Abstract
The opening lecture will provide a chronological overview of the risks that have weighed or are still weighing on human health, from the epidemic-war-famine trilogy, which has gradually and partially faded away to make way for so-called lifestyle factors (tobacco, alcohol, dietary imbalances, sedentary lifestyles) and physico-chemical agents. Our movement, centrifugal in relation to the patient and the onset of disease, will be to move from enumerating the causes of death to identifying the causes of causes. Until the beginning of the 20th century, infectious diseases, whose development was aided by the invention of agriculture, which brought humans and domestic animals closer together, fostering zoonoses, were the major cause of mortality in Europe. With the progressive control of zoonoses in northern countries came an epidemiological transition, consisting of a reduction in mortality, which led to a spectacular three-fold increase in life expectancy in three centuries (from around 25 years before the Revolution to 82 years today in France), explained by the reduction in mortality from infectious diseases, often occurring early, gradually replaced by chronic diseases, generally occurring at an older age. We will review the contribution of genetic polymorphisms and lifestyle factors to the onset of chronic diseases. We will then look at the changes in our environment during the Anthropocene, the general arguments in favor of an effect of the physico-chemical environment on the onset of these chronic diseases, and the more specific arguments in the same direction, based on recent methodological developments, both in the field of toxicology and, in humans, of exposure biomarkers and causal inference (Judea Pearl), which provides a rigorous framework for identifying the causes of diseases in a non-experimental approach.
