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France

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Country Correspondent
Pr Vincent Danel



Background


View France in a larger map Legend: = Government Agency, = NGO, = University, = Professional Society, = Poison Control Center, = Toxic Site.

The history of toxicology in France is closely linked to crimes and to forensic medicine. Most of the first toxicologists were forensic medicine specialists. Some famous criminal stories where toxicology played a key role are part of this history: 'l'affaire des poisons' under the reign of [Louis XIV], where the Marquise de Montespan, a former mistress of the king, was suspected of being at the head of a group of poisoners (many of them were condemned to death, even the then Marquise de Brinvilliers); the famous Marie Lafarge who was convicted of murdering her husband with arsenicin 1840 (he probably died of typhoïd); Hélène Jegado, a famous Briton poisoner, who was condemned to death in 1852; Marie Besnard, suspected in 1947 of having poisoned 12 people with [arsenic](she was eventually acquitted after some famous experts battles). More recently, French toxicologists reported from some hair analysis that Napoleon might have died from a criminal arsenic poisoning! Toxicology was also linked to occupational health rather early. [Lead] poisoning was the first ever poisoning recognized as an occupational pathology in 1919; amazingly enough, years later, child lead poisoning is since 1998 the only accidental poisoning which must be declared to Health authorities on a mandatory basis.

Toxicology is, perhaps, not as well recognized or organized as it might be in France, largely due to the lack of cohesive university programs devoted to the subject. It tends to fall largely within the scope of academic programs in pharmacy. Apart from some post-graduate courses, there are no programs in medical or veterinary schools. Most physicians practicing clinical toxicology have a background in intensive care and emergency medicine, forensic medicine, or occupational medicine. Analytical toxicology is mainly the field of pharmacists, pharmacologists and biologists, either in hospitals or in some Forensic Medicine Institutes.

What to do if Poisoned in France

A poisoned patient is normally admitted in a general emergency department or in an intensive care unit. The only dedicated poisoning unit that remains in France is in Hospital Lariboisière in Paris. Before being transferred to Hospital Lariboisière, this unit was the famous Fernand-Widal Clinical Toxicology unit, set up in the 1960s, altogether with the Paris Poison Control Center. A real French 'school' of Clinical Toxicology originated in Fernand-Widal and is still very lively in Lariboisière hospital. Two other dedicated clinical units that existed in Marseille and in Grenoble have now disappeared. Some people have particularly contributed to the recent history of Clinical Toxicology: Chantal Bismuth in Paris, Jacqueline Jouglard in Marseille and Louis Roche in Lyon. Louis Roche,with some others, founded the European Association of Poisons Control Centres and Clinical Toxicologists (EAPCCT) in 1964. There are currently 10 Poisons Control Centers (PCC) that answer the general public round the clock, and three Toxicovigilance Centers opened only during working hours; on the whole those centers receive about 200,000 calls per year. The people who answer on the phone are mainly physicians, sometimes pharmacists. All cases are registered in a national database maintained by the Paris Center; a chemical products and compounds composition database is run by the Nancy Center. Each Poisons Center is mainly funded by the University hospital to which it belongs; all centers depend from the Direction Générale de la Santé at the Ministry of Health. Some funding is provided by the Institut de Veille Sanitaire, especially for Toxicovigilance purposes. A good number of calls are also answered by the SAMU health system (dial 15). Mostly for economical reasons, there is now a clear trend towards the diminution of the number of PCC and towards setting up closer links between the SAMU system and the PCC. The Société de Toxicologie Clinique is obviously mainly interested in Clinical Toxicology.

The Toxicovigilance system, coordinated by the Institut de Veille Sanitaire, relies on the Poisons Control and Toxicovigilance Centers network; some poisonings such as carbon monoxide and [lead] poisoning are registered and followed-up at a national level.

Animal and experimental research is mainly done by pharmacists, biochemists and biologists; there are very few laboratories working exclusively in the field of toxicology; they are located either in Universities or in some private pharmaceutical firms. The Société Française de Toxicologie, the biggest French toxicology society, is mainly interested in research.

Risk assessment studies and epidemiological studies, as carried out in most health agencies, are mainly conducted by pharmacists or epidemiologists.

Toxicological Societies

There are thirteen different toxicology scientific societies, encompassing all fields of Toxicology and having from tens to hundreds members. Efforts are underway, however, to set up the French Federation of Toxicology. The main objectives at the moment are to organize a joint meeting as soon as possible, to list all possible Toxicology resources and to list all possible toxicology courses that may exist at the University at a post-graduate level.

Journals

There are no specialized toxicology journals published in France, and most toxicologists submit their works to international journals; an electronic journal has just been launched in Lyon.


Government Agencies


Non-Government Organizations


Universities

The links below, although not entirely current, will help in locating programs offering toxicology study in France.


Professional Societies


Poison Control Centers


Databases


Miscellaneous Resources


Key Publications


Legal Links


About France


Multilateral Organization Contacts


Literature References from TOXLINE (France)

Note: Overlap between these two sets of search results is likely.