Environmental Pollutants and Life Quality

The purpose of the cross-sectional interventional survey is to directly measure the population most susceptible to environmental determinants, the frequency of multidimensional variables, and the conditions that may change their health status. Specifically, the survey has two main objectives, corresponding to two outcomes to be investigated separately in the same populations.

• Recruitment of 380 children, 418 adults and 418 elderly. These sample sizes will be those planned for each unit (Taranto in Italy, Rybnik in Poland, and Genk-Hasselt County in Belgium).
• The areas of Tamburi (an area presumably highly exposed to environmental pollutants) and Talsano-Lama-San Vito will be selected for sampling in the city of Taranto.
• Administration of informed consents through general practitioners and pediatricians of free choice in the areas involved in recruitment.
• Collection of urine and blood samples to measure determinants associated with the concentration of black carbon (BC) in urine samples and other pollutants (PCBs, Benzene) in blood and urine. The collected exposure data will be used to create a pragmatic score (dose-response function) of environmental pollution contamination.
• Measurement of clinical, social and environmental determinants and predictors of quality of life (QoL), measured using a specific validated multinational questionnaire the EQ-5D-5L, and to create a probabilistic score, using feature selection algorithms in machine learning, that can predict different classes of QoL using clinical, social and environmental determinants.

Black carbon assay will be considered as a proxy for exposure to pollutants specifically related to steel production. This has been identified as one of the most promising biomarkers in terms of evidence of both deterministic and stochastic biological damage, in particular in the pediatric population,3 and it has even been demonstrated in fetal exposure4. In addition, the huge amount of urine samples collected will lead to the creation of a urine biobank for further (eventual) molecular analysis. Quality of life will be measured directly in different subpopulations, to be used to construct individual surrogate QALY scores.

On the sidelines of these macro objectives, however, additional biomarkers will be analyzed in the tissues of consenting subjects.

Specifically, the following will be analyzed :

• Benzene metabolites: S-phenyl-mercapturic acid (SPMA)c,t- muconic acids;
• metabolites of PAHs: the 1-hydroxypyrene (1-OHPyr)
• cotinine to identify smokers, those exposed to secondhand smoke, and in nonsmokers.
• PCR analysis for detection of telomere length (indicators of aging)

Inclusion criteria

• Within the population of Taranto (southern Italy), healthy volunteer subjects will be recruited, and sampled from the following geographic areas of the city: the Tamburi district (an area presumably highly exposed to environmental pollutants), and the Talsano-Lama-San Vito district.

Exclusion criteria

• unhealthy subjects
• Taranto people residing outside the above areas