Symposia

Chair: Irva Hertz-Picciotto (USA)
O-SY-001 | Wildfire smoke exposure reduction advice for people with asthma | Sotiris Vardoulakis (Australia)
O-SY-002 | California wildfires: mental and physical health, unmet needs, and future directions | Irva Hertz-Picciotto (USA)
O-SY-003 | Climate change in the Caribbean: transforming vulnerabilities into resiliency | José Cordero (USA)
O-SY-004 | Heat waves and forest fires and their combined effects in the Greater Athens area | Klea Katsouyanni (Greece)
O-SY-005 | Mortality burden of heatwaves in Sydney Australia is exacerbated by the urban heat island and climate change: can tree cover help mitigate the health impacts? | Ivan Hanigan (Australia)

PROPOSAL ABSTRACT (#59)

Chair: Irva Hertz-Picciotto¹

Presenters: Geoffrey Morgan², Jose Cordero³, Klea Katsouyanni⁴, Sotiris Vardoulakis⁵

¹University of California Davis, Davis, United States of America, ²University of Sydney, Sydney, Australia, ³University of Georgia, Athens, United States of America, ⁴School of Medicine, National and Kapodistrian University of Athens, Athens, Greece, ⁵The Australian National University, Canberra, Australia

Decades of greenhouse gas emissions have led to increased global temperatures, which have given rise to extreme weather events: hurricanes, wildfires, floods, droughts, and heat waves of unprecedented frequency, magnitude, intensity and devastation. This symposium will explore examples in Puerto Rico, Australia, Greece, and California, including overlapping extreme events involving fires, heat waves, floods, and COVID-19. Presentations will describe the experiences, unmet needs, and health impacts—both short- and long-term; and provide insights into responses, which varied from being effective, appropriate, inadequate or insufficient to protect the public. Understanding the infrastructure that is needed, along with strategies that generate the co-benefits of both mitigation and adaptation, can help to improve the health of the planet and the population. Examples of adaptation interventions in the built environment might include better home insulation, and actions at community and personal levels aiming to reduce exposure to extreme environmental conditions. Particular focus will be placed on populations at risk, such as people with asthma, mental illness or other chronic diseases, socioeconomically marginalized groups, and persons of color, indigenous peoples, and immigrants, all of whom are typically more vulnerable during and after wildfires and other extreme events. Challenges are magnified with multiple extreme events—either of different types or repeated experiences of the same event type, as ‘rare’ and ‘extreme’ weather patterns are increasingly intense, straining existing infrastructure and resources. Health impacts may be multiplied when repeated events become the norm, or when different types of extreme weather events compound each other, such as heat waves and wildfires, hurricanes and earthquakes, or infectious diseases and any of the others. Resilience may wane as climate change advances to deliver co-occurring disasters. Environmental epidemiologists have critical roles to play as researchers, educators, and advisors, and as partners with communities and governmental agencies that are seeking solutions.

SYMPOSIUM 02: Multimodal environmental influences on children and adolescent’s brain, cognitive, and mental health outcomes

Monday 19 Sept 2022 | 10:45-12:45

PROGRAM

Chairs: Amy Margolis (USA), Marianthi-Anna Kioumourtzoglou (USA)
O-SY-006 | Early-life urban exposome and brain structural morphology and connectivity in childhood | Monica Guxens (Spain)
O-SY-007 | Approaches to identify the contribution of understudied toxicants in complex metal mixtures | Johnnye Lewis (USA)
O-SY-008 | Do complex mixtures of prenatal environmental and social exposures explain variation in risk for behavioral symptoms in adolescence? | Jaime Benavides (USA)
O-SY-009 | Prenatal exposure to mixtures of replacement flame retardant chemicals and children’s neuro-behavioral outcomes in a sample of children from socioeconomically disadvantaged communities | Tracy Bastain (USA)
O-SY-010 | A life-course approach for examining the impact of multiple air pollutants on adolescent anxiety and depression and the role of DNA methylation | Kelly Brunst (USA)

PROPOSAL ABSTRACT (#32)

Title: Multimodal Environmental Influences on Children and Adolescent’s Brain, Cognitive, and Mental Health Outcomes

Chairs: Amy Margolis¹, Marianthi-Anna Kioumourtzoglou²

Presenters: Mònica Guxens³, Johnnye Lewis⁴, Tracy Bastain⁵, Kelly Brunst⁶, Jaime Benavides²

¹Columbia University Irving Medical Center, New York, United States, ²Columbia University Mailman School of Public Health, New York, United States, ³ISGlobal, Barcelona, Spain, ⁴University of New Mexico, Albuquerque, United States, ⁵University of Southern California, Los Angeles, United States, ⁶University of Cincinnati, Cincinnati, United States

There is a growing appreciation of the importance of interactions in the exposome, the totality of an individual’s exposures, on the pathophysiology of cognitive and mental health problems. Exposure to environmental toxicants during pregnancy and early childhood has been linked with increased risk of cognitive and mental health outcomes. Additionally, children living with economic and infrastructure disadvantages often face increased risk both from these factors themselves and the increased likelihood of exposure to chemical toxicants that is associated with these factors. In this symposium we will bring together findings from studies examining associations between prenatal and early-life chemical and social exposures on brain development and subsequent cognitive and mental health indicators and outcomes. We consider exposures to factors which are known to have neurotoxic effects including chemical exposures, social stressors, and elements of the built environment.

Importantly, individuals are not typically exposed to a single chemical or social stressor. These exposures often act on similar biological processes, and they also can have additive, synergistic, or antagonistic effects. Such findings underscore the need for multimodal approaches to studying exposures. In this symposium, we bring together five lines of research that investigate the combined effects of multiple exposures on brain, cognitive, and mental health outcomes. We also explore how different approaches to modeling mixtures of exposure address different research questions and require consideration for modeling different types of risk. Presentations will cover approaches to mixture modelling in the context of examining effects of prenatal exposures to air pollution, flame retardants, pesticides, and phthalates as well as known social stressors associated with economic disadvantage on children’s brain, cognitive and mental health outcomes.

SYMPOSIUM 03: Strengthening the global role of environmental epidemiology in the issue of water, sanitation and public health in Latin American and Caribbean countries

Monday 19 Sept 2022 | 10:45-12:15

PROGRAM

Chairs: Telma Cassia dos Santos Nery (Brazil), Marcio Ribeiro Barbosa (Brazil)
O-SY-011 | The role of the University in the formation, discussion and training of researchers in environmental epidemiology. How to strengthen Latin America? | Sandra Cortes (Chile)
O-SY-012 | Waterborne arsenic and fluoride exposure in Mexico: risk assessment and epidemiological research on their health effects | Paulina Farías Serra (Mexico)
O-SY-013 | Diseases and deaths from pesticides in Brazil | Paulo Junior Paz de Lima (Brazil)
O-SY-014 | Surveillance and epidemiological control network in Latin America – The importance of water and sewage monitoring. Overview of pesticides in water for human consumption in Brazil – Information through the website – Good water to drink “Água Boa de Beber” | Telma de Cassia dos Santos Nery (Brazil)
O-SY-015 | The role of the World Alternative Water Forum (FAMA) and social mobilization | Edson Aparecido da Silva (Brazil)

PROPOSAL ABSTRACT # 52

Title: Strengthening the global role of environmental epidemiology in the issue of water, sanitation and public health in Latin American and Caribbean countries

Chairs: Telma Cassia dos Santos Nery¹, Marcio Ribeiro Barbosa⁷

Presenters: Paulo Junior Paz de Lima², Edson Aparecido Silva³, Mikaela Renata Funada Barbosa⁴, Sandra Cortez Aranciba⁵, Paulina Farías⁶

¹Divisao de Pneumologia InCor HCFMUSP, São Paulo, Brazil, ²Forum Paulista de Combate aos Impactos aos Agrotoxicos e Transgenicos – São Paulo Forum to Combat the Impacts of Pesticides and GMOs, São Paulo, Brazil, ³ONDAS Observatório dos Direitos á Água e Saneamento, Brasilia, Brazil, ⁴Divisão de Microbiologia e Parasitologia – Companhia Ambiental do Estado de SP, São Paulo, Brazil, ⁵Departamento de Salud Pública Facultad de Medicina Pontificia Universidad Católica de Chile, Santiago del Chile, Chile, ⁶Dirección de Salud Ambiental Instituto Nacional de Salud Pública, Mexico City, Mexico, ⁷University Hospital HU USP, São Paulo, Brasil

Water and sanitation are fundamental factors in life and environmental health. In some Latin American countries, are frequently the impacts related to: a) contamination by chemical products such as pesticides, metals and other substances ; b) scarcity of resources; c) natural disasters. This symposium seeks to discuss investigations, research, indicators, involvement of universities, civil society, vulnerable population, current legislation. Brazil is one of the countries with the highest use of pesticides, Mexico has high rates of metals in the environment, Pan American surveillance networks through sewage already exist and universities expand student training and research. It is important to discuss reports and experiences in Latin American countries. The discussion of environmental epidemiology among countries can strengthen research, actions and public policies on the subject. The exhibitions will be from different institutions and countries, with the aim of building and strengthening research in environmental epidemiology, stimulating regional and global public policies.

SYMPOSIUM 04: PFAS hotspots and highly exposed communities: addressing community needs and advancing global collaborative exposure assessment and epidemiological research

Monday 19 Sept 2022 | 10:45-12:15

PROGRAM

Chairs: Tony Fletcher (United Kingdom), Laurel Schaider (USA)
O-SY-016 | PFAS exposures in Veneto, Italy: the role of biomonitoring in addressing a serious public health threat | Cristina Canova (Italy)
O-SY-017 | Risk assessment in PFAS “hotspot” populations – A challenge | Kristina Jakobsson (Sweden)
O-SY-018 | Perspectives in risk communication due to the PFOS pollution case in Korsoer, Denmark | Janne Julie Møller (Denmark)
O-SY-019 | PFAS in serum of residents living in the neighborhood of a major PFAS manufacturer plant in Belgium | Ann Colles (Belgium)
O-SY-020 | The PFAS hotspot HBM network: development of a HBM PFAS guidance document for emerging PFAS hotspots, based on shared experiences across PFAS hotspots in EU | Katleen De Brouwere (Belgium)

PROPOSAL ABSTRACT (#37)

Title: PFAS Hotspots and Highly Exposed Communities: Addressing community needs and advancing global collaborative exposure assessment and epidemiological research

Chairs: Tony Fletcher¹, Laurel Schaider²

Presenters: Cristina Canova³, Kristina Jakobsson⁴, Janne Møller⁵, Ann Colles⁶, Katleen De Brouwere⁶

¹London School of Hygiene and Tropical Medicine, London, United Kingdom, ²Silent Spring Institute, Newton, United States, ³University of Padua, Padua, Italy, ⁴University of Gothenburg, Gothenburg, Sweden, ⁵Holbæk Hospital, Holbæk, Denmark, ⁶Flemish Institute for Technological Research, Mol, Belgium

Exposure to per- and polyfluoroalkyl substances (PFAS), a widely-used class of persistent chemicals, has been linked to an array of adverse health outcomes. While most individuals have some level of everyday exposures to PFAS, some populations living near contaminated sites are exposed at extremely high levels. Many highly-exposed communities have been identified around the globe, and new communities continue to be discovered. The extent of health effects in these communities remain unclear, and guidance regarding levels of exposure and specific health outcomes is uncertain or inconsistent. However, there is a public health need for science-driven approaches to population monitoring, risk evaluation and community commucation.

This symposium will convene PFAS researchers from around the globe to address this global challenge. First, five senior researchers studying European hotspots will present their past experiences working in highly-exposed communities, each focused on a critical sub-topic (population biomonitoring, policy-driven research, risk assessment and communication, and collaboration across research groups). Presentations will be limited to 10 minutes each, leaving time for a 30-minute round-table discussion. This round-table will be moderated by Dr. Tony Fletcher (London School of Hygiene), a lead epidemiologist in the C8 studies in Ohio and West Virginia, and Dr. Laurel Schaider (Silent Spring Institute), an exposure scientist and community engagement expert. It will address topics such as the development of exposure modeling and monitoring after hotspot identification; critical research needs in human biomonitoring and assessing health effects; benefits and challenges of pooling data across cohorts; and the role of community and stakeholder engagement and communication.

Learning objectives

At the end of the symposium, participants will be able to:

Describe important lessons learned by researchers working with highly-exposed communities;
Discuss key public health challenges and policy needs of these communities;
Identify collaborations and synergies to strengthen our collective research and impact.

SYMPOSIUM 05: Undermeasured and undervalued: examining social-structural factors in women’s and children’s global environmental health

Monday 19 Sept 2022 | 13:15-14:45

PROGRAM

Chairs: Jessica Laine Carmeli (Switzerland), Ami Zota (USA)
O-SY-021 | Perinatal and children’s environmental epidemiology: what about birth integrity? | Jessica Laine Carmeli (Switzerland)
O-SY-022 | Adverse childhood events and health-related quality of life among women undergoing hysterectomy for uterine leiomyoma | Ami Zota (USA)
O-SY-023 | Maternal and newborn health risks of climate change: a call for awareness and global action | Nathalie Roos (Sweden)
O-SY-024 | Environmental hazards, social inequality, and fetal loss: implications of live-birth bias for estimation of disparities in birth outcomes | Dana Goin (USA)
O-SY-025 | Federally-assisted housing and blood lead levels in the United States, 1999-2016 | MyDzung Chu (USA)

PROPOSAL ABSTRACT (#38)

Title: Undermeasured and undervalued: Examining social-structural factors in women’s and children’s global environmental health

Chairs: Jessica Laine Carmeli¹, Ami Zota²

Presenters: Nathalie Roos³, Dana Goin⁴, MyDzung Chu²

¹Institute for Social and Preventive Medicine, University of Bern, Bern, Switzerland, ²Department of Environmental and Occupational Health, George Washington University Milken School of Public Health, , United States of America, ³Department of Medicine, Solna, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden, ⁴Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of California, San Francisco, United States of America

Many of the root causes of environmentally associated disease and health span (in)equities of race/ethnicity, gender, and class, among other social and structural factors. Such disparities may be particularly impactful for women and children, given that they experience greater inequities, and that early life (i.e., reproductive, pregnancy, infancy, and childhood) are susceptible and critical time periods for environmental exposures. While environmental epidemiologists have increasingly focused on social determinants of health, several areas of structural determinants, especially integrated layers, are largely understudied. Bringing together diverse, global researchers who investigate the role of structural factors in women’s and/or children’s environmental health, presentations will represent frameworks that are largely absent, silent, or undervalued in environmental epidemiology. Notably, the five presenters will cover theories, calls for action, and use concrete global examples (e.g., from population cohorts) for how to measure and incorporate social-structural factors, such as federal policies and systemic inequities, in environmental epidemiological studies. Presentations integrate exposures that occur concurrently, not sequentially or compartmentalised, including factors in social, physical, and chemical hazards surrounding women’s, reproductive, perinatal, and infant and children’s health. Presentations will cover a broad and inclusive range of environmental epidemiological concepts, including intersectionality, gaps in exposome research, integration of pregnancy, birth, and postpartum integrity into environmental epidemiology, environmental hazards and social inequality, the built environment and housing policy, and susceptible populations for climate change. Participants in this symposium will benefit from the identification of knowledge and research gaps in a critical and emerging area of environmental health, applicable on a global scale. This symposium will provide theoretical and practical frameworks for studying under-measured and undervalued structural factors in environmental health, pertinent for a wide range of public health researchers. Furthermore, works by the presenters identify modifiable risk factors for women and in early in life to prevent disease and promote health.

SYMPOSIUM 06: The Multi-Country Multi-City (MCC) Collaborative Research Network: an international collaboration for global studies on environmental risks, climate change, and health

Monday 19 Sept 2022 | 13:15-14:45

PROGRAM

Chairs: Antonio Gasparrini (United Kingdom), Ana Maria Vicedo-Cabrera (Switzerland)
O-SY-026 | The MCC Network: an international collaboration for global health research | Antonio Gasparrini (United Kingdom)
O-SY-027 | Global analyses on health effects of temperature and climate change: the contribution of the MCC Network | Ana Maria Vicedo-Cabrera (Switzerland)
O-SY-028 | Air pollution and daily mortality in the Multi-country Multi-city study: single and joint effect with heat | Massimo Stafoggia (Italy)
O-SY-029 | Mapping global mortality burden associated with multiple environmental stressors: a new framework by the MCC Network | Yuming Guo (Australia)
O-SY-030 | The role of environmental factors in the COVID-19 pandemic: research from the MCC Network | Francesco Sera (Italy)

PROPOSAL ABSTRACT (#18)

Title: The Multi-Country Multi-City (MCC) Collaborative Research Network: an international collaboration for global studies on environmental risks, climate change, and health

Chairs: Antonio Gasparrini¹, Ana Maria Vicedo-Cabrera²

Presenters: Aurelio Tobias³, Haidong Kan⁴, Massimo Stafoggia⁵, Yuming Guo⁶, Francesco Sera⁷

¹London School of Hygiene & Tropical Medicine, London, United Kingdom , ²University of Bern, Bern, Switzerland, ³Spanish Council for Scientific Research (CSIC), Barcelona, Spain, ⁴Fudan University, Shanghai, China, ⁵Lazio Region Health Service, Rome, Italy, ⁶Monash University, Melbourne, Australia, ⁷University of Florence, Florence, Italy

Addressing global environmental threats requires ambitious research endeavours based on large epidemiological assessments covering multiple regions. Multi-centre studies offer an excellent framework for this purpose, but they present various methodological and logistical problems. This symposium will describe the experience of the Multi-Country Multi-City (MCC) Collaborative Research Network, an international collaboration working on a global program of research on the associations between environmental stressors, climate change, and health.

The MCC Network is a partnership of more than 80 researchers from multiple countries. The network is built under a flexible collaborative scheme based on mutual contribution and data sharing, through which it has gathered one of the largest databases ever collected to study health risks associated with environmental factors. It lists now data from more than 1,000 locations around the world, and it has been used in several impactful studies published in leading epidemiological, medical, and environmental journals. The research within the MCC Network has been supported by intense methodological work, with the development of new analytical techniques that have become the state of the art for time series analysis in environmental epidemiology. The flexible collaborative framework has allowed MCC researchers to address multiple topics related to environmental health research, providing original evidence and important methodological advancements.

The symposium is articulated in a series of presentations by MCC researchers, and it will comprehensively illustrate examples of the multi-disciplinary work conducted so far as well as ongoing projects. The research of the MCC Network has already provided an exceptional contribution to our understanding of environment-health associations and the impacts of climate change. The collaborative framework can be replicated to address other research questions in this area and beyond.

SYMPOSIUM 07: Disparities in US drinking water quality and access

Monday 19 Sept 2022 | 13:15-14:45

PROGRAM

Chairs: Ronnie Levin (USA), Jacqueline MacDonald Gibson (USA)
O-SY-031 | Racial disparities in access to U.S. community water systems: effects on children’s health | Jacqueline MacDonald Gibson (USA)
O-SY-032 | Safe home water access for low-income families with young children | Angie Cradock (USA)
O-SY-033 | Socioeconomic disparities in exposures to unregulated industrial contaminants in U.S. public drinking water supplies | Laurel Schaider (USA)
O-SY-034 | Nitrate contamination in Maryland drinking water and policy reforms to safeguard private wells | Darya Minovi (USA)
O-SY-035 | Lead contamination of drinking water is an EJ issue | Ronnie Levin (USA)
O-SY-036 | The US Safe Drinking Water Act’s systemic failure to equitably safeguard vulnerable Americans from contaminants Including nitrates | Erik D. Olson (USA)

PROPOSAL ABSTRACT (#25)

Title: Disparities in US drinking water quality and access

Chairs: Ronnie Levin¹, Jacqueline Gibson²

Presenters: Angie Cradock¹, Darya Minovi³, Erik Olson⁴, Laurel Schaider⁵

¹Harvard School Of Public Health, Newton, United States of America, ²Department of Environmental and Occupational Health, Indiana University, Bloomington, USA, ³Center for Progressive Reform, Washington, USA, ⁴Natural Resources Defense Council, Washington, USA, ⁵Silent Spring Institute, Newton, USA

As analytical methods and social consciousness have evolved, so too has our awareness of social disparities and inequities related to environmental benefits and burdens. Mounting research and data reveals inconsistent environmental compliance by the United States’ 60,000 community water systems. Contamination of drinking water with lead, nitrates and industrial chemicals is not distributed equally: low-income, immigrant, Indigenous, and communities of color have higher exposures to hazardous drinking water contamination. At the same time, data show that many low-income families in both urban and rural areas do not have access to safe drinking water at home, compounding the toll particularly from the COVID-19 pandemic. Socioeconomic disparities are evident in exposures to industrial contaminants in US EPA’s unregulated drinking-water monitoring data. Flint Michigan is the most widely publicized municipal water crisis, but more typical than extreme: in 2015, an estimated 18 million Americans received water with high lead levels. Investigations of nitrate contamination show increasing levels associated with expanded agricultural activities, concentrated animal feedlots and land development. Nitrate contamination is more frequent in rural, low-income, minority and immigrant communities.

These disparities can no longer be ignored. In this symposium, we will highlight some of the current and emerging data on lead exposures associated with US public and private water supplies, disparities in access to clean drinking water for low-income families with young children, and systemic policy and implementation factors that maintain these inequities.

SYMPOSIUM 08: Magnetic Resonance Imaging (MRI); a cross-cutting tool at the intersection of environmental epidemiology and developmental neuroscience

Monday 19 Sept 2022 | 13:15-14:45

PROGRAM

Chairs: Megan Horton (USA), Akhgar Ghassabian (USA)
O-SY-037 | Pre-natal and neonatal neuroimaging in the BiSC cohort | Jordi Sunyer (Spain)
O-SY-038 | Resting-state functional connectivity patterns are associated with metal mixture exposure in young adolescents | Megan Horton (USA)
O-SY-039 | Prenatal exposure to endocrine disrupting chemicals and brain development in adolescents | Akhgar Ghassabian (USA)
O-SY-040 | Ambient air pollution and functional brain network development in adolescence | Devyn Cotter (USA)
O-SY-041 | Early-life exposure to air pollution and brain structural development across childhood: a longitudinal study | Monica Guxens (Spain)

PROPOSAL ABSTRACT (#33)

Title: Magnetic Resonance Imaging (MRI); a cross-cutting tool at the intersection of environmental epidemiology and developmental neuroscience

Chairs: Megan Horton¹, Akhgar Ghassabian

¹Icahn School Of Medicine At Mount Sinai, New York, United States of America

Brain development throughout the fetal and early childhood period is particularly vulnerable to neurotoxic exposures. Exposure to environmental chemicals during these early critical developmental windows may shift the individual onto a maladaptive trajectory, adversely impacting behavioral and cognitive outcomes across the life course. Little is known about the mechanistic processes by which environmental chemicals impact children’s brain development. Magnetic resonance imaging (MRI) offers unprecedented, non-invasive access to studying in vivo mechanisms linking early life environmental exposures with the structural and functional brain changes potentially underpinning adverse neurodevelopmental outcomes. Unlike questionnaire-based assessments commonly used in children’s environmental health research, MRI provides an objective, highly sensitive tool that translates across different study designs, life stages and populations, strengthening opportunities for translation of local studies across the globe. Researchers can investigate MRI-based brain phenotypes associated with different exposure proxies (i.e., internal and external biomarkers, environmental assessments, and exposure models). MRI may better identify subtle, subclinical changes prior to the onset of clinically recognizable disease.

Used by developmental neuroscientists and psychologists for decades in clinical populations, improved methods and advances in technology increase the accessibility of MRI in non-clinical pediatric populations. Here, we highlight examples from the growing number of environmental epidemiologists and neuroscientists around the world leveraging MRI to examine the impact of early life environmental exposures on brain development through the fetal, early childhood and adolescent periods. Presentations leverage exposure assessment technologies including longitudinal air pollution modeling, retrospective dentine biomarkers, and concurrent biological markers to measure exposure to different classes of environmental toxicants such as air pollution, neurotoxic metals, and non-persistent organics. The objective is to create a forum for discussion of challenges and opportunities in epidemiological studies that apply neuroimaging tools to establish the influences of early life environmental insults on brain development from the fetal period through adolescence.

Submission Number: 7

Title: Global perspectives on harmonizing chemical risk assessments: Current status and future needs

Chairs: Dr. Rachel Shaffer¹, Dr. Kurt Straif²

Presenters: Joanke van Dijk³, Dr. Marlene Agerstrand⁴, Dr. Richard Brown⁵

¹U.S. Environmental Protection Agency, Washington DC, United States of America, ²ISGlobal, Barcelona, Spain, ³Utrecht University, Utrecht , The Netherlands, ⁴Stockholm University, Stockholm, Sweden, ⁵World Health Organization, Geneva, Switzerland

Chemical assessment serves a fundamental role in the translation of science to policy. In recent years, there has been increasing attention to the need for more holistic and harmonized approaches to assessment that consider exposures across multiple frameworks and statutes (i.e., aggregate exposures), rather than the existing approach to assess one chemical in one context at a time. Harmonized risk assessment approaches can have numerous benefits, including decreasing the potential for duplication across government agencies, establishing standardized data submission requirements for industry, and reducing confusion to the public.

This symposium will discuss the current state of risk assessment in the European Union (EU) and United States (US) as well as goals and challenges in adopting a more integrated system (such as the “one substance, one assessment” approach). The symposium will begin with a brief introduction to current risk assessment approaches in the EU (Joanke van Dijk) and the US (Rachel Shaffer) as well as discussions about why a more integrated assessment approach is recommended. Then, we will focus on challenges related to the transparency, reliability, relevance, and accessibility of ecotoxicological and toxicological data within EU regulatory frameworks (Marlene Agerstrand). The final presentation (Richard Brown) will provide perspectives on this topic in the context of current efforts to advance harmonized control of chemicals and waste at the global level.

Individual Presentations:

Towards ‘one substance-one assessment’: An analysis of European chemical registration and environmental risk assessment frameworks
Joanke van Dijk (Copernicus Institute of Sustainable Development, Utrecht University & Institute for Biodiversity and Ecosystem Dynamics, University of Amsterdam)

Environmental Health Assessment in the United States
Rachel M. Shaffer (U.S. Environmental Protection Agency)

Advancing Coordination of Systematic Review
Kristina Thayer (U.S. Environmental Protection Agency)

Evaluating Chemical Hazard on a Global Scale
Tracey Woodruff (University of California, San Francisco)

Submission Number: 8

Title: The Use of Epidemiology in Risk Assessment: Challenges and Innovations in Translating Human Health Research

Chairs: Dr. Rachel Shaffer¹, Dr. Rebecca Nachman¹

Presenters: Dr. Thomas Bateson¹, Dr. Philippe Grandjean², Dr. Esben Budtz-Jorgensen³, Dr Matthew Wheeler⁴, Dr. Alexandra Larsen¹, Dr. Roel Vermeulen⁵

¹U.S. Environmental Protection Agency, Washington DC, United States, ²University of Southern Denmark , Odense, Denmark , ³University of Copenhagen, Copenhagen, Denmark , ⁴National Institute of Environmental Health Sciences, Durham, United States , ⁵National Institute for Public Health and the Environment, Utrecht, The Netherlands

This session will be an introduction to how international agencies perform dose-response analysis and derive toxicity values based on epidemiological data, with the goal of helping epidemiologists understand the downstream applications of their research. The session will begin with an overview of the challenges that arise when using epidemiological data in dose-response modeling (Tom Bateson, EPA). Then, a series of presentations will provide examples where academic scientists and international agencies have conducted such modeling with epidemiological data, including promising advancements for the field in the areas of benchmark dose (BMD) modeling and meta-regression. Drs. Budtz-Jorgensen, Grandjean, and Wheeler will discuss the use of epidemiologic data in benchmark (BMD) modeling and approaches to improve evaluation of and control for confounding. Dr. Larsen will discuss challenges and advancements with analyzing heterogenous epidemiologic data and proposed solutions in the context of meta-regression to evaluate health effects of inorganic arsenic. The final presentation, from Dr. Vermeulen, will present applications of Bayesian meta-regression to multiple data streams (human, animal, in vitro). Attendees will gain an improved understanding of the challenges and innovations with applying epidemiologic data in dose-response modeling to inform public health policies.

Individual Presentations:

Introduction to applying dose-response modeling from epi data to derive toxicity values
Tom Bateson (EPA)
Developments in benchmark modeling of epidemiological data
Esben Budtz-Jørgensen (University of Copenhagen) and Philippe Grandjean (University of Southern Denmark and Harvard School of Public Health)
Benchmark dose estimation using covariate-controlled epidemiology estimates
Matt Wheeler (NIEHS)
Advances in the meta-regression of heterogeneous studies: lessons learned from EPA’s analysis of inorganic arsenic
Alex Larsen (EPA)
Estimation of the exposure response relation by combining epidemiological, human biomarker and animal data in a Bayesian meta-regression model
Roel Vermeulen (RIVM)

Submission Number: 12

Title: Chemical exposures and children’s health in the United States: Results from the NIH Environmental influences on Child Health Outcomes (ECHO) Program

Chairs: Dr. Jessie Buckley¹, Dr. Deborah Bennett²

Presenters: Dr. Leonardo Trasande³, Dr. Rachel Miller⁴, Dr. Yun (Jamie) Liu⁵, Dr. Jennifer Ames⁶

¹Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America, ²University of California Davis, Davis, United States of America, ³New York University, New York, United States of America, ⁴Icahn School of Medicine at Mount Sinai, New York, United States of America, ⁵Brown University, Providence, United States of America, ⁶Kaiser Permanente Northern California, Oakland, United States of America

The National Institutes of Health’s Environmental influences on Child Health Outcomes (ECHO) Program, the largest ever study of children’s health in the United States, consists of more than 50,000 mother-child pairs from 69 cohorts with diverse geography and demographic characteristics. The goal of ECHO is to understand the environmental influences on childhood disease with a focus on pre-, peri-, and postnatal; respiratory; obesity; and neurodevelopment outcomes as well as factors that promote positive health. ECHO cohorts have measured a vast array of chemicals in pregnancy samples, including phthalates, environmental phenols, organophosphate ester flame retardants (OPFRs), and per- and polyfluoroalkyl substances (PFAS). Leveraging large sample sizes, diverse cohorts, and rich data, ECHO investigators are conducting innovative epidemiologic studies to address key gaps in children’s environmental health research. In this symposium, we will describe the ECHO resource as well as results of five innovative pooled analyses that span a variety of chemical classes and children’s health outcomes: OPFRs and perinatal outcomes, phthalates and perinatal outcomes, environmental phenols and asthma, PFAS and obesity, and PFAS and autism. We will conclude with a discussion of how ECHO can be leveraged to create opportunities for collaborative, solution-oriented research to improve children’s health in the United States and globally.

Individual Presentations:

Solution-oriented research for chemical exposures and children’s health: the ECHO Program

Jessie Buckley, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America

OPFR exposure and perinatal outcomes

Deborah Bennett

Effects of Phthalates on Fetal Growth: An ECHO-Wide Analysis

Leonardo Trasande, New York University, New York, United States of America

Exposures to environmental phenols and analogues and asthma risk

Rachel Miller, Icahn School of Medicine at Mount Sinai, New York, United States of America

Associations of Gestational Perfluoroalkyl Substances Exposure with Early Childhood BMI Z-Scores and Risk Of Overweight/Obesity: Results From the ECHO Cohorts

Yun (Jamie) Liu, Brown University, Providence, United States of America

Prenatal exposure to per- and polyfluoroalkyl substances (PFAS) and childhood autism-related outcomes

Jennifer L. Ames, Kaiser Permanente Northern California, Oakland, United States of America

Submission Number: 26

Title: The project EXHAUSTION – Heat and air pollution effects on cardiopulmonary mortality and morbidity: geographical variability and vulnerable groups in Europe

Chairs: Dr. Alexandra Schneider¹, Dr. Francesca de’Donato²

Presenters: Dr. Susanne Breitner-Busch³, Dr. Pierre Masselot⁴, Dr. Massimo Stafoggia², Dr. Siqi Zhang¹, Dr. Gerardo Sanchez Martinez⁵

¹Helmholtz Zentrum München, Institute of Epidemiology, Neuherberg, Germany, ²Department of Epidemiology Lazio Regional Health Service – ASL Roma 1, Rome, Italy, ³LMU Munich, Institute for Medical Information Processing, Biometry, and Epidemiology – Chair of Epidemiology, Neuherberg, Germany, ⁴London School of Hygiene & Tropical Medicine, London, United Kingdom, ⁵European Environment Agency, Copenhagen, Denmark

Extreme climatic conditions have been associated with adverse effects on human health and are one of the greatest threats of the century. Recent studies highlight the interactive effects of temperature and air pollution on mortality, with stronger temperature-mortality associations at higher exposure levels of ozone or particulate matter. However, evidence on the interaction between air pollution and temperatures as well as on the long-term effects of temperature exposure is inconclusive. Research in this field is sparse and with the increase of temperature extremes worldwide and the still consistently high air pollution levels in many parts of the world, there is an urgent need to fill these gaps. The European Horizon 2020 project EXHAUSTION seeks to quantify the changes in cardiopulmonary mortality and morbidity due to extreme heat and air pollution focusing on the geographical differences across Europe and within European countries as well individual risk factors. This symposium aims to present different methodological approaches for different geographical units, i.e. European cities, small area analysis on the level of districts and municipalities for selected European countries as well as individual analysis using selected European cohort data. A specific focus will be set on the analysis of the interaction between air pollution and temperatures as well as on vulnerability factors and susceptible population subgroups based on the project’s current findings from different geographic areas and for different health outcomes. The results will be disseminated to the general public and key decision- and policy-makers across Europe, providing a tool to increase European adaptation to climate change and improve public heath resilience. The knowledge gained in EXHAUSTION can support adaptation plans by providing useful information on areas most at risk in Europe other than urban areas as well as individual vulnerability factors to ensure that adaptation policy mechanisms target those most at risk.

Individual Presentations:

Short-term heat effects and effect modification by ambient air pollution on cardiovascular and respiratory mortality across 148 cities from 13 European countries
Susanne Breitner-Busch
Europe-wide variations of temperature-related excess mortality in urban areas considering demography, socio-economic, urban planning, environmental and climatic characteristics
Pierre Masselot
Analysis of short-term heat effects on cardiopulmonary mortality and morbidity using small area level data in five European countries
Massimo Stafoggia
Long-term effects of air temperature on cardiopulmonary outcomes in prospective European cohort: studies
Siqi Zhang
Heat health action plans in Europe: current evidence and future
Gerardo Sanchez Martinez

Submission Number: 27

Title: Location, Location, Location! The importance of geospatial exposure constructs to assess pesticide exposures and related adverse health outcomes in agricultural settings.

Chairs: Dr. Jose Suarez¹, Ms. Briana Chronister¹

Presenters: Dr. Beate Ritz², Dr. Georgia Kayser¹, Mariana Simões³, Dr. Robert Gunier⁴, Luis Palomo⁵

¹University of California San Diego, La Jolla, United States of America, ²University of California Los Angeles, Los Angeles, USA, ³Ultrecht University, Utrecht, Netherlands, ⁴University of California, Berkeley, Berkeley, USA, ⁵Universidad Nacional, Heredia, Costa Rica

People living in agricultural settings are at increased risk of pesticide exposure and pesticide-related negative health effects, such as asthma, cognitive delays, and adverse birth outcomes. Geospatial constructs aimed at understanding the spatial relationships between individuals and agricultural sources of pesticide exposures can be reliable indicators of chronic pesticide exposure that bypass the cost and methodological limitations of exposure biomarkers. Thus, geospatial techniques can be valuable tools to help establish causal links between pesticide exposures and health outcomes.

In this symposium we will discuss novel and relevant geospatial constructs to monitor pesticide exposures and to assess pesticide-related health effects in agricultural communities. This symposium includes six presentations of research across 3 continents, involving participants spanning the life-course (prenatal through adulthood):

Estimation of pesticide related health effects, including, metabolomic patterns, methylation changes, and gut microbiome, among pregnant women and older adults, using the California Pesticide Use Reports and land use data.
Identifying overlapping geospatial clustering patterns of urinary pesticide metabolite concentrations, depression, and anxiety symptoms amongst adolescent participants in agricultural areas of Ecuador.
Reproductive toxicity related with pesticide exposures measured using annual crop maps and a farmer pesticide use survey among a Dutch study of singleton births (2009-2013).
Respiratory health in relation to residential proximity to agricultural fungicide application sites, assessed in pregnancy and early life, in a rural birth cohort in California.
Associations of residential proximity to floricultural greenhouses with sex and adrenal hormone alterations in 525 Ecuadorian adolescents.
The use of geographical information systems and bystanders’ reports to assess adherence to pesticide use regulations in Costa Rica.

Individual Presentations:

Geographic and Record-Based Pesticide Exposure Assessment, Biologic Exposure Signatures, and Chronic Disease Modelling in California

Beate Ritz

Geospatial determinants of urinary pesticide concentrations and mental health in Ecuadorian adolescents.

Briana Chronister

Residential exposure to pesticides and birth outcomes in the Netherlands

Mariana Simões

Residential proximity to agricultural pesticide use and respiratory health in the CHAMACOS study.

Robert Gunier

Residential Proximity to Pesticide Sprayed Sites and Sex and Adrenal Hormones in Ecuadorian Adolescents

Georgia Kayser

Geospatial analyses as a tool to monitor the implementation of regulation on aerial pesticide spraying in Matina County, Costa Rica

Luis Palomo

Submission Number: 29

Title: Epidemiological studies for Preparedness and Response to Public Health and Environmental Crises and Disasters

Chairs: Prof. Elisabeth Cardis¹, Dr Kurt Straif^1,2

Presenters: Prof Cheryl Cohen³, Prof Iman Nuwayhid⁴, Prof Roberto Lucchini^5,6, Prof Claire Horwell⁷

¹Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain, ²Boston College, Boston, USA, ³Centre for Respiratory Disease and Meningitis, University of the Witwatersrand, Johannesburg, South Africa, ⁴American University of Beirut, Beirut, Lebanon, ⁵Department of Environmental Health Sciences, Florida International University, Miami, USA, ⁶University of Brescia, Brescia, Italy, ⁷Institute of Hazard, Risk & Resilience, Department of Earth Sciences, Durham University, Durham, United Kingdom

The global crisis posed by the COVID-19 pandemic has had major impacts in all areas of our lives, ranging from direct impact of the SARS-CoV-2 infection on COVID morbidity and mortality to indirect effects of the pandemic on the health and well-being of populations across the globe, the economy, societies and education.

History shows that our health and well-being may be affected by a variety of hazards including natural disasters and biological, chemical, radiological and physical hazards, epidemics and pandemics, and emerging infectious diseases. The key lesson from COVID-19, also learned from past nuclear accidents, is the need to be much better prepared.

Epidemiology can play a key role in preparedness, response and surveillance for all types of crises. This symposium will focus on lessons learnt from epidemiological studies in response to different environmental and public health crises. Despite the different nature of these crises, they share important commonalities, in terms of the consequences – which go further than direct somatic effects of exposures and include psychological, social and economic effects – and the epidemiologic approach needed – identification of affected populations, characterisation of exposure, follow-up and surveillance. Each speaker will focus on a particular environmental or public health crisis or disaster – radiological and chemical accidents, natural disasters and pandemics -, share their experience and address future needs for epidemiological surveillance, study protocols and long-term sustainability. The symposium will serve to identify commonalities and differences between the different crises and address the feasibility and desirability of developing core “all-hazards” epidemiological and surveillance protocols in the preparedness phase that can readily be adapted to different crises when they occur. It will provide an opportunity to foster synergies between epidemiologists involved in the study of different types of crises and to strengthen preparedness, response and surveillance for future global health crises.

Individual Presentations:

Lessons learnt from past nuclear accidents

Elisabeth Cardis, ISGlobal, Barcelona, Spain

Reflections on the response to the SARS-CoV-2 pandemic in South Africa

Cheryl Cohen, Centre for Respiratory Disease and Meningitis, University of the Witwatersrand, South Africa

BEIRUT BLAST: Lessons learned

Iman Nuwayhid, Faculty of Health Sciences, American University of Beirut, Lebanon

Emerging preparedness for major accidents: updates about the 9/11 health consequences and more recent events

Roberto Lucchini, Department of Environmental Health Sciences, Florida International University, USA and University of Brescia, Italy

Standardized epidemiological protocols for assessment of health impacts in eruption crises

Claire Horwell – Institute of Hazard, Risk & Resilience, Department of Earth Sciences, Durham University, UK

Submission Number: 34

Title: Perfluoroalkyl and polyfluoroalkyl substances (PFAS) in Indigenous communities: A case of environmental injustice

Chairs: Dr. Amira Aker^1,2, Dr. Mélanie Lemire^1,2

Presenters: Ms Lucy Grey³, Dr Samuel Byrne⁴, Dr Amalie Timmermann⁵, Dr Brian Laird⁶, Ms Whitney Gravelle⁷

¹Département de médecine sociale et préventive, Universite Laval, Quebec, Quebec, Canada, Quebec, Canada, ²Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Quebec, Canada, ³Makivik Corporation, Nunavik, Canada, ⁴Department of Biology, Middlebury College, Middlebury, USA, ⁵National Institute of Public Health, University of Southern Denmark, Odense, Denmark, ⁶School of Public Health Sciences, University of Waterloo, Waterloo, Canada, ⁷Bay Mills Indian Community, Bay Mills, USA

Perfluoroalkyl and polyfluoroalkyl substances (PFAS), dubbed “forever chemicals”, are synthetic chemicals used in industrial and consumer products for their water and stain resistant properties. Environmental contamination can occur via direct release from industrial facilities and the use of fire-fighting aqueous film-forming foam materials, and indirectly via landfill leachates and wastewater treatment discharge. These biopersistent chemicals also travel via oceanic and atmospheric transport to northern latitudes and biomagnify in Arctic food webs, particularly in marine mammals and seafood. Subsequently, elevated concentrations of PFAS have been identified in Indigenous Peoples worldwide who rely on traditional foods hunted, fished, and gathered from the land. In fact, PFAS exposure levels in Alaska, Greenland, and Nunavik are significantly higher than concentrations in the general US and Canadian populations. Perfluorononanoic acid (PFNA), for example, was detected at concentrations seven-fold higher in Nunavik compared to Canada, even though there are no known direct exposure sources of PFAS in the region. In southern latitudes (including the US mainland), recent reports have identified the lack of research of PFAS exposure levels in Indigenous tribal lands, despite the lands’ reduced access to safe public drinking water compared to non-tribal lands, increased risk of being near landfills and military operations, and the communities’ deep connection to and reliance on the land.

Our proposed symposium will present the latest results on PFAS exposure and exposure sources in Indigenous communities in Arctic regions and surrounding the Great Lakes in a series of five presentations. The talks will highlight the unique exposures in these communities and discuss the environmental injustices surrounding PFAS. Additionally, the ISEE annual meeting will be held a week before the Persistent Organic Pollutants Review Committee (POPRC) to discuss the inclusion of long-chain PFAS in the Stockholm Convention’s list of chemicals, and this symposium could help support the long-chain PFAS’ nomination.

Individual Presentations:

Elevated exposure to long-chain perfluoroalkyl and polyfluoroalkyl substances (PFAS) in Inuit from Nunavik, Arctic Canada: a call for global action
Amira Aker, Melanie Lemire and Lucy Grey

Exposure to PFAS in two Alaska Native Communities
Samuel Byrne

PFAS exposure and immunotoxic effects in children from Greenland
Amalie Timmermann

Determinants of Polyfluoroalkyl substances and perfluoroalkyl substances (PFAS) Biomarkers in First Nations Communities of the Northwest Territories and Yukon
Brain Laird

Indigenous lifeblood in land, water, and natural resources: the unknown threat of PFAS contamination
Whitney Gravelle

Submission Number: 39

Title: Climate change, heat and maternal health: estimating current and future burdens

Chairs: Dr. Sari Kovats¹, Prof Nathalie Roos³

Presenters: Dr Jeroen de Bont³, Dr Darshnika Pemi Lakhoo⁴, Dr Sarah Chapman², Dr Cherie Part¹

¹London School of Hygiene and Tropical Medicine, London, United Kingdom , ²Leeds University, Leeds, United Kingdom, ³Karolinska Instituet, Stockholm, Sweden, ⁴Wits RHI, , South Africa

Climate and weather extremes affect maternal and infant health through several mechanisms. The burden of heat on child mortality is significant and likely to increase in the future due climate change and other factors. Exposure to high ambient temperatures during pregnancy can increase the risk of maternal complications such as pre-eclampsia and preterm birth. This session will highlight advances in research methods to characterise the impact of environmental temperature on maternal and child health outcomes. Presentations will address the windows of exposure that may increase risk of adverse MNH outcomes and a comparison of analytical approaches. The session presents findings from the CHAMNHA (Climate, Heat And Maternal and Neonatal Health in Africa) study that aims to address key knowledge gaps in low-income settings to improve adaptation to high temperatures and increase resilience in healthcare systems.

Individual Presentations:

Intro and welcome
Nathalie Roos, Chair

Associations between ambient temperature and risk of shortened pregnancy in the Swedish Pregnancy Registry: a comparison of analytical approaches
Jeroen de Bont, Karolinska Instituet

Heat exposure during pregnancy and risk of maternal hypertensive disorders: A time-to-event study in Johannesburg, South Africa
Chérie Part, Research Fellow, London School of Hygiene & Tropical Medicine

Systematic review of the impacts of climate hazards on health service delivery
Sari Kovats, London School of Hygiene & Tropical Medicine

The effect of high and low ambient temperature on infant health: a literature review
Darshnika Pemi Lakhoo, Researcher, Wits RHI

Past and projected climate change impacts on heat-related child mortality in Africa
Sarah Chapman, Leeds University

Submission Number: 40

Title: Toxicity of air pollutant mixtures: Overcoming the toxic mixture of spatial misalignment, collinearity, and measurement error

Chairs: Professor Howard Chang, Professor Jaime Hart

Presenters: Prof. Adam Szpiro¹, Professor Donna Spiegelman, Professor Helen Suh, Professor Joshua Keller, Dimitris Evangelopoulos, Xin Zhou,

¹University Of Washington, Seattle, United States of America

There is strong and growing epidemiological evidence that exposure to ambient fine particulate matter air pollution is associated with morbidity and mortality. Since air pollution is a complex mixture of multiple chemical components and gases derived from regional and local sources, specialized statistical methods are needed to learn about the differential effects of classes of air pollution. Mixture modeling is a topic of significant interest in environmental epidemiology, where much of the focus is on efficiently analyzing highly collinear multivariate exposures with the potential for nonlinear associations and complex interactions. Comparatively little attention has been paid to the specific challenges in studying air pollution mixtures for large geographically widespread cohorts, specifically spatial misalignment of the monitoring data and measurement error in exposure assessment.

Presenters in this symposium will describe recent innovations in epidemiologic analysis of long-term air pollution exposure, conceptualized as a mixture of chemical components derived from multiple sources. The presentations will pay close to the connections between collinearity, spatial misalignment, and exposure measurement error, and the symposium will include a discussion of the advantages, disadvantages, and synergies of the proposed methods.

Individual Presentations:

Measurement errors in Gaussian mixture models using high-dimensional air pollution constituent data
Xin Zhou, PhD, Biostatistics, Yale University

Impact of exposure measurement error in multi-pollutant models: a simulation study in the time-series framework
Dimitris Evangelopoulos, Medicine, Imperial College London

Predictive clustering methods to identify differential toxicity of air pollutant mixtures
Joshua Keller, PhD, Statistics, Colorado State University

Two-stage residual analysis of associations between PM2.5 components and source factors in a US Medicare cohort
Helen Suh, PhD, Civil and Environmental Engineering, Tufts University

Submission Number: 48

Title: A New Era in Global Climate Change and Human Health Research Funding and Action

Chairs: Dr. Gwen Collman¹, Dr. Aubrey Miller¹

Presenters: Dr. Josh Rosenthal¹, Dr. Bryan Hubbel², Dr. Joan Brunkard³

¹National Institutes of Health, Bethesda, United States of America, ²Environmental Protection Agency, Durham, United States of America, ³Centers for Disease Control and Prevention, Atlanta, United States

There is international consensus that climate change poses many threats to human health and wellbeing. According to the Intergovernmental Panel on Climate Change (IPCC), the United Nation’s body for assessing the science related to climate change, a report concluded that there is high confidence “that global warming is projected to affect human health with primarily negative consequences.” Climate drivers affect human health outcomes directly through weather events such as extreme heat, wildfires, droughts, storm surges, and floods, and indirectly through a series of exposure pathways such as air and water quality, food quality, infectious diseases, and massive population displacement events. The World Health Organization predicts that between 2030 and 2050, climate change is expected to cause approximately 250,000 additional deaths per year, from malnutrition, malaria, diarrhea, and heat stress.

As the world calls for climate action to protect the health and well-being of its population, research remains critical in understanding impacts, adaptation, and mitigation measures to improve human health. Funding, therefore, must also encourage this critical research and move beyond traditional stovepipes to address this complex challenge. Funding organizations, public and private have in the past year announced numerous initiatives to address these research needs and expand the field of environmental and climate science to address this complex issue. Beyond expanding research, funding efforts include plans to build capacity, workforce, diversity, and equity in research around the world.

Speakers from the US National Institutes of Health and U.S. Centers for Disease Control and Prevention will join speakers from the U.S. Environmental Protection Agency to share research funding plans and initiatives to address climate change and human health issues.

Individual Presentations:

National Institutes of Health (NIH) Framework for Climate Change and Health Research

S. Environmental Protection Agency’s (EPA) Air, Climate and Energy Research Program

CDC’s New Agency-wide Climate and Health Strategy: Focus on Health Equity, Surveillance, Preparedness, Research and Communication

Submission Number: 49

Title: Impact of exposure measurement error (ME) on the health effect estimates: quantification and correction

Chairs: Prof Klea Katsouyanni¹, Dr. Dimitris Evangelopoulos¹

Presenters: Prof Joel Schwartz², Ms Barbara Butland³, Prof Evangelia Samoli⁴, Prof Donna Spiegelman⁵

¹Imperial College London, London, United Kingdom , ²Harvard T.H. Chan School of Public Health, Boston, Unites States, ³St George’s University of London, London, United Kingdom , ⁴National and Kapodistrian University of Athens, Athens, Greece, ⁵Yale School of Public Health, New Haven, Unites States

Although it is widely accepted that air pollution exposure, at least to pollutants of ambient origin, has adverse health effects, the quantitative effect estimates incorporate considerable uncertainty, especially because the relevant exposure (namely individual or population exposure to pollutants of ambient origin) is so difficult to measure accurately. Measurements of air pollutants concentrations from fixed site monitors or ad-hoc campaigns have been used in epidemiological studies assessing the associations between exposure to pollutants and multiple health outcomes, and also models (statistical, dispersion or hybrid) have been extensively developed and applied. However, these are generally based on a number of assumptions which lead to ME and additionally do not take individual time-activity and geographical location into account. The type and magnitude of ME inherent in all exposure assessment methods and specifically their impact on the effect estimation, in terms of bias and accuracy, have not been extensively studied but some results show that they are important. Thus, publications have shown that the bias introduced is mainly towards the null, especially in studies of long-term exposures. Its magnitude depends on the size of ME, the correlation between the “true” and the “surrogate” metric and the ratio of their variances. The latter two are influenced by the type of error (Classical or Berkson). Correction methods have been proposed but the evidence on how well they perform is sparse. This is an important area of research with policy application that has been largely neglected. Understanding the consequences of measurement error will lead to improved understanding of the associations of interest and help to develop further methods for correcting the health effect estimates. In this Symposium we will present results from recent studies which quantified the impact of various types of exposure measurement error on the effect estimates for health outcomes and evaluated correction methods.

Individual Presentations:

Introduction
Klea Katsouyanni (National and Kapodistrian University of Athens and Imperial College London)

Identifying determinants and charactering the type of exposure measurement error in association with different error-prone exposure assessment methods
Dimitris Evangelopoulos (Imperial College London)

Accounting for space and time in measurement error corrections
Joel Schwartz (Harvard T.H. Chan School of Public Health)

Using SIMEX and regression calibration to correct for classical and Berkson measurement error

Barbara Butland (St George’s University of London)/Evi Samoli (National and Kapodistrian University of Athens)

Empirical measurement error bias correction for the effects of functions of the exposure history: cumulative average PM2.5
Donna Spiegelman (Yale School of Public Health)

Submission Number: 50

Title: Is access to environmental public health monitoring and surveillance an equity and justice issue in Low- and Middle-Income Countries?

Chairs: Fuyuen Yip¹, Helen Crabbe²

Presenters: Matt Ashworth³, Sumi Mehta⁴, Eka Ruadze⁵, Giovanni Leonardi², Ariana Zeka⁶, Paolo Lauriola⁷

¹National Centre for Disease Control and Prevention, Washington DC, USA, ²Radiation, Chemical and Environmental Hazards Directorate, UK Health Security Agency, Didcot, United Kingdom, ³Institute of Environmental Science and Research, Christchurch, New Zealand, ⁴Environmental Health Program, Vital Strategies, New York, USA, ⁵The National Centre for Disease Control and Public Health, Tbilisi, Georgia, ⁶Brunel University London, London, United Kingdom, ⁷International Society of Doctors for the Environment, Modena, Italy

Climate crisis, environmental change and societal transitions have complex impacts on population health. Many societies experiencing these transitions, particularly those in low- and middle-income countries (LMICs) also have minimal capacities to monitor environmental and societal changes and their impacts on population health, and therefore to inform decision making and policy.

Not having such resources can lead to inability to identify and respond to such risks to health in LMICs nationally, regionally, or internationally and to build the necessary

surveillance and research infrastructure and access the funding required to strengthen such capacities. This contributes to widening the inequalities gap between countries and is therefore an environment and health equity and justice issue.

This symposium will invite a panel of experts in capacity building in LMICs to discuss and critically evaluate what are the policy/political system needs, evidence provision that inform political transitions, and the key elements needed to establish sustainable infrastructures that can provide the necessary evidence for sustainable health protection and prevention.

Other question to be considered in the symposium:

Building capacities and widening participation in environmental public health surveillance, research and policy translation in LMICs.

Individual Presentations:

Fresh water sustainability and health in Tonga
Matt Ashworth, Institute of Environmental Science and Research, New Zealand

Strengthening environmental health surveillance in low- and middle-income countries
Sumi Mehta, Environmental Health Program, Vital Strategies, USA

Interventions to reduce lead (Pb) exposure and value of a broad environmental health monitoring capacity
Eka Ruadze, The National Centre for Disease Control and Public Health of Georgia (NCDC&PH), Georgia

Role of field epidemiology to strengthen capacity building in Ghana and Zambia
Giovanni Leonardi, Environmental Epidemiology, Radiation, Chemical and Environmental Hazards Directorate, UK Health Security Agency, UK

Inequalities in environmental public health funding in the European region
Ariana Zeka, Brunel University London, UK

International Network for Public Health and Environmental Tracking (INPHET) and its role to Environmental Epidemiology
Paolo Lauriola, International Society for Doctors of Environment, Italy

Submission Number: 51

Title: Advancing Air Pollution Epidemiology in India: Building capacity locally to address questions of context, policy relevance and methodological robustness

Chairs: Dr Sumi Mehta², Dr Siddhartha Mandal³

Presenters: Dr. Pallavi Pant¹, Dr Bhargav Krishna⁴, , Dr Harish Phuleria⁵, Dr Cathryn Tonne⁶

¹Health Effects Institute, Boston, United States of America, ²Vital Strategies, New York, USA, ³Public Health Foundation of India, New Delhi, India, ⁴Centre for Policy Resarch, New Delhi, India, ⁵Indian Institute of Technology Bombay, Mumbai, India, ⁶ISGlobal, Barcelona, Spain

Air pollution is among the largest contributors to the overall burden of disease in India. However, cohort studies are not yet common in the country for studying the effects of environmental risk factors. Global experience has shown that well-designed and conducted scientific studies of varying designs provide the foundation for understanding the full extent of air pollution’s effects on health. In India, there is growing awareness that the evidence base on air pollution and health can be substantially strengthened to understand the effects of air pollution in Indian populations and inform air quality and health policymaking. To this end, several new studies have been published in recent years or are currently underway that leverage existing registry data sets, large-scale household surveys, or expanding the utility of existing cohorts.

These approaches, while enabling the generation of new knowledge, face three critical challenges especially from the perspective of young researchers. First, access continues to be constrained, especially with regard to registry and survey data and where accessible, the quality of data are heterogenous. Second, using these data or those from existing cohorts established for other purposes presents challenges from an analysis perspective. Third, given the health evidence base in India continues to lag high-income nations significantly, the avenues to publish studies that are highly policy-relevant but perhaps not novel in methodology presents constraints to young researchers.

The immediate need and opportunity exists to support key new studies as well as to expand capabilities for research in India in addition to opportunities for wider dissemination of work that is locally and contextually relevant. This session will provide an overview of the current state of science and highlight opportunities for conducting studies that are most relevant for questions of interest in India while considering available data as well as constraints.

Individual Presentations:

Reconciling methodolatry and policy relevance in air pollution epidemiology: Reflections from India
Bhargav Krishna, Centre for Policy Research, India

Assessing exposure to air pollution in India: Approaches, data and gaps
Harish Phuleria, IIT-Bombay, India

Bootstrapping air pollution epidemiology in the Indian context
Pallavi Pant, Health Effects Institute, USA

Strengthening the Evidence Base on Global Air Pollution Epidemiology: The Case for Collaboration and Engagement
Cathryn Tonne, ISGlobal, Spain

Submission Number: 53

Title: Scientist Connections with Environmental Justice Communities

Chairs: Prof. George Thurston, Dr. Kelvin Fong

Presenters: Chief Mi’sel Joe, Dr. Atanu Sarkar, Ms. Jenni Shearston, Dr. Yoshira Ornelas Van Horne

¹New York University School Of Medicine, New York, United States of America

In public decision-making, interest groups and stakeholders should be represented and have their voices heard. Unfortunately, with the environmental health implications of various policy decisions, certain communities are often at a great disadvantage: they lack access to sufficient or specific information to address complex scientific technicalities. We, as environmental epidemiologists, have relevant knowledge and capabilities to help these communities “level the regulatory playing field.” However, we often lack awareness of the extent to which a community is burdened by the particular environmental issue, the community’s perceptions about the issue, and how best to focus or discuss possible solutions. Indeed, navigating environmental justice (EJ) issues can be challenging; environmental health researchers are seldom trained in initiating and sustaining partnerships with the EJ community. In this session, we present real world cases in which community members and environmental epidemiologists engaged with communities to productively applied their capabilities and empower communities in the decision-making process, sharing the latest scientific knowledge and working towards a more environmentally just world.

Individual Presentations:

Introduction and Overview
Kelvin Fong, Dalhousie University

Indigenous community environmental challenges and needs
Chief Mi’sel Joe, Miawpukek Mi’kamawey Mawi’omi, Conne River, Newfoundland and Labrador, Canada

Engagement of communities is critical to environmental health: :Lessons from some remote Canadian communities
Atanu Sarkar, Memorial University

Partnering with the community to advocate for clean air: A case study from the South Bronx, NYC
Jenni Shearston, Columbia University

A Community-Centered Approach to Inform Change
Yoshira Ornelas Van Horne, USC

Expert Witness Testimony on Community Impacts of Natural Gas Pipeline Proposals
George Thurston, NYU School of Medicine

Discussion Forum: Opportunities for Scientist Engagement with Environmental Justice Communities
All Speakers

Submission Number: 57

Title: Two-way road: How has the environment affected the covid-19 pandemic and how the pandemic response affected the environment in the Latin America and Caribbean Region

Chairs: Dr. Marcela Tamayo-ortiz¹, Dr Rafael Buralli²

Presenters: Dr Horacio Riojas-Rodríguez³, Dr Nelson Gouveia⁴, Dr David Roja-Rueda⁵, Dr Astrid Schilmann³, Dr Agnes Soares⁶, Diego Fano-Sizgorich⁷

¹Mexican Social Security Institute, Mexico, Mexico, ²Ministério da Saúde do Brasil · Environmental and Occupational Health and Surveillance on Public Health Emergencies, Sao Paulo, Brasil, ³National Public Health Institute, Cuernavaca, Mexico, ⁴University of São Paulo, São Paulo, Brazil, ⁵Colorado State University, , United States, ⁶Panamerican Health Organization, Washington, United States, ⁷Universidad Peruana Cayetano Heredia, Lima, Peru

The COVID-19 pandemic has affected the Latin American and the Caribbean region in a different manner than the rest of the world. The infection rates in some countries, like Mexico and Brazil were extremely high, and for a couple of times the region was the epicenter of the pandemic. Many of the countries have faced unique challenges in the way they have managed the pandemic and its consequences, such as the waste generated by safety measures (e.g. face masks, gloves, syringes, etc.). This symposium will gather the experience of different countries in the LAC region on how air pollution and climate affected the COVID-19 spread and worse outcomes of the disease, how some countries measured the spread through water and different opportunities for the environment that have come about as a result of the pandemic. Furthermore, the session will include work on the long effects of COVID-19 (long-COVID) and how the environment has influenced them.

The symposium will have short presentations (max 10 min) to leave 30 minutes for discussion on how the different experiences in the LAC region can help inform policy and decision makers.

Individual Presentations:

Association between Covid-19 mortality and atmospheric pollution
Horacio Riojas, Mexico

Air pollution and post-Covid-19 syndrome
Nelson Gouveia, Brazil

Built Environment, Transport, and COVID-19
David Rojas, Mexico-USA-LAC

SARS-CoV-2 in wastewater: Studies in Latin America
Astrid Schilmann, Mexico

COVID-19 related waste management in the LAC region
Agnes Soares

Association between air pollution in Lima and the high incidence of COVID-19: findings from a post hoc analysis
Diego Fano-Sizgorich

SYMPOSIUM 09: Infections and the environment

Monday 19 Sept 2022 | 16:15-17:45

PROGRAM

Chairs: Manolis Kogevinas (Spain), Maribel Casas (Spain)
O-SY-042 | Immunotoxic chemicals, childhood infections, and long-term health effects | Maribel Casas (Spain)
O-SY-043 | Ambient air-pollution and COVID-19 | Manolis Kogevinas (Spain)
O-SY-044 | Climate change and cascading risks from infectious disease | Jan C. Semenza (Germany)
O-SY-045 | Looking forward: COVID-19 and greenhouse gas emissions | Kristie Ebi (USA)

ABSTRACT PROPOSAL (#58)

Title: Infections and the environment

Chairs: Manolis Kogevinas¹, Maribel Casas¹

Presenters: Jan Semenza², Kristie Ebi³

¹Isglobal- Barcelona Institute For Global Health, Barcelona, Spain, ²European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden, ³Department of Global Health, University of Washington, Seattle, USA

The COVID-19 pandemic is challenging the world’s economic and health systems and introducing completely new challenges. The outbreak of COVID-19 highlighted the links between the occurrence of new infections, the environment and climate at a global scale, and the need for trans-disciplinary approaches. The pandemic has highlighted the deep interconnections between problems that are typically studied in isolation or that previously were situated at the periphery of environmental epidemiology. The urgency of responding to the pandemic brought into prominence the need for global collaboration to develop actionable knowledge to emergencies and plans for preparedness. This will require the development of research in understudied populations and understudied thematic areas. In this symposium, we will focus on one of these areas specifically interlink between the environment, climate changes, and infectious diseases. Presentations will cover both proximal and long-term interlinks of the environment and infections. Presentations will discuss: the effects of infections in children in relation to chemical exposures and their combined effects on the immune system and long terms effects in; the association of air pollution with COVID-19 examining both clinical disease and effects on the immune system; the effects of increasing climate variability on cascading risks from infectious disease; and finally a view to the future on how the pandemic and our response to the pandemic may help achieve a more sustainable and inclusive climate-resilient pathway. We have limited the presentations to four so as to promote discussion with the participants. The symposium will cover a much-needed area on infections and the environment that are traditionally poorly discussed in our conferences. In the discussion, we will also focus on expected changes in environmental epidemiology research including the scope of the field, methods, data sources, and implementation of research, so as to better cover this key emerging field.

Submission Number: 60

Understanding the Link between the Urban Exposome and Health

Chairs: Prof. Annette Peters¹, Dr. Jelle Vlaanderen

Presenters: Dr Kees de Hoogh, Prof Mark Chadeau-Hyam, Dr. Olena Gruzieva, Prof. Evi Samoli, Prof. Nicole Probst-Hensch

¹Helmholtz Munich, Neuherberg, Germany

Novel methods in exposure modelling and data acquisition provide us with a wealth of data characterizing the urban exposome. In contrast to the past, we strive to assess environmental exposures no longer in isolation, but embark on analyses that more fully capture the multiple dimensions of the urban environment. Building upon available cohort data from multiple countries, we are able to enlarge the exposure contrasts and increase power, however have to deal with heterogeneous data.

Within this symposium, we present and discuss the multi-facetted challenges encountered in understanding the impact of the urban exposome on health. The conceptual work and the examples presented are building upon the work of the EU project EXPANSE.

We describe the advances in modelling the built environment, the physico-chemical environment, the social environment and the food environment. We discuss statistical and non-statistical approaches for assessing the impact of multiple exposures in the urban environment on health. We give examples for assessing the health impact in deeply phenotyped cohorts taking the links between environmental exposure and the lung. In addition, we highlight the challenge of assessing the urban exposome using administrative cohorts. To overcome the challenges of inadequate data, the idea of the urban labs will be described as a way to better understand the urban exposome in space and time. The EXPANSE project is going novel ways to engage with citizens and therefore, we end the symposium by a discussion session that is started by two discussants and then is engaging the audience. Specifically, the chairs will be seeking the exchange of perspectives from around the world.

We propose a symposium composed of five presentations each 10 minutes long presentations followed by two 5 min discussion statements. All presenters will form a panel for discussion with the audience for up to 25 minutes.

Individual Presentations:

Characterizing the urban exposome in Europe
Kees de Hoogh
Statistical methods for quantifying the link between the urban exposome and health
Mark Chadeau-Hyam

The urban exposome and lung health

Olena Gruzieva, Erik Melen

The urban exposome and mortality
Evi Samoli, Massimo Stafoggia
The urban labs – giving novel answers to open questions
Nicole Probst Hensch
Discussion: From results to impact around the world: How to engage and inform citizens
Mark Nieuwenhuijsen & Roel Vermeulen

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Symposia

SYMPOSIUM 01 (SN:59): Climate disasters, human health, and public health responses

SYMPOSIUM 03 (SN:52):Strengthening the global role of environmental epidemiology in the issue of water, sanitation and public health in Latin American and Caribbean countries

SYMPOSIUM 05 (SN:38): Undermeasured and undervalued: examining social-structural factors in women’s and children’s global environmental health

SYMPOSIUM 07 (SN:25): Disparities in US drinking water quality and access

SYMPOSIUM 09 (SN:58): Infections and the environment

SYMPOSIUM 02 (SN:32): Multimodal environmental influences on children and adolescent’s brain, cognitive, and mental health outcomes

SYMPOSIUM 04 (SN:37): PFAS Hotspots and Highly Exposed Communities: Addressing community needs and advancing global collaborative exposure assessment and epidemiological research

SYMPOSIUM 06 (SN:18): The Multi-Country Multi-City (MCC) Collaborative Research Network: an international collaboration for global studies on environmental risks, climate change, and health

SYMPOSIUM 08 (SN:33): Magnetic Resonance Imaging (MRI); a cross-cutting tool at the intersection of environmental epidemiology and developmental neuroscience

SN:07 - Global perspectives on harmonizing chemical risk assessments: Current status and future needs

SN:08 - The Use of Epidemiology in Risk Assessment: Challenges and Innovations in Translating Human Health Research

SN:12 - Chemical exposures and children’s health in the United States: Results from the NIH Environmental influences on Child Health Outcomes (ECHO) Program

SN:26 - The project EXHAUSTION - Heat and air pollution effects on cardiopulmonary mortality and morbidity: geographical variability and vulnerable groups in Europe

SN:27 - Location, Location, Location! The importance of geospatial exposure constructs to assess pesticide exposures and related adverse health outcomes in agricultural settings.

SN:29 - Epidemiological studies for Preparedness and Response to Public Health and Environmental Crises and Disasters

SN:34 - Perfluoroalkyl and polyfluoroalkyl substances (PFAS) in Indigenous communities: A case of environmental injustice

SN:48 - A New Era in Global Climate Change and Human Health Research Funding and Action

SN:40 - Toxicity of air pollutant mixtures: Overcoming the toxic mixture of spatial misalignment, collinearity, and measurement error

SN:39 - Climate change, heat and maternal health: estimating current and future burdens

SN:49 - Impact of exposure measurement error (ME) on the health effect estimates: quantification and correction

SN:50 - Is access to environmental public health monitoring and surveillance an equity and justice issue in Low- and Middle-Income Countries?

SN:51 - Advancing Air Pollution Epidemiology in India: Building capacity locally to address questions of context, policy relevance and methodological robustness

SN:53 - Scientist Connections with Environmental Justice Communities

SN:57 - Two-way road: How has the environment affected the covid-19 pandemic and how the pandemic response affected the environment in the Latin America and Caribbean Region

SN:60 - Understanding the Link between the Urban Exposome and Health

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