Urbanization has changed the land-use in Europe and the majority of the world. Over 80% of Europeans, who are expected to live in urban neighbourhoods by 2030, are at risk of developing chronic respiratory disease (CRD) due to the chronic exposure to increased levels of air pollution, that is characteristic for urban and peri-urban areas. Increased car traffic due to high population and building densities in cities have been associated with poor air quality. Research on how the continued urbanization and the built environment affect human health is emerging. To date, very little is known about how the built environment affects respiratory health in children directly, or indirectly by influencing health behaviours such as physical activity. Childhood is a period of growth and development, which makes children particularly vulnerable to changing environments. Because the respiratory system and the lungs act as the first organ of contact with air pollutants, the health effects of air pollution exposure need to be studied in combination with physical activity. Physical activity increases the breathing rate and the depth of breaths taken in, which facilitates pollutants to reach areas deep in the bronchial tree at higher concentrations, where they can cause damage locally, or be absorbed into the blood stream, and impact regulatory processes systemically. The purpose of this project is to analyze how the built environment affects the combined exposure to air pollution and physical activity with respect to children's respiratory health pre- and postnatally using an exposome approach. We will use data from the Human Early-Life Exposure (HELIX) project, including 1301 mother-child pairs from 6 longitudinal cohort studies across Europe. This research is important, because we will use original, innovative, and interdisciplinary methods to assess how the built environment affects respiratory health in early life, the optimal time point to prevent CRD.

The research proposed in this project is focused on the study of one of the most challenging and potentially-dangerous impacts of climate in European societies: the mortality associated with environmental temperatures in the current context of global warming. The research objectives of the proposal are (i) the description of the dependency between counts of deaths and climate variables contributing to increased body stress, (ii) the inference of future projections of mortality under scenarios of increased greenhouse gas concentrations, (iii) the study of the effect of adaptation measures on these projections, and (iv) the development of an early warning system of mortality risk as a climate service for European societies. During the implementation of all these objectives, the main results and conclusions of the research will be communicated to the general public and disseminated in specialized circles within and outside the research field. The research and methodology here proposed are clearly innovative, given that the project will integrate climate information and tools with unprecedented high-quality mortality and sociodemographic data in a multidisciplinary approach that will take into account the degree of adaptability of human societies and individuals to scenarios of increased greenhouse gas concentrations in the atmosphere. In this sense, the design of the proposal clearly fits into the main guidelines and objectives defined by the European Commission in the work programme of the initiative Horizon 2020, which contributes to the generation of climate services that provide useful guidance to health care systems, governments and policy makers throughout Europe.

Chagas disease (CD) is a parasitic, systemic and chronic disease caused by the protozoan Trypanosoma cruzi. Approximately 30% of chronically infected people develop cardiac, digestive, neurological or mixed alterations. CD affects 7 million people worldwide, mainly in endemic areas of 21 continental Latin American countries, where T. cruzi is mainly a vector-borne disease. In non-endemic regions, a major role is played by congenital (mother-to-fetus) transmission, leading CD to become an emerging disease in Europe and other non-endemic regions. It is increasingly clear that more efforts are needed at the basic research level to improve our understanding of the molecular and clinical aspects of this route of transmission. Understanding the genetic bases of the interaction between the host and the parasite could shed light into the molecular mechanisms behind congenital transmission. In this project, we aim to use state-of-the-art genomic techniques to understand the relationship between T. cruzi genotype and the host genotype in congenital transmission of CD. Identifying the factors governing this matter will not only help to better understand the mechanisms behind the diseases, but it could also help to target the group of infected pregnant women at higher risk of transmission. We will examine the parasite and the host genotypes in blood samples from infected pregnant women transmitting and not transmitting the infection. We will assess parasite diversity by developing a new strategy for T. cruzi genetic typing based on the MinION, a portable long-read DNA sequencer. For the genotyping of the host, we will use genome-wide SNP arrays. We will use multivariate analysis for determining putative relationships between host and parasite genotypes and congenital transmission of CD. This project will provide the first attempt at determining genetic causes of congenital CD considering both, host and parasite genotypes by applying the state-of-the-art genomic techniques.

Neurological disorders such as Autism Spectral Disorders (ASD) in children are lifelong conditions for which there is no cure,treatment options are very limited AND create huge burdens on children, families and society. Potential long-term consequences of poor cognitive performance and presence of autistic traits are poor social development, low educational achievement, diminished economic productivity and unemployment, mental health issues, and increased risk of antisocial behaviour. In the case of ASD, a lifelong disorder, there is no cure and limited treatment options are available. Therefore, it is essential to identify modifiable risk factors to prevent their onset and prevalence. Air pollution is postulated as a risk factor since it is believed to cause neuroinflammation, oxidative stress and neurodegenerative pathology. Traffic noise shows inconclusive associations with cognitive performance. The experience in cognitive and neurobehavioral development epidemiologic analysis and wide-scale modelling at the host institution, with different modelling approaches and existing models available for UK and London at the partner´s institutions, and the experience of exposure assessment methods of the fellow dovetail nicely to accomplish the goal of the COGNAC project. This is to explore the associations between air pollution and noise with cognitive performance and the presence of autistic traits in children using a large children cohort. The innovative aspects of this proposal are combining multi-pollutant and noise exposure, using very detailed maps of these environmental stressors and assessing effects at critical windows of exposure. The scientific impact of this fellowship results from the identification of the effect of air pollution and noise in cognitive development and the presence of autistic traits in children. The skills acquired in this fellowship will be decisive fo establishing me in one of the leaders in environmental health applied to neurocognition.

Green CURIOCITY: As a consequence of climate change, the European climate is getting warmer and the impact on childhood health and development is insufficiently understood. Equally, the potential to reduce heat related health risks through nature based solutions (NBS), such as exposure to urban natural environments (for example urban green spaces), calls for further investigation. Green CURIOCITY aims to provide evidence for improved knowledge about how heat exposure during pregnancy affects birth outcomes and how long-term exposure to heat may influence children’s neurodevelopment. The project will also investigate how adverse effects can be prevented through a potentially mitigating impact of urban natural environments in the context of NBS. Green CURIOCITY has a strong impact and implementation component, both by proposing to develop vulnerability maps, demonstrating urban “hot-spots” where the risk of negative impacts of heat is aggravated due to specific socio-demographic and land use patterns and by the development of a plugin tool for a Geographic Information System software to predict impact of urban natural environments on childhood heat-related health outcomes in partnership with WHO. The suggested methods include advanced statistical and geospatial analyses in combination with map production and software development. We will use existing data from the Human Early-Life Exposure (HELIX) cohort and link to state-of-the-art environmental exposure data to assess impact on birth and neurodevelopmental outcomes. The results are expected to be of high relevance and impact due to the project’s alignment with contemporary urgent challenges related to climate change, urban landscapes, and the health of future generations. In particular, the project’s focus on solutions and communication tools will provide opportunities for innovative evidence-based implementation strategies.