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The role of the research epidemiologist in responding to an environmental alert Volume 12, issue 4, Juillet-Août 2013

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EHESP Rennes, Sorbonne Paris Cité EHESP Département épidémiologie et biostatistiques Hôpital Broussais, Bâtiment Leriche 96, rue Didot 75014 Paris France, IRIS UMR 8156-997 Université Paris-13 UFR SMBH 74, rue Marcel Cachin 93017 Bobigny Cedex France, Giscop93 Université Paris-13 UFR SMBH 74, rue Marcel Cachin 93017 Bobigny Cedex France

Following the 1998 report of a case of mesothelioma in the neighborhood of a former asbestos-milling plant, various investigations took place from 2005 through 2012. From an epidemiological perspective, these allowed us to describe a cluster of 11 cases of asbestos-specific diseases associated with essentially environmental exposure (living or going to school near the site). They also demonstrated the multiplicity of exposure circumstances, from environmental to occupational and para-occupational (domestic or “take-home”). The size of the population exposed at the threshold of 10 F/l might reach 32 000 people, and that counts only the residents during a single census year (1975), more than 23 000 of whom might still have been alive in 2009. The analysis highlights the importance, but also the difficulties, of integrating field expertise into institutional science. We also underline the complementarity between the quantitative approaches of the epidemiologist and the qualitative viewpoint and tools of the historian and the sociologist. Together they can put isolated numbers into context and flesh on their bones, so to speak, thereby supporting the implementation of a public health program and taking into account the diversity of the social and sanitary issues. The intersection between health democracy and translational research based on mixed methods thus seems crucial to environmental health issues.