Environment and Health: from human exposure to health impact assessment
Unit of Environmental Epidemiology, CNR Institute of Clinical Physiology (IFC-CNR), Pisa, Italy
According to WHO, 12.6 million deaths globally, equal to 23% (95% CI: 13–34%) of all deaths, are attributable to the environment. Taking into account both death and disability, the fraction of the global burden of disease due to the environment is 22% (95% CI: 13–32%). In children under the age of five, up to 26% (95% CI: 16-38%) of all deaths could be prevented if the environmental risks were removed.
Epidemiological research in the environmental field is undergoing a significant scientific and technological progress, due to the swirling growth in the science of exposure, toxicology and ecotoxicology, and sciences of omics.
The role of risk and impact assessments is rapidly growing for providing evidence on the negative effects on human health of exposure to chemical, physical and biological substances. Most diseases have a multifactorial aetiology, some disease components arise from endogenous processes, and some result from the human activities. A multi- and trans-disciplinary approach between exposure scientists, toxicologists, epidemiologists, environmental scientists and many other disciplines, is fundamental to face the complex environmental problems on a local and global scale and their implications for prevention.
To enhance the exposure assessment, quality and coverage of measures and reduction of uncertainty in the measurement process are crucial. A lot of techniques are now available as remote sensing, personal sensors and other sampling techniques, computational exposure tools, omics techniques, long-life exposure matrices (exposome), pharmacokinetic models.
Large banks of cells collected in various populations are available for toxicological research, to test hypotheses on the relationships between chemicals, genes and diseases, as well as there are new assays, models and approaches to predict biological responses.
The data available today can be used to address many of the problems that agencies daily face. Advances are promising for carrying out advanced risk assessments and for improving public health and the environment. A transparent and understandable comunication on strengths and limitations of the approaches is necessary in the framework of participatory studies.
Dr. Fabrizio Bianchi is Director of Research, Epidemiologist, Head of Environmental Epidemiology and Diseases Registries Research Unit – Institute of Clinical Physiology of the National Research Council. Coordinator of the Tuscany Registry of Rare Diseases and Tuscany Registry of Birth Defects; WP4 leader of the CNR- International Centre of advanced study in environment, ecosystem and human health. Since 2010, coordinator of : CNR interdepartmental project on Environment and Health, HIA21 and GIOCONDA EC-LIFE Projects, RISCRIPRO and SEPIAS projects of the Italian Ministry of Health, WP coordinator of the EPIRARE –EC DG SANCO.
Professor in-charge in Epidemiology at the GECA master of the Sant’Anna University-Pisa, member of the Academic Board and teacher of the Master in Epidemiology at the University of Turin. Member of Scientific board and reviewer of several scientific journals. Author of over 300 scientific articles in international journals with impact factor (H-index=35). Author of several articles in popular magazines and interviews in national and regional media.