Our environment and our health are tightly interlinked. Global warming and increased pollution mean that half the world’s population is at greater risk of developing cancer as well as cardiovascular, neurological and autoimmune disease. As part of the Convergence programme, researchers at TU Delft, Erasmus Medical Centre and Erasmus University Rotterdam are collaborating on a 5-year Flagship project to measure the real-time health effects of climate change and pollution at the individual level, providing the data needed to plan better treatment strategies, and better policies to reduce the negative health effects at the societal level.

The project’s goal at its most simple is to use tiny sensors to detect chemicals produced by the skin that reflect our body’s response to different kinds of environmental stress – and then use this information to prevent disease developing, plan better treatment and implement policies to reduce people’s exposure to harmful environmental effects. “We know that prolonged exposure to pollutants or heat is often correlated with an increased risk of chronic disease so we thought it was essential to try and prevent that,” explains Dr Alina Rwei, Chemical Engineer at TU Delft and the project’s Main Lead. “So if we could detect what was happening in the very early stages, really understand the tissue’s biological response and associated mechanisms when exposed to that environmental stress, then we could prevent prolonged exposure and therefore, development into these very serious chronic disease that are much harder to treat. But to do that, we first need to understand what’s happening at the tissue level when we expose these tissues to pollutants.”

Premature babies and wireless sensors

Rwei’s previous research had focussed on the development of wearable sensors for premature babies: “During neo-natal Intensive Care, you need to continuously monitor the vital signs so the babies are wired up to all kinds of devices. This is very bulky so we miniaturised the sensors so that they were small enough to put on the baby’s head and monitor them for brain oxygenation and blood flow. We also made the sensors wireless so the babies didn’t need to deal with all the wires and the parents could interact with the babies more easily.”

“Meanwhile I was looking for someone who could measure the impact of the environment on healthy skin,” adds Dr. Bing Thio, Dermatologist at Rotterdam’s Erasmus Medical Centre and Flagship Lead at Erasmus Medical Centre “so when I read about Rwei’s work on these sensors, I got in touch.”

Biomarkers for stress in sweat

Bing’s interest is in detecting the skin’s immunological response to external stress: “Skin is the first barrier of your immune system, sensing dangers from the outside. And what fascinates me is that all these different kinds of danger – viruses, bacteria, air pollution – will be felt by the immune system in the skin which produces proteins we generally call biomarkers.” Bing’s original proposal was to work with Rwei to develop sensors for detecting these biomarkers in the skin. “Then the Flagship opportunity came along and we saw a great opportunity to expand this project into something much larger,” says Rwei. “And then Bing jumped in and said ‘How about sensing the effects of climate change and pollution?’”

Previously, Rwei’s sensors were designed to monitor common vital signs such as heart rate or blood oxygenation: “But what we’re trying to develop here are more biochemical methods to sense these biomarkers in the skin, specifically in sweat.” Determining which particular biomarkers are the best ones to use to reflect environmental stress is one of the first tasks for Bing’s Flagship team.

Personalised Advice and Policy Change

The third arm of this Flagship project involves looking at population data, both to try to understand how climate and pollution influence how people behave, and also how various health policies affect people’s health and health behaviours – research which will be led by Dr“We will start working with the data we already have. For example we have anonymised individual information at the population level about people developing different diseases, and we also know where people live and work so we can see whether people have been exposed to different levels of air pollution or the effects of climate change. We can also look at the effects of policy changes so far; for instance in some cities speed limits have already gone from 50 k.p.h. to 30 k.p.h. And we can also link all that to data to what we know about health behaviours; whether people do sport, how they eat, how much they sleep.”

Five years from now

What does the team hope to have achieved five years from now? Rwei: “We have two aims: one is that from a clinical perspective, we hope to develop sensors that are able to monitor the immunological response of the body, and to correlate that with the environmental stress that the human subject is exposed to. Once we have that, we hope to be able to deliver useful information to the clinicians to be able to intervene at an early stage to prevent deterioration of health due to these environmental stresses. And secondly, from the societal perspective, we hope to be able to come up with effective policy intervention strategies – to advise governmental or other public entities what they can do to help the population to be aware and also to prevent the negative effect of environmental stress.