Title: Environmental Exposures and Health
Funder: Department of Health and Social Care

Abstract: Background Since 2014 the HPRU in the Health Impact of Environment Hazards (http://hieh.hpru.nihr.ac.uk/), a partnership between King's, Imperial and PHE has provided high quality scientific evidence to support PHE in implementing effective public health interventions to reduce the burden of ill health. Overarching aims of the HPRU Air pollution, noise, illicit drugs and tobacco are major underlying causes of chronic diseases while emerging exposures such as microplastics and e-cigarettes pose possible risks to human health. Combined these represent a considerable burden to the NHS and public purse. Many environmental exposures are ubiquitous and there is potential to reduce morbidity and mortality from disease, increase healthy life expectancy, reduce health inequalities from appropriate interventions and controls and improve understanding of the interactions of genetic and environmental factors. Exposures are often low level and can occur over a lifetime, while chronic effects are incremental making the assessment of adverse outcomes, and the benefits of interventions, challenging. Furthermore, effects can be compounded and exacerbated by combined environmental stressors including gaseous and particulate pollution, inter-individual variation from different physical states (for example obesity and pre-existing disease) and genetic variation that gives rise to varying susceptibilities. To address these complex issues, we utilise recently improved exposure assessment methods including data geocoding and linkage along with omic technologies to produce an integrated approach to environmental health research and risk assessment. This approach, across our themes, allows us to focus activity around a conceptual framework that examines links from the molecular level through man to populations across the life course, to advance knowledge and better inform environment and health policy. Research questions Our major focus is air pollution, both ambient and indoor pollutants which are an increasing area of concern. The work proposed (meta-analysis of adverse birth outcomes, cognitive development in children and exposures on the London Underground) are all work that has been requested by COMEAP, the Committee on the Medical Effects of Air Pollutants. In addition, we will investigate the toxicity of e-cigarette components, brake and tyre wear particles, micro-plastics and nanoparticles associated with specific household products. Potential outcomes We will: i) identify existing and emerging environmental hazards, ii) quantify the risk to human individuals and populations, iii) further the understanding of Biochemical pathways and toxic properties of such environmental contaminants, and iv) identify the populations and individuals at greatest risk so that interventions (including prevention policies and treatments) can be appropriately targeted.

Lay abstract: Background Since 2014 the HPRU in the Health Impact of Environment Hazards (http://hieh.hpru.nihr.ac.uk/), a partnership between King's, Imperial and PHE has provided high quality scientific evidence to support PHE in implementing effective public health interventions to reduce the burden of ill health. Overarching aims of the HPRU Air pollution, noise, illicit drugs and tobacco are major underlying causes of chronic diseases while emerging exposures such as microplastics and e-cigarettes pose possible risks to human health. Combined these represent a considerable burden to the NHS and public purse. Many environmental exposures are ubiquitous and there is potential to reduce morbidity and mortality from disease, increase healthy life expectancy, reduce health inequalities from appropriate interventions and controls and improve understanding of the interactions of genetic and environmental factors. Exposures are often low level and can occur over a lifetime, while chronic effects are incremental making the assessment of adverse outcomes, and the benefits of interventions, challenging. Furthermore, effects can be compounded and exacerbated by combined environmental stressors including gaseous and particulate pollution, inter-individual variation from different physical states (for example obesity and pre-existing disease) and genetic variation that gives rise to varying susceptibilities. To address these complex issues, we utilise recently improved exposure assessment methods including data geocoding and linkage along with omic technologies to produce an integrated approach to environmental health research and risk assessment. This approach, across our themes, allows us to focus activity around a conceptual framework that examines links from the molecular level through man to populations across the life course, to advance knowledge and better inform environment and health policy. Research questions Our major focus is air pollution, both ambient and indoor pollutants which are an increasing area of concern. The work proposed (meta-analysis of adverse birth outcomes, cognitive development in children and exposures on the London Underground) are all work that has been requested by COMEAP, the Committee on the Medical Effects of Air Pollutants. In addition, we will investigate the toxicity of e-cigarette components, brake and tyre wear particles, micro-plastics and nanoparticles associated with specific household products. Potential outcomes We will: i) identify existing and emerging environmental hazards, ii) quantify the risk to human individuals and populations, iii) further the understanding of Biochemical pathways and toxic properties of such environmental contaminants, and iv) identify the populations and individuals at greatest risk so that interventions (including prevention policies and treatments) can be appropriately targeted.

Research activity codes: 2.6 RESOURCES AND INFRASTRUCTURE (AETIOLOGY)
Health categories: RESPIRATORY;GENERIC HEALTH RELEVANCE