ExpoMIN: Influence of Environmental Exposures to Air Pollutants and PFAS on the occurrence of Sudden unexpected death in infancy (SUDI)

Sudden Unexpected Infant Death (SUDI) is the leading cause of infant mortality in France between 1 month and 1 year of age, with approximately 300 deaths each year. Despite thorough post-mortem investigations, nearly half of these deaths remain unexplained. According to the “triple risk” model, SUDI may result from a combination of an infant’s intrinsic vulnerability, a critical developmental period, and exposure to external stressors — particularly environmental factors. However, the effects of air pollution and persistent chemical substances such as PFAS (per- and polyfluoroalkyl substances) remain largely understudied in this context.

Led by Dr. David Boels, the ExpoMIN project aims to explore the role of environmental exposures, particularly extreme temperatures, air pollution (nitrogen dioxide, fine particulate matter PM2.5 and PM10), and PFAS, in the occurrence of SUDI.

The project adopts an interdisciplinary approach combining environmental epidemiology, spatial modeling, and toxicological analysis, drawing on data from the national OMIN registry and its associated biocollections.

Preliminary findings suggest a potential increase in SUDI risk during episodes of extreme temperature, as well as a possible link with recent exposure to certain air pollutants. The detection of PFAS in biological samples also indicates the presence of invisible yet preventable chemical exposures.

ExpoMIN seeks to identify high-risk environmental exposure profiles to help guide targeted prevention strategies. In the long term, the project may lead to the development of decision-support tools for families and healthcare professionals — particularly during heatwaves, air pollution peaks, or in specific geographic areas. It directly contributes to the objectives of the French National Environmental Health Plan (PNSE4), opening new perspectives for perinatal environmental health.