Periodic Reporting for period 4 - EXPANSE (EXposome Powered tools for healthy living in urbAN SEttings)
Période du rapport: 2024-01-01 au 2025-06-30
By 2030 over 80 % of Europeans will live in cities. Urban living offers many opportunities but also exposes citizens to a complex mix of factors such as air pollutants, noise, heat, limited green space, mobility patterns, diet and chemicals from consumer products. These combined environmental, social and behavioural influences make up the urban exposome. Mounting evidence shows that this component of the exposome is a major driver of cardio-metabolic and pulmonary diseases (CMPD), which together account for the largest share of deaths and chronic illness in Europe.
The EXPANSE project answers a key policy question: How to maximize one’s health in a modern urban environment? The aims:
• Map and characterise the external urban exposome at unprecedented European scale and spatial resolution.
• Measure the internal exposome—the biological changes and chemical imprints in the body that reflect real-life exposure.
• Link external and internal exposures to health outcomes in large population studies to reveal causes, mechanisms and early warning markers of CMPD.
• Create open, user-friendly tools so that citizens, urban planners and policymakers can translate exposome knowledge into effective action.
The EXPANSE project answers a key policy question: How to maximize one’s health in a modern urban environment? The aims:
• Map and characterise the external urban exposome at unprecedented European scale and spatial resolution.
• Measure the internal exposome—the biological changes and chemical imprints in the body that reflect real-life exposure.
• Link external and internal exposures to health outcomes in large population studies to reveal causes, mechanisms and early warning markers of CMPD.
• Create open, user-friendly tools so that citizens, urban planners and policymakers can translate exposome knowledge into effective action.
Completed work
Europe-wide high-resolution exposure maps:
Harmonised maps of the urban exposome now cover many European countries at a spatial resolution down to 25m. These maps integrate air pollutants, noise, temperature, greenness, mobility, food environment indicators and social context. The data are FAIR (findable, accessible, interoperable and reusable) and can be used in health-impact assessment or policy analysis.
Urban Labs: real-life observatories
5 Urban Labs followed citizens for up to 18 months using GPS tracking, time-activity diaries, new air-pollution sensors and mobile phone applications. These unique data reveal how people interact with their environment, how daily behaviour shapes exposure, and how targeted interventions affect health.
Internal Exposome atlas
Over 10 000 blood-samples from 13 European cohorts were analysed with state-of-the-art ultra-high-resolution mass spectrometry, harmonised across laboratories in Europe and the USA. This is now one of the largest untargeted metabolomics resources worldwide, identifying thousands of chemical fingerprints and early molecular response markers of environmental stress.
Health-Impacts and Mechanisms:
Analyses across birth, adult and administrative cohorts of 28 million Europeans show that multiple exposures act jointly to harm health:
• Long-term exposure to fine particulate matter increases the risk of metabolic syndrome, hypertension, elevated triglycerides and diabetes.
• Combined exposure to air pollution, built environment and temperature increases the risk of asthma and impairs lung function.
• Urban heat, land-use patterns and air pollution jointly increase all-cause mortality.
The EXPANSE project demonstrated how urban exposures leave chemical marks on DNA and alter gene expression, many years before clinical diseases manifest. We identified metabolic fingerprints predictive of heart attack, stroke, type 2 diabetes and chronic obstructive pulmonary disease.
New Metrics and Models for Decision Making
A key innovation is the Exposome Risk Score (ERS), which weights and combines major pollutants and greenness to estimate the cumulative health burden of city living. Based on the urban environmental conditions we measured, the ERS suggests that roughly one-third of cardiovascular disease and over three-quarters of chronic obstructive pulmonary disease in older Europeans can be attributed to these modifiable urban exposures.
Complementing the ERS, an agent-based urban health model, piloted with the City of Amsterdam, allows policy makers to test and compare interventions before implementation. Together these tools enable evidence-based design and evaluation of healthier, climate-resilient cities.
Europe-wide high-resolution exposure maps:
Harmonised maps of the urban exposome now cover many European countries at a spatial resolution down to 25m. These maps integrate air pollutants, noise, temperature, greenness, mobility, food environment indicators and social context. The data are FAIR (findable, accessible, interoperable and reusable) and can be used in health-impact assessment or policy analysis.
Urban Labs: real-life observatories
5 Urban Labs followed citizens for up to 18 months using GPS tracking, time-activity diaries, new air-pollution sensors and mobile phone applications. These unique data reveal how people interact with their environment, how daily behaviour shapes exposure, and how targeted interventions affect health.
Internal Exposome atlas
Over 10 000 blood-samples from 13 European cohorts were analysed with state-of-the-art ultra-high-resolution mass spectrometry, harmonised across laboratories in Europe and the USA. This is now one of the largest untargeted metabolomics resources worldwide, identifying thousands of chemical fingerprints and early molecular response markers of environmental stress.
Health-Impacts and Mechanisms:
Analyses across birth, adult and administrative cohorts of 28 million Europeans show that multiple exposures act jointly to harm health:
• Long-term exposure to fine particulate matter increases the risk of metabolic syndrome, hypertension, elevated triglycerides and diabetes.
• Combined exposure to air pollution, built environment and temperature increases the risk of asthma and impairs lung function.
• Urban heat, land-use patterns and air pollution jointly increase all-cause mortality.
The EXPANSE project demonstrated how urban exposures leave chemical marks on DNA and alter gene expression, many years before clinical diseases manifest. We identified metabolic fingerprints predictive of heart attack, stroke, type 2 diabetes and chronic obstructive pulmonary disease.
New Metrics and Models for Decision Making
A key innovation is the Exposome Risk Score (ERS), which weights and combines major pollutants and greenness to estimate the cumulative health burden of city living. Based on the urban environmental conditions we measured, the ERS suggests that roughly one-third of cardiovascular disease and over three-quarters of chronic obstructive pulmonary disease in older Europeans can be attributed to these modifiable urban exposures.
Complementing the ERS, an agent-based urban health model, piloted with the City of Amsterdam, allows policy makers to test and compare interventions before implementation. Together these tools enable evidence-based design and evaluation of healthier, climate-resilient cities.
EXPANSE support several key EU strategies:
• European Green Deal & Zero Pollution: EXPANSE quantifies combined exposures driving disease and premature death, providing functions to guide stricter air-quality and mobility policies.
• EU Urban Agenda & Climate Adaptation: High-resolution maps and ERS support low-emission and cooling plans, track progress, and target vulnerable communities.
• Chemicals Strategy & REACH: Detection of thousands of blood compounds offers early warnings on emerging contaminants.
• Health Inequality & Just Transition: Analyses show low-income and marginalised groups face higher exposures, reinforcing the need for fair urban planning and investment.
All datasets comply with FAIR data principles and are linked to the European Human Exposome Network (EHEN) and emerging research infrastructures such as EIRENE and the International Human Exposome Network (IHEN). This ensures long-term accessibility and interoperability with European environmental and health-data systems.
Societal benefits:
• Health impact – A clear pathway to reduce the burden of heart, lung and metabolic diseases, potentially saving many thousands of lives and lowering healthcare costs.
• Equity – Insight into how disadvantaged communities face higher environmental risks, guiding fair and effective protection measures.
• Economic efficiency – Evidence to support smarter infrastructure and preventive health investments, helping reduce long-term public expenditure.
• Citizen engagement – The EXPANSEEKER mobile app and participatory Urban Labs empower residents with personal exposure information and opportunities to co-design healthier neighbourhoods.
Key Outputs and Tools
All results are consolidated in the Urban Exposome Toolbox, an open-access suite of resources that includes:
• Exposome Maps – Europe-wide, fine-scale exposure data layers.
• Exposome Risk Score – A practical index for comparing combined environmental risks across regions and for monitoring progress towards cleaner, healthier cities.
• Early-warning biomarkers – DNA-methylation and metabolomics signatures for future disease risk assessment.
• Agent-based intervention models – Tools for municipalities to test the health and economic impacts of planned measures.
• Data portals and software – Freely accessible analytical scripts, metadata catalogues and integration with EHEN infrastructure.
These outputs are designed for immediate use by city planners, public health authorities, researchers, NGOs and citizen groups.
Next Steps
To maximise impact, the consortium recommends:
• Embedding EXPANSE outputs in EU policy cycles, for example integrating ERS and Toolbox data into future revisions of air-quality directives, chemicals regulation and climate-health adaptation plans.
• Scaling the Urban Labs concept across Europe to accelerate uptake of proven interventions.
• Ensuring sustained infrastructure and maintenance of the Toolbox through European research infrastructures such as EIRENE and the EHEN.
Conclusion
EXPANSE shows that a substantial share of chronic heart, lung and metabolic disease in Europe can be traced to modifiable urban environmental conditions. By providing freely accessible data, biomarkers and decision-support tools, the project equips European policymakers, planners and citizens to translate exposome science into effective urban planning and regulation—creating healthier, more equitable and climate-resilient cities for future decades.
• European Green Deal & Zero Pollution: EXPANSE quantifies combined exposures driving disease and premature death, providing functions to guide stricter air-quality and mobility policies.
• EU Urban Agenda & Climate Adaptation: High-resolution maps and ERS support low-emission and cooling plans, track progress, and target vulnerable communities.
• Chemicals Strategy & REACH: Detection of thousands of blood compounds offers early warnings on emerging contaminants.
• Health Inequality & Just Transition: Analyses show low-income and marginalised groups face higher exposures, reinforcing the need for fair urban planning and investment.
All datasets comply with FAIR data principles and are linked to the European Human Exposome Network (EHEN) and emerging research infrastructures such as EIRENE and the International Human Exposome Network (IHEN). This ensures long-term accessibility and interoperability with European environmental and health-data systems.
Societal benefits:
• Health impact – A clear pathway to reduce the burden of heart, lung and metabolic diseases, potentially saving many thousands of lives and lowering healthcare costs.
• Equity – Insight into how disadvantaged communities face higher environmental risks, guiding fair and effective protection measures.
• Economic efficiency – Evidence to support smarter infrastructure and preventive health investments, helping reduce long-term public expenditure.
• Citizen engagement – The EXPANSEEKER mobile app and participatory Urban Labs empower residents with personal exposure information and opportunities to co-design healthier neighbourhoods.
Key Outputs and Tools
All results are consolidated in the Urban Exposome Toolbox, an open-access suite of resources that includes:
• Exposome Maps – Europe-wide, fine-scale exposure data layers.
• Exposome Risk Score – A practical index for comparing combined environmental risks across regions and for monitoring progress towards cleaner, healthier cities.
• Early-warning biomarkers – DNA-methylation and metabolomics signatures for future disease risk assessment.
• Agent-based intervention models – Tools for municipalities to test the health and economic impacts of planned measures.
• Data portals and software – Freely accessible analytical scripts, metadata catalogues and integration with EHEN infrastructure.
These outputs are designed for immediate use by city planners, public health authorities, researchers, NGOs and citizen groups.
Next Steps
To maximise impact, the consortium recommends:
• Embedding EXPANSE outputs in EU policy cycles, for example integrating ERS and Toolbox data into future revisions of air-quality directives, chemicals regulation and climate-health adaptation plans.
• Scaling the Urban Labs concept across Europe to accelerate uptake of proven interventions.
• Ensuring sustained infrastructure and maintenance of the Toolbox through European research infrastructures such as EIRENE and the EHEN.
Conclusion
EXPANSE shows that a substantial share of chronic heart, lung and metabolic disease in Europe can be traced to modifiable urban environmental conditions. By providing freely accessible data, biomarkers and decision-support tools, the project equips European policymakers, planners and citizens to translate exposome science into effective urban planning and regulation—creating healthier, more equitable and climate-resilient cities for future decades.