Response to exceptional environmental situations: contributions of syndromic surveillance in France

Background

Syndromic surveillance (SS) enables early detection of public health threats and population health monitoring. This work aimed to present tools prepared to assess short-term impact for exceptional environmental situations (EES) in France.

Methods

A literature review identified pathologies likely to occur after major environmental events. Corresponding syndromic indicators were selected from the French SS system (SurSaUD®), which includes emergency department (ED) visits (OSCOUR® network) and unplanned GP consultations (SOS Médecins [SOSM]). Lists of indicators were finalized through working groups and analysis of past experiences.

Results

Six priority EES were identified: storms, floods, wildfires, industrial accidents, earthquakes, and droughts. For each, 35–47 indicators (most of them being available for both OSCOUR® and SOSM) were classified into chapters such as digestive, respiratory, infectious diseases, and mental health. Three standard dashboard (DB) templates were developed to monitor short-term variations in the number of ED visits and SOSM medical acts, both all-cause and by indicator. Two DB allow monitoring daily variations compared to the 90 previous days for all ages (DB1) or by age groups (<15, ≥15) with supporting numerical data (DB2). The 3rd DB assesses weekly trend for all ages to enable longer-term analysis. DBs are configurable for different geographic areas and can be set up on the event day (D0) for automatic next-morning production. Additional tools map the residential areas of patients who usually visit each ED and provide typical data completeness at D + 1, aiding in the definition of surveillance areas and data interpretation. Advanced procedures include tagging event-related ED visits and SOSM consultations using predefined associated diagnostic codes.

Conclusions

DBs enable reactive health monitoring during EES, supporting decision-makers in implementing health management measures alongside other data sources.

Key messages

• Dashboards based on syndromic surveillance data are reactive tools for monitoring population health during major environmental events.

• The system’s operability depends on clear preparedness and procedures within a broader health monitoring framework involving multiple stakeholders.