Santé publique France is France’s national public health agency. A public institution under the authority of the Minister of Health, formed through the merger of several public institutions and established by Ordinance 2016-246 of April 15, 2016, the agency works to promote public health. As a scientific, expert, and public health safety agency, its missions include:

1. Epidemiological observation and surveillance of the health status of the population; 
2. Monitoring health risks threatening the population;
3. Promoting health and reducing health risks;
4. Developing prevention and health education;
5. Preparation for and response to health threats, alerts, and crises;
6. Issuing public health alerts.

The agency is organized into 12 departments—some scientific, some cross-functional, and some providing operational support.

The agency’s strategic priorities and work program, established by its Board
of Directors, are organized into three areas: Strengthening the capacity for anticipation and rapid response to health threats; Measuring and assessing the extent of diseases and risk factors to guide their prevention and control; Strengthening the health impact of all public policies and the prevention and promotion of health.

Department of Occupational Health and Safety

Internship Responsibilities

The internship tasks are divided into two parts:

• A literature review of epidemiological studies aimed at identifying the relative risks associated with occupational exposures and diseases, focusing on the most recent and relevant studies to be considered in estimating FRA.
• A component aimed at estimating FRA using Levin’s formula to document the proportion of cancers attributable to various occupational exposures. This work requires, as a preliminary step, estimating the proportion of exposure to the risk factor by cross-referencing job-exposure matrices with a sample of occupational histories.

Internship Activities

The occupational exposure–disease pairs selected for this internship are:

• formaldehyde and leukemias
• formaldehyde and nasopharyngeal cancer
• wood dust and nasopharyngeal cancer
• wood dust and cancer of the nasal cavities and facial sinuses
• gasoline and myeloid leukemia
• Gasoline and bladder cancer

The first activity of the internship involves identifying, within the epidemiological literature, the most relevant relative risks to consider when characterizing the association between the occupational exposure-disease pairs listed above. For exposures to formaldehyde and wood dust, the relative risks were the subject of a literature review in 2017 during previous work on attributable risk fractions (ARFs), which will need to be updated. For gasoline, the attributable risk fraction was not estimated in the previous studies.

The second activity aims to estimate the AAR using Levin’s formula. To do so, the prevalence of occupational exposure (PE) for a given hazard will be estimated by cross-referencing an occupation-exposure matrix from the Matgéné program with population data from a sample of occupational histories representative of the population in 2020. The cross-referencing will be based on job codes (the PCS2003 classification (Professions and Socioprofessional Categories) for occupation and the NAF2008 classification (French Classification of Economic Activities) for economic sector), taking into account all jobs held by workers in the sample. The attributable risk fractions will then be estimated using the Levin formula. The number of cancer cases attributable to the occupational exposure under study can be estimated based on the observed cancer incidence rates in France.