Interview with Roel Vermeulen, Professor of Environmental Epidemiology and Exposome Science at Utrecht University and the University Medical Center Utrecht. He is also director of the Institute for Risk Assessment Sciences (IRAS) and the Dutch consortium Exposome-NL, and project coordinator of the EXPANSE project which is part of the European Human Exposome Network. His scientific research focuses on environmental risk factors for non-communicable diseases with a strong emphasis on integrating epidemiology, high quality exposure assessment and molecular biology into multidisciplinary investigations.
Why is it important to talk about cities as part of the Human Exposome Network?
Roel Vermeulen: To understand the mechanisms that determine human health, it is important to investigate both urban contexts and rural areas. In particular, studying cities is important for three different reasons:
- Around 70% of Europe’s population lives and interacts in complex urban environments. It is expected that this will increase in the coming years.
- There are major health differences between European urban populations, and also within European cities. We can’t explain this by known factors. In order to reduce existing health inequalities, it is essential to understand the differences between these urban contexts and analyse the correlations with the different health parameters.
- High-density living and activities in cities contribute to a complex urban fabric, thereby resulting in an interconnected web of exposures and behaviours that together may affect human health.
Without a good understanding of this complex urban fabric and these interconnected exposures – the so called urban exposome – we’re not able to implement effective preventive measures or to design healthy neighbourhoods for the future.
With the EXPANSE project, we would like to contribute to this understanding by creating a long-term sustainable ‘toolbox’. This new infrastructure could be used to generate knowledge about the urban exposome and this knowledge could in turn be translated into actionable information for citizens, public sector policy makers and private sector companies.
What are some of the challenges facing health in urban contexts?
Roel Vermeulen: There are many. Some of these challenges relate to the physical or chemical environment (air pollution, noise) or the built environment (green and blue spaces). Others concern food (accessibility to healthy food choices) or the social environment (social cohesiveness). We know quite a bit about a number of these factors and only very little about others, particularly about how they interconnect. Moreover, we don’t know how best to implement effective and sustainable preventive measures.
In your opinion, is it important to involve doctors to raise awareness of these issues?
Roel Vermeulen: Yes, we need a more bottom-up approach to understand these issues. In general, the health community and, more specifically, general practitioners (GPs), are at the forefront of primary care and disease prevention. They are the ones seeing patients and hearing what is really going on in their lives and environments. Our challenge is to gather the issues that are raised with GPs and translate them into scientific studies to provide answers. Also, GPs can help disseminate these answers and offer advice. Furthermore, we can involve others who experience these situations first hand, such as social housing cooperatives.
So what should be the main objective of these frontline workers?
Roel Vermeulen: Transforming a collective goal, such as the goal of protecting the environment and climate, into something that takes on personal importance and urgency: what effect does climate change have on our children’s health today? How does exposure to ultra-fine particles affect our health and ability to function? How can we change our urban fabrics to make cities more pandemic-proof?
We risk to perceive climate and environmental issues as very distant from our own experience if they are not translated on a personal level with a sense of immediate relevance.
Who else would need to be involved? What stakeholders have been involved in the project?
Roel Vermeulen: It’s important to involve the likely users of the outcomes of the EXPANSE project (citizens, policy makers, scientists, etc.) at an early stage because this will allow us to reflect on what we are doing and whether the results of our efforts will be translated into useful and actionable insights.
For this reason, we have involved citizen associations that are active in citizen science initiatives and architects who will design the neighbourhoods of the future and translate our insights into something that can actually be built. We also make sure that all data and insights are FAIR (Findable, Accessible, Interoperable, and Reusable) and as open as possible. Communication is fundamental. You can do the right thing, but if you are not able to communicate it correctly, nothing will happen.