Ellen Imbernon

Institut de veille sanitaire, Charenton, Île-de-France, France

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Publications (142)235.65 Total impact

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    ABSTRACT: Two years after the 2001 Toulouse industrial disaster, a longitudinal study was set up to evaluate the impact of the disaster. The current substudy examines the medium-term impact (5 years) the incident had on the mental health of 3,004 participants. As part of the monitoring, data relating to the psychotropic drug use of 2,494 participants were collected from administrative databases 4 years after the disaster. Use of psychotropics was higher among women for anxiolytics (10.4% for men and 15.0% for women), hypnotics (10.5% and 17.0%), and antidepressants (7.6% and 11.2%). Exposure to the disaster, especially proximity to the exposure, was significantly associated with the use of antidepressants in men, OR = 3.22, 95% CI[1.57, 6.61]. This was also the case for other exposure factors (saw dead or injury, injured, home damage, death or injury loved one, psychological disorders, exposure toxic fumes): range of OR 1.75 to 2.52 in men, 1.48 to 1.62 in women. In conclusion, this study highlights the medium-term psychological impact of an industrial disaster on psychotropic drug use and the potential for using medical records data as a means for tracking postdisaster mental health.Resumen2 años después del desastre industrial ocurrido en Toulouse en 2001, se implementó un estudio longitudinal, para evaluar su impacto. El estudio actual examina el efecto psicológico a un mediano plazo (5 años), que tuvo este incidente en 3.004 participantes. Como parte del monitoreo, se recopiló la información sobre el uso de medicamentos psicotrópicos en un total final de 2.494 participantes, desde la base de datos administrativos, 4 años después del desastre. El uso de psicotrópicos fue mayor en mujeres, para ansiolíticos (10,4% en hombres & 15% en mujeres), hipnóticos (10,5% y 17%) y antidepresivos (7,6% y 11,2%). La exposición al desastre, especialmente la cercanía a la exposición se asoció significativamente al uso de antidepresivos en hombres (odds ratio: 3.22, 95% intervalo de confianza []). Lo mismo ocurrió con otros factores de exposición (visión de muerte o heridas, daño de sus hogares, muerte o daño de sus seres queridos, trastornos psicológicos, exposición a gases tóxicos: rango de OR: 1,75 a 2,52 en hombres y 1.48 a 1.62 en mujeres). En conclusión este estudio refleja el impacto psicológico a un mediano plazo del desastre industrial tales como el uso de medicamentos psicotrópicos y el potencial del uso del registro de la información médica como recurso para el seguimiento de la salud mental posterior al desastre.Traditional and Simplified Chinese Abstracts by AsianSTSS標題:法國工業災難四年後一批工人的精神科藥物使用情況撮要:2001年圖盧茲工業災難事件的兩年後,一個縱向研究評估災難的影響。現在的子研究檢視3004名參與者的精神健康在事件後的中期影響(即五年後)。監測最後餘下的2494名參與者的情況,我們在災難四年後從行政數據中搜集參與者的精神藥物使用數字。其中女士使用精神藥物的情況較嚴重,包括抗焦慮藥(男士為10.4% 而女士15%),安眠藥(10.5%和17%)及抗抑鬱藥(7.6%和11.2%)。災難經歷,尤其是近距離接觸,與男士使用抗抑鬱藥有顯著關係(比值比=3.22, 95%置信區間﹝1.57, 6.61﹞)。這點亦在其他經歷因素中出現(目睹死亡或受傷、受了傷、家居毀壞、親人死亡或受傷、心理疾病、毒氣經歷:OR區間是男人1.75至2.52,女1.48至1.62)。結論是:本研究突顯工業災難後的中期心理影響,其中有精神藥物使用和利用病歷記錄來試圖追踪創傷後精神健康。标题:法国工业灾难四年后一批工人的精神科药物使用情况撮要:2001年图卢兹工业灾难事件的两年后,一个纵向研究评估灾难的影响。现在的子研究检视3004名参与者的精神健康在事件后的中期影响(即五年后)。监测最后余下的2494名参与者的情况,我们在灾难四年后从行政数据中搜集参与者的精神药物使用数字。其中女士使用精神药物的情况较严重,包括抗焦虑药(男士为10.4% 而女士15%),安眠药(10.5%和17%)及抗抑郁药(7.6%和11.2%)。灾难经历,尤其是近距离接触,与男士使用抗抑郁药有显著关系(比值比=3.22, 95%置信区间﹝1.57, 6.61﹞)。这点亦在其他经历因素中出现(目睹死亡或受伤、受了伤、家居毁坏、亲人死亡或受伤、心理疾病、毒气经历:OR区间是男人1.75至2.52,女1.48至1.62)。结论是:本研究突显工业灾难后的中期心理影响,其中有精神药物使用和利用病历记录来试图追踪创伤后精神健康。
    Journal of Traumatic Stress 08/2014; 27(4). · 2.72 Impact Factor
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    ABSTRACT: An excessive risk of suicide among agriculture workers has been observed in several studies in France and abroad. Accordingly, French Institute for Public Health Surveillance and Social Insurance in agriculture sector launched collaboration with aim at producing indicators of suicide mortality among agriculture workers population on a regular basis.
    Occupational and environmental medicine. 06/2014; 71 Suppl 1:A18.
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    ABSTRACT: To estimate prevalence and risk of current asthma among affiliates to the health insurance for self-employed workers according to economic activities.
    Occupational and Environmental Medicine 06/2014; 71 Suppl 1:A19. · 3.22 Impact Factor
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    ABSTRACT: Objective: To examine the incidence and risk factors for incident thoracic spine pain (TSP) in workers representative of a French region's working population.Methods: Prospective study: 3,710 workers were assessed in 2002-2005, and 2,332 (62.9%) of them were re-assessed in 2007-2010. TSP was assessed by a self-administered Nordic questionnaire at baseline and at follow-up. At baseline all participants completed a self-administered questionnaire on personal factors and work exposure. A total of 1,886 subjects (1,124 men and 762 women) without TSP at baseline were eligible for analysis. Associations between incident TSP and risk factors at baseline were analyzed by multivariate logistic regression.Results: The incidence rate of TSP was 5.2% [95% CI 3.9-6.6]) per 100 males and 10.0 [7.8-12.1] per 100 females. TSP was often associated with low back pain and neck pain. TSP in men was associated with age (ORs ranging from 2.6 [0.95–7.1] at 30-49 years to 6.0 [2.1 –17.3] at 50 years and over), being tall (OR 2.2 [1.2-3.9]), frequent/sustained trunk bending (OR 3.0 [1.5- 6.1]), lack of recovery period or change in the task (OR 2.0 [1.2-3.6]) and driving vehicles (OR 2.8 [1.4-5.5]). Being overweight and obesity were associated with lower risk (OR 0.5 [0.3-0.96]). TSP in women was associated with high perceived physical workload (OR 1.9 [1.1-3.3]), after adjustment for confounding variables.Conclusion: The risk model of TSP combined personal and work-related organizational and physical factors. Trunk bending appeared to be a strong independent predictor of TSP in this working population. © 2014 American College of Rheumatology.
    Arthritis Care & Research. 03/2014;
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    ABSTRACT: The aim of the study was to assess both personal and occupational risk factors for non-specific neck disorder (ND) in a representative working population characterized by various levels of exposure to work-related constraints. ND during the preceding 7 days was assessed in 3,710 workers surveyed by 83 occupational physicians between 2002 and 2005. Personal risk factors and work exposure were assessed by a standardized examination and a self-administered questionnaire. Associations between ND and personal and occupational factors were analyzed using logistic regression modeling separately in men and in women. Results: The personal risk factors for ND were age (OR for 1-year increment 1.02, 95% CI 1.01 to 1.03 in men and 1.03 [1.01-1.04] in women) and previous history of arthritis disease (OR 2.39 [1.17-4.91] in men and 3.95 [1.92-8.12] in women). The risk of ND increased with previous history or upper limb musculoskeletal disorders in men (OR 1.58 [1.17-2.13]) and decreased with BMI in women (OR for 1-kg/m2 increment 0.96, [0.93-0.99]). The work-related risk factors of ND were sustained or repeated arm abduction (OR 2.08 [1.35-3.21] in men and 2.22 [1.27-3.86] in women) and neck flexion (OR 1.64 [1.26-2.12] in women). Work pace dependent on customers (OR 1.42 [1.10-1.83]) and psychological demand of the task (OR 1.49 [1.15-1.92]) increased the risk of ND in men. Work pace dependent on quantified targets (OR 1.37 [1.05-1.79]) and low supervisor support (OR 1.68 [1.30-2.17]) increased the risk of ND in women. This study highlighted the multifactorial nature of ND.
    Journal of Occupational Health 02/2014; · 1.63 Impact Factor
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    ABSTRACT: To estimate the proportion of pleural mesothelioma cases that can be attributed to asbestos exposure in France including non-occupational exposure. A population-based case-control study including 437 incident cases and 874 controls was conducted from 1998 to 2002. Occupational and non-occupational asbestos exposure was assessed retrospectively by two expert hygienists. ORs of pleural mesothelioma for asbestos-exposed subjects compared to non-exposed subjects, and population-attributable risk (ARp) of asbestos exposure were estimated using a conditional logistic regression. A clear dose-response relationship was observed between occupational asbestos exposure and pleural mesothelioma (OR=4.0 (99% CI 1.9 to 8.3) for men exposed at less than 0.1 f/mL-year vs 67.0 (99% CI 25.6 to 175.1) for men exposed at more than 10 f/mL-year). The occupational asbestos ARp was 83.1% (99% CI 74.5% to 91.7%) for men and 41.7% (99% CI 25.3% to 58.0%) for women. A higher risk of pleural mesothelioma was observed in subjects non-occupationally exposed to asbestos compared to those never exposed. The non-occupational asbestos ARp for these subjects was 20.0% (99% CI -33.5% to 73.5%) in men and 38.7% (99% CI 8.4% to 69.0%) in women. When considering all kinds of asbestos exposure, ARp was 87.3% (99% CI 78.9% to 95.7%) for men and 64.8% (99% CI 45.4% to 84.3%) for women. Our study suggests that the overall ARp in women is largely driven by non-occupational asbestos exposure arguing for the strong impact of such exposure in pleural mesothelioma occurrence. Considering the difficulty in assessing domestic or environmental asbestos exposure, this could explain the observed difference in ARp between men and women.
    Thorax 02/2014; · 8.38 Impact Factor
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    ABSTRACT: Mesothelioma is a rare disease less than 0.3% of cancers in France, very aggressive and resistant to the majority of conventional therapies. Asbestos exposure is nearly the only recognized cause of mesothelioma in men observed in 80% of case. In 1990, the projections based on mortality predicted a raise of incidence in mesothelioma for the next three decades. Nowadays, the diagnosis of this cancer is based on pathology, but the histological presentation frequently heterogeneous, is responsible for numerous pitfalls and major problems of early detection toward effective therapy. Facing such a diagnostic, epidemiological and medico-legal context, a national and international multidisciplinary network has been progressively set up in order to answer to epidemiological survey, translational or academic research questions. Moreover, in response to the action of the French Cancer Program (action 23.1) a network of pathologists was organized for expert pathological second opinion using a standardized procedure of certification for mesothelioma diagnosis. We describe the network organization and show the results during this last 15years period of time from 1998-2013. These results show the major impact on patient's management, and confirm the interest of this second opinion to provide accuracy of epidemiological data, quality of medico-legal acknowledgement and accuracy of clinical diagnostic for the benefit of patients. We also show the impact of these collaborative efforts for creating a high quality clinicobiological, epidemiological and therapeutic data collection for improvement of the knowledge of this dramatic disease.
    Annales de Pathologie 02/2014; 34(1):51-63. · 0.24 Impact Factor
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    ABSTRACT: This study was designed to describe the difficulties of epidemiological follow-up of employees by occupational health services.
    Santé publique (Vandoeuvre-lès-Nancy, France). 01/2014; 26(1):33-43.
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    ABSTRACT: Organizational downsizing has become highly common during the global recession of the late 2000s with severe repercussions on employment. We examine whether the severity of the downsizing process is associated with a greater likelihood of depressive symptoms among displaced workers, internally redeployed workers and lay-off survivors.
    PLoS ONE 01/2014; 9(5):e97063. · 3.53 Impact Factor
  • Archives des Maladies Professionnelles et de l Environnement 12/2013; 74(6):670. · 0.22 Impact Factor
  • Archives des Maladies Professionnelles et de l Environnement 12/2013; 74(6):664. · 0.22 Impact Factor
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    ABSTRACT: In 2003, a cluster of renal cell carcinoma (RCC) cases was reported among men working at a French chemical plant using a proprietary process to produce vitamin A. The 10 index cases yielded a standardised incidence ratio of 13.1 for 1994-2002. Nine of these 10 cases were diagnosed by a plant-specific abdominal ultrasonography screening programme that targeted exposure to an intermediate chemical, 4-chloro-1,1-dimethoxy-3-methyl-2-butene, commonly named 'chloracetal C5', suspected as the cause by some experts. Epidemiological investigations sought to examine the relations between occupational exposures and RCC. A retrospective cohort mortality study and a nested case-control study were conducted. The cohort study included all workers who had been employed at the plant for at least 6 months between 1960 and 2003. The case-control study included an extensive search within the region for other kidney cancer cases among the cohort members. Industrial hygienists assessed occupational exposure. From 1968 to 2006, no significant excess mortality was observed for all causes of death or for all cancers. We found excess mortality for kidney cancer only among women. The nested case-control study showed a dose-response relation for cumulative exposure to chloracetal C5: the OR rose from 2.5 in the low-exposure category to 10.5 in the high-exposure group. Adjustment for screening attenuated this relation. The results of the case-control study were consistent with the positive results of in vivo genotoxic tests and suggest that chloracetal C5 can have a causal role in RCC.
    Occupational and environmental medicine 08/2013; · 3.64 Impact Factor
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    ABSTRACT: More than 80% of mesothelioma cases in men are attributable to occupational asbestos exposure compared to only 40% in women. The objective of the study was to characterize a series of female pleural mesotheliomas according to known and suspected risk factors. From the exhaustive recording of 318 female mesothelioma cases in the French National Mesothelioma Surveillance Program between 1998 and 2009, multiple correspondence analysis and hybrid clustering were performed to characterize these cases according to expert assessed occupational and non-occupational exposure to asbestos and man-made vitreous fibers, X-ray exposure, and history of cancer and non-malignant respiratory diseases. Four clusters were identified: (1) occupational exposure to asbestos and man-made vitreous fibers (7.9% of subjects); (2) radiation exposure during radiotherapy (12.9%); (3) increased asbestos exposure (19.8%); and (4) "non-exposure" characteristics (59.4%). These results will allow hypotheses to be generated about associations between mesothelioma and non-occupational asbestos exposure, X-ray exposure and history of respiratory disease. Am. J. Ind. Med. © 2013 Wiley Periodicals, Inc.
    American Journal of Industrial Medicine 08/2013; · 1.97 Impact Factor
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    ABSTRACT: Despite the lack of data on the human health potential risks related to the engineered nanomaterials (ENM) exposure, ENM handling spreads in industry. The French government officially charged the InVS to develop an epidemiological surveillance of workers occupationally exposed to ENM. An initial surveillance plan was proposed on the basis of literature review and discussions with national and international ENM and occupational safety and health (OSH) experts. In site investigations and technical visits were then carried out to build an adequate surveillance system and to assess its feasibility. The current plan consists of a multi-step methodology where exposure registry construction is paramount. Workers potentially exposed to carbon nanotubes (CNT) or nanometric titanium dioxide (TiO2) will be identified using a 3-level approach: 1-identification and selection of companies concerned with ENM exposure (based on compulsory declaration and questionnaires), 2-in site exposure assessment and identification of the jobs/tasks with ENM exposure (based on job-expose matrix, further supplemented with measurements), and 3-identification of workers concerned. Data of interest will be collected by questionnaire. Companies and workers inclusion questionnaires are designed and currently under validation. This registration is at the moment planned for three years but could be extended and include other ENM. A prospective cohort study will be established from this registry, to pursue surveillance objectives and serve as an infrastructure for performing epidemiological and panel studies with specific research objectives.
    Journal of Physics Conference Series 04/2013; 429(1):2066-.
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    ABSTRACT: RATIONALE: Occupational co-exposure to asbestos and other fibers or particles could modify the carcinogenicity of asbestos with regard to pleural mesothelioma. OBJECTIVES: To estimate associations between pleural mesothelioma and occupational mineral wool and silica exposure and to study the impact of occupational co-exposure on the risk of pleural mesothelioma. METHODS: 1,199 male cases and 2,379 controls were included in a French pooled case-control study. Complete job histories were collected and occupational exposure to asbestos, mineral wool (MW), and silica were assessed by three French job exposure matrices. Unconditional logistic regression models adjusted for age, birth date, and occupational asbestos exposure were used to estimate odds ratios (OR) and 95% confidence intervals. MEASUREMENTS AND MAIN RESULTS: A significant association between mesothelioma and MW exposure was observed after adjustment for occupational asbestos exposure. OR for subjects exposed to less than 0.01 f/ml-y was 1.6 (95% CI: 1.2-2.1) and increased to 2.5 (95% CI: 1.8-3.4) for subjects exposed to more than 0.32 f/ml-y. All ORs for silica exposure were around the null. Co-exposure to either asbestos and MW or asbestos and silica seemed to increase the risk of pleural mesothelioma. ORs were 17.6 (95% CI: 11.8-26.2) and 9.8 (95% CI: 4.2-23.2) for subjects exposed to both asbestos and MW and for subjects exposed to both asbestos and silica, respectively, compared to 4.3 (95% CI: 1.9-9.8) for occupational asbestos exposure alone. CONCLUSION: Our results are in favour of an increased risk of pleural mesothelioma for subjects exposed to both asbestos and MW or asbestos and silica.
    American Journal of Respiratory and Critical Care Medicine 03/2013; · 11.04 Impact Factor
  • Archives des Maladies Professionnelles et de l'Environnement. 11/2012; 73(5):729.
  • Archives des Maladies Professionnelles et de l Environnement 11/2012; 73(5):714–715. · 0.22 Impact Factor
  • Archives des Maladies Professionnelles et de l'Environnement. 11/2012; 73(5):715–716.
  • Archives des Maladies Professionnelles et de l'Environnement. 11/2012; 73(5):720.
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    ABSTRACT: BACKGROUND: The aim of this study was to determine the rates of compensation awarded to patients presenting with pleural mesothelioma and factors linked to such compensation in France. METHODS: The study population consisted of 2,407 patients presenting with pleural mesothelioma, recorded by the National Mesothelioma Surveillance Programme between January 1, 1999 and December 31, 2009. Analysis of claims for recognition as "occupational disease" (OD) and claims for compensation by the Compensation Fund for Asbestos Victims (FIVA) were analyzed. RESULTS: Approximately 30% of subjects presenting with pleural mesothelioma, affiliated to the General National Health Insurance fund, neither sought recognition as an OD nor claimed for FIVA compensation. Gender, age at diagnosis, type of health insurance, and socio-professional category influence the likelihood of patients presenting with mesothelioma seeking compensation for this disease. CONCLUSIONS: Results show an under-compensation of pleural mesothelioma as OD and by the FIVA in France. Am. J. Ind. Med. © 2012 Wiley Periodicals, Inc.
    American Journal of Industrial Medicine 08/2012; · 1.97 Impact Factor

Publication Stats

938 Citations
235.65 Total Impact Points


  • 2003–2014
    • Institut de veille sanitaire
      • Department of Occupational Health
      Charenton, Île-de-France, France
  • 2010–2013
    • Université Victor Segalen Bordeaux 2
      • Institut de Santé Publique d'Epidémiologie et de Développement (ISPED)
      Bordeaux, Aquitaine, France
  • 2012
    • Université de Versailles Saint-Quentin
      • Centre de Recherche en Épidémiologie et Santé des Populations (CESP)
      Versailles, Île-de-France, France
    • L'Université Nantes Angers Le Mans
      Naoned, Pays de la Loire, France
  • 2006–2012
    • Centre Hospitalier Universitaire d'Angers
      Angers, Pays de la Loire, France
  • 2011
    • Institut National du Cancer
      Billancourt, Île-de-France, France
    • Agence Régionale de Santé (ARS)
      Lutetia Parisorum, Île-de-France, France
  • 2008–2011
    • University of Angers
      • Laboratoire d'Ergonomie et d'Épidémiologie en Santé au Travail
      Angers, Pays de la Loire, France
  • 2009–2010
    • Claude Bernard University Lyon 1
      • Unité mixte de recherche epidémiologique et de surveillance transport travail environnement
      Villeurbanne, Rhone-Alpes, France
  • 2007–2010
    • Assistance Publique – Hôpitaux de Paris
      Lutetia Parisorum, Île-de-France, France
    • Centre Hospitalier Universitaire de Caen
      Caen, Lower Normandy, France
  • 2008–2009
    • Centre Hospitalier Universitaire de Nice
      Nice, Provence-Alpes-Côte d'Azur, France
  • 1996–2006
    • French Institute of Health and Medical Research
      • Center for Research in Epidemiology and Population Health CESP
      Lutetia Parisorum, Île-de-France, France
  • 1993–2002
    • Électricité de France (EDF)
      Lutetia Parisorum, Île-de-France, France
  • 2001
    • Unité Inserm U1077
      Caen, Lower Normandy, France