Health impact of traffic related air pollution (TRAP) in teenagers from the PARIS birth cohort – PARIS14-TRAP

Aim. This innovative project aims at better understanding the role of traffic-related air pollution (TRAP) on different phenotypes of (co)morbidity (pubertal development, overweight and cardiometabolic disorders, respiratory and allergic diseases, neurodevelopmental disorders) in teenagers from the PARIS birth cohort.
Scientific obstacles. They are related to the possible sources of bias (selection, information and confounding) the team will attempt to avoid or minimize. The main challenge will be to convince teenagers to participate in the health examination. In order to stimulate their motivation, a meeting will be organized in 2016 with all PARIS families, with the support of Paris municipality. Health data from different sources will be collected to approach morbidity, either perceived, reported by teenagers and their parents, doctor-diagnosed or measured. Biological measurements will be performed in a single laboratory. Standard Operating Procedures will describe each task and all staff involved in the project will be trained and regularly supervised to detect discrepancies with regard to the protocol. The clinical staff will be specialized in caring for young people.
Work program. It is organized in 10 tasks (T) based on the longitudinal follow-up of the PARIS birth cohort till adolescence including assessment of TRAP exposure in different time windows, early, current and lifetime (by an air dispersion model – T1), assessment of potential confounders/modifiers (T2), health examination at 14 years (T3) including assessment of pubertal development (T4), cardio-metabolic risk factors (anthropometric measurements, blood pressure, heart rate - T5), respiratory and allergic morbidity (spirometry, exhaled nitric oxide [eNO], skin prick tests – T6), neurodevelopment (standardized tests for memory, attention, IQ, behavior – T7). A biological task (T8) consists of blood sampling for full blood count, lipids, glucose, specific IgE, and sex hormones, and constitution of biological collections. The statistical analysis of all collected data is task 9 while coordination is task 10.
Overall impact of the project. At the frontiers of knowledge and its transfer to society, this prospective population-based epidemiological research project, conducted in actual exposure conditions, will provide the highest level of scientific evidence to guide public action. It will help to better characterize and quantify the global health impact of TRAP exposure in adolescents, to clarify the relevant exposure time windows and the role of obesity and puberty as independent, intermediate, modifying or confounding factors. The growing concern over TRAP exposure and its potential effects on human health have led to a strong societal demand. The classical scientific valorisation through publications and communications has to be accompanied with a strategy for disseminating results to the participating families and to health professionals. The teenagers will become "ambassadors of environmental health" in their high school, at the core of educational programs, developed in partnership with the French Agency for the Environment and Energy Management (ADEME).
Partners. The research team EA 4064 (Paris Descartes University) already benefits from the cooperation with the Paris municipality and Paris public hospitals (AP-HP). A collaboration will be established with health centers from the Primary Sickness Insurance Fund for the health examination, and with the Biochemistry Department of the Bichat hospital (Paris) and the Medical University of Vienna (Austria) for the biological assays. The partnership with Professor Maryse Bouchard from the University of Montreal (Canada) will bring additional expertise in the characterization of the neurotoxic effects of environmental exposures. Both teams have complementary skills that perfectly fit with this high-level research program focused on major issues in environmental health.