Aims: To study practices and procedures with respect to electrotherapy in physiotherapy departments and to study physiotherapists’ perception of health risk, health consequences and protection of health from different risks including electromagnetic field emissions from electrotherapy devices. Methods: This cross-sectional study was conducted in three phases from June 2002 to December 2003. The first phase was an audit of the practices and procedures regarding electrotherapy in National Health Service physiotherapy departments (N = 46 including 7 departments in pilot study) located in 12 counties in the southeast and southwest of England including Greater London. The second phase comprised one observational visit to each of the same physiotherapy departments to characterise their occupational environment. The third phase was a questionnaire survey of 584 physiotherapists working in these departments. Variables concerned perception of health risk, health consequences and protection of health associated with different risk factors. Results: In the first two phases, the recruitment rate of the departments was 80.7% (46 out of 57) and response rate of those recruited was 100% (n=46). The response rate for the last phase of the study was 66.8% (390 out of 584). Results of the practices and procedures audit show that ultrasound was the most common form of electrotherapy while microwave diathermy was neither available nor used in these departments. Pulsed shortwave diathermy was used 4-5 days per week while continuous shortwave diathermy was used rarely. Electrotherapy was provided to up to 50% of patients per week in the departments. The observational visits to the departments revealed that there were metallic objects within close proximity of diathermy equipment and wooden treatment couches for treatment with PSWD and CSWD were rare. The risk perception survey showed that physiotherapists generally perceived a moderate health risk and health consequences (harm) from exposure to EMF emissions from electrotherapy devices. Protection from EMFs in physiotherapy departments was generally perceived as ‘usually’ possible. Conclusions: Physiotherapy departments report safe electrotherapy practices. Use of diathermy devices that use RF EMFs is declining. The key predictors of physiotherapists’ perception of health risk were perception of health consequences and vice versa. Gender was a significant predictor of the perception of health risks and health consequences. The main predictor of perception of protection against risk was the knowledge of environmental and health issues. Latent dimensions of perceptions of health risk, health consequences and protection from risk were identified and confirmed and their predictors were determined.

Le transport est un facteur important de la croissance urbaine et de la viabilité des centres urbains mais il est également responsable de nombreuses nuisances telles que le bruit, la pollution de l'air et les accidents de la route, qui causent aujourd'hui de nombreux impacts sur la santé, telles que la gêne. L'objectif principal de notre thèse était d'identifier les déterminants (sociodémographiques, socioéconomiques, liés à la mobilité quotidienne) d'une gêne ressentie vis-à-vis du bruit, de la pollution de l'air et des accidents de la route. L'objectif secondaire était d'identifier les déterminants de la perception du risque sanitaire vis-à-vis de ces trois nuisances et du ressenti des effets du bruit et de la pollution de l'air sur sa propre santé ou celle de son entourage ; dans le but in fine de voir si des inégalités sociales se dessinaient dans le champ de cette problématique. Pour ce faire, deux études transversales ont été menées en population générale, dans le département du Rhône en 2013 puis en 2014 respectivement. La principale conclusion de notre étude est que le milieu socioéconomique ne joue un rôle prédominant ni dans l'expression de la gêne ni dans la perception du risque sanitaire. En revanche, les usagers des modes doux (marche, vélo) et des transports publics sont plus gênés par la pollution de l'air et le bruit du trafic routier comparés aux usagers motorisés. Par ailleurs, la gêne liée à la pollution de l'air influencerait le ressenti des effets du bruit et de la pollution de l'air sur sa propre santé. Nos résultats devraient être utiles aux décideurs politiques dans le cadre des politiques urbaines. Créer un environnement plus « friendly » en réduisant l'utilisation des voitures, en promouvant l'utilisation des modes doux, en améliorant les transports en commun et leur utilisation, en développant des installations pour les piétons et pour les cyclistes - toutes ces mesures sont autant de mesures nécessaires pour réduire les nuisances dus au trafic routier et ainsi le sentiment de gêne et d'insécurité / An important factor supporting urban growth, and the viability of the urban centers, is transportation but road transport is still a common important source of traffic accidents, noise, and air which have heavy consequences on public health such as annoyance. The main objective of our thesis was to identify the determinants of each kind of trafficrelated annoyance (sociodemographic, socioeconomic, daily mobilty). The secondary objective was to identify the determinants of health risk perception and the feelings of health effects on his own health. Then, tow cross-sectional studies have been conducted in the general population, in the Rhône Department, in France. The main finding of our study is that the socioeconomic level doesn’t play a rule neither in the expression of annoyance nor in the health risk perception. However, active travel modes and public transport users are highly annoyed by traffic air pollution and road-traffic noise more than motorized users. Moreover, annoyance related to air pollution seemed to influence the feeling of health effects of noise and air pollution. Our results should be useful for urban policies. Create a friendly environment by reducing the use of cars, promoting non-motorized or “active” travel mode use (walking, cycling), to improve public transport and to promote the use of public transport, avoiding to add noisy road infrastructure near population centers, to develop facilities for pedestrians and for cyclists - all of these measures are needed to reduce road-traffic nuisances and the feeling of annoyance