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HEALTH PROTECTION RESEARCH UNIT ANNUAL REPORT 2017/18 Financial Year

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HEALTH PROTECTION RESEARCH UNIT ANNUAL REPORT 2017/18 Financial Year HEALTH PROTECTION RESEARCH UNIT ANNUAL REPORT 2017/18 Financial Year Note: The accompanying ‘NIHR Health Protection Research Unit – Guidance on Completion of Annual Reports’ for 2017/18 Financial Year contains essential guidance on the information you need to provide when completing this form. Please note that the overview of activities (and other sections of the Progress Report) should reflect activities which fall within the remit of the NIHR HPRU funding scheme. Please complete the form using a font size no smaller than 10 point (Arial). 1. UNIT DETAILS Name of the NIHR Health Protection Research Unit: Contact details of the individual to whom any queries on this Annual Report will be referred. Feedback on this report will be provided to the Director, copied to the manager. Name: Angela Lewis Job Title: Programme Manager Address: King’s College London, Franklin Wilkins Building, 150 Stamford Street, London SE1 9NH Email: [email protected] Tel: 020 7848 3765 2. DECLARATIONS AND SIGNATURES Contact details of the University administering the NIHR Health Protection Research Unit award: Name: King’s College London Address: Franklin Wilkins Building, 150 Stamford Street, London SE1 9NH Name of the Director: Professor Frank J. Kelly I hereby confirm, as Director of the NIHR Health Protection Research Unit award, that this Annual Report has been completed in accordance with the guidance issued by the Department of Health and provides an accurate representation of the activities of the NIHR Health Protection Research Unit: Signature …… ………….. Date: 8th May 2018…… (Director) NIHR Health Protection Research Unit– Progress Report 201718 1 3. SUMMARY OF ACTIVITIES FOR THE COLLECTIVE NIHR HPRU PUBLIC REPORT The NIHR HPRU in the Health Impact of Environment Hazards (HIEH) provides high quality scientific evidence to support PHE’s roles in implementing effective public health interventions to prevent and reduce the burden of ill health associated with environmental hazards. During 2017/18 the HIEH HPRU progressed its leading environmental effects on health research to advance understanding of the causes and effects of key environmental issues affecting public health on a number of fronts. In Theme 1 we progressed work on the health impacts of bioaerosols from waste composting facilities and intensive farming. Intensive farming sites require permits to operate from the English Environment Agency and current guidance requires that a site specific risk assessment be carried out for sensitive receptors living within 100m of the site. This differs from the requirement for composting which applies to large scale composting sites. The primary purpose of this work was therefore to provide evidence about whether these limits should be aligned. This work revealed that most occupational studies that had considered this issue reported a negative impact on worker health outcomes, particularly respiratory symptoms. The findings from studies investigating the health of communities living near intensive farms were more mixed indicating further work is required. There is a clear need for the new studies to include better exposure data in terms of the qualification and quantification of different bioaerosols, and variation due to farming type or practice under consideration. Ideally long-term continuous measurements using molecular analysis methods to determine the type of bioaerosol exposure are required. These would take into account the effectiveness of measures of air filtering at sites. Additionally, greater understanding of bioaerosol dispersal patterns downwind of farms is required as this would assist in determining suitable distances for residences from the site. On the basis of the limited current evidence it was felt there was no compelling evidence to align the limit values for risk assessment at the current time. In Theme 2 we addressed a fundamental issue in testing for hazard in complex mixtures as UVCB products are a challenge for regulators and producers alike for assessing hazard. Currently read across is seen as the best way forward to avoid large amounts of new animal based testing but the complexity and variability of these products is proving challenging for defining read-across groups acceptable to the regulators. In this project we sought to establish biologically based, rather than chemically based groupings to which new products can be added for the purposes of read-across as required. With our partners we designed a multi cell assay that uses 10 cell lines and 6 iPESC derived lineages to test the effects of these mixtures using both apical end point assays and partial transcriptome gene expression analysis in response to UVCB. Measurable end points of response to exposure to 161 distillation oil products and reference chemicals across four concentrations have been derived. This research will contribute to the greater understanding and assessment of these complex mixtures, allowing potential reduction in hazard and therefore risk for products that are extensively used by most people. Further work understanding chemical exposures was progressed for both chemical and biological exposures. In Theme 3 we addressed the validity of self-reported mobile phone use as a better understanding of this issue is essential to any future evaluation and interpretation of the associations between exposure to radio- frequency electromagnetic fields and long-term health. In COSMOS, we found fair to moderate agreement between self-reported and operator-derived data on mobile phone use. The sensitivity of self-report was generally high for correctly identifying those adults with the smallest amount of mobile phone use, but lower for identifying heavy mobile phone use. This is in line with our observation that respondents were more likely to underestimate than overestimate their mobile phone use. In the SCAMP study, agreement between self- reported mobile phone use and mobile operator traffic data was highest for the duration spent talking on mobile phones per day compared to frequency of calls and number of text messages sent. Adolescents overestimated their mobile phone use during weekends compared to weekdays. In Theme 4 a successful cross-collaboration with the Emergency Preparedness and Response HPRU was undertaken which investigated how to increase the behavioural impact of health communications in various public health threat contexts. Crucial for this work was the acknowledgement that protecting public health must involve the development of more effective communications strategies aiming at encouraging people to take protective measures against the health impact of air pollution. The work informed the design of a study that investigated how to improve the behavioural impact of existing air quality alert messages through a systematic manipulation of key communication variables found by systematic review. Both intended and actual adherence behaviours were investigated. Although the sample size was small, we had encouraging results. Compared to the usual air quality alert messages sent by an existing air alert smartphone App, our newly developed messages seemed able to increase intentions to make permanent behavioural changes NIHR Health Protection Research Unit– Progress Report 201718 2 and actual use of preventative medication. During 2017/18 the work we are undertaking in the HPRU has continued to contribute to our success in securing £13,385,884 of external funding. Tim Gant received funding from CONCAWE to establish new toxicological screening assays (£271K). Paul Elliott received funding via Imperial BRC award for biobanking and health informatics development (£5M) and a UK DRI award (£1.5M). Mireille Toledano received MRC funding to add a cognitive development arm to the ongoing SCAMP study (£618K). Terry Tetley’s nanotoxicology research was supported by AstraZeneca (£2M). David Green received NERC/Defra funding to establish a new air quality monitoring supersite in London (£397K & £150K, respectively). Frank Kelly received funding via the new Wellcome Trust Centre investigating Pathways to Equitable Health Cities (£325K). We continue to be actively involved in public engagement activities. Researchers from Themes I, II and IV took part in the New Scientist Live event in July 2017 with posters, leaflets and interactive games on topics including bioaerosols, the microbiome, air quality and health and a compendium of other chemical hazards. At this event, HPRU researchers spoke to approximately 4000 people (1000 per day), with the Unit Director Professor Frank Kelly delivering one of the key podium presentations on the risks associated with air pollution. A new initiative has led to the establishment of a joint Community Advisory Board (CAB) between the HPRU and the MRC-PHE Centre for Environment and Health. New members from the British Lung Foundation, the British Heart Foundation and the Patient’s Association, as well as a director of public health (Lewisham), have joined the CAB. CAB members meet 2-3 times per year and provide comment and feedback on research strategy and programmes, input ideas, and provide opinion on ethical issues. NIHR Health Protection Research Unit– Progress Report 201718 3 4. OVERVIEW OF ACTIVITIES The Health Impact of Environmental Hazards HPRU undertakes cutting edge research to advance understanding of the causes and effects of key environmental issues affecting public health and thereby influence policy for improving health locally, nationally, and globally. The focus of our research addresses four
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