Ecological study on hospitalizations for cancer, cardiovascular, and respiratory diseases in the industrial area of Etang-de-Berre in the South of France

Abstract

The Etang-de-Berre area is a large industrialized area in the South of France, exposing 300,000 inhabitants to the plumes of its industries. The possible associated health risks are of the highest concern to the population, who asked for studies investigating their health status. A geographical ecological study based on standardized hospitalizations ratios for cancer, cardiovascular, and respiratory diseases was carried out over the 2004-2007 period. Exposure to air pollution was assessed using dispersion models coupled with a geographic information system to estimate an annual mean concentration of sulfur dioxide (SO₂) for each district. Results showed an excess risk of hospitalization for myocardial infarction in women living in districts with medium or high SO₂ exposure, respectively, 38% [CI 95% 4 : 83] and 54% [14 : 110] greater than women living in districts at the reference level exposure. A 26% [2 : 57] excess risk of hospitalization for myocardial infarction was also observed in men living in districts with high SO₂ levels. No excess risk of hospitalization for respiratory diseases or for cancer was observed, except for acute leukemia in men only. Results illustrate the impact of industrial air pollution on the cardiovascular system and call for an improvement of the air quality in the area.

Figure 1

Study area and localization of air quality monitoring stations.

Figure 2

The industrial surrounding of Etang-de-Berre area. High and low level refers to the European Council Directive 96/82/EC of 9 December 1996 on the control of major-accident hazards involving dangerous substances.

Figure 3

From SO₂ concentrations grid to urban exposure estimation.

Figure 4

SO₂ exposure estimations by district (2008 data).