The DEMETER project
The link between the environment and health is a growing concern and a methodological challenge. Assessing total exposure—known as the “exposome“—is essential for evaluating “cocktail effects”; however, due to various constraints (such as the complexity or even lack of data and methods), associations are currently estimated primarily on an exposure-by-exposure basis.
The development of standardized methodologies and reliable tools is therefore just as necessary as the highly precise assessment of combined exposures.
Current trends are quite encouraging: environmental databases are expanding; the National Health Data System (SNDS) provides medical-administrative and geographic information covering the entire French territory; biological assays for pollutant metabolites are becoming increasingly accessible; and exposure assessment via questionnaires is widely used in clinical studies.
In this context, as part of the DEMETER project, we propose cross-referencing these various data and methods to improve the assessment of environmental exposures: jointly evaluating perceived exposure—via questionnaires—and objective assessments, whether at the individual level through biological measurements or at both individual and collective levels using geographic data.
The DEMETER project makes it possible to test this combined approach using the example of precocious puberty (PP) and exposure to endocrine-disrupting chemicals (EDCs), such as pesticides. Indeed, the geographical disparity in PP incidence suggests an environmental origin.
DEMETER therefore focuses on establishing a cohort of children, which serves as an essential basis for assessing EDC exposure using various approaches:
- a questionnaire assessing exposure to endocrine-disrupting chemicals (EDCs)
- repeated urinary measurements
- a study of the link between environmental data (use of plant protection products, crop density, EDC pollutants) and the incidence of pathologies potentially linked to EDCs, as estimated using the SNDS (French National Health Data System)
These three approaches will enable a highly precise and complementary assessment of exposures. Finally, DEMETER is committed to a conscientious strategy for reporting and communicating results to parents and participants, ensuring the dissemination of comprehensive information that is accessible to all yet does not cause anxiety.
Project leaders:
Aurélie PORTEFAIX
As a pediatrician and head of the Child Health and Environment Program at the Centre d’Investigation Clinique de Lyon, I conduct research on environmental health topics within the Department of Pediatrics at the Hospices Civils de Lyon. Working alongside the research team at the RESHAPE U1290 laboratory, I focus both on the link between exposures and health effects in children and on communicating research findings back to participants, in partnership with Professor Préau’s team. My goal is to provide reliable scientific information that is accessible to the general public, in order to improve the health of children—the adults of tomorrow—and future generations.
Astrid COSTE
An epidemiologist with the Prévention Cancer Environnement Department since 2020—and affiliated with Inserm Unit 1296 (Radiation: Defense, Health, Environment)—I have approached the link between the environment and health through two disciplines: geography and epidemiology.
During my PhD in epidemiology and an initial post-doctoral position in Switzerland, I investigated the role of exposure to ultraviolet radiation and pesticides in the development of pediatric cancers. My research at the Centre Léon Bérard allows me to delve deeper into the health effects of residential exposure to agricultural pesticides—focusing this time on testicular germ cell tumors as part of the TESTIS case-control study. Additionally, I am developing an interventional research project, SOLSTEEN, which focuses on preventing UV exposure in middle schools across the Lyon metropolitan area.
The DEMETER project allows me to work on children’s health again, and we will apply methods developed within the TESTIS study to estimate the exposure of children in our study population to agricultural endocrine-disrupting pesticides.
