Pillar 4 - External Exposure & Health

WP4.1 Space and health
WP4.2 Eco-behaviour and exposure
WP4.3 Follow up studies
WP4.4 Emerging chemicals

 

WP4.1 Space and health

Background

Neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD), mood and anxiety disorders, and conduct disorders are widespread in industrialized countries and importantly contribute to the total burden of disease during adulthood [81,82]. The development of the central nervous system starts during pregnancy and reaches maturity in adulthood. Therefore, the exposure to environmental factors during childhood and adolescence may play an important role in the development of neuropsychological disorders [83]. In this regard, contact with natural environments or green spaces may play a crucial role in the brain development [84,85]. To date, the relationship of neurobehavioral and/or cognitive development with green spaces during childhood has only been investigated in the frame of the Spanish BREATHE (brain development and air pollution in school children) project [86,87]. They reported reduced scores for ADHD and improved cognitive and behavioral development among children attending schools close to green areas and/or living close to green spaces.

Green spaces provide children and adolescents opportunities for engagement, risk taking, discovery, creativity, mastery and control, strengthening sense of self and inspiring basic emotional states [84,85], In addition, they enhance psychological restoration [88], provide opportunities for physical activity [89,90], and influence the construction of social networks [91]. All these factors may impact positively on their cognitive development. Furthermore, the characteristics of the outdoor environment may influence the microbial environment which has an impact on the immune system and on mental health [92]. In addition, green spaces have a potential for improving outdoor air quality. In green areas the outdoor concentrations of traffic related air pollutants is reduced [93–96], and high concentrations of these outdoor air pollutants are associated with impaired neuropsychological development [97]. Moreover, proximity to certain green spaces such as agricultural areas may involve exposure to pesticides which are associated to impaired neuropsychological development and autism [98].

Other potential mediators in the relationship between cognition and green spaces may be telomere length and the levels of cortisol [99,100]. Telomeres consist of TTAGGG tandem repeats and cap chromosomes [101]. They undergo progressive attrition in somatic cells because DNA polymerase is unable to fully replicate the ends of DNA caused by the unidirectional growth and the requirement for a primer to initiate synthesis [102]. As a result telomeres progressively shorten in somatic cells and a mean leukocyte telomere length has been observed to diminish with age [103,104]. In adults telomere length was observed to be strongly related to the telomere length at birth, which widely varied and showed synchrony with telomere length of different organs [105–107]. Previously, we showed that maternal residential proximity to traffic and lower residential surrounding greenness is associated with shorter placental telomere length at birth [108]. The interrelations between residential greenness, telomere length, cortisol levels and cognitive outcomes in adolescents have not been addressed so far.

Objectives

  • To investigate the relationship between the proximity to green spaces and cognition and behavior in adolescents. We will take the residential green space exposure over the life time (prenatal to adolescence) into account.

  • To investigate the interplay of potential important mediators such as cortisol and telomere length in the association between cognition and green space.

  • To link residential landscape variables to biomonitoring results including markers of exposure to traffic (e.g.: PAH’s, ‘t,’t-muconic acid) and pesticides to understand potential exposure differences which are associated with the residential environment.

  • To study the potential interplay of the biomonitoring results between green space and cognition.

  • The interrelation between green space and particulate air pollution on cognition.

 

WP4.2 Eco-behaviour and exposure

Background

In a survey of more than 10 000 households in 10 countries (Australia, Canada, the Czech Republic, France, Italy, Korea, Mexico, the Netherlands, Norway and Sweden) the OECD looked at factors that affect people’s behaviour towards the environment in 5 specific areas:
1. water use, 2. energy use, 3. personal transport choices, 4. organic food consumption, 5. waste generation and recycling.  Recently, studies indicate that there may be a relation between ecological behaviour in these area’s (e.g. living in energy-efficient houses, buying environmentally friendly products, buying organic foods, vegetarian diet, …) and (1) the exposure to environmental contaminants as well as (2) certain health effects. For example, a recent Norwegian study found that consumption of organically produced foods during pregnancy was associated with a lower prevalence of hypospadias in the male off-spring, which may be induced by in utero exposure to endocrine disrupting chemicals [112]. A second examples is the study of Serrano et al., investigating whether reported use of ecofriendly and chemical-free products was associated with lower phthalate biomarker levels in comparison to not following such practices [113]. They found that women who reported rarely/never purchasing ecofriendly, chemical-free and environmentally friendly personal care (PCP) and household products had higher levels of monoethyl phthalate (MEP) compared to always/often respondents. Sometimes following these practices were associated with monoisobutyl phthalate (MiBP) levels that were about 18% lower as compared to always/usually respondents. They observed trends for increasing concentrations of MEP with decreasing frequency of purchasing ecofriendly PCPs (p = 0.01) or house products (p = 0.03). Regarding the diet, reports of rarely/never eating food that is organic, ecofriendly, environmentally-friendly or chemical-free were related to lower MEP levels as compared to always/usually following this practice. Lastly, rarely or never eating food marked “organic”, “pesticide-free”, or “chemical-free” during pregnancy was associated with sum of Di-2-ethylhexyl phthalate(DEHP) metabolite levels that were  lower in comparison to those in the always/usually category [113]. Therefore, associations in both direction were found and both studies indicated that future investigations are needed to clarify the role of consumer product choices in relation to contaminant exposure and health effects.

Another interesting issue, related to eco-behaviour, is the potential public health impacts of changes to indoor air quality and temperature due to major changes in housing to improve energy efficiency (see figure). A recent study published in BMJ, assessed the health effects of home energy efficiency intervention in England [114]. Hamilton et al. concluded that energy efficiency retrofits in housing can improve health by reducing exposure to cold and air pollutants if these retrofits are properly implemented alongside ventilation. They referred to mental health, respiratory health, cardiovascular health, etc. Nevertheless, they stressed that maximising the health benefits requires careful understanding of the balance of changes in pollutant exposures, highlighting the importance of ventilation to mitigate the risk of poor indoor air quality [114].

Objectives

It is of interest to investigate also in the Flemish population whether associations exist between certain ecological behaviour (including healthy consumer-behaviour: buying environmentally friendly products, consuming organic food and living in energy efficient houses) and exposure to environmental contaminants (and maybe also related health effects). To this end, 3 research questions will be answered:

  • How can eco-behaviour be defined in Flanders?

  • Does eco-behaviour affect the internal exposure level?

  • Is eco-behaviour associated with better health parameters?


WP4.3 Follow up studies

Background

As this proposal is directed towards a fourth FLEHS campaign, a lot of effort has been done during the past years to establish a framework (protocol) for follow-up of the populations that were part of the previous campaigns. Consent of all participants was requested for follow up through health databases such as ‘Kind & Gezin’, ‘Centrum voor Leerlingenbegeleiding’ and ‘Intermutualistisch Agentschap (IMA)’. Besides their internal exposure status at the moment of the human biomonitoring investigation, we also archived their external burden of exposure through completing databases on exposure to particulate matter (PM10 and PM2.5), ozone, black carbon and noise (Irceline, dienst Milieuhinder, departement Leefmilieu, Natuur en Energie van de Vlaamse overheid). 

Objectives

This Flemish database and biobank of about 1800 newborns and their mothers, 2200 adolescents (14-15 year-old) and 1600 adults (200 20-40 and 1400 +50 years old) allows identification of biomarkers as early warning signals for development of disease in a later stage of life. As exposure through environmental and lifestyle is so well characterized in the past FLEHS campaigns, this database offers a unique prospect to identify risk factors for disease development and therefore the opportunity to intervene and intervene, or make the first steps towards a Flemish preventive medicine concept. 
 

WP4.4 Emerging chemicals

BACKGROUND

Emerging chemicals are, as the name indicates, chemicals that are currently introduced to substitute known harmful chemicals in consumer products that are widely used by the general population, such as plastics, food contact materials, personal care products, household products, furniture, etc. Human biomonitoring aims at detecting the presence of such emerging chemicals in the wider population. This is of interest also in the context of chemicals policy, as it is a tool to explore when new exposures are frequent enough to show up in the general population [116].

OBJECTIVES

  • We will collect information on internal exposure to a range of emerging chemicals in Flemish adolescents based on the assumption that they are present in consumer products that are widely used in the population,

  • We aim for identification of metabolites/parent emerging chemicals and their metabolites by using an array of analytical approaches, such as A) untargeted screening, B) suspect screening of emerging chemicals and their metabolites, C) targeted measurements of emerging chemicals and/or their metabolites identified by pct A and B.

  • We will identify life style-specific exposure profiles: compounds that may differ in relation to specific behavioural patterns. This activity allows evaluation of differences between common lifestyle and behaviour and the more alternative “eco-behaviours” mentioned in WP4.2, such as: living in energy efficient houses, organic food consumption, consumption of local food, avoiding plastic food packaging, or preferential use of environmental friendly products (e.g. cleaning/disinfectants and personal care products). This should give guidance towards more accurate prevention measures that protect against exposure to ubiquitous environmental toxicants and their substitutes in new materials.

 

Meerjarenplan 2016-2020