Perceptible and known effects on populations: links between Exposome and diseases
THE FAM WOULD LIKE TO THANK THE HUNDREDS OF PEOPLE WHO ATTENDED THE DEBATE ONLINE.
NONE OF THIS WOULD HAVE BEEN POSSIBLE WITHOUT ITS SPEAKERS, PATRONS AND PARTNERS.
In creating its Foundation, the French Academy of Medicine wished to put at the service of society as a whole its unique capacity to bring together, on essential health and social issues and around the best French and international experts, all the political, medical, scientific, economic and associative stakeholders. To fulfil its mission, the Foundation of the French Academy of Medicine (FAM) has chosen to organise debates open to the public and the media and directly relayed to the public authorities, based on excellent scientific publications or communications. In addition to their level, these debates are distinguished from other events of the same type by the benefit of the institutional status and the guarantees of credibility and ethics which are recognised to the French Academy of Medicine.
After its first cycle of debates on the theme of “Society and Ageing”, two others are underway on the themes of “Food today and tomorrow” and “Exposure to chemical pollution – Exposome and public health”.
The subject of human exposure to mixtures of chemical contaminants is wide-ranging, of major health importance and is becoming increasingly complex, as illustrated by the case of pollutants with endocrine-disrupting effects. This pollution is sometimes visible, as in the case of smog in large megacities (Beijing, New Delhi, etc.), or invisible, as in the case of pesticides, plasticisers or solvents in the environment, drinking water or food.
The effects of this pollution on health (cancers, infertility, cognitive disorders, diabetes, obesity) and the associated economic impacts are increasingly well quantified. For the European Union, the annual cost of the impact of endocrine disruptors has been estimated at around 157 billion euros*.
Considerable work is still required to better quantify the risk resulting from the combination of the presence of a hazard, its effects and the exposure of populations.
There is a great deal of ambition to better assess exposures and quantify risks, particularly at European level. The aim is to establish the notion of Exposome in the sense of the totality of an individual’s exposure leading to effects often in the medium or long term.
Thanks to the expected progress, the aim is to identify the agents, situations and populations at risk in order to construct health prevention policies.
This cycle will allow the audience to better understand the complex issue of the Exposome, its ambitions and the major associated health issues. The proceedings of these debates will be presented to the French National Assembly.
Session II – Links between Exposome and diseases, perceptible and known effects on populations
Exposure of populations to mixtures of chemical contaminants, particularly through air, food, beverages and skin contact, occurs throughout life. Major scientific progress has allowed us to better identify the nature of chemical agents and to better understand their pathways, their targets of action and their effects on human health. Today, 4 main types of pathologies associated with multiple exposures to chemical contaminants are noted :
1. “Hormone-dependent diseases” and the role of endocrine disruptors:
– Metabolism (diabetes)
– Hormone-dependent cancers
– Developmental and reproductive disorders…
2. Other cancers and other environmental exposures: asbestos, UV radiation…
3. Cardiovascular, respiratory, allergies and air pollution
4. Neuropsychological disorders
After presenting the main areas that guide risk assessment, the FAM is continuing its series of debates on the Exposome and the health risks linked to multiple chemical exposures by approaching the levels of knowledge on known and internationally measured health impacts. The debate is cover diseases linked to endocrine disruptors (hormone-dependent cancers, developmental disorders, metabolic diseases, etc.), the consequences of air pollution, cancers, and cognitive and behavioural functional syndromes linked to environmental exposures.
In view of the many concerns about the information on pollutants in our environment, the session is provided an opportunity for exchange and debate on the state of the science. The debate is also proposed to discuss known examples, figures, types of contaminants (including unknown mixtures) and critical life stages.
Prof. Bernard Charpentier (President of the French Academy of Medicine)
Olivier Bohuon (President of the FAM)
Prof. Yves Lévi (acadamician, Vice-President of the FAM)
14:20 The estimation of environmental impacts on health: issues and purposes
Sébastien Denys (Director of the Health-Environment-Work Directorate, Santé Publique France)
Prof. Philippe Bouchard (endocrinologist, Foch Hospital), moderator
14:40 Chlordecone: an emblematic endocrine disruptor
Prof. Luc Multigner (Director of research INSERM – Institute of research in health, environment and work)
14:55 Endocrine disruptors and type II diabetes
Prof. Claude Jaffiol (Honorary President of the French National Academy of Medicine)
15:10 Exposures to chemical contaminants and child health
Charline Warembourg (researcher at INSERM – UMR1085 Irset)
15:25 Health impacts of ambient air pollution
Dr Sylvia Medina (coordinator of the Air et santé monitoring program, Santé publique France)
15:40 Discussion with the audience
Prof. Richard Villet (FAM General Secretary), moderator
16:10 The influence of endocrine disruptors on the incidence of breast cancer
Prof. Henri Rochefort (academician, former director of the INSERM Unit (U148) Hormones and Cancer)
16:25 Cancers: comparative study of the causes of cancers in France
Prof. Béatrice Fervers (Head of Cancer and Environment Department, Centre Léon Bérard)
16:40 Environment and cancer: mechanisms and perspectives at INCa
Dr Jérôme Foucaud (Head of the Human and Social Sciences-Epidemiology-Public Health Department, within INCa’s Research Division)
16:55 Presentation on feedback from the field on the concerns of local residents exposed to pesticide spraying in their agricultural environment
Testimony of the association Générations futures – François Veillerette, spokesperson
17:10 Discussion with the audience
17:25 Conclusion – Senate Report “Environmental Health: a new ambition”
Senator Florence Lassarde