RESPIRA Project: Understanding the role of environmental contaminants in respiratory diseases

Abstract

In the last century, there was a shift from an outdoor to an indoor lifestyle and presently we spend 80- 90% of our lives inside buildings. This artificial habitat has unique features (e.g. insulation, humidity) that promote the accumulation of not only biological agents (e.g. bacteria, fungi) but also chemical contaminants; therefore, it is a prime interface between such agents and humans. However, humans are not evolutionary prepared to deal with such an artificial habitat and scientific evidence suggests that the increasing incidence of Non Communicable Diseases (NCDs) in western societies may be a consequence of the ubiquitous exposure to environmental contaminants. Respiratory diseases are a paradigmatic case study, as they are deeply responsive to environmental contaminants. Furthermore, the economic burden of respiratory diseases is overwhelming, exceeding 380 billion € in Europe, with asthma and chronic obstructive pulmonary disease (COPD) representing the greatest portion with over 200 billion €. The study of indoor environmental quality as well as the development and progression of chronic respiratory diseases have received a great deal of attention in the past few years. However, most of those surveys focus on single contaminants exposure. RESPIRA project aims to contribute towards a better understanding of the role of multiple stressors in respiratory diseases by providing a multidisciplinary approach to the environmental determinants of health. We will evaluate indoor contamination by metals and organometals in the domestic environment of patients with COPD and matched controls by analysing the levels of the selected contaminants in house dust samples and corresponding human samples. Furthermore, the microbial indoor community will also be evaluated in air and dust samples from those houses. This case control study is being developed in collaboration with the pulmonology department of Estarreja public hospital and will characterize 50 patients and 50 matched controls. The goal of RESPIRA project is to unravel possible associations between the indoor contaminants and the exacerbations symptoms in patients with respiratory diseases. Guidelines regarding the minimization of exposure can then be proposed to reduce the number/severity of exacerbations and prevent new cases, which ultimately will be translated into better respiratory health status of patients with chronic respiratory disease and of the general populations. In this presentation, the project rationale and the study protocol will be described, and the ongoing work will be explained.