The health effects of high and moderate doses of ionizing radiation are recognized, but the impacts at lower doses are less clear. Medical workers represent the largest occupational group exposed to radiation. Herein, we examine mortality patterns in a Canadian cohort of medical workers, sex differences in risk, and trends in exposure over time. Annual whole-body effective doses for 301,740 medical workers between 1951 and 2018 were obtained from the Canadian National Dose Registry. Dose trends were characterised by job class and sex. Underlying cause of death was ascertained using linkage to mortality data through 2020. Standardized mortality ratios (SMRs) were estimated to compared the risk of mortality among 124,180 workers with with a lifetime cumulative dose > 0 mSv to the Canadian general population. Internal cohort comparisons incorporated person-time and events among unexposed workers. Poisson regression was used for internal cohort comparisons to explore healthy worker bias. The mean annual radiation dose among workers declined from 0.56 mSv during 1948–1977 to 0.09 mSv in 2000–2018. Compared to the general Canadian population, all-cause mortality was lower for both men (SMR = 0.54, 95

BACKGROUND:We aimed to characterize paramedic infection prevention and control (IPAC) measures reportedly used before and during the coronavirus disease 2019 (COVID-19) pandemic among select Canadian provinces. METHODS:IPAC measures were characterized using self-reported questionnaire data from paramedics enrolled in the CORSIP study between January 2021 and January 2023. Participant demographics and changes to IPAC measures were characterized using descriptive and nonparametric statistics. Cumulative IPAC changes were plotted against COVID-19 cases in the general population, denoting when paramedic-specific IPAC guidance would have been available. RESULTS:Significant variability was observed in worker demographics and which IPAC measures were reportedly used by paramedic services across Canada. Overall, paramedic participants (n=2,828) reported changes being made to all available IPAC measured soon after the pandemic was declared, primarily enhancement and new implementation of specific controls. Most paramedics reported using IPAC measures necessary when caring for COVID-19-infected patients. CONCLUSIONS:Paramedic services across Canada used variable IPAC measures before and during COVID-19. Although most employers were responsive in implementing changes early in the pandemic, validation of which controls are necessary for paramedic workers may lead to more consistent IPAC measures being used by paramedic services.

OBJECTIVES:Ionising radiation is a human carcinogen; however, there are uncertainties about the shape of the exposure-response function at low doses. We evaluated the relationship between radiation dose and cancer incidence in a cohort of Canadian nuclear power plant workers (NPPWs) with protracted exposures to low-dose ionising radiation. METHODS:The cohort included 75 350 workers employed at one of five Canadian nuclear power plants any time between 1945 and 2010. Exposure to cumulative whole-body effective dose was determined through personal monitoring. A total of 4370 incident cancers were identified through record linkage of these workers to national cancer registries (1969-2010). Vital status was determined through linkages to national mortality and tax databases. Standardised incidence ratios (SIRs) were calculated to compare cancer incidence rates of the cohort with the Canadian general population. Poisson regression was used to characterise dose-response relationships via categorical and linear excess relative risk (ERR) models. RESULTS:Significantly elevated SIRs were found for solid cancers (combined), melanoma, colon and prostate cancer, while a reduced SIR was found for lung cancer. Positive, but not statistically significant excess risks were found for melanoma (ERR/100 mSv=0.32; 95% CI: -0.23 to 0.87) and prostate cancer (ERR/100 mSv=0.12; 95% CI: -0.05 to 0.29). An inverse association was found for lung cancer (ERR/100 mSv=-0.18; 95% CI: -0.01 to -0.36). CONCLUSIONS:Our findings suggest that Canadian NPPWs have increased risks of prostate cancer and melanoma from low-dose ionising radiation exposure. Estimates should be cautiously interpreted due to the inability to adjust for demographic and lifestyle factors.

Introduction Previous results suggest that COVID-19 adversely impacted a number of health and coping measures among Canadian paramedics, particularly females. Estimated prevalence for meeting screening criteria for mental health disorders and suicidal thoughts were higher than previously reported. Objectives To provide an update on the impact of the COVID-19 pandemic on the wellbeing of Canadian paramedics with the inclusion of an additional year of participant data. Methods Self-reported questionnaire data was collected from paramedics across five Canadian provinces as part of the COVID-19 Occupational Risks, Seroprevalence and Immunity among Paramedics (CORSIP) project. Validated psychological assessment tools were used to screen for major depressive disorder (MDD, PHQ-9 questionnaire) and probable post-traumatic stress disorder (PTSD, PC-PTSD-5 questionnaire). Satisfaction with life (SWL) scores were adapted from validated Canadian Census questions and confirmed by reliability analysis. All measures were compared before versus during the pandemic using Wilcoxon signed-ranked, Cliff's d, and differences in proportions tests where appropriate. Results Questionnaires from an additional 1662 recruited paramedics were included, now totaling 3568 participants. Prevalence meeting screening criteria remained similar for MDD (31.6%) and PTSD (41.4%), with PTSD risk continuing to not be impacted by COVID-19. Paramedics continued to report higher median SWL scores (20 vs. 17, p<.001) prior to the pandemic, with a large effect size (d=0.58) that suggests a greater probability of reporting higher SWL prior to COVID-19. Suicidal ideation (i.e., 'thoughts that you would be better off dead, or of hurting yourself in some way') was reported by 9.0% of paramedics, which was consistent with original findings. Conclusion Original findings appear stable with the addition of another year of participant data. Future analyses will be employed to investigate whether health and satisfaction measures differed between the original cohort and added participants by adjusting for questionnaire responses with respect to the pandemic timeline.

ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

INTRODUCTIONConsumption of cocaine can lead to numerous injuries and poisoning. However, only a limited number of studies have explored cocaine-related injuries. This study examined a wide range of injuries and poisonings related to cocaine only and in combination with other substances in Canada using sentinel surveillance data captured by the electronic Canadian Hospitals Injury Reporting and Prevention Program (eCHIRPP).METHODSInjuries and poisonings related to the use of cocaine only or in combination with other substances were identified in the eCHIRPP database between January 2012 and December 2019 for all ages. Descriptive analyses were performed to investigate the distribution of demographic and injury characteristics in poisoning and injury records related to the use of cocaine only and in combination with other substances. Statistical analyses were conducted to find the proportion of cocaine-related injuries per 100000 eCHIRPP records. Cocaine-related injury trends were assessed using annual percent change (APC) Results: Cocaine-related injuries and poisonings were observed in 123 records per 100 000 eCHIRPP records. Of the 1482 patients who presented to emergency departments of CHIRPP sites with this type of injury or poisoning, the majority involved cocaine use in combination with one or more substances (80.0%; n = 1186), whereas cocaine-only use was the minority (20.0%; n = 296). Among all cocaine-related records, poisoning was the leading diagnosis (62.7%; n = 930) and most injuries and poisonings were unintentional (73.5%; n = 1090). Overall, the trend of cocaine-related eCHIRPP records for all age groups increased over the study period from 2012 to 2019 (APC [total] = 47.8%, p < 0.05).CONCLUSIONOur findings of a higher proportion of cocaine-related injuries and poisonings among adolescents and young adults, as well as the co-consumption of cocaine with other substances, demonstrate the importance of extensive surveillance of cocainerelated injuries and poisonings and the implementation of evidence-based public health interventions.

IntroductionL’utilisation des trottinettes motorisées gagne en popularité au Canada comme ailleurs. Cette étude vise à résumer les caractéristiques des traumatismes liés à l’utilisation des trottinettes motorisées selon les données de la plate-forme électroniquedu Syst ème canadien hospitalier d’information et de recherche en prévention des traumatismes (eSCHIRPT) et à en analyser les tendances. L’eSCHIRPT recueille des renseignements sur l’événement ayant entraîné le traumatisme et des données cliniques sur le traitement (la partie du corps touchée, la nature et l’intentionnalité du traumatisme ainsi que le traitement administré) auprès de 11 hôpitaux pédiatriques et de 9 hôpitaux généraux du Canada. RésultatsUne recherche en texte libre à l’aide de mots-clés a permis de relever 523 cas de traumatismes liés à l’utilisation d’une trottinette motorisée entre janvier 2012 et décembre 2019. La plupart des traumatismes signalés concernaient des hommes (62,7 %). Le traumatisme le plus fréquent était une fracture ou une luxation (36,9 %) et 14,3 % de l’ensemble des patients ont été admis à l’hôpital. Une régression Joinpoint a montré une augmentation statistiquement significative des traumatismes liés à l’utilisation d’une trottinette motorisée entre 2012 et 2017 (variation annuelle de 18,4 %). ConclusionLes résultats de notre étude indiquent qu’il faut poursuivre les efforts de prévention et améliorer les messages éducatifs sur la conduite sécuritaire et l’importance de l’utilisation d’un équipement de protection pour prévenir les traumatismes chez les utilisateurs.

Background:Vaping prevalence rates have increased among Canadian youth. Evidence suggests that vaping poses significant health risks to children and adolescents.Objectives:The objectives of the study were to investigate epidemiological characteristics of acute injury/illness cases due to the inhalation of vaping aerosols among children and adolescents across Canada and to explore factors contributing to severe cases.Methods:Data from the 2019 Canadian Paediatric Surveillance Program cross-sectional survey on vaping-related injury/illness were used. Analyses focused on injury/illness cases (n=71) among children and adolescents aged 0 to 17 years who presented to participating paediatricians for a harm related to the inhalation of vaping aerosols. We conducted descriptive analyses and performed logistic regression to explore associations between severe presentations requiring hospitalization or intensive care unit (ICU) admission and selected case characteristics.Results:Of the 71 reported injury/illness cases related to inhalation of vaping aerosols, 56% of patients were male, and 68% were aged 15 to 17 years. Nicotine vaping was reported in 42% of cases, and cannabis vaping in 24%. Fifty-four per cent presented with respiratory distress, 18% with symptoms of nicotine toxicity, and 41% required hospitalization and/or admission to the ICU. Cases presenting with respiratory distress were more likely to be hospitalized/admitted to the ICU (odds ratio [OR]=5.37, 95% confidence interval [CI]:1.76 to 16.39).Conclusions:The inhalation of vaping aerosols among children and adolescents may contribute to acute injury/illness. Clear associations between study variables and severe cases could not be established due to a small sample size. Additional research is needed to determine predictors and preventable risk factors of severe vaping-related injuries.

Introduction: Consumption of cocaine can lead to numerous injuries and poisoning. However, only a limited number of studies have explored cocaine-related injuries. This study examined a wide range of injuries and poisonings related to cocaine only and in combination with other substances in Canada using sentinel surveillance data captured by the electronic Canadian Hospitals Injury Reporting and Prevention Program (eCHIRPP). Methods: Injuries and poisonings related to the use of cocaine only or in combination with other substances were identified in the eCHIRPP database between January 2012 and December 2019 for all ages. Descriptive analyses were performed to investigate the distribution of demographic and injury characteristics in poisoning and injury records related to the use of cocaine only and in combination with other substances. Statistical analyses were conducted to find the proportion of cocaine-related injuries per 100000 eCHIRPP records. Cocaine-related injury trends were assessed using annual percent change (APC). Results: Cocaine-related injuries and poisonings were observed in 123 records per 100 000 eCHIRPP records. Of the 1482 patients who presented to emergency departments of CHIRPP sites with this type of injury or poisoning, the majority involved cocaine use in combination with one or more substances (80.0%; n = 1186), whereas cocaine-only use was the minority (20.0%; n = 296). Among all cocaine-related records, poisoning was the leading diagnosis (62.7%; n = 930) and most injuries and poisonings were unintentional (73.5%; n = 1090). Overall, the trend of cocaine-related eCHIRPP records for all age groups increased over the study period from 2012 to 2019 (APC [total] = 47.8%, p < 0.05). Conclusion: Our findings of a higher proportion of cocaine-related injuries and poisonings among adolescents and young adults, as well as the co-consumption of cocaine with other substances, demonstrate the importance of extensive surveillance of cocainerelated injuries and poisonings and the implementation of evidence-based public health interventions.

IntroductionSi la consommation de cocaïne est à l’origine de nombreuses blessures et intoxications, seul un nombre limité d’études a porté sur les blessures liées à la cocaïne. Cette étude a permis d’analyser un large éventail de blessures et d’intoxications liées à la consommation de cocaïne seule et en combinaison avec d’autres substances au Canada,à l’aide des données de surveillance sentinelle saisies dans la plateforme électronique du Système canadien hospitalier d’information et de recherche en prévention des traumatismes (eSCHIRPT). MéthodologieNous avons extrait les dossiers correspondant aux blessures et aux intoxications liées à la consommation de cocaïne, seule ou en combinaison avec d’autres substances, saisis dans la base de données de l’eSCHIRPT entre janvier 2012 et décembre 2019 pour tous les groupes d’âge. Nous avons effectué des analyses descriptives afin d’obtenir la répartition des caractéristiques des patients et des blessures au sein des dossiers mentionnant des intoxications et des blessures liées à la consommation de cocaïne seule ou en combinaison avec d’autres substances. Nous avons réalisé des analyses statistiques afin de déterminer la proportion de blessures liées à la cocaïne pour 100 000 dossiers consignés dans l’eSCHIRPT. Nous avons évalué les tendances relatives aux blessures liées à la cocaïne en utilisant la variation annuelle en pourcentage (VAP). RésultatsDes blessures et des intoxications liées à la cocaïne ont été signalées dans 123 dossiers pour 100 000 dossiers consignés dans l’eSCHIRPT. Des 1 482 patients qui se sont présentés aux urgences des établissements participant au SCHIRPT en lien avec ce type de blessure ou d’intoxication, la majorité avaient consommé de la cocaïne en combinaison avec une ou plusieurs substances (80,0 %; n = 1 186) plutôt que de la cocaïne seule (20,0 %; n = 296). Sur l’ensemble des dossiers associés à la cocaïne, l’intoxication était le diagnostic le plus fréquent (62,7 %; n = 930) et la plupart des blessures et des intoxications étaient non intentionnelles (73,5 %; n = 1 090). Globalement, les déclarations d’incidents relatifs à la cocaïne ont connu une hausse dans l’eSCHIRPT pour tous les groupes d’âge (VAP [total] = 47,8 %, p < 0,05) au cours de la période à l’étude (2012­2019). ConclusionLa proportion plus importante de blessures et d’intoxications liées à la cocaïne chez les adolescents et les jeunes adultes ainsi que la consommation simultanée de cocaïne et d’autres substances révélées par notre étude témoignent de l’importance de procéder à une surveillance exhaustive des blessures et des intoxications liées à la cocaïne ainsi qu’à des interventions de santé publique fondées sur des données probantes

BACKGROUND:Despite reductions in exposure for workers and the general public, radon remains a leading cause of lung cancer. Prior studies of underground miners depended heavily upon information on deaths among miners employed in the early years of mine operations when exposures were high and tended to be poorly estimated. OBJECTIVES:To strengthen the basis for radiation protection, we report on the follow-up of workers employed in the later periods of mine operations for whom we have more accurate exposure information and for whom exposures tended to be accrued at intensities that are more comparable to contemporary settings. METHODS:We conducted a pooled analysis of cohort studies of lung cancer mortality among 57,873 male uranium miners in Canada, Czech Republic, France, Germany, and the United States, who were first employed in 1960 or later (thereby excluding miners employed during the periods of highest exposure and focusing on miners who tend to have higher quality assessments of radon progeny exposures). We derived estimates of excess relative rate per 100 working level months (ERR/100 WLM) for mortality from lung cancer. RESULTS:The analysis included 1.9 million person-years of observation and 1,217 deaths due to lung cancer. The relative rate of lung cancer increased in a linear fashion with cumulative exposure to radon progeny (ERR/100 WLM=1.33; 95% CI: 0.89, 1.88). The association was modified by attained age, age at exposure, and annual exposure rate; for attained ages <55  y, the ERR/100 WLM was 8.38 (95% CI: 3.30, 18.99) among miners who were exposed at ≥35  years of age and at annual exposure rates of <0.5 working levels. This association decreased with older attained ages, younger ages at exposure, and higher exposure rates. DISCUSSION:Estimates of association between radon progeny exposure and lung cancer mortality among relatively contemporary miners are coherent with estimates used to inform current protection guidelines. https://doi.org/10.1289/EHP10669.

INTRODUCTION:The use of motorized scooters is gaining popularity in Canada and elsewhere. This study aims to summarize characteristics of injuries related to use of motorized scooters using data from the electronic Canadian Hospitals Injury Reporting and Prevention Program (eCHIRPP) and to analyze trends. The eCHIRPP collects information associated with the injury event and clinical information related to treatment (the injured body part, the nature of the injury, injury intent and treatment received) from 11 pediatric and 9 general hospitals across Canada.RESULTS:A free-text search using keywords identified 523 cases related to motorized scooter injuries between January 2012 and December 2019. Most of the injuries reported were among males (62.7%). Fracture/dislocation was the most frequent injury (36.9%), and 14.3% of all patients were admitted to hospital. Joinpoint regression showed a statistically significant increase in injuries related to motorized scooter use between 2012 and 2017 (annual percent change of 18.4%).CONCLUSION:Study findings indicate the need for continued preventive efforts and improved educational messages on safe riding and the importance of the use of protective equipment to prevent injuries among riders.

Dans un deuxième article, l’ASPC s’est servie des données des ambulanciers paramédicaux pour détecter des pics dans les cas de surdose liée aux opioïdes avant que les patients entrent en contact avec le système de soins de santé9. 73 p. En ligne à : https://www.canada.ca/fr/sante-publique/services/grippe-influenza/preparation-canada-cas-grippe-pandemique-guide-planification-secteur-sante.html 3 Habib H. Has Sweden’s controversial covid-19 strategy been successful? BMJ. 2020;369:m2376. https://doi.org/10.1136/bmj.m2376. Can J Infect Dis Med Microbiol. 2010;21(3):111-114. https://doi.org/10.1155/2010/420628 7 Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Life-threatening bronchiolitis related to electronic cigarette use in a Canadian youth.

Introduction Numerous studies highlighted the association between radon exposure and lung cancer risk. Nevertheless the question of radon-related risks for non-cancer diseases, and more specifically circulatory system diseases (CSD) have received limited investigation. Among uranium miners, only one cohort observed an association between radon exposure and CSD. Objectives To investigate the relationship between cumulative radon exposure and CSD mortality in the PUMA study (Pooled Uranium Miners Analysis), a large international pooled set of cohorts of uranium miners. Methods The PUMA study includes seven cohorts of uranium miners from Czechia, France, Germany, Canada and USA. Annual radon exposure has been estimated individually and expressed in Working Level Months (WLM). The relationship between cumulative radon exposure, applying a 5-years lag, and CSD death, and more specifically ischemic heart disease and cerebrovascular disease, was assessed with an internal Poisson regression model integrating a linear excess relative risk (ERR) structure, expressed per 100 WLM. Results The PUMA study includes 119,709 male uranium miners hired between 1942 and 1996. The follow-up duration was between 30–39 years in each of the cohorts, contributing to 4.3 million person-years. The mean value of cumulative radon exposure in individual cohorts ranged between 31 and 580 WLM. At the end of follow-up, 52,450 miners were dead (44% of the cohort), and among them 17,494 deaths from CSD were recorded. The exposure-risk relationship did not show any increase in CSD risk associated with cumulative radon exposure (ERR/100 WLM=2.3.10–4; 95% confidence interval [-0.0033; 0.0042]). No increase in risk was observed for ischemic heart disease or cerebrovascular disease death. Conclusion The PUMA study has a large study population and a high level of statistical power. These preliminary results did not show any increased risk for CSD mortality among uranium miners.

BACKGROUND AND AIM: Radon, a ubiquitous gas, and its progeny are a leading environmental and occupational cause of lung cancer. To better inform radiation protection standards by estimating risk, we assembled an international cohort study of workers employed in uranium mining in Canada, the Czech Republic, France, Germany, and the United States. METHODS: We focus on miners employed during the more contemporary period of the uranium mining industry when radon exposures tended to be comparatively low, and individual exposure data are available. A cohort of 56,614 male uranium miners first employed in 1960 or later was assembled and followed to ascertain causes of death. Estimates of excess relative rate (ERR) per working level month (WLM) of cumulative radon progeny exposure for mortality from lung cancer were derived by internal Poisson regression. RESULTS:In the follow-up period a total of 1217 lung cancer deaths occurred, accumulating 1.9 million person-years at risk. The relative rate of lung cancer increased in a linear fashion with cumulative exposure to radon progeny, lagged 5 years (ERR/100 WLM=1.34; 95% CI: 0.89, 1.89). Attained age was a clear modifier of this association, showing a decrease in ERR/WLM with increasing attained age. Further potential modifiers are age at exposure or time since exposure and exposure rate. CONCLUSIONS:PUMA provides the most precise and informative estimates to-date of the association between low-level exposure to radon progeny and lung cancer mortality. The results strengthen the basis for radiation protection standards for radon and its progeny. KEYWORDS: Ionizing radiation, Occupational exposures, Risk assessment,International collaboration

L’objectif général de cette étude était de montrer comment utiliser les renseignements recueillis dans le cadre du Programme de la sécurité des produits de consommation (le Programme) pour identifier certains dangers émergents. Plus spécifiquement, il s’agissait de caractériser et de quantifier les tendances en matière de vapotage en utilisant les rapports d’incident reçus au cours des cinq dernières années dans le cadre du Programme. Les données recueillies dans le cadre du Programme ont été extraites pour la période du 1er janvier 2015 au 30 septembre 2019. Nous avons synthétisé les données sous forme de statistiques descriptives et nous avons quantifié les tendances en utilisant la variation annuelle en pourcentage. Dans le but d’établir des comparaisons reposant sur les caractéristiques des rapports d’incident lié au vapotage, nous avons utilisé les rapports proportionnels de blessures (RPB) et les intervalles de confiance (IC) à 95 % correspondants, ce qui permet de comparer les blessures liées au vapotage à l’ensemble des blessures signalées dans le cadre du Programme. Au total, 71 rapports d’incident lié au vapotage ont été reçus dans le cadre du Programme entre le 1er janvier 2015 et le 30 septembre 2019. Au cours de cette période, la hausse de la variation annuelle en pourcentage quant au nombre de rapports d’incident reçus s’est établi à environ 73 % annuellement (p $lt; 0,05). Parmi les blessures signalées, 41 % étaient des brûlures. Le nombre de rapports d’incident touchant les hommes (RPB = 1,89; IC à 95 % : 1,51 à 2,36) et les 15 à19 ans (RPB = 11,53; IC à 95 % : 4,95 à 26,8) en lien avec le vapotage était, en proportion, supérieur à celui de l’ensemble des autres signalements dans le cadre du Programme. Bien que le nombre de rapports d’incident lié aux produits de vapotage soit faible, les résultats de notre analyse laisse penser que ces incidents sont davantage susceptibles de survenir au sein de certains groupes, en particulier chez les hommes et chez les jeunes.

Previous studies on traumatic brain injury trends in Canada have been restricted to hospitalization and emergency department visit data. However, many concussion patients may present first, or only, to family physicians. Therefore, the true burden of concussion in Canada is likely underestimated. The Canadian Primary Care Sentinel Surveillance Network (CPCSSN) collects information electronically from family physicians across Canada and can potentially be used for concussion surveillance. The objective of this study is to explore the feasibility of using data collated from CPCSSN for concussion surveillance purposes and examine trends over time. Electronic medical records housed by CPCSSN from 2010 to 2016 were analyzed. Case ascertainment was determined through a combination of International Classification of Diseases, Ninth Revision codes. Binomial regression models were used to calculate the prevalence ratio (PR) of concussion by age, sex, deprivation indices, body mass index, and comorbid conditions. Concussion prevalence rates increased from 2010 to 2016 (p < 0.001). Based on 2016 data, males had a higher prevalence of concussion compared with females (PR = 1.09; 95% CI 1.02, 1.18), and those aged 10–14 (PR = 8.52; 95% confidence interval [CI] 6.34, 11.44) and 15–19 (PR = 7.75; 95% CI 5.84, 10.28) had higher prevalence of concussion compared with those aged 0–4 years. This pilot study demonstrates the feasibility of using the CPCSSN system for surveillance of concussion in the Canadian population. The initial findings on prevalence are in agreement with previous studies that have used hospitalization or emergency department data.

La majorité des études sur l’exposition à la fumée du tabac et la qualité du sommeil se fondent sur le tabagisme autodéclaré, ce qui peut entraîner des erreurs de classification de l’exposition et des biais liés à l’autodéclaration. L’objectif de cette étude consistait à étudier les associations entre la concentration de cotinine urinaire – un marqueur biologique de l’exposition à la fumée du tabac – et diverses mesures de la qualité du sommeil, soit le temps de sommeil, la continuité ou l’efficacité du sommeil, la satisfaction à l’égard du sommeil et le degré de vigilance durant les heures normales d’éveil. À l’aide des données d’un échantillon national de 10806 adultes (âgés de 18 à 79 ans) tiré de l’Enquête canadienne sur les mesures de la santé (2007-2013), nous avons effectué des analyses de régression logistique binaire pour estimer les associations entre concentration de cotinine urinaire et mesures de la qualité du sommeil, en tenant compte des facteurs de confusion éventuels. De plus, nous avons effectué une régression logistique ordinale pour évaluer les associations entre concentration urinaire de cotinine et présence d’un nombre plus élevé de troubles du sommeil. Dans l’ensemble, 28,7 % des répondants à l’enquête ciblant les adultes canadiens présentaient des concentrations de cotinine urinaire supérieures à la limite de détection, et la prévalence de chaque trouble du sommeil variait entre 5,5 % et 35,6 %. Une concentration élevée de cotinine dans l’urine (4e quartile par rapport à une concentration inférieure à la limite de détection) était associée à une probabilité significativement plus élevée d’avoir un temps de sommeil trop court ou trop long (rapport de cotes [RC] = 1,41; IC à 95 % : 1,02 à 1,95; tendance p = 0,021), d’avoir de la difficulté à s’endormir ou à rester endormi (RC = 1,71; IC à 95 % : 1,28 à 2,27; tendance p = 0,003), de ressentir une insatisfaction à l’égard du sommeil (RC = 1,87; IC à 95 % : 1,21 à 2,89; tendance p = 0,011) et de présenter un nombre plus élevé de troubles du sommeil (RC = 1,64; IC à 95 % : 1,19 à 2,26; tendance p = 0,001). Les relations observées étaient plus marquées chez les femmes que chez les hommes. Notre étude, qui a fait appel à un marqueur biologique de l’exposition à la fumée du tabac, contribue à l’ensemble de la littérature traitant de l’effet de l’exposition aux substances toxiques de l’environnement sur la qualité du sommeil en montrant qu’il existe une relation entre l’exposition à la fumée du tabac et un sommeil de mauvaise qualité. Pour tenir compte des limites inhérentes à la nature transversale du plan d’étude et pour mieux évaluer les effets sur le long terme de l’exposition à la fumée de tabac sur la qualité du sommeil, il est nécessaire de réaliser des études longitudinales.