CONTEXT:Public interest for citizen science (CS) in environmental health is growing. The goals of environmental health research projects are diverse, as are the methods used to reach these goals. Opportunities for greater implication of the civil society and related challenges differ at each step of such projects. These methodological aspects need to be widely shared and understood by all stakeholders. The LILAS initiative (acronym for "application of citizen science approaches such as LIving LAbS to research on environmental exposures and chronic risks") aimed to 1) favor a mutual understanding of the main issues and research methods in environmental health, of their stakes for different actors, but also of the requirements, strengths and limitations of these methods and to 2) identify expected benefits and points of attention related to stronger degrees of participation as part of environmental health research projects.METHODS:The LILAS initiative gathered institutional researchers, academics and civil society representatives interested in environmental exposures. Five meetings allowed to collectively identify different types of environmental health research studies and reflect about the benefits, limitations, and methodological issues related to the introduction of growing citizen participation as part of such studies. An analytic table matrix summarizing these aspects was co-created and filled by participants, as a tool devoted to help stakeholders with the definition of future CS research projects in environmental health.RESULTS:For different fields of research (e.g.: studies for assessment of environmental exposures, interventions on these exposures, quantitative risk assessment, epidemiological studies), the matrix lists expected benefits for various stakeholders, the fundamental principles of research methods and related practical constraints, but also advantages and limitations related to the use of CS or conventional research approaches.CONCLUSION:The LILAS initiative allowed to develop a tool which provides consolidated grounds for the co-creation of research projects on environmental exposures involving CS.

Context: Participatory research in environmental health remains rare in France. The objectives of environmental health research projects can, like their methods, be very diverse. Opportunities for greater involvement of civil society, as well as its challenges, differ at each step of such research activities. All these aspects need to be widely shared. As a preparatory step toward the development of concrete new participatory research projects on multiple environmental exposures, the LILAS project aimed to (1) favor the mutual understanding of the main issues and research methods in environmental health and their stakes for different participants, but also the requirements, strengths, and limitations of these methods, and (2) identify the expected benefits and points to watch out for related to stronger civic participation in these projects. Methods: The LILAS project identified and gathered together institutional researchers, academics and civil society participants (mainly from nongovernmental organizations) interested in multiple exposures (chemical and radiological). The relevant literature was searched to learn from previous participatory research projects in this broad field. Several meetings enabled the group to collectively identify different types of studies and analyze the benefits, limitations and methods related to the introduction of such participation. An analysis matrix was co-constructed and completed by study participants, as in a Living Lab approach. Results: The matrix lists for different types of studies (assessment of environmental exposures, identification of their determinants, interventions on these exposures, quantitative risk assessment, epidemiological studies, experimental research, ecosystem health, etc.) the expected benefits for several categories of stakeholders, the fundamental principles of research methods, and their related practical constraints, advantages and limitations related to the use of participatory or more standard approaches. Conclusion: The LILAS project enabled the development of a solid basis for the co-construction of participatory research projects to study multiple environmental exposures.

Les essais nucleaires atmospheriques realises par les Etats-Unis, l’ex Union sovietique, le Royaume-Uni, la Chine et la France entre 1945 et 1980 ont entraine des retombees radioactives dans l’environnement. La question des consequences de ces rayonnements ionisants sur la sante des populations exposees se pose depuis plusieurs decennies. Cette expertise collective Inserm, sollicitee par le ministere de la Defense, a pour objectif d’evaluer les consequences sanitaires des essais nucleaires atmospheriques menes par la France en Polynesie francaise entre 1966 et 1974. Afin d’explorer la relation eventuelle entre certaines pathologies et une exposition aux rayonnements ionisants, en particulier aux faibles doses, le groupe pluridisciplinaire d’experts specialistes en sociologie, sante publique, epidemiologie, dosimetrie, radiobiologie et genetique, a analyse les connaissances scientifiques internationales disponibles sur les dommages sanitaires des essais nucleaires atmospheriques realises par les differents pays dont la France ; il s’est egalement interesse aux effets sanitaires causes par d’autres types d’exposition aux rayonnements ionisants, ainsi qu’aux mecanismes biologiques sous-jacents et aux methodes retrospectives d’estimation des doses recues. A l’issue de cette analyse, le groupe d’experts propose des perspectives de recherche, de surveillance sanitaire et de veille scientifique afin d’ameliorer l’evaluation et le suivi des consequences des essais nucleaires sur la sante en Polynesie francaise.

BACKGROUND AND AIM: Participatory research in environmental health is still rare in France. The objectives of environmental health research, in general, can be very diverse (e.g.: identifying situations associated with risks estimating exposures and effects, testing the effectiveness of preventive actions) and related methods are diverse as well. Opportunities for greater implication of the civil society and related challenges differ at each step of research activities. These aspects need to be better known and shared collectively. The LILAS project aimed to 1) co-construct, among institutional researchers, academics and civil society representatives, a mutual understanding of the main problematics and research methods in environmental health, their stakes for different actors, but also the requirements, strengths and limitations of these methods 2) identify expected benefits and points of vigilance related to stronger degrees of participation as part of such environmental health research projects. METHODS: LILAS gathered institutional researchers, academics and civil society representatives interested in multiple exposures (chemical, radiological). Several meetings allowed to collectively identify different types of study (including environmental epidemiological studies) and reflect about the added value, limitations, and methodological principles related to the introduction of growing participation as part of such studies. An analysis matrix was co-created and filled by participants. RESULTS:For different types of studies (studies for assessment of environmental exposures, identification of their determinants, interventions on these exposures, development of sensors, quantitative risk assessment, environmental epidemiological studies, experimental research, studies on the health of ecosystems…), the matrix lists expected benefits for several categories of stakeholders, fundamental methodological principles and practical constraints, advantages and limitations related to the use of participatory approaches (such as the living lab one) or more "classical" approaches. CONCLUSIONS:LILAS has allowed, through a cross-acculturation process, to develop consolidated grounds for the co-construction of future participatory research projects on multiple environmental exposures. KEYWORDS: Key-words: Multiple exposures, participatory research, methods in environmental health research, Living Lab, co-creation,

L'état de santé d’une population, dont son bien-être, résulte d’interactions complexes entre plusieurs facteurs d'ordre socio-économique, environnemental et individuel. Réduire les inégalités de santé implique l’identification et la caractérisation des facteurs sociaux et des facteurs de risque environnementaux et du cadre de vie afin d’interpréter la façon dont ils se cumulent sur un territoire donné. Ces analyses des déterminants et des mécanismes permettent in fine d’identifier et de hiérarchiser les mesures de gestion et de réduction de l’exposition dans le but d’améliorer la santé de la population. Ainsi, différentes démarches ont été développées à l’international, à des échelles spatiales et temporelles et des niveaux de maturité différents. Les dispositifs mis en place nécessitent avant tout une mise en cohérence de la production et du traitement de données de nature variable pour construire des indicateurs pertinents et utiles à la mise en œuvre d’actions de prévention, de surveillance ou d’alerte, compte tenu de la vulnérabilité spécifique des territoires et des populations qui y vivent. Il s’agit de faire débattre les chercheur.e.s, les scientifiques, juristes, philosophes, les associations, les professionnel.e.s de la santé, de l’aménagement du territoire et du développement durable, de la communication…, et les responsables politiques et publics (international, Europe, France, collectivités territoriales), mais aussi le secteur privé.

Contexte Les recherches participatives en sante-environnement restent peu developpees en France. Les objectifs poursuivis de maniere generale par les recherches en sante-environnement (ex : identifier des situations potentiellement a risque, estimer des expositions, evaluer des effets, tester des actions preventives) et les methodes employees a ces fins sont varies. Les opportunites d’une plus grande implication de la societe civile et defis associes different a chaque etape de ces recherches. Ces aspects demandent a etre mieux apprehendes collectivement. Le projet LILAS vise, en amont du developpement de futurs projets de recherches participatives sur les multi-expositions environnementales, a 1) co-construire, entre chercheurs institutionnels, academiques et representants de la societe civile, une bonne comprehension commune des principales problematiques et methodes de recherche en sante-environnement, de leurs enjeux, prerequis, forces et limites 2) identifier les benefices et points de vigilance lies a l’introduction de plus fortes dimensions participatives dans ces recherches. Methode adoptee Le projet LILAS a rassemble des chercheurs institutionnels, academiques et representants de la societe civile interesses par les multi-expositions (chimiques, radiologiques). Une recherche bibliographique a ete initiee pour tirer le retour d’experience de projets de recherches participatives en sante-environnement. Plusieurs reunions ont permis d’identifier collectivement differents types d’etudes et de reflechir sur les apports, limites et principes methodologiques relatifs a l’introduction de differents degres de participation dans celles-ci. Une matrice d’analyse a ete co-construite puis alimentee par les participants, en s’inspirant des approches « Living Lab ». Resultats Pour differents types d’etudes (etudes d’evaluations d’expositions, d’identification de leurs determinants, tests d’interventions sur ceux-ci, developpement de capteurs, evaluations de risques sanitaires, etudes epidemiologiques, recherches experimentales, etudes sur la sante des ecosystemes…), la matrice liste les benefices attendus pour plusieurs categories de parties prenantes, les principes methodologiques fondamentaux et contraintes pratiques, les avantages et limites relatifs a l’emploi d’approches participatives (comme l’approche Living Lab) ou plus “classiques”, mais egalement les besoins d’accompagnements institutionnels et les effets structurants necessaires a leur deploiement et leur amelioration qualitative. Conclusion LILAS a permis, par acculturation croisee, de poser des bases consolidees pour la co-construction de futurs projets de recherches participatives sur les multi-expositions environnementales.

Background: Triggers of multiple sclerosis (MS) relapses are essentially unknown. PM10 exposure has recently been associated with an increased risk of relapses. Objectives: We further explore the short-term associations between PM10, NO2, benzene (C6H6), O-3(,) and CO exposures, and the odds of MS relapses' occurrence. Methods: Using a case-crossover design, we studied 424 MS patients living in the Strasbourg area, France between 2000 and 2009 (1783 relapses in total). Control days were chosen to be 35 days relative to the case (relapse) day. Exposure was modeled through ADMS-Urban software at the census block scale. We consider single-pollutant and multi-pollutant conditional logistic regression models coupled with a distributed-lag linear structure, stratified by season ("hot" vs. "cold"), and adjusted for meteorological parameters, pollen count, influenza-like epidemics, and holidays. Results: The single-pollutant analyses indicated: 1) significant associations between MS relapse incidence and exposures to NO2, PM10, and O-3, and 2) seasonality in these associations. For instance, an interquartile range increase in NO2 (lags 0-3) and PM10) exposure were associated with MS relapse incidence (OR = 1.08; 95%CI: [1.03-1.14] and OR = 1.06; 95%CI: [1.01-1.11], respectively) during the "cold" season (i.e., October-March). We also observed an association with O-3 and MS relapse incidence during "hot" season (OR = 1.16; 95%CI: [1.07-1.25]). C6H6 and CO were not significantly related to MS relapse incidence. However, using multi-pollutant models, only O-3 remained significantly associated with the odds of relapse triggering during "hot" season. Conclusion: We observed significant single-pollution associations between the occurrence of MS relapses and exposures to NO2, O-3 and PM10, only O-3 remained significantly associated with occurrence of MS relapses in the multi-pollutant model.

The health status of the populations of developed countries has never been as satisfactory, but will it stay that way? Research on the subject is difficult due to the complex interactions between our environment and our health, with risks inherent to each noxious agent. Preventing the risks proven to be linked to the quality of our living environments is usually the responsibility of authorities, but individuals can also adopt precautionary practices.

The health status of the populations of developed countries has never been as satisfactory, but will it stay that way? Research on the subject is difficult due to the complex interactions between our environment and our health, with risks inherent to each noxious agent. Preventing the risks proven to be linked to the quality of our living environments is usually the responsibility of authorities, but individuals can also adopt precautionary practices.

Background/Aim: Triggers of multiple sclerosis (MS) relapses are essentially unknown. Relapses' incidence varies across seasons, suggesting a possible role of season-dependent factors such as meteorological variables and ambient air pollution. Relatively few studies have investigated this hypothesis, but the role of ambient air pollution is of growing interest; a recent study from our group observed an increased risk of relapses with ambient PM10 exposures until 3 days before the relapse onset (cold season). Methods: We conducted a time-stratified case-crossover design to further explore separately the short-term associations between other pollutants (e.g., NO2, Benzene (C6H6), O3, and CO) and the odds of MS relapses occurrence. Our study population consists of 536 relapsing MS patients living in Strasbourg area (France) who experienced 2,052 relapses (2000-2009). Control days are chosen to be ±35 days relative to the case (relapse) day. We performed a conditional logistic regression coupled with a distributed-lag model (considering lags 0 to 3) using the "dlnm" R package, stratified by season (hot and cold), and adjusted on all lagged meteorological variables (daily maximum temperature, maximum relative humidity and maximum atmospheric pressure), lagged pollen count, lagged influenza-like epidemics, and holidays. Results: An interquartile range increase in NO2 (lags 1 to 3 cumulated) was associated with MS relapses incidence (ORNO2=1.28 [95%CI: 1.05-1.55]) during cold months (i.e., October to March). C6H6 and CO were not significantly related to MS relapse incidence (ORC6H6=1.13 [95%CI: 0.95-1.35] and ORco=1.09 [95%CI: 0.89-1.34], respectively). We also observed non-significant association between O3 during hot months and MS relapse incidence (ORO3=1.12 [95%CI: 0.88-1.44]). Conclusions: We found a significant association between NO2 and the occurrence of MS relapses using a case-crossover design, relevant to studies with rare event outcomes. Strengths of our study include a precise exposure spatio-temporal model and a clinically-diagnosed outcome from a fairly exhaustive MS registry.

HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L’archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d’enseignement et de recherche français ou étrangers, des laboratoires publics ou privés. Ozone, NO 2 and PM 10 are associated with the occurrence of multiple sclerosis relapses. Evidence from seasonal multi2 pollutant analyses Maxime Jeanjean, Marie-Abele Bind, Jonathan Roux, Jean-Claude Ongagna, Jérôme De Sèze, Denis Bard, Emmanuelle Leray

Dans un entretien paru dans le quotidien Ouest-France le 20 mai 2018, le ministre de lu0027Ecologie Nicolas Hulot declare que son ministere a acte le principe de « lu0027effet cocktail » permettant « du0027adapter nos methodes pour evaluer la dangerosite de certaines substances pas seulement en fonction de la dose mesuree mais eventuellement de lu0027effet quu0027elles peuvent produire une fois combinees entre elles » en faisant reference notamment aux perturbateurs endocriniens.