P5. Epidemiology and Prevention in Environmental and Occupational Health

The purpose of the programme is to encourage collaborative research in the field of epidemiology and prevention of environmental and occupational health issues.

Strategic Objectives

Study the role of the most significant environmental pollutants in air, water and diet during pregnancy and early-life, and their effects on childhood growth and development.
Participate in the preparation of European scientific policy advisory guidelines.
Estimate the interaction of environmental and occupational determinants in the development of lung cancer in order to participate in designing lung cancer secondary prevention policies. Evaluate lung cancer exposure-response ratios. Estimate interactions between occupational carcinogens and investigate the effects of tobacco as a potential factor confusing or modifying the occupational effects on lung cancer.
Evaluate the dietary factors associated with excess weight and obesity in children from 4 to 7 years old (INMA study).
Determine the effect of an intensive weight loss intervention on the incidence of DM2, based on a pattern of a conventional low-calorie Mediterranean diet, physical activity and behavioural therapy versus advice on the Mediterranean diet in the study. PREDIMED+DM Intervention Study.

Lines of Research

Effects of prenatal and postnatal exposure to environmental pollutants on neurodevelopment, pulmonary function, allergies and respiratory health in the INMA (Infancia y Medio Ambiente- Childhood and Environment) cohort.
Describe the combined effect of endocrine disruption through exposure biomarkers and describe their relationship with obesity, development and reproductive health. Neurotoxicity and neuroestrogen of environmental pollutants and/or pollutants carried in food in connection with exposure during development. ENDOCRINE DISRUPTION AND HEALTH.
Evaluate the dietary factors associated with excess weight and obesity in children from 4 to 7 years old in the INMA study. Description and quantification of factors associated with excess weight and obesity. NUTRITION AND HEALTH.
Determine the effect of an intensive weight loss intervention on the incidence of DM2, based on a pattern of a conventional low-calorie Mediterranean diet, physical activity and behavioural therapy versus advice on the Mediterranean diet in the study. PREDIMED+DM Intervention Study.
Estimate the interaction of the environmental and occupational determinants in the development of lung cancer (CAPUA STUDY). Study of the role of lifestyles and genetic determinants on the aetiology of gastric cancer by means of pooled-analyses of individual data collected in observational (case and control) studies. LIFESTYLE AND STOMACH AND LUNG CANCER.

Strategic Subprogrammes

1. Infancia y Medio Ambiente (Childhood and Environment) (www.projectinma.org)

The Infancia y Medio Ambiente project (INMA cohort) has been prospectively tracking the development of about 4000 newborns from gestation to adolescence in Asturias, Gipuzkoa, Granada, Menorca, Ribera del Ebre, Sabadell, and Valencia for 10 years. The project evaluates the effects of prenatal and postnatal exposure during pregnancy and early-life to environmental pollutants (air pollution, water pollution, persistent and non-persistent toxic compounds, metals, tobacco, electromagnetic fields, social inequality, occupational aspects, microbial agents in homes, breastfeeding, nutrition, genetics) in hormonal disorders, congenital disorders, reproductive health, intrauterine growth, postnatal growth, neurodevelopment, respiratory health and atopy, obesity, sleep issues and sexual development in the INMA birth cohort.

General Objective:

INMA - Infancia y Medio Ambiente is a research project created for the purpose of studying the role of the most significant environmental pollutants present in the air, in the water and in the diet during pregnancy and early-life, and their effects on childhood growth and development.

The INMA project has three objectives, namely to:

Describe the degree of individual prenatal exposures to environmental pollutants and the internal doses of these pollutants during gestation, birth and childhood in Spain.
Evaluate the impact of pre- and postnatal exposure to different environmental pollutants on the growth, health and development of children, from early foetal stages until adolescence.
Evaluate how genetic and nutritional factors can modify the effects of environmental pollutants on childhood growth.

INMA Project Research Subject-matter:

Air pollution; Water pollution; Persistent toxic compounds; Non-persistent toxic compounds; Metals; Tobacco; Electromagnetic fields; Social inequality; Occupation; Microbial agents in homes; Breastfeeding; Nutrition; Genetics; Hormonal disorders; Congenital disorders; Reproductive health; Intrauterine growth; Postnatal growth; Neurodevelopment; Respiratory health and atopy; Obesity; Sleep issues; Sexual development.

Since it was created, the project has been funded by external sources resulting from calls for competitive research project proposals in Spain (CIBERESP, FIS, and other regional agencies) and in Europe (ESCAPE, ENRIECO, CONTAMED, among others). It has also always had its own web page: www.projectinma.org.

INMA is made up of seven CIBERESP groups and six other groups are actively participating in the project.

Internationalization:

The INMA Project collaborates in 13 international projects:

MeDALL-Mechanisms of the Development of ALLergy
ESCAPE-European Study of Cohorts for Air Pollution Effects
CHICOS-Developing a Child Cohort Research Strategy for Europe
DENAMIC-DEvelopmental Neurotoxicity Assessment of MIxtures in Children
CONTAMED-Contaminant mixtures and human reproductive health
EGG/EAGLE-Early Genetics and Lifecourse Epidemiology/Early Genetics Growth
BREATHE-BRain dEvelopment and Air polluTion ultrafine particles in scHool childrEn
EARNEST- Diet in Pregnancy
EUCCONET- network of large scale and generalist cohorts of inter-disciplinary themes
HiWATE-health risks associated with long-term exposure to low levels of disinfectants and disinfectant by-products (DBPs) in water.
HITEA-Indoor air pollution in Europe
HELIX-The Human Early-Life Exposome
GERONIMO-Generalised EMF Research using Novel Methods

Communication Plan:

The INMA Project collaborates in knowledge dissemination activities:

Participation in the preparation of technical reports and health recommendations
Preparation of European scientific policy orientation guidelines
Organisation of and participation in Congresses and scientific Meetings
Organisation of and participation in Workshops and Courses
Disclosure activities for disseminating the work and the results obtained among the general population (conferences, articles, interviews, newsletters, seminars, preparation of customised reports for city/town councils, appearance in the mass media)

2. Endocrine Disruption, Development and Health

Early endocrine disruption during the foetal/embryonic stage can affect development and have consequences on reproductive health in later stages of life. It has been suggested that environmental pollutants with hormonal activity play a large role in the pathogenesis of hormone-related diseases even though individual compounds, at standard exposure concentrations, cannot be associated with a disease. In some particular situations, the combined effect seems to play an important role, such as the case of the risk of cryptorchidism/hypospadia associated with the oestrogen load in placentas studied by our own work group. Nevertheless, epidemiological observations would have to be paired with mechanistic studies that help understand the pathogenic role of the endocrine disruptors and their interaction with the genome.

Scientific objectives:

Develop and evaluate total effective endocrine disruptor load biomarkers. These biomarkers will be based on the quantification of the hormonal effect in in vitro bioassays representative of two hormonal activities - anti-androgenic and anti-oestrogenic activity, among others, using biological tissues and fluids available in the current cohorts biorepositories in CIBERESP (INMA, MCC-Spain, among others).
Identify new chemical compounds with hormonal activity by means of the fractionation and targeted chemical analysis approach (toxicity identification and evaluation, TIE) on hormonally active tissue/fluid extracts in bioassays, and investigate the determining factors of exposure, including the resulting epigenetic regulation.
Contribute to the development of the European policy on Endocrine Disruption and Environmental Health Research and to the European and Spanish Biomonitoring Strategy of human exposure to environmental pollutants. Develop methodologies based on the measurement of the combined effect by means of using in vitro bioassays that consider the mode of action to be of greatest interest in any study in environmental epidemiology.

3. Lifestyle and Cancer

The CAPUA (CAncer de PUlmón (Lung Cancer) in Asturias) study: Lung cancer is the typical example of a disease that can be attributed to the interaction between environmental exposure determinants. The CAPUA study (comprising hospital cases and controls) incorporated in 2010 in the SYNERGY project and in the ILCCO consortium, coordinated by IARC, analyses the occupational and genetic risk factors of lung cancer. This project pools together several European case and control studies to analyse the effects of exposure to occupational carcinogens in the development of lung cancer. In this regard, individuals provide information about any history of tobacco smoking and their work history, offering the best tool available for estimating the effects of exposure to asbestos, PAHs, nickel, chromium and silica in an occupational setting. The objectives of the SYNERGY project are to, among others, develop a specific job exposure matrix-project (SYN-JEM), develop exposure variables based on the matrix SYN-JEM and other parameters of exposure progression, and to estimate interactions between occupational carcinogens.

The SYNERGY Project results will be taken into account when establishing levels of exposure to occupational carcinogens in the European Union.

Strategic Objectives of SYNERGY SPAIN:

Exploratory analysis of combined risks based on the combined ISCO and ISIC codes for all cases and controls of the SYNERGY consortium pool.
Exposure to diesel engines and lung cancer for all cases and controls of the SYNERGY consortium pool.
Occupational exposure of workers in bars and restaurants and its association with lung cancer, for all cases and controls of the SYNERGY consortium pool.
Evaluate the modifying effect of tobacco, diet and alcohol in occupational exposure to asbestos and polycyclic aromatic hydrocarbons.
Exposure to biological risks and risk of lung cancer for all cases and controls of the SYNERGY consortium pool.
Exposure to low doses of tobacco smoke and lung cancer for all cases and controls of the SYNERGY consortium pool.
Evaluate the association and role of a prior respiratory disease (tuberculosis, pulmonary fibrosis, chronic obstructive pulmonary disease, chronic bronchitis, emphysema and asthma) in the development of lung cancer for all cases and controls of the ILCCO consortium pool.
Estimate the contribution of the family history in the risk of developing lung cancer, especially among those who have never smoked, for all cases and controls of the ILCCO consortium pool.

Other Collaborations:

Collaboration with other CIBERESP MCC SPAIN subprogrammes. As a recruiting node, we share all the strategic objectives of the CIBERESP MCC SPAIN Project.
Inclusion and collaboration in the European Consortium StoP for epidemiological studies of stomach cancer cases and controls.
Collaboration as a constituent member in the DEDIPAC Project for the study of diet and physical activity determinants within the European Joint Programming Initiative (JPI) ‘A Healthy Diet for a Healthy Life’.
Collaborations with other CIBERESP programmes. Subprogramme 2. Mammographic density and breast cancer, Group 7 (Dr. Marina Pollán).
Collaboration in the PREDIMED-PLUS DM intervention study. Recruiting node. Collaboration with Group 16 in Programme 1 and other CIBEROBN groups.

Attached Groups

See spanish website for furher information about research groups participating in this program.

Attached groups (Spanish)