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Oleko A, Saoudi A, Zeghnoun A, Pecheux M, Cirimele V, Mihai Cirtiu C, Berail G, Szego E, Denys S, Fillol C. Exposure of the general French population to metals and metalloids in 2014-2016: Results from the Esteban study. Environ Res 2024; 252:118744. [PMID: 38579993 DOI: 10.1016/j.envres.2024.118744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 03/13/2024] [Accepted: 03/16/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND The purpose of the Esteban study was to describe levels of various biomarkers of exposure to several environmental pollutants, including metals and metalloids, among the French population. This paper describes the distribution of concentrations of 28 metals and metalloids in two different populations, and estimates the main determinants of exposure to total arsenic, the sum of inorganic arsenic (iAs) and its two metabolites monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA), cadmium, chromium, copper, mercury and nickel. METHODS Esteban is a cross-sectional study conducted between 2014 and 2016 on a random sample of 2503 adults (18-74 years old) and 1104 children (6-17 years old) from the general population. The data collected included biological samples (blood, hair, and urines), socio-demographic characteristics, environmental and occupational exposure, and information on dietary factors and lifestyle. The geometric mean and percentiles of the distribution were estimated for each metal. Multivariate analyses were performed to identify the determinants of exposure using a generalized linear model. RESULTS Only four metals had a quantification rate below 90% in adults (beryllium, iridium, palladium, and platinum), and three metals in children (beryllium, iridium, and platinum). The concentrations of total arsenic, cadmium, chromium and mercury were higher than those found in most international studies. The determinants significantly associated with exposure were mainly diet and smoking. CONCLUSIONS Esteban provided a nationwide description of 28 metal and metalloid exposure levels for adults (some never measured before) and for the first time in children. The study results highlighted widespread exposure to several metals and metalloids. These results could be used to advocate public health decisions for continued efforts to reduce harmful exposure to toxic metals. The Reference values (RV95) built from Esteban could also be used to support future government strategies.
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Affiliation(s)
- Amivi Oleko
- Santé Publique France, French Public Health Agency, 12 Rue Du Val D'Osne, 94415, Saint Maurice Cedex, France.
| | - Abdessattar Saoudi
- Santé Publique France, French Public Health Agency, 12 Rue Du Val D'Osne, 94415, Saint Maurice Cedex, France
| | - Abdelkrim Zeghnoun
- Santé Publique France, French Public Health Agency, 12 Rue Du Val D'Osne, 94415, Saint Maurice Cedex, France
| | - Marie Pecheux
- Santé Publique France, French Public Health Agency, 12 Rue Du Val D'Osne, 94415, Saint Maurice Cedex, France
| | - Vincent Cirimele
- ChemTox 3 Rue Grüninger, Parc D'Innovation F, Illkirch Graffenstaden, 67400, France
| | - Ciprian Mihai Cirtiu
- Centre de Toxicologie Du Québec (CTQ), Institut National de Santé Publique Du Québec (INSPQ), 945 Av., Wolfe, Québec, G1V 5B3, Canada
| | - Géraldine Berail
- Laboratoire de l'Environnement et de l'Alimentation de la Vendée (LEA Vendée), La Roche sur Yon, France
| | - Emmanuelle Szego
- Santé Publique France, French Public Health Agency, 12 Rue Du Val D'Osne, 94415, Saint Maurice Cedex, France
| | - Sébastien Denys
- Santé Publique France, French Public Health Agency, 12 Rue Du Val D'Osne, 94415, Saint Maurice Cedex, France
| | - Clémence Fillol
- Santé Publique France, French Public Health Agency, 12 Rue Du Val D'Osne, 94415, Saint Maurice Cedex, France
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Tagne-Fotso R, Zeghnoun A, Saoudi A, Balestier A, Pecheux M, Chaperon L, Oleko A, Marchand P, Le Bizec B, Vattier L, Bouchart V, Limon G, Le Gléau F, Denys S, Fillol C. Exposure of the general French population to herbicides, pyrethroids, organophosphates, organochlorines, and carbamate pesticides in 2014-2016: Results from the Esteban study. Int J Hyg Environ Health 2023; 254:114265. [PMID: 37748265 DOI: 10.1016/j.ijheh.2023.114265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/19/2023] [Accepted: 09/19/2023] [Indexed: 09/27/2023]
Abstract
Esteban is a nationwide cross-sectional study conducted in France in 2014-2016, including 2503 adults aged 18-74 years old and 1104 children aged 6-17 years old, as part of the French Human Biomonitoring programme. The present paper describes the biological levels of five families of pesticides analysed on random sub-samples of 900 adults and 500 children for urine concentrations, and 759 adults and 255 children for serum concentrations, and the determinants of exposure. Organophosphates, carbamates and herbicides were measured in urine by UPLC-MS/MS; chlorophenols and pyrethroids were measured in urine by GC-MS/MS; specific organochlorines were measured in serum by GC-HRMS. Multivariate analyses were performed to identify the determinants of exposure using a generalized linear model. Pyrethroid metabolites were quantified in 99% of adults and children, with the exeption of F-PBA, which was quantified in 31% of adults and 27% of children, respectively. Carbamates and some specific organophosphates were barely or not quantified. DMTP was quantified in 82% of adults and 93% of children, and γ-HCH (lindane) was quantified in almost 50% of adults and children. Concentration levels of pesticide biomarkers were consistent with comparable international studies, except for β-HCH, DMTP, and the deltamethrin metabolite Br2CA, whose levels were sometimes higher in France. Household insecticide use and smoking were also associated with higher levels of pyrethroids. All pyrethroids concentration levels were below existing health-based HBM guidance values, HBM-GVsGenPop, except for 3-PBA, for which approximately 1% and 10% of children were above the lower and upper urine threshold values of 22 μg/L and 6.4 μg/L, respectively. Esteban provides a French nationwide description of 70 pesticide biomarkers for the first time in children. It also describes some pesticide biomarkers for the first time in adults, including glyphosate and AMPA. For the latter, urine concentration levels were overall higher in children than in adults. Our results highlight a possible beneficial impact of existing regulations on adult exposure to organochlorine and organophosphate pesticides between 2006 and 2016, as concentration levels decreased over this period.
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Affiliation(s)
- Romuald Tagne-Fotso
- Santé Publique France, The National Public Health Agency, 12 Rue Du Val D'Osne, Saint-Maurice Cedex, 94415, France.
| | - Abdelkrim Zeghnoun
- Santé Publique France, The National Public Health Agency, 12 Rue Du Val D'Osne, Saint-Maurice Cedex, 94415, France
| | - Abdessattar Saoudi
- Santé Publique France, The National Public Health Agency, 12 Rue Du Val D'Osne, Saint-Maurice Cedex, 94415, France
| | - Anita Balestier
- Santé Publique France, The National Public Health Agency, 12 Rue Du Val D'Osne, Saint-Maurice Cedex, 94415, France
| | - Marie Pecheux
- Santé Publique France, The National Public Health Agency, 12 Rue Du Val D'Osne, Saint-Maurice Cedex, 94415, France
| | - Laura Chaperon
- Santé Publique France, The National Public Health Agency, 12 Rue Du Val D'Osne, Saint-Maurice Cedex, 94415, France
| | - Amivi Oleko
- Santé Publique France, The National Public Health Agency, 12 Rue Du Val D'Osne, Saint-Maurice Cedex, 94415, France
| | | | | | | | | | | | | | - Sébastien Denys
- Santé Publique France, The National Public Health Agency, 12 Rue Du Val D'Osne, Saint-Maurice Cedex, 94415, France
| | - Clémence Fillol
- Santé Publique France, The National Public Health Agency, 12 Rue Du Val D'Osne, Saint-Maurice Cedex, 94415, France
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Oleko A, Pecheux M, Saoudi A, Zeghnoun A, Hulin M, Le Barbier M, Menard C, Denys S, Fillol C. Estimation of blood lead levels in the French population using two complementary approaches: Esteban (2014-2016) as part of the human biomonitoring program and the national surveillance system for childhood lead poisoning (2015-2018). Environ Res 2022; 213:113630. [PMID: 35679905 DOI: 10.1016/j.envres.2022.113630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 06/02/2022] [Accepted: 06/04/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Used widely for centuries, lead is a common environmental pollutant. As a cumulative toxic, its presence in the body is always evidence of exposure, and health effects occur without threshold. Though regulated by European directives, lead requires close monitoring due to its environmental persistence and toxicity. METHODS The first data source was the French surveillance system for monitoring childhood lead poisoning, which records the screening results of children (-18 years), providing data on their temporal and geographical distribution, characteristics, and risk factors. The second data source was Esteban, a cross-sectional study conducted in 2014-2016 on a random sample of the French population as part of the human biomonitoring program. The Esteban lead study concerns 904 children (6-17 years) and 999 adults (18-74 years), providing data on biological samples, sociodemographic characteristics, occupational exposure, environmental and dietary factors. RESULTS The surveillance system highlighted that lead poisoning affected 10% of children screened between 2015 and 2018. The main risk factor remains housing. Esteban confirmed this observation, finding a general mean of blood lead level (BLL) at 9.9 and 18.5 μg/L for children and adults, respectively. In children, parents' occupation increased BLLs. In adults, the greatest exposure factors were smoking, age, place of residence, alcohol, bread-based products, and homegrown livestock products. In both, drinking tap water and year of housing construction increased BLLs. CONCLUSIONS The surveillance system showed a high number of children with lead poisoning despite the implementation of prevention measures, which mainly concern lead paints in old and degraded homes. To help identify children at risk, healthcare providers need to know about exposure from housing and the emerging sources identified in the Esteban survey. Despite lower BLLs, the well-known risk factors of lead exposure persist, meaning prevention efforts must continue in order to limit their impact on the population.
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Affiliation(s)
- Amivi Oleko
- Santé Publique France, French Public Health Agency, 12 Rue du Val d'Osne, 94415, Saint Maurice Cedex, France.
| | - Marie Pecheux
- Santé Publique France, French Public Health Agency, 12 Rue du Val d'Osne, 94415, Saint Maurice Cedex, France
| | - Abdesattar Saoudi
- Santé Publique France, French Public Health Agency, 12 Rue du Val d'Osne, 94415, Saint Maurice Cedex, France
| | - Abdelkrim Zeghnoun
- Santé Publique France, French Public Health Agency, 12 Rue du Val d'Osne, 94415, Saint Maurice Cedex, France
| | - Marion Hulin
- Santé Publique France, French Public Health Agency, 12 Rue du Val d'Osne, 94415, Saint Maurice Cedex, France
| | - Mélina Le Barbier
- Santé Publique France, French Public Health Agency, 12 Rue du Val d'Osne, 94415, Saint Maurice Cedex, France
| | - Céline Menard
- Santé Publique France, French Public Health Agency, 12 Rue du Val d'Osne, 94415, Saint Maurice Cedex, France
| | - Sébastien Denys
- Santé Publique France, French Public Health Agency, 12 Rue du Val d'Osne, 94415, Saint Maurice Cedex, France
| | - Clémence Fillol
- Santé Publique France, French Public Health Agency, 12 Rue du Val d'Osne, 94415, Saint Maurice Cedex, France
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Pécheux M, Saoudi A, Zeghnoun A, Oleko A, Fillol C. Assessment of multi-chemical exposure using human biomonitoring data from the French Esteban study using exposure load method. Int J Hyg Environ Health 2022; 246:114054. [DOI: 10.1016/j.ijheh.2022.114054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/10/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022]
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Dereumeaux C, Mercier F, Soulard P, Hulin M, Oleko A, Pecheux M, Fillol C, Denys S, Quenel P. Identification of pesticides exposure biomarkers for residents living close to vineyards in France. Environ Int 2022; 159:107013. [PMID: 34890902 DOI: 10.1016/j.envint.2021.107013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/29/2021] [Accepted: 11/29/2021] [Indexed: 05/12/2023]
Abstract
Biomonitoring can be relevant for assessing pesticides exposure of residents living close to vineyards (LCTV). However, because xenobiotics are generally present at low levels in human biological matrices and the sources of pesticide exposure are multiple, several challenges need to be overcome to reliably assess exposure in residents LCTV. This includes particularly identifying the most appropriate exposure biomarkers, the biological matrices in which they should be measured, and analytical methods that are sufficiently sensitive and specific to quantify them. The aim of the present study was to develop a tiered approach to identify relevant biomarkers and matrices for assessing pesticide exposure in residents LCTV. We used samples from a biobank for 121 adults and children included in a national prevalence study conducted between 2014 and 2016 who lived near or far from vineyards. We analyzed five priority pesticides (folpet, mancozeb, tebuconazole, glyphosate, and copper) and their metabolites in urine and hair samples. We identified relevant biomarkers according to three criteria related to: i) the detection frequency of those pesticides and metabolites in urine and hair, ii) the difference in concentrations depending on residence proximity to vineyards and, iii) the influence of other environmental and occupational exposure sources on pesticide levels. This tiered approach helped us to identify three relevant metabolites (two metabolites of folpet and one of tebuconazole) that were quantified in urine, tended to be higher in residents LCTV than in controls, and were not significantly influenced by occupational, dietary, or household sources of pesticide exposure. Our approach also helped us to identify the most appropriate measurement strategies (biological matrices, analytical methods) to assess pesticide exposure in residents LCTV. The approach developed here was a prerequisite step for guiding a large-scale epidemiological study aimed at comprehensively measuring pesticides exposures in French residents LCTV with a view to developing appropriate prevention strategies.
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Affiliation(s)
- Clémentine Dereumeaux
- Direction of Environmental and Occupational Health, Santé Publique France, Saint Maurice Cedex, France.
| | - Fabien Mercier
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S1085, F-35000 Rennes, France
| | - Pauline Soulard
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S1085, F-35000 Rennes, France
| | - Marion Hulin
- French Agency for Food, Environmental and Occupational Health & Safety (ANSES), 14 rue Pierre et Marie Curie, 94701 Maisons-Alfort, France
| | - Amivi Oleko
- Direction of Environmental and Occupational Health, Santé Publique France, Saint Maurice Cedex, France
| | - Marie Pecheux
- Direction of Environmental and Occupational Health, Santé Publique France, Saint Maurice Cedex, France
| | - Clémence Fillol
- Direction of Environmental and Occupational Health, Santé Publique France, Saint Maurice Cedex, France
| | - Sébastien Denys
- Direction of Environmental and Occupational Health, Santé Publique France, Saint Maurice Cedex, France
| | - Philippe Quenel
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S1085, F-35000 Rennes, France
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Hardy EM, Dereumeaux C, Guldner L, Briand O, Vandentorren S, Oleko A, Zaros C, Appenzeller BMR. Hair versus urine for the biomonitoring of pesticide exposure: Results from a pilot cohort study on pregnant women. Environ Int 2021; 152:106481. [PMID: 33706039 DOI: 10.1016/j.envint.2021.106481] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/26/2021] [Accepted: 02/20/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND/AIM The quantitative assessment of human exposure to contaminants such as pesticides is a crucial step in the characterization of exposure-associated risk. For this purpose, biomonitoring is often privileged as it presents the advantage of integrating all the possible sources and routes of exposure and of being representative of the internal dose resulting from exposure. Although biological fluids such as urine and blood have been used to date for this purpose, increasing interest has also been observed over the past decade for hair analysis. The present work aimed at comparing the information obtained from the analysis of urine versus hair regarding exposure to pesticides in a pilot cohort of pregnant women. METHODS In ninety-three pregnant women included in the pilot of the French cohort ELFE, one urine and one hair sample were collected simultaneously from each subject at the maternity. Samples were analyzed using GC-MS/MS analytical methods allowing for the detection of both parent pesticides and metabolites, and designed to be as similar as possible between urine and hair for reliable inter-matrix comparison. Fifty-two biomarkers of exposure were targeted, including parents and metabolites of organochlorines, organophosphates, pyrethroids, carbamates, phenylpyrazoles and other pesticides. RESULTS The number of different compounds detected ranged from 16 to 27 (median = 22) in hair, and from 3 to 22 (median = 12) in urine. In hair, 24 compounds were found in > 40% of the individuals, whereas only 12 compounds presented the same frequency of detection in urine. Among the chemicals detected in > 80% of both hair and urine samples, only one (pentachlorophenol) showed a signification correlation between hair and urine concentrations. CONCLUSIONS The present results highlight the multiple exposure of the pregnant women included in this cohort and suggest that hair provides more comprehensive information on pesticide exposure than urine analysis. This study thus supports the relevance of hair analysis in future epidemiological studies investigating association between exposure and adverse health effects.
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Affiliation(s)
- Emilie M Hardy
- Human Biomonitoring Research Unit, Luxembourg Institute of Health (LIH), Strassen, Luxembourg
| | | | | | - Olivier Briand
- French Ministry of Agriculture, Agrifood, and Forestry, Paris, France
| | | | - Amivi Oleko
- Santé Publique France, Saint-Maurice, France
| | - Cécile Zaros
- Institut National d'Etudes Démographiques, Aubervilliers, France
| | - Brice M R Appenzeller
- Human Biomonitoring Research Unit, Luxembourg Institute of Health (LIH), Strassen, Luxembourg.
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Fillol C, Oleko A, Saoudi A, Zeghnoun A, Balicco A, Gane J, Rambaud L, Leblanc A, Gaudreau É, Marchand P, Le Bizec B, Bouchart V, Le Gléau F, Durand G, Denys S. Exposure of the French population to bisphenols, phthalates, parabens, glycol ethers, brominated flame retardants, and perfluorinated compounds in 2014-2016: Results from the Esteban study. Environ Int 2021; 147:106340. [PMID: 33422968 DOI: 10.1016/j.envint.2020.106340] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 12/10/2020] [Accepted: 12/12/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND As part of the French Human Biomonitoring (HBM) programme, the Esteban study described, among other things, biomarkers levels of various chemicals in adults (18-74 years old) and children (6-17 years old). This paper describes the design of the study and provides, for the first time, data on the biological exposure of the general French population to a wide range of contaminants posing a threat to human health which are currently found in domestic environments. METHODS Esteban is a cross-sectional study conducted on a nationwide sample of the French general population. Exposure biomarkers of six families of contaminants deemed detrimental to adults' and children's health were measured in biological samples collected either at participants' homes by a nurse, or brought to a National Health Insurance examination centre. All participants were randomly selected (2503 adults and 1104 children). The geometric mean and percentiles of the distribution of levels were estimated for each biomarker. Most of the descriptive statistical analyses were performed taking into account the sampling design. RESULTS Results provided a nationwide description of biomarker levels. Bisphenols (A, S and F), and some metabolites of phthalates and perfluorinated compounds (PFCs) (specifically, PFOS and PFOA) were quantified in almost all the biological samples analysed. Higher levels were observed in children (except for PFCs). Levels were coherent with international studies, except for bisphenols S and F, brominated flame retardants (BFRs) and parabens (with higher levels reported in the USA than in France). CONCLUSION AND PERSPECTIVES This study is the first to provide a representative assessment of biological exposure to domestic contaminants at the French population level. Our results show that the French general population was exposed to a wide variety of pollutants in 2014-2016, and identify the determinants of exposure. These findings will be useful to stakeholders who wish to advocate an overall reduction in the French population's exposure to harmful substances. Similar future studies in France will help to measure temporal trends, and enable public policies focused on the reduction of those chemicals in the environment to be evaluated.
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Affiliation(s)
- Clémence Fillol
- Santé publique France, 12 rue du Val d'Osne, 94415 Saint Maurice Cedex, France.
| | - Amivi Oleko
- Santé publique France, 12 rue du Val d'Osne, 94415 Saint Maurice Cedex, France
| | - Abdesattar Saoudi
- Santé publique France, 12 rue du Val d'Osne, 94415 Saint Maurice Cedex, France
| | - Abdelkrim Zeghnoun
- Santé publique France, 12 rue du Val d'Osne, 94415 Saint Maurice Cedex, France
| | - Alexis Balicco
- Santé publique France, 12 rue du Val d'Osne, 94415 Saint Maurice Cedex, France
| | - Jessica Gane
- Santé publique France, 12 rue du Val d'Osne, 94415 Saint Maurice Cedex, France
| | - Loïc Rambaud
- Santé publique France, 12 rue du Val d'Osne, 94415 Saint Maurice Cedex, France
| | - Alain Leblanc
- Centre de Toxicologie du Québec (CTQ), Institut National de Santé Publique du Québec (INSPQ), Canada
| | - Éric Gaudreau
- Centre de Toxicologie du Québec (CTQ), Institut National de Santé Publique du Québec (INSPQ), Canada
| | - Philippe Marchand
- Oniris, INRAE, LABERCA Route de Gachet, Site de la Chantrerie, CS 50707, 44307 Nantes Cedex 3, France
| | - Bruno Le Bizec
- Oniris, INRAE, LABERCA Route de Gachet, Site de la Chantrerie, CS 50707, 44307 Nantes Cedex 3, France
| | - Valérie Bouchart
- LABEO, 1 Route de Rosel, Saint Contest, 14053 Caen Cedex 4, France
| | | | - Gaël Durand
- LABOCEA, 120 avenue de Rochon, CS10052, 29280 Plouzané, France
| | - Sébastien Denys
- Santé publique France, 12 rue du Val d'Osne, 94415 Saint Maurice Cedex, France
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Lailler G, Piffaretti C, Fuentes S, Nabe HD, Oleko A, Cosson E, Fosse-Edorh S. Prevalence of prediabetes and undiagnosed type 2 diabetes in France: Results from the national survey ESTEBAN, 2014-2016. Diabetes Res Clin Pract 2020; 165:108252. [PMID: 32526264 DOI: 10.1016/j.diabres.2020.108252] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 05/27/2020] [Accepted: 06/04/2020] [Indexed: 01/03/2023]
Abstract
AIM To assess the prevalence of prediabetes, undiagnosed diabetes and diagnosed diabetes in France, among adults between 2014 and 2016 using data from the nationwide Esteban survey. METHODS National cross-sectional study conducted between 2014 and 2016 in metropolitan France. Individuals aged 18 to 74 were recruited with a 3-stage geographic sampling. They completed two face-to-face interviews, filled in a self-administered questionnaire and underwent a medical examination with the collection of biological samples. Their data were linked to the National Health Data System to identify anti-diabetic drugs reimbursement. Prediabetes and undiagnosed diabetes were defined as no diagnosis of diabetes and 6.1 mmol/l ≤ Fasting Plasma Glucose (FPG) < 7.0 mmol/l for prediabetes and FPG ≥ 7.0 mmol/l for undiagnosed diabetes. Non-pharmacologically treated diabetes and pharmacologically treated diabetes were defined as self-reported diabetes without or with self-reported or reimbursed antidiabetic medication, respectively. Estimated prevalence were weighted to take into account survey design and non-response. RESULTS The ESTEBAN survey recruited 3476 adults, 2270 were included in this analysis. The weighted prevalence was 1.7% [1.1 - 2.4] for undiagnosed diabetes (men: 2.7%, women; 0.9%), 9.9% [8.3 - 11.5] for prediabetes (men: 13.2%, women: 7.0%), 5.7% [4.3 - 7.1] for diagnosed diabetes. Among the diagnosed cases, 79% were pharmacologically treated. Among all diabetes cases, 23% were undiagnosed. CONCLUSION The prevalence of undiagnosed diabetes and prediabetes is increasing in France. Our results highlight the need to increase primary prevention and reinforce secondary prevention of diabetes.
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Affiliation(s)
- Grégory Lailler
- Santé Publique France, Department of Non-Communicable Diseases and Trauma
| | - Clara Piffaretti
- Santé Publique France, Department of Non-Communicable Diseases and Trauma
| | - Sonsoles Fuentes
- Santé Publique France, Department of Non-Communicable Diseases and Trauma
| | | | - Amivi Oleko
- Santé Publique France, Department of Environmental and Occupational Health, Saint-Maurice, France
| | - Emmanuel Cosson
- Department of Diabetology, Endocrinology and Metabolism, CRNH-IdF, CINFO, Paris 13 University, Sorbonne Paris cité, Avicenne Hospital, AP-HP, 93000 Bobigny, France; UMR U1153 Inserm, U1125 Inra, Cnam, Paris 13 University, Sorbonne Paris cité, 93000 Bobigny, France
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Dereumeaux C, Saoudi A, Oleko A, Pecheux M, Vandentorren S, Fillol C, Denys S. Surveillance biologique de l’exposition des femmes enceintes françaises aux polluants de l’environnement : résultats du volet périnatal du programme national de biosurveillance mis en œuvre au sein de la cohorte Elfe. Toxicologie Analytique et Clinique 2017. [DOI: 10.1016/j.toxac.2017.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Balicco A, Oleko A, Szego E, Boschat L, Deschamps V, Saoudi A, Zeghnoun A, Fillol C. Protocole Esteban : une Étude transversale de santé sur l’environnement, la biosurveillance, l’activité physique et la nutrition (2014–2016). Toxicologie Analytique et Clinique 2017. [DOI: 10.1016/j.toxac.2017.06.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Szego E, Balicco A, Boschat L, Oleko A, Saoudi A, Zeghnoun K, Fillol C. L’étude Esteban : description de l’échantillon. Rev Epidemiol Sante Publique 2016. [DOI: 10.1016/j.respe.2016.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Oleko A, Szego E, Contreres J, Delamaire C, Fillol C, Lefranc A, Lemoisson C. L’étude Esteban – étude de santé sur l’environnement, la biosurveillance, l’activité physique et la nutrition. Rev Epidemiol Sante Publique 2013. [DOI: 10.1016/j.respe.2013.07.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Zeman F, Boudet C, Tack K, Floch Barneaud A, Brochot C, Péry A, Oleko A, Vandentorren S. Exposure assessment of phthalates in French pregnant women: Results of the ELFE pilot study. Int J Hyg Environ Health 2013; 216:271-9. [DOI: 10.1016/j.ijheh.2012.12.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Revised: 12/03/2012] [Accepted: 12/18/2012] [Indexed: 10/27/2022]
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Antignac JP, Veyrand B, Kadar H, Marchand P, Oleko A, Le Bizec B, Vandentorren S. Occurrence of perfluorinated alkylated substances in breast milk of French women and relation with socio-demographical and clinical parameters: results of the ELFE pilot study. Chemosphere 2013; 91:802-808. [PMID: 23473698 DOI: 10.1016/j.chemosphere.2013.01.088] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2012] [Revised: 01/08/2013] [Accepted: 01/19/2013] [Indexed: 05/27/2023]
Abstract
A previously developed and validated methodology based on liquid chromatography coupled to high resolution mass spectrometry was used for determine the concentration levels of 14 perfluoroalkylated substances (PFASs) in a set of 48 breast milk samples collected from French women in the frame of the ELFE pilot study. In accordance with other similar studies conducted at european and international levels, PFOS, PFOA, and PFHxS were detected and quantified in most of the analyzed samples (90%, 98% and 100%, respectively), and appeared as major contributors to the total PFAS exposure (38%, 37%, 25%, respectively), whereas the other targeted PFAS were very rarely, if not, found at the limits of detection of the method. Also in agreement with other published data, the concentration levels measured for the detected substances varied from <0.05 to 0.33μg/L for PFOS (median=0.079), from <0.05 to 0.22μg/L for PFOA (median=0.075), and from 0.04 to 0.07μg/L for PFHxS (median=0.050). On the basis of this relatively limited data set, no statistically significant relation was observed between these exposure levels and developmental outcomes, in particular the weight at birth. Similarly, no relation was observed between the measured PFAS levels and various socio-demographical parameters including the consumption of seafood, alcohol, smoking, or socio-economical level. These results suggest a need for further research and better knowledge regarding the sources, pharmacokinetics, and factors of exposure for other substances belonging to this class of emerging contaminants.
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Affiliation(s)
- Jean-Philippe Antignac
- LUNAM Université, Oniris, USC 1329 Laboratoire d'Etude des Résidus et Contaminants dans les Aliments, Nantes, France.
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Focant JF, Fréry N, Bidondo ML, Eppe G, Scholl G, Saoudi A, Oleko A, Vandentorren S. Levels of polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans and polychlorinated biphenyls in human milk from different regions of France. Sci Total Environ 2013; 452-453:155-162. [PMID: 23500409 DOI: 10.1016/j.scitotenv.2013.02.057] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 02/05/2013] [Accepted: 02/05/2013] [Indexed: 06/01/2023]
Abstract
We report on the pilot study carried out before the start of the Elfe project (French longitudinal study from childhood). A total of 44 samples of mature human milk were collected at home 8 weeks after delivery. A total of 7 polychlorinated dibenzo-p-dioxins (PCDDs), 10 polychlorinated dibenzofurans (PCDFs), 12 dioxin-like (DL) polychlorinated biphenyls (PCBs), and 6 non dioxin-like (NDL)-PCBs were measured. For total TEQ (PCDD/Fs and DL-PCBs), the geometric mean concentration was 17.81 pg TEQ(WHO05)/g lipids. Relative PCDD, PCDF, and DL-PCB contributions to the arithmetic mean TEQ(WHO05) were 38%, 18%, and 44%, respectively. The use of TEF(WHO05) instead of TEF(WHO98) resulted in a 27% reduction of the total TEQ value. Although PCDD levels did not significantly change (less than 0.5% increase), PCDF and DL-PCB levels both decreased by 35% and 38%, respectively. Levels have been compared to data obtained during a previous non-reported national study conducted in 1998 (TEF(WHO98)) in French lactaria (n=244). The mean of PCDD/Fs has decreased about 39.4% (18.8 pg TEQ(WHO98)/g lipids in 1998 vs 11.4 pg TEQ(WHO98)/g lipids in pilot study), respectively 41.5% for PCDDs (10.6 pg TEQ(WHO98)/g lipids in 1998 vs 6.2 pg TEQ(WHO98)/g lipids in pilot study) and 36.7% for PCDFs (7.9 pg TEQ(WHO98)/g lipids in 1998 vs 5.0 pg TEQ(WHO98)/g lipids in pilot study). For the sum of the 6 NDL-PCBs, the 2007 geometric mean concentration in milk was 176.3 ng/g lipids. The arithmetic mean lipid concentration in 2007 breast milk was 26.4 g/l (range from 6.0 to 46.7 g/l). A PCDD/F and DL-PCB daily intake was estimated to be 62.3 pg TEQ(WHO05)/kg body weight per day (85.0 pg TEQ(WHO98)/kg body weight per day) for a baby of 5 kg of body weight fed daily with 700 ml of maternal milk containing 25 g/l of lipids.
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Affiliation(s)
- Jean-François Focant
- CART Mass Spectrometry Laboratory, Organic and Biological Analytical Chemistry, Chemistry Department, University of Liège, Sart-Tilman, B-4000 Liège, Belgium.
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Vernay M, Sponga M, Salanave B, Oleko A, Deschamps V, Malon A, Castetbon K. O62 Statut en vitamine D de la population adulte en France : l’étude nationale nutrition santé (ENNS, 2006–2007). NUTR CLIN METAB 2011. [DOI: 10.1016/s0985-0562(11)70066-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Oleko A, Betsou F, Sarter H, Gerdil C, Desbois I, Charles MA, Leridon H, Vandentorren S. A Pilot Study of the ELFE Longitudinal Cohort: Feasibility and Preliminary Evaluation of Biological Collection. Biopreserv Biobank 2011; 9:223-227. [PMID: 21977239 DOI: 10.1089/bio.2010.0032] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Accepted: 03/27/2010] [Indexed: 01/06/2023] Open
Abstract
Etude Longitudinale Française depuis l'Enfance (ELFE) will be a national French cohort of 20,000 children followed from birth to adulthood. Biological samples will be taken at birth to evaluate the fetal exposition to several substances. A pilot study was carried out in October 2007 to test the preanalytical factors that affected sample quality. A variety of fractions were collected by the midwife after delivery from different blood collection tubes. Options in the collection process were 2 daily transports of samples, centralized and standardized processing methodology, and storage of multiple aliquots in liquid nitrogen or at -80°C. We analyzed preanalytical factors that could have affected coagulation and then soluble CD40 Ligand (sCD40L) as a quality control tool for serum quality. Cord blood and urine were collected from 82% and 84% of women, respectively, who agreed to be followed up in the ELFE project. The use of syringe was the main factor correlated with coagulation (relative risk: 2.79 [1.47; 5.31], P<0.01). Maternity unit status was also associated with coagulation (RR: 1.48 [1.03; 2.13] in a private maternity unit vs. a public maternity) as well as time between collection and centrifugation (RR 1.03 [1; 1.07] when time between collection and centrifugation increases from 1 h). There were no extremely low sCD40L values indicating extreme exposures to room temperatures. This first evaluation study allowed us to stress the importance of carefully recording all potentially critical preanalytical variables that might be used at a large-scale level.
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Vandentorren S, Zeman F, Morin L, Sarter H, Bidondo ML, Oleko A, Leridon H. Bisphenol-A and phthalates contamination of urine samples by catheters in the Elfe pilot study: implications for large-scale biomonitoring studies. Environ Res 2011; 111:761-764. [PMID: 21684541 DOI: 10.1016/j.envres.2011.05.018] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2010] [Revised: 05/09/2011] [Accepted: 05/26/2011] [Indexed: 05/30/2023]
Abstract
Exposure to phthalates and Bisphenol A could cause developmental and reproductive toxicity. This study provides a first assessment of these exposures for more than 250 French pregnant women. The median concentrations of total and free Bisphenol A in urine were similar to those in other studies except the highest concentrations (5% of women had total and free Bisphenol A >50μg/L). Our study highlights high levels of Di-(2-ethylhexyl)-phthalate metabolites in pregnant women, suggesting recent exposure, probably in hospital. Differences between types of delivery (caesarean vs. natural) support this hypothesis. This is a significant implication for large-scale biomonitoring studies among this population.
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Castetbon K, Méjean C, Deschamps V, Bellin-Lestienne C, Oleko A, Darmon N, Hercberg S. Dietary behaviour and nutritional status in underprivileged people using food aid (ABENA study, 2004-2005). J Hum Nutr Diet 2011; 24:560-71. [DOI: 10.1111/j.1365-277x.2011.01158.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bonaldi C, Vernay M, Roudier C, Salanave B, Oleko A, Malon A, Castetbon K, Fagot-Campagna A. A first national prevalence estimate of diagnosed and undiagnosed diabetes in France in 18- to 74-year-old individuals: the French Nutrition and Health Survey 2006/2007. Diabet Med 2011; 28:583-9. [PMID: 21294766 DOI: 10.1111/j.1464-5491.2011.03250.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To estimate the nationwide prevalence of diagnosed and undiagnosed diabetes and pre-diabetes in adults residing in France. METHODS A probability sample of a non-institutionalized civilian population residing throughout the whole of continental France was recruited from February 2006 to March 2007 for the French Nutrition and Health Survey. All individuals aged between 18 and 74 years who agreed to participate in the survey were included; thus there were 3115 participants, 2102 of whom were undergoing biochemical assessments. The prevalence of diagnosed diabetes was estimated using self-reported diabetes history and the prevalence of undiagnosed diabetes was estimated using fasting plasma glucose ≥ 7.0 mmol/l or HbA(1c) ≥ 6.5% (≥ 48 mmol/mol). RESULTS The prevalence of diagnosed diabetes was 4.6%, 95% CI 3.6-5.7. The prevalence of undiagnosed diabetes according to standard fasting plasma glucose criteria was 1% (95% CI 0.6-1.7) and contributed to less than 20% of all cases of diabetes. This proportion decreased with age from 30% in 30- to 54-year-olds to 12% in 55- to 74-year-olds. Based on HbA(1c) criteria, the prevalence of undiagnosed diabetes was 0.8% (95% CI 0.4-1.6). CONCLUSIONS The prevalence of diagnosed diabetes in adults in France is comparable with recent estimates from Northern Europe. The percentage of total diabetes that is undiagnosed is low in France, which may be explained by a widely practised strategy of opportunist screening. During the past years, improvements in diabetes care and increased awareness may have contributed towards decreasing the prevalence of undiagnosed diabetes more widely in Europe, and studies should further monitor such improvements.
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Affiliation(s)
- C Bonaldi
- Department of Chronic Diseases and Injuries, French Institute for Public Health Surveillance, Saint Maurice, France.
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Méjean C, Deschamps V, Bellin-Lestienne C, Oleko A, Darmon N, Hercberg S, Castetbon K. Sociodemographic and economic determinants of overweight and obesity in female food-aid users in France (the ABENA study 2004-2005). Prev Med 2010; 51:517-8. [PMID: 20851140 DOI: 10.1016/j.ypmed.2010.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2010] [Revised: 09/08/2010] [Accepted: 09/09/2010] [Indexed: 11/28/2022]
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Méjean C, Deschamps V, Bellin-Lestienne C, Oleko A, Darmon N, Hercberg S, Castetbon K. Erratum: Associations of socioeconomic factors with inadequate dietary intake in food aid users in France (The ABENA study 2004–2005). Eur J Clin Nutr 2010. [DOI: 10.1038/ejcn.2010.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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