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Interview with Jordi Sunyer: "Seeing the results of research is something that takes a hold of you forever"

Monday, November 3th, 2014

Interview with Jordi Sunyer:

Professor Jordi Sunyer Deu, professor of Preventive Medicine and Public Health at the Department of Experimental and Health Sciences (CEXS) and the co-director of the Centre for Research in Environmental Epidemiology (CREAL), a UPF-affiliated centre, has received a grant from the European Research Council to study the possible relationship between air pollution and neurological development in children.

In 2014, he has received the John Goldsmith Award, considered the Nobel Prize of the environmental sciences, for his sustained contributions to the knowledge and practice of environmental epidemiology. It is awarded by the International Society for Environmental Epidemiology (ISEE) and is the most important prize in this area of knowledge.

- What led you to dedicate your professional life to the environment and public health?
Although I was initially interested in clinical medicine, I was soon attracted by the possibility of using epidemiological knowledge to prevent disease. Fate led me to research the Barcelona asthma epidemics of the 1980s. The hospitals were overwhelmed with very severe cases and some patients died suddenly. The initial hypothesis was atmospheric pollution, but we discovered that it was caused by a soy protein being unloaded in the port. They took action on the silos in the port to stop the problem, the number of asthma patients in the emergency ward fell from eight to five a day, and the number of asthmatics in intensive care fell from one every four days to one every ten days across the city as a whole. Seeing the results of research is something that takes a hold of you forever.

- What has struck you most about pollution? Can you tell us something encouraging and something negative?

The findings about soybean-related asthma were very dramatic for the patients who were suffering from it, but the impact among the overall population was limited. As a result of that research, we began to study the role of pollution and we found subtle effects on patients with asthma and chronic obstructive pulmonary disease, but which had a major impact on the persistence of the exposure and the entire urban population at risk. In the United States in the 1990s, they were discussing the criteria to improve the air in American cities and the American Environmental Protection Agency contacted me. Our experience was useful because the country's air quality improved significantly. In Europe we have lagged behind, but the criteria of the European Union (EU) are not as strict, which means that there is damage to health that could be avoided.

" The most toxic pollutants they emit are almost ultrafine particles mainly emitted by diesel vehicles "

- Which is the biggest pollutant of the air we breathe?

City air has a common feature everywhere: millions of motor vehicles. We now know that the most toxic pollutants they emit are almost ultrafine particles mainly emitted by diesel vehicles. It has been possible to curb other sources of pollution more easily, such as incinerators, power stations and the metal industry.

- To what extent are we environmentally aware?

I don't know of any sociological studies on the subject, but I think we are still not sufficiently aware for it to be decisive when we elect our political representatives. The fact that climate change is one of the greatest challenges of the century and air pollution is among the ten most important determining factors for health, even more than cholesterol, is still largely unknown.

- How do you calculate the cost-benefit of clean air in terms of public health?

We have a protocol that is managed by government agencies, such as the World Health Organization (WHO) to monitor the risks. The experts, based on a systematic review of scientific literature, initially agree on guideline levels below which there is considered to be no effect. The second step is a cost-benefit analysis with economists, engineers and other professionals of the various measures to take in order to reach the guideline levels. The third step is the responsibility of political institutions, and involves the management of risk and choosing the best strategy.

- Can you give us some examples?

When it became known that lead affects the brain's growth and development, we removed it from petrol. Air quality levels have been established for air pollution by particles. Each city must choose its own initiatives. In Europe, more than 220 governments have created plans approved by the EU, and the consequent reduction in pollution and improvement of health indicators has been assessed. In this country, we do not have any approved plans. However, there are many risks for which we are unaware of the damage caused. Now we only have the precautionary principle, as in the case of mad cow disease.

- Can individual actions really make a difference to global health?

Of course. Initiatives must obviously take place on a community basis. Both in terms of climate change and urban pollution. A very good example has been the ban on smoking in public places which has led to a real protection of health, which is not achieved by individual attitudes. Having said that, however, a cultural shift is required. And so we need to change people individually. We must understand that we cannot ignore nature, that we are a planet and that its population has tended to converge in terms of costs and benefits. Our transforming activity and its economic, social and health impact cannot be considered independently of the biogeophysical systems of the biosphere and its ecosystems, desertification and the disappearance of species. For the first time in history, we have made ourselves the subjects of an experiment with results that we do not know, and for this reason we need a comprehensive policy, but above all a cultural shift towards a global and ecological perspective.

" For the first time in history, we have made ourselves the subjects of an experiment with results that we do not know".

- Has knowledge derived from environmental research led to any decision-making in health policy? Can you give us an example?

I mentioned smoking. Control policies provide protection from environmental smoke above all. Another case is the ban on asbestos. Here we have seen the case in Cerdanyola where both workers and residents died from cancer of the lungs and pleural cavity. The prohibition of smoking and asbestos are success stories. The opposite is true of air pollution inside buildings. It is the fourth major risk factor for health, ahead of obesity, lack of exercise or malnutrition. But it happens in developing countries. And the measures with new domestic combustion processes have failed, usually due to the weight of tradition.

- What are the environmental challenges in Barcelona? What is the measure that you think is most urgent to implement?

Pollution of the city by motor traffic is by far the most important. We must make space for citizens by applying a range of initiatives. The plan for large blocks and landscaping two out of every three streets is promising. The congestion zone, with limited access depending on the vehicle's pollution level, is the most widely used measure in Europe.

- What do the results of your studies say about how air pollution affects children?

In recent years, we have discovered that pollution affects prenatal growth, birth weight, respiratory symptoms in early child, the growth of lung function and the growth of mental development. We have more than enough evidence to act.

" The use of new lab technologies, new sensors for measuring personal pollution and neuroimaging studies allow us to make progress "

- What are you currently working on?

At the moment we are focusing on the effect of the chemical environment, such as hormone disruptors that are common in everyday life (in cosmetics, plastics, food) and air pollution, both during pregnancy and in the early years of life, and their interaction with genetic determinants in the development of the brain and its impact on mental health (mainly disorders like ADHD and behaviour disorders). The use of new lab technologies (what we call "OMIC"), new sensors for measuring personal pollution and neuroimaging studies allow us to make progress.

Source: UPF


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