Why are the health consequences for the population so difficult to assess?

• Nine months after the fire which damaged many drums of chemical products offered on the premises of the Lubrizol factory in Rouen, no biomonitoring study and no sampling were carried out with the population of the agglomeration .
• “The application of the precautionary principle in matters of health monitoring cannot be justified,” denounce the senators in charge of the fire investigation committee who released their report on Thursday.
• They are calling on the government to carry out a statistical study for the population most exposed to the fire and to create two morbidity registers relating to general cancers and birth defects.

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The observation of Senator Christine Bofanti-Dossat (LR) is bitter. “A year after the fire, (…) the public authorities will still not be able to provide answers on the health and environmental consequences”, she deplored on Thursday at the time of the report of the commission of inquiry sure
the fire at the Lubrizol factory in Rouen on September 26, 2019. Surrounded by the chairman of the committee and his co-rapporteur,
the elected official castigated the strategy put in place by the government on the health monitoring of the population.

Pointing to an accumulation of delays and a lack of political will, the senators made several proposals to assess in the long and medium terms the consequences of the fire on the health of Rouennais. But the obstacles remain numerous and the concern of the latent population. Why is it a problem to measure the health impact of this disaster and what measures are underway? 20 minutes make the point.

Differentiated monitoring

After the fire which devastated more than a thousand barrels of chemical products from the Lubrizol factory, a follow-up was quickly put in place for the officers – firefighters or police officers – who intervened on the site during the accident.
This follow-up includes blood tests in particular carried out after the disaster, then one month after and six months after. For the general population, only a “declared health survey” is currently planned. Delayed for the first time due to the coronavirus epidemic, this survey, which will include 5,000 people, is to be launched this month, France Public Health told senators.

For elected officials, this monitoring represents however a limited interest: “It aims above all to apprehend the feelings of the populations. It retains only “perceived health”, to the detriment of the more exhaustive data of “declared health” (…) the data collected during this declarative health survey will be essentially subjective and therefore will not provide the public authorities with a state general health objective of the exposed population, “they write. As for the results of samples taken from professionals, “no conclusion” could not be established at the moment “due to the lack of certain data,” said the Senate report.

No biomonitoring study

Contrary to what is done for professionals, no biomonitoring study is currently planned for the exposed population. However, some local elected officials and members of civil society have been asking for it for months. “The biomonitoring set up for first responders is a good thing and fortunately it exists, but we would like it to be extended to the entire population a priori exposed to the plume of smoke. But each time we are told that there is no reason to worry, “says Laura Slimani,
municipal councilor in Rouen member of the Génération-s movement.

A “manifest lack of will,” said Lot-et-Garonne senator Christine Bonfanti-Dossat on Thursday: “As far as short-term health monitoring is concerned, the first results were rather reassuring. On the other hand, long-term monitoring continues to pose real difficulties. “Especially since the expectation among the population is very high, says 20 minutes Simon de Carvalho, co-president of the association Les sinistrés de Lubrizol: “We are asking for analyzes by an independent laboratory. We are going to call on all the mayors of the agglomeration and the senators to obtain funding to carry out these health analyzes since the State refuses to do so. Only that can reassure the population. “

“We don’t know what to look for”

To justify the absence of samples and biomonitoring of the local population, the Minister of Health at the time, Agnès Buzyn, had explained: “There could even be a biomonitoring investigation, in order to verify if, compared to a given toxic, we must look for a particular disease but, for the moment, we have no track. We should know what products are actually in the environment. We don’t find anything abnormal, so we don’t know what to look for. “

An inaudible argument and a strategy “which cannot be justified” for elected officials. “The Minister expressed doubts about the advisability of medium-term health monitoring on the sole basis of the acute phase analyzes carried out by health experts, who did not” find any pollutants above the thresholds of usual environmental contamination “, even though the results of the environmental monitoring phase have not all been delivered”, they say.

To improve this health monitoring, the members of the inquiry commission made two proposals to the government, relating to the collection of health data. The first consists in creating a more general “cohort” (a statistical study) which does not concern only the firefighters but “all the people intervened during the fire and during the subsequent management of the chemicals, and submit to a biomonitoring program “. Senators also call for the creation of two morbidity registers, “One relating to general cancers and the other to congenital malformations” across the Seine-Maritime department for long-term monitoring.

If this report has no binding value for the government, the chairman of the commission of inquiry, Senator Hervé Maurey (Modem) assured that elected officials would remain “mobilized” on the subject in the coming months: “We do not we don’t want what happened in Rouen to be forgotten. (…) Our goal is to ensure that all these proposals are taken up, that they do not end up in a drawer. “

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