Descriptive epidemiological analysis of mass psychogenic illness managed by 'Santé publique France' 2010–2014. Identification of key factors for evaluation
| Autor: | M. Sassi, C. Daniau, F. Kermarec, A.-C. Colleville |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Mass psychogenic illness
Typology medicine.medical_specialty Epidemiology Public Health Environmental and Occupational Health Environmental pollution Context (language use) Environmental exposure Sick building syndrome Public health surveillance Intervention (counseling) medicine Psychiatry Psychology |
| Zdroj: | Revue d'Épidémiologie et de Santé Publique. 66:S335 |
| ISSN: | 0398-7620 |
| DOI: | 10.1016/j.respe.2018.05.260 |
| Popis: | Introduction “Sante publique France”, the French institute for public health surveillance, and its regional intervention units (Cire) are frequently asked to investigate outbreaks of acute and benign symptoms occurring in communities and presenting a dimension of crisis through their unexplained nature, making their evaluation complex. A methodological investigation guide was published in 2010 to recommend a multidisciplinary assessment of these situations. In order to review prior knowledge acquired, a systematic review of the investigations conducted by the metropolitan Cire was carried out. The review aimed at establishing a more precise typology of these multifactorial outbreaks, in order to identify the aspects of these phenomena still insufficiently described, and which must be characterized to improve their management. Method Each investigation conducted by a metropolitan Cire between 1 January 2010 and 31 December 2014 was examined retrospectively to document 38 indicators of interest. All of the episodes subject to a written response from the Cire in the form of a note or a report were selected. Results Between 2010 and 2014, 46 situations were investigated. In most of them, the indicators described in the literature corresponding to sick building syndromes were found, including: –mild symptoms (including headaches in 82% of cases), various nonspecific symptoms (98%), which disappear when leaving the incriminated premises; –a higher incidence among women or in certain subcategories of people (83%); –a suspected environmental exposure (63%); –the concomitant presence of environmental nuisances (56%); –the existence of an anxiogenic context (43%); –the existence of a triggering event (37%). Given the data available at the end of the investigations, it was possible to classify these outbreaks into three categories: –those that could be managed only through the improvement of indoor air quality and the reduction of environmental pollution (6 situations); –those that could not be managed without implementing a concerted action between all the stakeholders, and managing aggravating factors such as the amplification of symptoms due to panic, rumors, or great anxiety (7 situations having all affected children), factors of psychological or social vulnerability (2 situations), or lack of confidence in managers, suspicions of organizational problems (12 situations including 11 in the workplace); –those for which the investigations were unable to identify clearly the origin of the facts (7 situations). Conclusion Overall, outbreaks are heterogeneous and involve factors on air quality, crisis management, reactivity, organization of expertise, communication, consultation, redistribution of chronic symptoms or recognition of lived experiences, all in a non-hierarchical way. Their fine description through human and social sciences is a key factor in their management. |
| Databáze: | OpenAIRE |
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