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Exploring environmental determinants of Crohn's Disease at the territorial scale: insights from an integrative ecological study in Northern France
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Edité par CCSD -
International audience. In the context of multifactorial diseases with unknown etiology, environmental factors should be assessed comprehensively and with a multidimensional approach. Prioritizing concepts like data reuse and territorial analysis appears relevant before focusing on specific environmental exposures. However, such approaches come with challenges related to accessing, standardizing, and conducting multivariate analysis on environmental data. To address this, we propose a framework for reusing public environmental data to generate spatialized indicators and define complex territorial profiles. Leveraging 24 public data sources, 113 spatialized indicators were developed at the municipal level in France, encompassing various aspects of the physical and outdoor environment: contamination levels (air, water, soil), polluting emissions, location of emission sources, land use, agricultural practices, natural features, and climate.Using this dataset, a multivariate classification method was implemented to establish a territorial typology and distinguish seven environmental profiles among municipalities. This classification provides a multidimensional description of territories and contributes to understanding how environmental pressures and amenities are distributed in space and overlap.These results were finally used to evaluate the spatial association with the incidence of Crohn’s disease (CD; EPIMAD registry), a multifactorial disease with a partially unknown etiology, and a significant suspicion of environmental influence. Hence, CD incidence was compared across environmental profiles, and ecological regressions (BYM2 model) were conducted. The analysis revealed significant associations between CD incidence and markers of intensive agricultural practices, such as agricultural land use for specific crops and proxies for pesticide usage. Furthermore, significant associations were observed with soil pollution by metals.
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