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 Printable version |
Environmental threats to public health and warning systems: Conceptualization and stakes |
Environnement, Risques & Santé. Volume 11, Number 6, 493-501, Novembre-Décembre 2012, Article original
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 Résumé
Article gratuit
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Author(s) : Julie Micheau, Frédéric Dor, Ricardo de Gainza, Christine A. Romana |
Summary : In 2009, the French Institute for Public Health Surveillance, a major actor in health alerts, listed 106 environmental threats to public health. The aim of this article is to extend this census by identifying the warning systems that exist in environmental health, to describe their functions, their structure, their organizational methods and finally their utility for the stakeholders. This study, based initially on a consultation of the websites of the principal countries working in this field and interviews with those managing them (industries, public authorities, associations, etc), enabled us to conduct an analysis aimed at illuminating the often polysemic concepts of threat, surveillance/monitoring and alert/warning. It provides avenues for understanding the similarities of surveillance and warning systems developed throughout the world. By modeling this system, we produced a classification useful for understanding the stakes of public action. The control theory of engineering science suggests that these systems can be modeled as loops that command environmental or health status by control mechanisms fed by measurements of environmental or health indicators. This generic representation is completed by the concept of temporality, which distinguishes the immediate reaction from delayed action and the immediate variability from that distant from the event. It is not easy to interpret surveillance system results, especially because of the difficulty in identifying the attributable risk fraction for one or more given agents. This theoretical model, by distinguishing known from unknown threats and chronic from acute exposure, allows a better analysis of the ways of monitoring environmental health and of designing warning systems for action. Three categories were identified: environmental surveillance for health purposes, specific health surveillance in environmental health and generic health surveillance. Two perspectives can be mentioned. The first is based on an approach that integrates environmental and health indicators for a detailed identification of risks. The second aims at ranking exposure situations by risk level. |
Keywords : environmental threat, surveillance, warning system |
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