Data about internal exposures are useful to decode the exposome. The paper provides extensive information for EWAS. Information included serves as a guideline - snapshot in time without any claim to comprehensiveness - to interpret HBM data and offers opportunities to collect information about the internal exposure of stressors if no specific BoE is available.
Background: Urban outdoor air pollution, especially particulate matter, remains a major environmental health problem in Skopje, the capital of the former Yugoslav Republic of Macedonia. Despite the documented high levels of pollution in the city, the published evidence on its health impacts is as yet scarce. Methods: we obtained, cleaned, and validated Particulate Matter (PM) concentration data from five air quality monitoring stations in the Skopje metropolitan area, applied relevant concentration-response functions, and evaluated health impacts against two theoretical policy scenarios. We then calculated the burden of disease attributable to PM and calculated the societal cost due to attributable mortality. Results: In 2012, long-term exposure to PM2.5 (49.2 μg/m3) caused an estimated 1199 premature deaths (CI95% 821–1519). The social cost of the predicted premature mortality in 2012 due to air pollution was estimated at between 570 and 1470 million euros. Moreover, PM2.5 was also estimated to be responsible for 547 hospital admissions (CI95% 104–977) from cardiovascular diseases, and 937 admissions (CI95% 937–1869) for respiratory disease that year. Reducing PM2.5 levels to the EU limit (25 μg/m3) could have averted an estimated 45% of PM-attributable mortality, while achieving the WHO Air Quality Guidelines (10 μg/m3) could have averted an estimated 77% of PM-attributable mortality. Both scenarios would also attain significant reductions in attributable respiratory and cardiovascular hospital admissions. Conclusions: Besides its health impacts in terms of increased premature mortality and hospitalizations, air pollution entails significant economic costs to the population of Skopje. Reductions in PM2.5 concentrations could provide substantial health and economic gains to the city.
Climate change is a major environmental threat of our time. Cities have a significant impact on greenhouse gas emissions as most of the traffic, industry, commerce and more than 50% of world population is situated in urban areas. Southern Europe is a region that faces financial turmoil, enhanced migratory fluxes and climate change pressure. The case study of Thessaloniki is presented, one of the only two cities in Greece with established climate change action plans. The effects of feasible traffic policies in year 2020 are assessed and their potential health impact is compared to a business as usual scenario. Two types of measures are investigated: operation of underground rail in the city centre and changes in fleet composition. Potential co-benefits from reduced greenhouse gas emissions on public health by the year 2020 are computed utilizing state-of-the-art concentration response functions for PM, NO and CH. Results show significant environmental health and monetary co-benefits when the city metro is coupled with appropriate changes in the traffic composition. Monetary savings due to avoided mortality or leukaemia incidence corresponding to the reduction in PM, PM NO and CH exposure will be 56.6, 45, 37.7 and 1.0 million Euros respectively. Promotion of 'green' transportation in the city (i.e. the wide use of electric vehicles), will provide monetary savings from the reduction in PM, PM, NO and CH exposure up to 60.4, 49.1, 41.2 and 1.08 million Euros. Overall, it was shown that the respective GHG emission reduction policies resulted in clear co-benefits in terms of air quality improvement, public health protection and monetary loss mitigation.
Nowadays, the advancement of mobile technology in conjunction with the introduction of the concept of exposome has provided new dynamics to the exposure studies. Since the addressing of health outcomes related to environmental stressors is crucial, the improvement of exposure assessment methodology is of paramount importance. Towards this aim, a pilot study was carried out in the two major cities of Greece (Athens, Thessaloniki), investigating the applicability of commercially available fitness monitors and the Moves App for tracking people's location and activities, as well as for predicting the type of the encountered location, using advanced modeling techniques. Within the frame of the study, 21 individuals were using the Fitbit Flex activity tracker, a temperature logger, and the application Moves App on their smartphones. For the validation of the above equipment, participants were also carrying an Actigraph (activity sensor) and a GPS device. The data collected from Fitbit Flex, the temperature logger, and the GPS (speed) were used as input parameters in an Artificial Neural Network (ANN) model for predicting the type of location. Analysis of the data showed that the Moves App tends to underestimate the daily steps counts in comparison with Fitbit Flex and Actigraph, respectively, while Moves App predicted the movement trajectory of an individual with reasonable accuracy, compared to a dedicated GPS. Finally, the encountered location was successfully predicted by the ANN in most of the cases.
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