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Background: Environmental factors determine children&rsquo ; s health. Quantifying the health impacts related to environmental hazards for children is essential to prioritize interventions to improve health in Europe. Objective: This study aimed to assess the burden of childhood disease due to environmental risks across the European Union. Methods: We conducted an environmental burden of childhood disease assessment in the 28 countries of the EU (EU28) for seven environmental risk factors (particulate matter less than 10 micrometer of diameter (PM10) and less than 2.5 micrometer of diameter (PM2.5), ozone, secondhand smoke, dampness, lead, and formaldehyde). The primary outcome was disability-adjusted life years (DALYs), assessed from exposure data provided by the World Health Organization, Global Burden of Disease project, scientific literature, and epidemiological risk estimates. Results: The seven studied environmental risk factors for children in the EU28 were responsible for around 211,000 DALYs annually. Particulate matter (PM10 and PM2.5) was the main environmental risk factor, producing 59% of total DALYs (125,000 DALYs), followed by secondhand smoke with 20% of all DALYs (42,500 DALYs), ozone 11% (24,000 DALYs), dampness 6% (13,000 DALYs), lead 3% (6200 DALYs), and formaldehyde 0.2% (423 DALYs). Conclusions: Environmental exposures included in this study were estimated to produce 211,000 DALYs each year in children in the EU28, representing 2.6% of all DALYs in children. Among the included environmental risk factors, air pollution (particulate matter and ozone) was estimated to produce the highest burden of disease in children in Europe, half of which was due to the effects of PM10 on infant mortality. Effective policies to reduce environmental pollutants across Europe are needed.

Intro -- Title page -- Table of Contents -- Copyright -- Contributors -- Chapter 1: Traffic-related air pollution: Emissions, human exposures, and health: An introduction -- Abstract -- Acknowledgments -- Introduction -- Chapter 2: Air pollution, air quality, vehicle emissions, and environmental regulations -- Abstract -- Sources of air pollution -- Pollutant concentration and units -- History of air pollution control regulations in the United States -- Pollutant emission trends in the United States -- Transportation emissions in the United States -- Transportation emissions and near-road communities -- Conclusion -- Chapter 3: Traffic monitoring and modeling for energy, air quality, and health -- Abstract -- Introduction -- Traffic monitoring data -- Modeling advances -- Gaps and opportunities -- Conclusions -- Chapter 4: Vehicle emissions measurement and modeling -- Abstract -- Acknowledgments -- Introduction -- Vehicle emissions monitoring -- Vehicle emissions modeling -- Current and future challenges -- Summary and conclusions -- Chapter 5: Air pollution monitoring and modeling -- Abstract -- Monitoring -- Modeling -- Model to monitor comparisons -- Summary and conclusion -- Chapter 6: Traffic-related air pollution and exposure assessment -- Abstract -- Introduction -- Exposure pathways -- Vehicle emissions -- Traffic-related air pollution -- Exposure assessment methods -- Conclusions -- Chapter 7: Air pollution epidemiology -- Abstract -- Introduction -- Short history of air pollution epidemiology -- Epidemiological designs for studying short-term health effects of air pollution -- Epidemiological designs for studying long-term health effects of air pollution -- Experimental designs in air pollution epidemiology -- Summary -- Chapter 8: Systematic reviews and metaanalyses of air pollution epidemiological studies -- Abstract -- Introduction.

Background: Environmental factors determine children's health. Quantifying the health impacts related to environmental hazards for children is essential to prioritize interventions to improve health in Europe. Objective: This study aimed to assess the burden of childhood disease due to environmental risks across the European Union. Methods: We conducted an environmental burden of childhood disease assessment in the 28 countries of the EU (EU28) for seven environmental risk factors (particulate matter less than 10 micrometer of diameter (PM(10)) and less than 2.5 micrometer of diameter (PM(2.5)), ozone, secondhand smoke, dampness, lead, and formaldehyde). The primary outcome was disability-adjusted life years (DALYs), assessed from exposure data provided by the World Health Organization, Global Burden of Disease project, scientific literature, and epidemiological risk estimates. Results: The seven studied environmental risk factors for children in the EU28 were responsible for around 211,000 DALYs annually. Particulate matter (PM(10) and PM(2.5)) was the main environmental risk factor, producing 59% of total DALYs (125,000 DALYs), followed by secondhand smoke with 20% of all DALYs (42,500 DALYs), ozone 11% (24,000 DALYs), dampness 6% (13,000 DALYs), lead 3% (6200 DALYs), and formaldehyde 0.2% (423 DALYs). Conclusions: Environmental exposures included in this study were estimated to produce 211,000 DALYs each year in children in the EU28, representing 2.6% of all DALYs in children. Among the included environmental risk factors, air pollution (particulate matter and ozone) was estimated to produce the highest burden of disease in children in Europe, half of which was due to the effects of PM(10) on infant mortality. Effective policies to reduce environmental pollutants across Europe are needed.

Green spaces are defined as open spaces of ground, covered by vegetation, including parks and gardens. This kind of environment is linked to many positive effects and its importance is growing due to increasing urbanization. Understanding what drives people to use green urban space is fundamental to creating appropriate campaigns to develop the use of such spaces and improve the citizens' quality of life. A questionnaire on the attitude towards green space was developed and submitted to people from two Italian regions. Emilia-Romagna and Veneto are two regions in the North of Italy with different territorial policies. Three hundred and ten surveys were collected (167 in Emilia-Romagna and 143 in Veneto). Significant differences were observed between regions, age groups and in relation to the kind of work (p < 0.05). People from Emilia-Romagna have higher scores of attitudes towards green space than people from Veneto, underlining the importance of territorial policies. Moreover, younger participants (18–30 years) seem to be less attracted to green urban space. Being an employee seems to influence the attitude towards green space. Particular attention should be given to subjects of the younger age groups and to the number of hours spent at work. This could be an important element for future research, so that political action can be implemented with these categories in mind.

Green spaces are defined as open spaces of ground, covered by vegetation, including parks and gardens. This kind of environment is linked to many positive effects and its importance is growing due to increasing urbanization. Understanding what drives people to use green urban space is fundamental to creating appropriate campaigns to develop the use of such spaces and improve the citizens' quality of life. A questionnaire on the attitude towards green space was developed and submitted to people from two Italian regions. Emilia-Romagna and Veneto are two regions in the North of Italy with different territorial policies. Three hundred and ten surveys were collected (167 in Emilia-Romagna and 143 in Veneto). Significant differences were observed between regions, age groups and in relation to the kind of work (p < 0.05). People from Emilia-Romagna have higher scores of attitudes towards green space than people from Veneto, underlining the importance of territorial policies. Moreover, younger participants (18–30 years) seem to be less attracted to green urban space. Being an employee seems to influence the attitude towards green space. Particular attention should be given to subjects of the younger age groups and to the number of hours spent at work. This could be an important element for future research, so that political action can be implemented with these categories in mind.

BACKGROUND: Road traffic is the main source of environmental noise in European cities and one of the main environmental risks to health and wellbeing. In this study we aimed to provide an in-depth assessment of available road traffic noise data and to estimate population exposure and health impacts for cities in Europe. METHODS: We conducted the analysis for 724 cities and 25 greater cities in 25 European countries. We retrieved road traffic strategic noise maps delivered under the Environmental Noise Directive (END) or available from local sources. We assessed noise exposure using the 24 h day-evening-night noise level indicator (Lden) starting at exposure levels of 55 dB Lden - based on data availability - for the adult population aged 20 and over (n = 123,966,346). For the adults exposed to noise levels above 55 dB Lden we estimated the health impacts of compliance with the World Health Organization (WHO) recommendation of 53 dB Lden. Two primary health outcomes were assessed: high noise annoyance and Ischemic Heart Disease (IHD), using mortality from IHD causes as indicator. Exposure Response Functions (ERFs) relating road traffic noise exposure to annoyance and IHD mortality were retrieved from the literature. Uncertainties in input parameters were propagated using Monte Carlo simulations to obtain point estimates and empirical 95% Confidence Intervals (CIs). Lastly, the noise maps were categorized as high, moderate and low quality following a qualitative approach. RESULTS: Strategic noise map data was delivered in three distinct formats (i.e. raster, polygon or polyline) and had distinct noise ranges and levels of categorization. The majority of noise maps (i.e. 83.2%) were considered of moderate or low quality. Based on the data provided, almost 60 million adults were exposed to road traffic noise levels above 55 dB Lden, equating to a median of 42% (Interquartile Range (IQR): 31.8-64.8) of the adult population across the analysed cities. We estimated that approximately 11 million adults were highly annoyed by road traffic noise and that 3608 deaths from IHD (95% CI: 843-6266) could be prevented annually with compliance of the WHO recommendation. The proportion of highly annoyed adults by city had a median value of 7.6% (IQR: 5.6-11.8) across the analysed cities, while the number preventable deaths had a median of 2.2 deaths per 100,000 population (IQR: 1.4-3.1). CONCLUSIONS: Based on the provided strategic noise maps a considerable number of adults in European cities are exposed to road traffic noise levels harmful for health. Efforts to standardize the strategic noise maps and to increase noise and disease data availability at the city level are needed. These would allow for a more accurate and comprehensive assessment of the health impacts and further help local governments to address the adverse health effects of road traffic noise.

IntroductionGreen-blue spaces (GBS), such as parks, woodlands, and beaches, may be beneficial for population mental health and wellbeing. However, there are few longitudinal studies on the association between GBS and mental health and wellbeing, and few that incorporate network analysis as opposed to simple Euclidian proximity.
Objectives and ApproachWe are examining the association between the availability of GBS with wellbeing and common mental health disorders. We will use geographic information systems (GIS) to create quarterly household level GBS availability data using digital map and satellite data (2008-2018) for over 1 million homes in Wales, United Kingdom. We will link GBS availability to individual level mental health (1.7 million people with General Practitioner (GP) data) and data from the National Survey for Wales (n = 24,000) on wellbeing (Warwick Edinburgh Mental Wellbeing Scale (WEMWBS)) using the Secure Anonymised Information Linkage (SAIL) databank.
ResultsWe created an historic dataset of GBS availability using road network and path data to create quarterly household level GBS exposures (2008-2018). We tested Residential Anonymised Linking Fields (RALFs) and accurately linked 97\% of individuals and their health data to their home and GBS exposure. The 1.65 million exposure-health data pairs, updated quarterly, will enable a longitudinal panel study to be built. Using GP recorded data on treatments, diagnoses, symptoms and prescriptions for mental health problems we identified 35,000 people had a common mental health disorder in 2016, and 24,000 people answered the National Survey for Wales questions about their wellbeing and use of GBS. We will explore how house moves, and visits to GBS change the association between GBS availability and outcomes.
Conclusion/ImplicationsThis study fills the gap in the evidence base around environmental planning policy to shape living environments to benefit health. It will inform the planning and management of GBS in urban and rural environments and contribute to international work on impacts of the built environment on mental health and wellbeing.

Several citizen science (CS) initiatives have been adopted in environmental science to monitor air and noise pollution, and water quality related to civic concerns. Nevertheless, CS projects in environmental epidemiology remain scarce. This is because little attention has been paid to evaluate associations of environmental exposures with health effects directly. This narrative review aims to promote the understanding and application of CS in environmental epidemiology. There are many commonalities between CS and other participatory approaches in environmental epidemiology. Yet, CS can foster the democratization of scientific governance and enhance the sustainability of research projects more effectively than other existing participatory approaches. This is especially the case in projects where citizens are invited to participate, engage and become involved throughout all the phases of a research project (co-created projects). This paper identifies various challenges and opportunities specific to the implementation of co-created CS projects in environmental epidemiology. The development of more locally relevant research designs, using local knowledge, obtaining medical ethical clearance, and co-analysing the association between exposure and health, are examples of opportunities and challenges that require epidemiologists to go beyond the traditional research framework and include more outreach activities. Continued efforts, particularly the sharing of information about projects' collaborative processes, are needed to make CS a more concrete and cohesive approach in environmental epidemiology.