Efeitos da qualidade do ar na saúde da população urbana residente em Portugal usando registos individuais

HEART project aims to develop a holistic framework combining expertise from environmental sciences and environmental epidemiology to assess the impacts of ambient air pollution (AAP) on the health of the Portuguese urban population using individual health data from Electronic Medical Records (EMRs). The state-of-the-art highlights that:i) air pollution is still a problem for human health, ii) little knowledge on the impact of unregulated pollutants ultrafine particles (UFP) and black carbon (BC)-observations are lacking and modelling is challenging, iii) lack of associations between air pollution and some health endpoints, iv) a direct assessment of the associations between individual-level exposure to air pollution and individual-level health outcomes has yet to have been conducted in Portugal, mainly due to a lack of harmonization of individual clinical data. These gaps in scientific knowledge were translated into the research questions of the HEART project: • Which data and methods are necessary/suitable to conduct a holistic epidemiological study in Portugal? • Are dispersion models adequate to get a long period assessment of long-term exposures for all relevant pollutants at urban scale? • What are the concentrations of unregulated air pollutants, namely UFP and BC, and do they pose health risks to urban populations? • How can one best combine monitoring and modelling tools to better relate the hyperlocal variability of air quality levels with morbidity and mortality impacts on resident population in urban areas, and associate those relations to specific sources? • What can be recommended to stakeholders (healthcare professionals and policy-makers) to promote a better air quality, health and well-being? To answer these questions, the following specific objectives were defined: • Measure ambient concentrations of air pollutants, namely particulate matter (PM2.5 and UFP), nitrogen dioxide (NO2) and BC for every 50m segments in the streets of the study area (plus the municipality of Porto), using an electric car equipped with sensors • Apply a high spatial resolution air quality model to the study area for 2025 (when measurements take place) and a historic period. • Build high spatial resolution APP concentration maps using measured and modelled data and extract these concentrations for each address in the municipalities of the study area. • Assess the association between AAP and several health outcomes (morbidity and mortality) using EMRs from residents in the study area in an observational longitudinal study (retrospective cohort) • Produce valuable AAP exposure and epidemiological information that allows Portugal to collaborate in international European studies on the effects of environmental exposure on human health This will be the first project where a hyperlocal air quality map of a large Portuguese urban area for several air pollutants is produced. Moreover, to the best of the research team's knowledge, HEART will also be the first Portuguese study determining the association and effect sizes of air pollutants on health that is not based on indirect computations of relative risks and preventable disease/mortality burden. Furthermore, by investigating associations with non-regulated components and to with specific sources of air pollution, both not yet deeply enough studied in epidemiological studies, the project contributes greatly to the global effort in determining disease drivers related to air pollution.