Assessment of health outcomes (WP4) SINPHONIE Project kick-off meeting 10-12 November, REC...

Assessment of health outcomes (WP4)

SINPHONIE Project kick-off meeting 10-12 November, REC Conference Center,

Szentendre Hungary

Giovanni Viegi, MDDirector, CNR Institute of Biomedicine and Molecular

Immunology “Alberto Monroy”, Palermo, Italy

Head, Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy

Professor of “Health Effects of Pollution”, School of Environmental Sciences, University of Pisa, Italy

2006-07 Past-President, European Respiratory Society (ERS)

2009-11 Member of Planning Group, Global Alliance against chronic Respiratory Diseases (GARD)

Main Respiratory Effects related to Indoor Air

NONO22

ETSETS

PMPM

Association between Volatic Organic Compound (VOC) and respiratory Association between Volatic Organic Compound (VOC) and respiratory healthhealth

VOCsVOCs

MouldMould

Acute respiratory Illnesses

Bronchitic/asthmatic symptoms without fever and ARI

PMPM2.52.5

Computed as concentration x exposure time. Indices dichotomized (high/low) by their respective median values.

PMPM2.52.5

WP4 – Assessment of health outcomes Leaders: CNR Palermo, NIEH

IDMEC-FEUP, NIEH, JRC, UPMCParis06, UMIL, USiena, RIVM, THL, IPH-A, IPH-BH, LABOREX, LGH, NPHI-CZ, HPI, MS, PHA-SK

Objectives- data collection on: familial factors, lifestyle, exposures in the home

environment, health status of children by questionnaire surveys, focusing on respiratory symptoms/diseases and allergic rhinitis

- data collection on absenteeism from schools due to respiratory diseases

- provide protocols, procedures of quality control and training for the measurement of lung function in children

- provide protocols and training for a simple test for attention/concentration ability

Task 1. Development of:a. questionnaires by children (information on children's respiratory

health)

b. questionnaire by parents (respiratory/allergic symptoms/diseases and dietary intake about children, home risk factors and familiarity for respiratory/allergic diseases)

c. questionnaire by teachers (their respiratory/allergic symptoms/diseases and dietary intake, self-perceived air quality inside/outside the school, and self-perceived influence of poor air quality on school performance, home risk factors, familiarity for respiratory/allergic diseases, and knowledge and management of school issues related to air quality and to children with asthma)

(Month 8)

Task 2. Development of protocol to measure absenteeism due to respiratory diseases (report forms completed by a teacher), in order to record illness-related absence of the children in the school attendance (Month 18)

Task 3. Development of protocol for attention/concentration tests(Month 7)

Task 4. Development of protocol for lung function measurements, including criteria for quality control(Month 7)

Task 5. Training workshops(Month 7-8)

WP4.1 - Clinical field survey Leaders: Siena University, NIEHIDMEC-FEUP, NIEH, JRC, IPH-ALB, IPH-BH, IEH, LABOREX, LGH, CSGL, NPHI-CZ; HPI, THL, UPMCParis06, UBA, UOWM, UMIL, USiena, CNRPalermo, FSM, KTU, UMalta, IOMEH, UAVR, UBB, RIVM, NILU, PHA-SK, MC, UCL

- organization and the execution of clinical surveys using the methods devised in WP4

- contact and enroll the primary schools participating in the study

- perform the questionnaires survey on children, parents and teachers

- perform the spirometry

- perform the attention/concentration test

WP4.2 - Clinical tests and noninvasive biomarkers Leader: Uppsala University

IDMEC-FEUP, NIEH, JRC, IPH-ALB, IPH-BH, IEH, LABOREX, LGH, CSGL, NPHI-CZ; HPI, THL, UPMCParis06, UBA, UOWM, UMIL, USiena, CNRPalermo, FSM, KTU, UMalta, IOMEH, UAVR, UBB, RIVM, NILU, PHA-SK, MC, UCL, UU

- perform noninvasive clinical tests and biomarkers to evaluate the response of the exposed mucosae to different school indoor environments, both in allergic and nonallergic children

- perform clinical investigations (spirometry, acoustic rhinometry, skin prick tests, nasal lavage, exhaled breath condensate, tear film stability, exhaled NO)

The European HESE Study (Health Effects of School Environment)

http://ec.europa.eu/health/ph_projects/2002/pollution/pollution_2002_04_en.htm

Measurements of fungal DNA were performed by quantitative polymerase chain reaction (qPCR) in 46 classrooms (21 schools) attended by 616 schoolchildren (mean age 10 yrs) of Italy, Denmark, Sweden, Norway, and France.

METHODS (1)

Poster ERS Barcelona, 2010

Concentrations of fungal DNA (CE/g dust) in monitored classrooms

log

-to

tal

fu

ng

al D

NA

(C

E/g

du

st)

6.5

6.0

5.5

5.0

4.

4.0

Siena Udine Oslo Uppsala Århus Reims

Poster ERS Barcelona, 2010

In CONCLUSION, there is a relevant exposure in European schools to moulds as assessed by fungal DNA, which is associated with adverse respiratory health effects in schoolchildren

Poster ERS Barcelona, 2010

Some issues for Discussion- What health assessment can be done in kindergarten- Which age range of primary school is to be studied- Which country center (s) performs only core or also extended protocol (s)- What about other personnel than teachers- Which country has participated in ISAAC studies (questionnaire already translated)- Where and when to perform the training workshop- Others viegi@ibim.cnr.it

viegig@ifc.cnr.it