Concepts & Objectives

With clear evidence for current and future global and regional climate, land use and air quality change, it is crucial to improve our understanding of how these environmental changes will impact human health. As assessed in the last report of the Intergovernmental Panel on Climate Change (IPCC), climate change foreseen for the next several decades of the 21st century over the European region is expected to increase the occurrence of extreme events, such as heat-waves, drought and flood, to worsen air pollution through higher temperatures and more stagnant conditions, and to possibly cause migration of new invasive plant species and disease vectors. In addition, these changes might occur in correspondence of widespread urban sprawl, population and traffic increase and land degradation. The complex interplay across these multiple stressors might exacerbate the overall effect of environmental change on human health in synergistic ways that are difficult to assess from a disciplinary perspective. Therefore, there is an urgent need to develop integrated and cross-disciplinary approaches to assess health risks consequent to severe environmental change and to design suitable adaptation policies. These approaches need to establish quantitative models of disease response to environmental stressors to be used for projections of future disease risk.

Ambrosia artemisiifolia L. (Asteraceae) called common ragweed is an annual Ambrosia herbaceous plant with origins in North America. Although it was first observed in Europe in the mid 19th century, it began to spread in Europe after 1940, first in Hungary and then spread to Eastern European countries, South Eastern France and Northern Italy. It has continued to spread into many continental Europe countries. It is a highly invasive plant with allergenic pollen that causes hay fever (rhino-‐conjunctivitis), asthma and atopic dermatitis.

Ambrosia has a significant negative impact on the European economy through its effect on health, agriculture, biodiversity and even tourism. The rates at which Ambrosia is spreading and the rates at which individuals are becoming allergic are on the rise. The relative rise in the prevalence of allergy related to the coming Ambrosia epidemic may add an enormous burden on European health care costs. Furthermore, it invades crops potentially reducing yields of commercial agriculture products and further reduces the economy by reducing tourism in endemic areas such as the Croatian coast. There is an urgent need for awareness of invasive plants along with early detection and preventive management initiatives, along with sustainable strategies to control and reduce this invasive plant. To prevent future invasion and reduce current invasion will incur heavy costs to farmers in Europe. There are biological approaches such as insect, mite or fungi from Ambrosia native regions that can be utilised in addition to herbicides, etc. Decisions and policy regarding these strategies need to be based on cost-‐benefit ratios especially in the context of the effects on health and health care costs. Atopica aims to better understand and quantify the effects of environmental changes on Ambrosia pollen-‐ induced allergic disease in Europe, using a highly interdisciplinary and integrated approach. Specifically, we plan to evaluate and model the influence of changes in climate, air quality, land use, subsequent distribution of invasive allergenic plant species and allergic pollen distribution on human health. Among the main scientific questions atopica plans to address are:

What is the uncertainty in simulating airborne pollen concentration variability and outbursts using climate, vegetation and atmospheric dispersion models?
How will future changes in climate, air quality and land use affect the emissions and concentrations and allergenicity of allergenic pollens in Europe?
How will changes in pollen and air pollutant concentration affect prevalence of sensitisation and allergenic diseases in vulnerable groups (e.g. children, elderly)?
Can mathematical models of disease response to pollen concentrations be developed and used for risk assessment purposes?
How will established Birch vs. new invasive Ambrosia pollens respond to environmental changes?
What will be the impact on health care and health policy of the global and regional climate, air quality and pollen changes?
How can public policy respond to the need to reduce the risk factors leading to increased pollen-‐induced allergic disease?
Does the estimated personal exposure (case study) reflect the spatial and temporal variability of urban and rural exposures and the conditions in indoor and outdoor microenvironments?
Are there enhanced risks of allergic morbidity and more severe disease associated with vulnerability factors such as pre-‐maturity, atopic eczema, chronic disease, pre-‐existing allergy, etc.?
Which environmental stressors are responsible for the observed health effects of allergy to Ambrosia pollen in humans and the development of de novo sensitisation, asthma and allergy and the progression of allergic diseases?