relationships between ambient air pollutants and childhood asthma and eczema.

Background: Galaxolide (HHCB) is used for fragrance in many consumer products. The aim of the current study was to use objective assessments of HHCB to build a predictive model in order to estimate indoor-measured HHCB concentrations from questionnaire-based data on dwelling characteristics and occupants’ habits and activities. Methods: Environmental assessments of indoor HHCB, dwelling characteristics were carried out in 150 dwellings in Brittany (France). Among the various models that were tested, the best predictive model for the reduced set of characteristics was identified on the basis of the coefficient of determination (R2) criterion. Results: Linear regression model showed among the best performances (R2 = 0.48), together with some more complex models. According to the estimated results, the main variables that significantly increased HHCB concentrations were: living in rural area, drying clothes inside dwellings, painted walls, chipboard furniture, double glazing, damaged floors and duration of bathroom door being kept open. Laminated floors and presence of indoor plants were found to significantly decrease HHCB concentrations. Discussion: The linear model based on objective assessments and questionnaire-derived data about dwelling characteristics and occupants’ activities constituted an easy method for predicting indoor air HHCB concentrations. For studies including a large number of dwellings, modeling of HHCB concentrations is cheaper than measuring it in every location. Our methodological procedure can be applied to other indoor air pollutants.

International audience; BACKGROUND: Studies have shown diverse strength of evidence for the associations between air pollutants and childhood asthma, but these associations have scarcely been documented in the early life. The purpose of this study was to evaluate the impacts of various air pollutants on the development of asthma phenotypes in the first year of life. METHODS: Adjusted odds ratios were estimated to assess the relationships between exposures to air pollutants and single and multi-dimensional asthma phenotypes in the first year of life in children of the EDEN mother-child cohort study (n = 1,765 mother-child pairs). The Generalized Estimating Equation (GEE) model was used to determine the associations between prenatal maternal smoking and in utero exposure to traffic-related air pollution and asthma phenotypes (data were collected when children were at birth, and at 4, 8 and 12 months of age). Adjusted Population Attributable Risk (aPAR) was estimated to measure the impacts of air pollutants on health outcomes. RESULTS: In the first year of life, both single and multi-dimensional asthma phenotypes were positively related to heavy parental smoking, traffic-related air pollution and dampness, but negatively associated with contact with cats and domestic wood heating. Adjusted odds ratios (aORs) for traffic-related air pollution were the highest [1.71 (95% Confidence Interval (CI): 1.08-2.72) for ever doctor-diagnosed asthma, 1.44 (95% CI: 1.05-1.99) for bronchiolitis with wheezing, 2.01 (95% CI: 1.23-3.30) for doctor-diagnosed asthma with a history of bronchiolitis]. The aPARs based on these aORs were 13.52%, 9.39%, and 17.78%, respectively. Results persisted for prenatal maternal smoking and in utero exposure to traffic-related air pollution, although statistically significant associations were observed only with the asthma phenotype of ever bronchiolitis. CONCLUSIONS: After adjusting for potential confounders, traffic-related air pollution in utero life and in the first year of life, had a greater impact on the development of asthma phenotypes compared to other factors.

Background: Galaxolide (HHCB) is used for fragrance in many consumer products. The aim of the current study was to use objective assessments of HHCB to build a predictive model in order to estimate indoor-measured HHCB concentrations from questionnaire-based data on dwelling characteristics and occupants’ habits and activities. Methods: Environmental assessments of indoor HHCB, dwelling characteristics were carried out in 150 dwellings in Brittany (France). Among the various models that were tested, the best predictive model for the reduced set of characteristics was identified on the basis of the coefficient of determination (R2) criterion. Results: Linear regression model showed among the best performances (R2 = 0.48), together with some more complex models. According to the estimated results, the main variables that significantly increased HHCB concentrations were: living in rural area, drying clothes inside dwellings, painted walls, chipboard furniture, double glazing, damaged floors and duration of bathroom door being kept open. Laminated floors and presence of indoor plants were found to significantly decrease HHCB concentrations. Discussion: The linear model based on objective assessments and questionnaire-derived data about dwelling characteristics and occupants’ activities constituted an easy method for predicting indoor air HHCB concentrations. For studies including a large number of dwellings, modeling of HHCB concentrations is cheaper than measuring it in every location. Our methodological procedure can be applied to other indoor air pollutants.