The urban exposome framework and a proof-of-concept study

Abstract

PDS 71: Exposome, Johan Friso Foyer, Floor 1, August 27, 2019, 4:30 PM - 5:30 PM Cities face rapid changes including increasing inequalities and public health issues. Therefore, urban centers should become more resilient, monitor and address all emerging issues with cost-effectively. Using the city and inter-city areas as measurement units, the urban exposome can be defined as the continuous spatiotemporal monitoring of environmental and health indicators with an interdisciplinary approach that combines qualitative and quantitative methods. The urban exposome framework was applied in a proof-of-concept study in Limassol, Cyprus combining: a mixed-methods study on stakeholders’ perceptions, a systematic assessment of secondary data from the cancer, birth and death registries, and a population health and biomonitoring survey. Data collection was conducted in summer 2017. The first results on drinking water and quality of life were described and combined with an agnostic environment-wide association analysis (EWAS). Water quality parameters and participants’ opinions on city life (i.e. neighborhood life, health care and green space access) were mapped using small administrative areas as the reference unit. In the exploratory EWAS analysis, all variables were used (questionnaire responses and water quality metrics) to describe correlations. Overall, urban drinking-water quality using chemical (disinfection byproducts-trihalomethanes) and microbial (coliforms, E. coli, and Enterococci) quality indicators did not raise concerns. General health and having a chronic disease were significantly (FDR-corrected p-value<0.1) associated with different health conditions e.g. hypertension and asthma, as well as having financial issues in access to dental care. Additionally, correlations between water trihalomethanes and participant behaviors (e.g. household cleaning, drinking water habits) were documented. This proof-of-concept study showed the potential of using integrative approaches to develop urban exposome profiles to prospectively identifying within-city differences in environmental and health indicators. The continuous monitoring of the urban exposome will allow stakeholders to timely identify and develop targeted to the city interventions to tackle urban health challenges.