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Journal ArticleDOI

Eau potable et santé publique : défis actuels et futurs

09 Jun 2006-Journal of Water Science (Université du Québec - INRS-Eau, Terre et Environnement (INRS-ETE))-Vol. 19, Iss: 2, pp 127-135

AbstractL’eau que nous consommons chaque jour est essentielle a la vie. Sa qualite a toujours ete un element indispensable a un environnement favorable a la sante. Actuellement, loin d’avoir ete resolu, le probleme de la qualite de l’eau de boisson est toujours une priorite de sante publique, autant dans les pays en voie de developpement que dans les pays industrialises. Ce texte presente six defis pour la sante publique dans le dossier de l’eau potable pour les annees futures : Finalement, le probleme de la qualite de l’eau potable doit etre apprehende dans une perspective mondiale. more

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Journal ArticleDOI
15 Sep 2012
Abstract: Cet article vise la comprehension du contexte et du jeu des acteurs ayant mene a l’adoption du Reglement sur la qualite de l’eau potable. Cette initiative a permis au Quebec de se positionner parmi les Etats ayant des normes de qualite et des controles de production parmi les plus rigoureux sur le continent nord-americain. Une adaptation de l’approche contextualiste de Pettigrew (1990 ; 1992) est retenue comme cadre d’analyse. Cette approche insiste sur l’importance, au moment d’un changement, de l’interaction entre trois dimensions : le contexte, le contenu et le processus. De maniere a preciser cette derniere dimension, il est propose de recourir a l’idee de coalitions, un concept propre a l’approche des reseaux de politiques publiques. Cet apport permet de mieux cerner l’influence des organisations externes a l’appareil gouvernemental et de fournir une explication des relations entre les differentes dimensions du contextualiste.

2 citations

Journal ArticleDOI
Abstract: The scope of this work is focused on the removal of methylene blue (MB) from aqueous solution by adsorption (bach method) on polyacrylonitrile-co-sodium methallyl sulfonate copolymer (AN69) and polyacrylic acid (PAA) synthetic membranes which were prepared specifically for this purpose. Investigations have covered membrane properties and the determination of adsorption parameters. The immobilization of PAA chains into AN69 matrix was revealed by FTIR analysis, whereas the presence of small superficial microcavities was demonstrated by AFM scanning. Otherwise, the increase in PAA fraction (0 to 10%), in membrane composition, induces an increase in swelling ratio (12–22%) and ionic exchange capacity (0.8–1.2 meq/g). Moreover, the equilibrium adsorption capacity improves with the increase in alkalinity of initial adsorbate solution (pH = 2–11) and with the concentration (C = 20–80 mg/L). The results of kinetic adsorption show that the mechanism of adsorption is perfectly fitted by pseudo-second order (R2 = 0.999) and the isotherm adsorption follows the Freundlich isotherm (R2 = 0.98). From the different applied adsorption models, it was found that the maximum Langmuir adsorption capacity Qm was 116 mg/g and the Freundlich index of adsorption n was 2.2.

1 citations

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01 Jan 1998
Abstract: We are witnessing a paradigm shift in the way medicine is practiced, taught, and evaluated. It was relatively recently that medicine knew no limits. New diagnostic procedures led to more medical and surgical procedures and to greater expense. It was assumed that patients would be the recipient of these advances. However, the uncontrolled costs of medical care and the poor documentation of patient benefit ushered in a new era of cost conscientiousness. Now, there is a need to show that medicine produces value for money. As a result, new methodologies such as cost-effectiveness analysis, cost-benefit analysis, and cost-utility analysis have become commonplace in medical journals. This has created a need to revise medical education and postgraduate training in order to accommodate new methodologies and new controversies. Within the last few years, several influential publications have emerged. Perhaps the most important of these is the book Cost-Effectiveness in Health and Medicine edited by Martha Gold and colleagues.1 This book summarizes the consensus of an expert panel convened to review cost-effectiveness analysis in health care. The Gold book covers the theory but does not teach the methods. Methods for the Economic Evaluation of Health Care Programmes by Michael Drummond and colleagues offers specific, step-by-step methodologies for conducting economic evaluations. This is the second edition of a book originally published in 1987. During the ten years between editions, there were very substantial advances in theory and methods for economic evaluations of health care programs. The revised edition brings the text up to date. Methods for the Economic Evaluation of Health Care Programmes arises from the teaching of health economics at McMaster University. The McMaster Centre for Health Economics and Policy Analysis is internationally regarded as a focal point for economic evaluations of health care. Among other advances, researchers at the Centre have produced a widely used methodology, known as the Health Utilities Index, for estimating the cost/utility of health programs. The book was originally developed for a course at McMaster and for a workshop offered by the McMaster faculty. The second edition adds one new author (Bernie O’Brien) who has more recently joined the McMaster faculty. The second edition also introduces substantial changes in the chapters on cost-effectiveness, cost-utility, and cost-benefit analysis. These are important improvements because of the profound methodological developments in these areas. In addition, the second edition includes new chapters on collection and analysis of data and on the presentation and use of data. These new chapters add discussion on the pros and cons of economic evaluations and on some of the difficulties in the interpretation of economic data. In addition, the second edition includes many more boxes and illustrations to facilitate the interpretation of the text. Perhaps the greatest contribution of the book is the very detailed presentation of cost/utility analysis. It is now common to offer discussions of the cost to produce a year of life adjusted for life quality. This is known as a quality adjusted life year (QALY). There are a variety of different methods for estimating QALYs. Nevertheless, QALYs estimated using different methods are often found in the same comparison or “league” table. This book goes into considerable detail in how QALYs are estimated and describes some of the methodological issues and problems in estimating these outcomes. Unlike other texts, the book provides systematic stepby-step instruction in how both costs and health benefits can be estimated. In summary, the role of health economics is becoming firmly established in the evaluation of health care programs. In combination with Gold and colleagues’ book,1 which provides a detailed theoretical discussion of economic analysis, Methods for the Economic Evaluation of Health Care Programmes offers systematic training in the application of economic methodologies. This book can serve as a basic text for students hoping to understand the complex methodologies of economic evaluation. In addition, the book is a handy reference for advanced practitioners of economic analysis.

6,537 citations

Journal ArticleDOI
TL;DR: Several PhACs from various prescription classes have been found at concentrations up to the microg/l-level in sewage influent and effluent samples and also in several surface waters located downstream from municipal sewage treatment plants (STPs).
Abstract: The occurrence and fate of pharmaceutically active compounds (PhACs) in the aquatic environment has been recognized as one of the emerging issues in environmental chemistry. In some investigations carried out in Austria, Brazil, Canada, Croatia, England, Germany, Greece, Italy, Spain, Switzerland, The Netherlands, and the U.S., more than 80 compounds, pharmaceuticals and several drug metabolites, have been detected in the aquatic environment, Several PhACs From various prescription classes have been found at concentrations up to the mug/l-level in sewage influent and effluent samples and also in several surface waters located downstream from municipal sewage treatment plants (STPs). The studies show that some PhACs originating from human therapy are not eliminated completely in the municipal STPs and are, thus, discharged as contaminants into the receiving waters. Under recharge conditions, polar PhACs Such as clofibric acid, carbamazepine, primidone or iodinated contrast agents can leach through the subsoil and have also been detected in several groundwater samples in Germany. Positive findings of PhACs have, however, also been reported in groundwater contaminated by landfill leachates or manufacturing residues. To date, only in a few cases PhACs have also been detected at trace-levels in drinking water samples. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved

2,700 citations

26 Feb 1987
TL;DR: The role of health economics is becoming firmly established in the evaluation of health care programs and can serve as a basic text for students hoping to understand the complex methodologies of economic evaluation.
Abstract: How to use the book basic types of economic evaluation critical assessment of economic evaluation cost analysis cost effectiveness analysis cost utility analysis cost benefit analysis collecting and analyzing data presenting and using economic evaluation results how to take matters further.

2,515 citations

Journal ArticleDOI
TL;DR: This massive outbreak of watery diarrhea among the residents of Milwaukee was caused by cryptosporidium oocysts that passed through the filtration system of one of the city's water-treatment plants, and water-quality standards and the testing of patients for cryptOSporidium were not adequate to detect this outbreak.
Abstract: Background Early in the spring of 1993 there was a widespread outbreak of acute watery diarrhea among the residents of Milwaukee. Methods We investigated the two Milwaukee water-treatment plants, gathered data from clinical laboratories on the results of tests for enteric pathogens, and examined ice made during the time of the outbreak for cryptosporidium oocysts. We surveyed residents with confirmed cryptosporidium infection and a sample of those with acute watery diarrhea consistent with cryptosporidium infection. To estimate the magnitude of the outbreak, we also conducted a survey using randomly selected telephone numbers in Milwaukee and four surrounding counties. Results There were marked increases in the turbidity of treated water at the city's southern water-treatment plant from March 23 until April 9, when the plant was shut down. Cryptosporidium oocysts were identified in water from ice made in southern Milwaukee during these weeks. The rates of isolation of other enteric pathogens remained stab...

1,999 citations

30 Aug 1996
TL;DR: The signatories of this letter acknowledge that there are strong differences in opinion about the potential consequences of future climate change on disease incidence and distribution, but share common concerns; they wish to emphasize that despite any differences, there are many areas where they agree.
Abstract: The article “Apocalypse not” by Gary Taubes (News & Comment, 7 Nov., [p. 1004][1]) addresses the issue of fundamental differences of opinion among health scientists about the impact of climate on human health. While we acknowledge that there are strong differences in opinion about the potential consequences of future climate change on disease incidence and distribution, we share common concerns; we wish to emphasize that despite any differences, there are many areas where we agree. The key questions behind the climate/health research agendas are, How will climate change alter health risks, to what extent will risks be altered, and what can be done to mitigate any potential increase in health risks? At issue is not which is more important, climate factors or improved health measures; rather, it is important to assess how health risks might change in both industrialized and more vulnerable developing countries. The complexity of this public health issue entails far more uncertainty than many health hazards with which we are familiar. Impacts may occur indirectly through simultaneous disturbances of other sectors, including water supply, food production, or habitat. Thus far, scientists have found great difficult in communicating this extra level of uncertainty. We agree on the need to improve understanding of the complex relationships between climatic conditions and disease transmission dynamics. We also agree that disease incidence is influenced by multiple factors (none of us will argue that climate is the only or the most important factor). Well-designed research studies must be conducted to gain a better understanding of how these multiple factors relate to each other and how all might be influenced by climate. Identifying risk factors that influence disease transmission is a key to public health planning, and as more data from climate/health research studies become available, the influence of weather will be better understood. We recognize that extreme weather events such as those that may accompany this year's El Nino place an extra burden on sanitation and general public health systems. The early regional forecasts obtained from El Nino exemplify important new predictive capabilities that public health officials can use in their public health planning. Interdisciplinary research and interagency cooperation can go far toward improving the health risk assessment associated with climate change. Ecology-based research and monitoring combined with advances in climate forecasting will enhance our understanding of complex environmental health hazards and may provide the public with early warning systems that allow timely public health interventions. The signatories of this letter agree that public health is of great importance and that public health infrastructure and services must be improved worldwide. We recognize that environmental and socioeconomic conditions underpin health status; effective and sustainable public health prevention will ultimately require improvement in these underlying conditions. It is important to realize, however, that the projected climate change may have a profound influence on an aspects of human ecology, and we strongly recommend that research be supported to allow development of effective prevention strategies that will help mitigate its effect on public health. [1]: /lookup/doi/10.1126/science.278.5340.1004

571 citations