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              <p>It is increasingly suspected that the health impact of air pollution may be greateramong socioeconomically disadvantaged populations than among those who are betteroff. However, health impact assessments of air pollution generally do not takesocioeconomic status into account. In this paper, we propose an approach to thequantitative estimation of the short-term impacts of environmental risk factors such as airpollution among socioeconomically contrasted populations. We do so through anillustrative case study of ambient air pollution and emergency calls for asthma attacks inStrasbourg (France). Next, we discuss the potential advantages of this approach as well asits current limitations, and then look at the research needs that must be addressed toimprove its applicability. Among these, the most urgent appear to be the needs forimproved exposure estimates and for large-scale epidemiological studies that useharmonized methods to investigate the modification by socioeconomic status and otherfactors of the effects of air pollution. Case-crossover designs offer promisingperspectives for that purpose, especially as more accurate and individualized estimatesof air pollution exposure become available for epidemiological studies</p>
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              <p>On suspecte de plus en plus que l’ampleur des impacts sanitaires de la pollution atmosphérique augmente à mesure que le niveau socio-économique des populations décroît. Cependant, à ce jour, les évaluations d’impacts sanitaires de la pollution atmosphérique n’intègrent en général pas la dimension socio-économique. Dans cet article, une approche est proposée pour estimer quantitativement les effets à court terme de la pollution atmosphérique au sein de populations présentant des niveaux socio-économiques contrastés. Cette approche est illustrée par une application aux appels d’urgence pour crises d’asthme dans la communauté urbaine de Strasbourg. Les avantages de l’approche proposée y sont discutés, ainsi que les limites actuelles à son application. Des axes de recherche à développer pour améliorer son applicabilité sont identifiés. Parmi ceux-ci, l’amélioration de l’estimation des expositions à la pollution atmosphérique ainsi que la réalisation d’études multicentriques de grande ampleur, employant des méthodologies harmonisées afin d’étudier simultanément les interactions par le niveau socio-économique et par d’autres facteurs apparaissent de première importance. Le schéma d’étude cas-croisés offre des perspectives prometteuses pour répondre à cet objectif. Il permettra en particulier de prendre en compte à l’échelle individuelle des indicateurs d’exposition de plus en plus fins, au fur et à mesure que ceux-ci deviendront disponibles pour des études épidémiologiques.</p>
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