Environmental Health in Perinatal and Early Childhood: Awareness, Representation, Knowledge and Practice of Southern France Perinatal Health Professionals
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Study Design
2.3. Thematic Content Analysis
2.4. Statistical Analysis
3. Results
3.1. Response Rate and Study Sample Characteristics
3.2. Environmental Health Representations
3.3. General Knowledge in Environmental Health
3.3.1. Item Analysis
3.3.2. Analysis by Topic
3.3.3. Intergroup Analysis According to Profession
3.4. Environmental Health Subjective Aspects
3.5. Training and Information
4. Discussion
4.1. Perception and Representation of Environmental Health
4.2. Attitudes and Barriers
4.3. Knowledge and Training Needs
4.4. Limitations and Strengths of the Study
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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n = 962 | |
---|---|
Gender n (%) | 843 a |
Male | 59 (7%) |
Female | 784 (93%) |
Age—years (mean ± SD) | 822 b |
<42 years | 400 (48,7%) |
>42 years | 422 (51.8%) |
Length of service n (%) | 839 c |
<1 year | 42 (5%) |
1 to 5 years | 117 (13.9%) |
5 to 10 years | 153 (18.2%) |
>10 years | 527 (62.8%) |
Geographic area of practice n (%) | 837 d |
Bouches du Rhône (Marseille) | 432 (51.9) |
Alpes Maritimes (Nice) | 131 (15.7) |
Var (Toulon) | 95 (11.4) |
Vaucluse (Avignon) | 70 (8.4) |
Alpes de Hautes-Provence | 35 (4.2) |
Hautes-Alpes | 26 (3.1) |
Monaco Corse | 5 (0.6) |
Corse | 38 (4.6) |
Answer | |||||
---|---|---|---|---|---|
Question Expected Responses [3,22,23,24,25,26,27] | Mean ± SD | Correct and Extreme n (%) | Correct and Unsure n (%) | Wrong n (%) | Does not Know n (%) |
To prevent viral infection, pregnant women are advised not to air their dwelling place—fully disagree | 4.84 ± 0.62 | 828 (91.2) | 45 (5) | 22 (2.4) | 13 (1.4) |
Outdoor pollutants are not harmful for children under 3 as their body is not yet sensitive to it—fully disagree | 4.78 ± 0.73 | 801 (88.2) | 64 (7) | 32 (3.5) | 11 (1.2) |
Cigarette smoke spreading in the room persists after the smoker’ exit—strongly agree | 4.79 ± 0.65 | 776 (86.6) | 93 (10.4) | 20 (2.2) | 7 (0.8) |
In utero exposure to endocrine disruptors do not impact the foetus when organogenesis is incomplete—fully disagree | 4.72 ± 0.83 | 785 (86.5) | 62 (6.2) | 40 (4.4) | 21 (2.3) |
In humans impacts of environmental toxicants can be discovered several years after exposure as they sometimes display delayed effects—strongly agree | 4.74 ± 0.56 | 713 (78.5) | 170 (18.7) | 9 (1) | 16 (1.8) |
Pregnant women are advised to burn incense and use air fresheners to relax—fully disagree | 4.67 ± 0.67 | 685 (76.5) | 149 (16.6) | 15 (1.7) | 47 (5.2) |
Exposure to pesticide can affect male fertility—strongly agree | 4.68 ± 0.64 | 683 (75.2) | 176 (19.4) | 9 (1) | 40 (4.4) |
To avoid exposure to endocrine disruptors it is recommended to use plastics food containers—fully disagree | 4.55 ± 0.82 | 634 (70.8) | 155 (17.3) | 24 (2.7) | 83 (9.3) |
Pregnant women can enter in a freshly painted room as soon as paint is dry without exposing themselves to chemicals—fully disagree | 4.40 ± 0.89 | 536 (59.8) | 241 (26.9) | 43 (4.8) | 76 (8.5) |
Plastic baby bottles are recommended instead of glass bottles—fully disagree | 4.30 ± 1.06 | 540 (59.5) | 221 (24.3) | 91 (10.6) | 51 (5.6) |
Indoor air can be more polluted than outdoor’—strongly agree | 4.39 ± 0.93 | 526 (58.7) | 272 (30.4) | 56 (6.2) | 51 (5.6) |
In humans all diseases due to environmental toxicants are reversible—fully disagree | 4.32 ± 0.91 | 493 (54.3) | 273 (30.1) | 48 (5.3) | 94 (10.4) |
Pregnant women are advised to use sprayed cosmetics and cleaning agents—fully disagree | 4.26 ± 0.92 | 486 (54.2) | 188 (21) | 26 (2.9) | 196 (21.9) |
Release of endocrine disruptors present in plastic food containers is increased by heating process—strongly agree | 4.40 ± 0.76 | 469 (53.8) | 300 (34.4) | 14 (1.6) | 88 (10.1) |
Ingestion and inhalation are the sole route of exposure to environmental toxicants—fully disagree | 4.08 ± 1.08 | 406 (44.5) | 326 (35.7) | 130 (14.3) | 50 (5.5) |
Pregnant women are advised to prefer fatty fish (salmon, sardines, and mackerel) to lean fish (cod, hake) as heavy metals contained in lean fish are not harmful. Strongly disagree | 3.79 ± 1.14 | 328 (36.6) | 195 (21.8) | 114 (12.7) | 259 (28.9) |
pesticides are eliminated by careful rinsing of fruits and vegetables—fully disagree | 3.65 ± 1.24 | 251 (28.0) | 366 (40.8) | 246 (27.5) | 33 (3.7) |
Pregnant women are advised to use rinse-off hygiene products (e.g., soap instead of cleaning lotion) for themselves and their child under 3 as they are less skin permeable and less harmful—strongly agree | 3.58 ± 0.96 | 146 (16.8) | 332 (38.1) | 93 (10.3) | 300 (34.4) |
All baby products made in France do not contain toxic agents—fully disagree | 4.07 ± 0.98 | 350 (40.2) | 329 (37.8) | 84 (9.6) | 108 (12.4) |
To reduce electromagnetic waves exposure, it is advisable to place the baby monitor at least 1m away from the bed—strongly agree | 3.65 ± 0.89 | 137 (15.7) | 384 (44.1) | 68 (7.8) | 282 (32.4) |
Environmental risks for male and female fertility are essentially the same—strongly agree | 3.17 ± 1.08 | 87 (10.0) | 290 (33.3) | 269 (30.9) | 225 (25.8) |
Mothers are advised to feed fish to children under 3 at least 2 times a week—fully disagree | 2.65 ± 1.10 | 29 (3.3) | 185 (21.2) | 392 (45.0) | 265 (30.4) |
Consuming organic food can reduce obstetrical complications—strongly agree | 2.81 ± 1.11 | 46 (5.3) | 204 (23.4) | 333 (38.2) | 288 (33.1) |
It is generally advised to wait 2 months before installing baby in his freshly redecorated/refurbished bedroom strongly agree | 3.37 ± 0.85 | 81 (9.0) | 287 (32.0) | 95 (10.6) | 433 (48.3) |
Pregnant women are advised to eat fatty fish at least 2 times a week—fully disagree | 3.06 ± 1.26 | 139 (15.3) | 240 (26.4) | 365 (40.2) | 164 (18.1) |
Themes | n (%) | Qualitative data |
---|---|---|
Paucity of knowledge | 403 (73.7) | Lack of knowledge regarding toxicants and their relevance to the geographic area of practice. Lack of scientific proof, evidence-based medicine data and professional recommendation. Poor knowledge of what it is possible to advice. lack of training |
Fear of patient’ reaction | 52 (9.5) | Patients seen as poorly concerned by the EH problem, fear of evoking guilt and stress, fear of being seen as a patronizing |
Inability to provide solution Lack of solution | 63 (11.5) | Expensive solutions, no solution to provide (particularly with respect to occupational exposure), benefice/risk balance difficult to evaluate, lack of support or resource (institutional or colleague) |
Pregnancy follow up visit: an inappropriate time | 36 (6.6) | Lack of time, lack of tools to explains (leaflets, brochures, posters) |
Communications issues | 22 (4.0) | Lack of communication skills, differences in risk perception between professionals and patients due to culture or language skills, patient non-fluent in French |
Multiple sources of information/wealth of scientific data | 16 (2.9) | Large body of literature and information difficult to sort. A scientific field in constant evolution. Lack of time to find pertinent information |
Environment/society conflict of interest | 11 (2.0) | Conflict of interest between consumerism and health advices, lack of action taken by public authorities and governments bodies. Lobbying of companies |
Need of coordination between professionals | 4 (0.7) | Need of coordination between professionals |
Multiplicity of prevention messages | 3 (0.5) | Multiplicity of prevention messages |
Not a priority | 4 (0.7) | Priority settings (Medical aspects) |
Daily habits difficult to change | 7 (1.3) | Daily habits difficult to change |
Themes | n (%) | Qualitative Data |
---|---|---|
Pollution | 292 (40.1) | Air pollution, industrial pollution, plants and factories, drinking water pollution, vehicle exhaust fumes, sea pollution, soil pollution |
Daily hygiene and cleaning products | 147 (20.2) | Cosmetic and hygiene products, hair dyes, baby products, nappies, cleaning products, plastics, baby bottles, bisphenols, plastics toys, sprays, clothes |
Inadequate housing | 78 (10.7) | Lead, lead poisoning, insalubrious housing, asbestos, substandard housing |
Pesticides | 99 (13.6) | Pesticides |
Occupational exposures | 63 (8.6) | Use of toxic cleaning products, poor premises ventilation, hospital wastes, disposable medical devices and consumables, plastic consumables, poor recycling, baby hygiene products and cosmetics, inappropriate use of disinfecting hand products, X-rays, paints, virus and bacterial exposure, nosocomial infections, anesthetic gas, lack of day light, use of smelling products, rehabilitation of hospital premises, hospital food |
Endocrine disruptors | 62 (8.5) | Endocrine disruptors |
Diet | 68 (9.3) | Diet during pregnancy and breastfeeding, baby food |
Indoor air | 38 (5.2) | Indoor air quality, Carbon monoxide intoxication, heating system, ventilation, air conditioning, furniture, paints, refurbishing, solvents |
Toxic consumption | 35 (4.8) | Tobacco smoking, alcohol, drugs, addictions, medications |
Electromagnetic waves | 25 (3.4) | Micro waves, Wi-Fi, electromagnetic waves |
Wastes | 23 (3.2) | Wastes, absence sorting of recycling |
Socio-economic level | 30 (4.1) | Precariousness, economic costs, socio-economic difficulties |
Noise | 8 (1.1) | Noise |
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Sunyach, C.; Antonelli, B.; Tardieu, S.; Marcot, M.; Perrin, J.; Bretelle, F. Environmental Health in Perinatal and Early Childhood: Awareness, Representation, Knowledge and Practice of Southern France Perinatal Health Professionals. Int. J. Environ. Res. Public Health 2018, 15, 2259. https://doi.org/10.3390/ijerph15102259
Sunyach C, Antonelli B, Tardieu S, Marcot M, Perrin J, Bretelle F. Environmental Health in Perinatal and Early Childhood: Awareness, Representation, Knowledge and Practice of Southern France Perinatal Health Professionals. International Journal of Environmental Research and Public Health. 2018; 15(10):2259. https://doi.org/10.3390/ijerph15102259
Chicago/Turabian StyleSunyach, Claire, Barbara Antonelli, Sophie Tardieu, Michele Marcot, Jeanne Perrin, and Florence Bretelle. 2018. "Environmental Health in Perinatal and Early Childhood: Awareness, Representation, Knowledge and Practice of Southern France Perinatal Health Professionals" International Journal of Environmental Research and Public Health 15, no. 10: 2259. https://doi.org/10.3390/ijerph15102259