Laboratoire d’étude et de recherche en santé publique
Avenue du Pr Léon Bernard
35043 Rennes cedex
CHU de Rouen
Département de biostatistiques
France, SEPIA-Sante, Baud, Cire Océan Indien
InVS de la Réunion
It is increasingly suspected that the health impact of air pollution may be greater among socioeconomically disadvantaged populations than among those who are better off. However, health impact assessments of air pollution generally do not take socioeconomic status into account. In this paper, we propose an approach to the quantitative estimation of the short-term impacts of environmental risk factors such as air pollution among socioeconomically contrasted populations. We do so through an illustrative case study of ambient air pollution and emergency calls for asthma attacks in Strasbourg (France). Next, we discuss the potential advantages of this approach as well as its current limitations, and then look at the research needs that must be addressed to improve its applicability. Among these, the most urgent appear to be the needs for improved exposure estimates and for large-scale epidemiological studies that use harmonized methods to investigate the modification by socioeconomic status and other factors of the effects of air pollution. Case-crossover designs offer promising perspectives for that purpose, especially as more accurate and individualized estimates of air pollution exposure become available for epidemiological studies.