ATHLETE

Background and study aims

We know that early life is a key period for our development and exposures to environmental hazards such as ambient air pollution, environmental tobacco smoke, water and food contaminants, noise, pesticides and ultraviolet light may lead to long-term health effects with large social and economic costs. This means identifying and implementing cost-effective preventive actions and policies to reduce our exposures to adverse environmental hazards during this critical early-life period would have the greatest impact.

ATHLETE is studying the human exposome – the totality of all non-genetic exposures including all hazards in our external physical and chemical environments as well as our internal molecular signatures. This approach encompasses the complexity of how we experience our environment, therefore our exposures, and will help us understand what exposures we experience during pregnancy, childhood, and adolescence, as well as identifying and implementing interventions to reduce our exposure to the urban and chemical exposome.

Building on the previous work in HELIX, this study will build on 16 existing birth cohorts from 11 European countries to:

• collect a suite of environmental exposure data (urban, chemical, lifestyle, and social risk factors)
• link the ‘early life exposome’ with children and young people’s cardiometabolic, respiratory, and mental health outcomes
• calculate the economic costs and health impacts in order to estimate the societal impact of the exposome
• implement interventions to reduce exposure to the urban and chemical exposome
• translate research findings and knowledge for policymakers and our community

What does the study involve?

ATHLETE has three sub-studies:

Data collection from BiB participants

We followed-up BiB participants (n=233) who were previously involved in a study called HELIX, and collected a suite of new data. This data will be used to understand how our exposures impact on our health.

Citizen scientists and co-production of interventions

We recruited 10 children from 2 schools in Bradford, and 10 children from 2 schools in Barcelona, Spain, to take part as citizen scientists to understand where and when key exposures to urban pollutants on their school journey were occurring.

This sub-study will demonstrate the development and evaluation of co-produced effective and scalable interventions to reduce personal exposure to the harmful effects of the urban exposome. We focused on primary school-aged children as children are particularly vulnerable to their urban environment – a source of physical, chemical and behavioural exposures (e.g. pollution, lack of green space, noise, physical activity) – all of which have been associated with a variety of health outcomes including asthma, mental health, obesity and cognitive development). Schools are often urban exposome ‘hotspots’ located in areas of high pollution or noise, which is compounded by high levels of car use during the ‘school run’. We know that within the UK around half of children are driven to school.

Pupil citizen scientists carried personal air pollution sensors to quantify their levels of exposure and identify where these exposures were occurring on their school journey. Static air pollution sensors were also placed in schools to monitor levels throughout the data collection period and questionnaires were completed to understand school travel modes and preferences, play and physical activity, and self-assessed physical and mental health. Citizen scientists also participated in ‘walkalong’ interviews with researchers to explore their perceptions of the urban exposome on their journey from school to home, as well as their perceived barriers and enablers to reducing these harmful exposures. These measures fed into co-production workshops at each school where children, parents, teachers, and local stakeholders worked together to come up with interventions to reduce the exposure children experience on their school journeys. These co-produced interventions were then implemented and we will follow-up with the children, parents, and schools using both quantitative and qualitative methods to understand the sustainability of these co-produced interventions.

Identifying effective interventions and understanding barriers and enablers to their adoption

We carried out a systematic search of the literature to identify interventions which are effective at reducing urban exposures and interventions which are effective at reducing chemical exposures from personal care products and food packaging. A policy briefing note was created for both the urban and chemical interventions with recommendations on what actions individuals and policymakers could take to help reduce harmful exposures.

Qualitative interviews have been conducted with women to understand motivations for using personal care products and their barriers and enablers to removing or replacing products for chemically safer alternatives, and stakeholder interviews to understand what may be barriers and enablers to adopting effective interventions to reduce urban exposures.

Where is the study run from?

Bradford Institute for Health Research (UK)

When is the study starting and how long is it expected to run for?

January 2020 to June 2025

Who is funding the study?

European Union’s Horizon 2020 research and innovation programme under grant agreement number 874583—the Advancing Tools for Human Early Lifecourse Exposome Research and Translation (ATHLETE) project.