Social inequalities in morbidity, mortality and their causes, including disparities in education, work conditions, access to healthcare, smoking and psychosocial stress, have been the object of increasing attention in the spheres of demography and sociology (in France, see Desplanques, 1993; Mesrine, 1999; Ledere et al., 2000). However, environmental factors affecting health, such as exposure to pollution and toxic substances, which are major factors in the prevalence of certain diseases, have not yet been studied in France in the context of social inequalities. In addition to diffuse pollution sources (air pollution), France currently counts 24 nuclear sites, 130 incinerators, close to 1,250 landfills, 3,700 polluted sites, 1,100 industrial sites that pose major risks in the event of an accident and 300,000 to 400,000 "potentially polluted" sites, at least 80% of which are probably contaminated (Ogé and Simon, 2004). These sites often contain hydrocarbons, heavy metals and solvents, and may also release air pollutants (particulate matter, sulphur dioxide, nitrogen dioxide, dioxins).
The health effects of many pollutants are well known (Aubert, 2006). Nitrogen dioxide exacerbates cardio-respiratory diseases (USEPA, 1996; DOH, 1998), lead increases the risk of cardio-vascular diseases and lead poisoning in children (Fischbein, 1992) and sulphur dioxide is a carcinogen (Soskolne et al., 1989). In high concentrations, particulate matter and sulphur dioxide may be responsible for a mortality increase of close to 25% (Hertzman, 1995). Proximity to landfills is associated with high rates of congenital malformations (Dolk et al., 1998; Elliott et al., 2001) and the ash, heavy metals and dioxins emitted by incinerators are associated with high rates of cancer, respiratory disease and congenital malformations (Allsopp et al., 2001). The effects of pollutants on health depend on their concentrations and combinations, as well as on individual exposure and susceptibility (ATSDR, 2005). In France, the Ministry for Ecology, Sustainable Development and Spatial Planning (Ministère de l'écologie, du développement et de l'aménagement durables, MEDAD) estimates that 30,000 premature deaths per year are linked to urban air pollution and that environmental factors are involved in 7% to 20% of all cancers (MEDAD, 2007b).
Today, the problem of social inequalities in exposure to environmental risks has become a major issue. Inequalities of this type have already been observed in many industrialized countries (United States, Canada, United Kingdom, Germany, the Netherlands and Eastern European countries), where they are addressed through public policies promoting sustainable development and social justice. French and European legislation tends to concentrate on furthering rights to a healthy environment and greater justice in the environmental sphere (Bélier, 2002; Stec, 1998).
This study is part of a new research focus on "environmental justice" and the distribution of environmental risks. It provides an international overview of recent methodological and analytical developments in this domain and presents the data available in France.
1. Methodological aspects
Many studies have observed that disadvantaged populations are exposed to particularly high levels of environmental risk, although they have often been criticized for their lack of scientific rigour. The main criticisms concern the geographical level of the analysis, the definition of populations "at risk" and reference groups, the impossibility of generalizing on the basis of case studies, and the use of inappropriate statistical tools (Bowen, 2002).
1.1 Environmental risk indicators
For studies of localized pollution, the results depend on the types of sites analysed (industrial facilities, incinerators, landfills, etc.). Socioeconomic differences between areas with incinerators or nuclear establishments and areas without such facilities are often not significant because only a small number of such sites exist. …