Mercury, DDT, dioxins, asbestos… the second half of the 20th century was marked by numerous health crises, but awareness took several decades to develop. The WHO addressed the topic in the early 1990s and proposed a definition of environmental health in 1994(1). France, for its part, presented its first National Health-Environment Plan (PNSE) in 2004. Today, what are the notable developments?

At the beginning of 2003, a group of scientists from France and Quebec published Environment and Public Health – Foundations and Practices, a work of over 1,000 pages that quickly became a reference in the field. Covering principles and methods; environmental contamination, population exposure, and health risks; the harmful effects of pollutants on health; and practices in environmental health, this book was updated in 2023. While air, water, and soil quality, food contamination, radiation, odors, noise, natural disasters and technological accidents, zoonoses, and workplace contamination remain current issues, new topics have emerged or gained importance over the last twenty years. These include nanomaterials, endocrine disruptors, electromagnetic waves (especially from mobile phones and screens), and, of course, climate change and its various impacts on health. This new edition also extensively covers the “One Health” approach(2) and the concept of the exposome(3), which have appeared recently.

An Assessment of the First Three PNSEs

In 2022, the French High Council of Public Health reviewed the National Health-Environment Plans launched in France from 2004 to 2017 (PNSE 1 to 3). The report’s authors call for rapid action to improve air quality (“air pollution remains a major public health issue,” “it is therefore important to accelerate measures to reduce pollution levels, not only peaks but especially background pollution”). They also recommend strengthening the consideration of emerging risks (nanomaterials, electromagnetic waves, endocrine disruptors) and multiple pollutant exposures (cocktail effects). Furthermore, they highlight the need to develop knowledge of the health effects of environmental risks in the context of major climate disruption and recommend establishing a true interministerial national health-environment strategy.

Some Progress and Setbacks Since the Report

Regarding electromagnetic waves, knowledge has been evolving significantly in recent years. For example, an editorial published at the end of April 2025 for parents of young children states that “in 2025, doubt is no longer allowed, and the numerous international scientific publications remind us that the consequences of early and prolonged screen exposure are proven.” It continues, “neither screen technology nor its content, including supposedly educational content, is suitable for a developing brain. A child is not a miniature adult: their needs are different.” This editorial is signed by Servane Mouton, neurologist and co-chair of the Commission on the Impact of Young People’s Screen Exposure.

As for endocrine disruptors (bisphenols, phthalates, pesticides, PCBs…), several measures have been initiated in France, such as the removal of bisphenol A from baby bottles and food packaging and monitoring of certain populations (children, pregnant women…). However, in a 2024 evaluation of the second strategy conducted by IGAS and IGEDD, the authors recommend going further and aiming for “zero exposure” within ten to fifteen years.

In the field of nanomaterials, it should be noted that while titanium dioxide (TiO₂, known as coloring E171) has been banned in candies, ready meals, and processed meats, its classification as a carcinogen was annulled in early August 2025 by the European Court of Justice. According to some scientists, it is the nanoparticle form that is considered carcinogenic, but this does not justify canceling the classification entirely.

Chemicals in the Spotlight Summer 2025

As part of the sixth revision of the directive on carcinogenic, mutagenic, and reprotoxic agents (CMRD), the European Commission introduced new measures in mid-July 2025 to strengthen worker protection against hazardous chemicals. These include new exposure limits for cobalt and inorganic compounds (mainly used in battery production), polycyclic hydrocarbons or PAHs (present in steel, iron, and aluminum production or welding fumes), and 1,4-dioxane (used as a solvent in chemical and textile production).

Regarding persistent pollutants (PFAS), France adopted a law at the end of February 2025 to protect populations from the risks associated with these substances. In this context, the Ministry of Ecological Transition announced on July 31 the upcoming consultation of two implementing decrees: one on the ban of PFAS in everyday objects (cosmetics, textiles, and ski wax) and another on adopting a trajectory to reduce industrial PFAS emissions by 2030.

This overview would be incomplete without mentioning the strong reactions of scientists to the Duplomb law, which, aiming to lift constraints on farming, seeks, among other things, to re-authorize acetamiprid, a neonicotinoid pesticide. The bill triggered an unprecedented petition in the summer (+2 million signatures) and also prompted statements from scientific organizations. For example, the editorial led by Professor Sujobert on behalf of the French Society of Hematology and signed by 45 organizations considers that this reauthorization “will increase exposure of the entire population, especially farmers, to pesticides.” It cites various studies and collective expert assessments that establish “a strong presumption of a link between exposure to these substances and many cancers (prostate, leukemia, myeloma, lymphomas, pediatric cancers) as well as neurodegenerative diseases, lung conditions, and neurodevelopmental disorders in children.” The editorial also emphasizes that “the current approval system relies on tests measuring molecule toxicity in the laboratory, which is not sufficient to detect all possible effects on human health.” In short, for its authors, “adopting the Duplomb law would represent a major step backward for public health.” This analysis was also shared at the end of July by the National Council of the Order of Physicians, which announced the launch of a structured reflection on links between health and the environment.

Climate Change: What Are the Health Risks?

Climate change and its consequences have many health impacts. Heatwaves and extreme heat have direct effects (headaches, cramps, nausea…) but also indirect effects on our bodies. For example, a study published in April 2025 in Environmental Health shows that high temperatures during pregnancy and early life can delay language development in children. Pollen growth can lead to allergies or asthma. The movement of insects that may carry diseases can promote the spread of these illnesses in regions where they were not previously common. This is the case, for example, with tiger mosquitoes and ticks, which can transmit multiple diseases (Lyme disease, tularemia, tick-borne encephalitis). Greater UV exposure can increase the risk of melanoma (skin cancer). Warmer and more humid periods can encourage the development of mycotoxins (natural toxins produced by certain molds) in food, which can be harmful, particularly for vulnerable populations (children, elderly, or chronically ill people). Trauma from extreme events, such as losing a home during a fire or storm, is also a concern.

A Broad Expansion of Knowledge Available to Public Authorities

While at the beginning of the 2000s, the argument of insufficient knowledge of the health impacts of the environment was somewhat acceptable, this is no longer the case. An ever-growing number of studies and reports are being published, and major research institutes dedicate a large part of their activities to this topic. This is far from what some call “fake news.” Doctors are also involved, as shown by the open letter sent to the government in June 2025 by the Regional Unions of Healthcare Professionals (URPS) alerting about cadmium exposure, a heavy metal in the soil that can cause kidney damage and bone fragility if ingested. The Green Data for Health initiative also brings together a community of French health-environment actors to improve understanding of environmental impacts on health by linking environmental and health data. Since April 2025, ANSES has coordinated this mission, previously led by the Ecolab laboratory of CGDD. With this wealth of knowledge, the only remaining task is to make decisions that reduce exposures…

1. Environmental health article

2. The “One Health” approach considers the complex links between animal health, human health, and the environment in a global approach to health challenges. Following the Covid-19 pandemic and, more recently, the Mpox crises (formerly “monkeypox”), reflections for better prevention and anticipation of new infectious health crises have shown the need to also consider environmental factors (source: Anses).

3. The exposome corresponds to the sum of environmental exposures a person experiences throughout life, through diet, air, radiation, behaviors, and the sound, psycho-emotional, and socio-economic environment (source: Inserm).