 So, thank you. Good morning, everybody. This is our case study. The group is composed by myself, Elena, Ali, Raymond, Cyril, Betuel, Americo, and Abdel Tata. It's difficult. We decided to use a case study in a hospital in a developing country. And why we decided to do this? Because the hospital is an indoor environment that should be as clean as possible because there could be immunocompromised patients. So the hypothesis that we wanted to test is where? Is the hospital a source of exposure of pollutants? And to compare the two cases, two sites, one rural and one urban, to see, to check if the same facility in the same country but in different areas can actually determine a difference in the exposure. Someone else wants to speak? So the objectives were to measure different types of pollutants, whether indoor or outdoor, the hospital that is, as Maurizio said, we're going to have two hospitals, one in rural and one in urban. The pollutants would be PR, heavy metals, volatile organic compounds, and other gases concentration, and as well, microbiological contaminants. I wonder why. So there will be also chemical analysis of the water contaminants. The population would be the hospital workers and the patients. And the patients would be classified into three categories. The categories that are patients staying in the hospital for one to three days or from three days to one week or more than one week. And we selected the population to be patients aged more than 30. Split me in. So the analytical techniques to measure the contamination, first of all, active sampling, and then classical chemical characterization for the endpoints. So we will thought about putting in representative points a sampler, that sample particles, PN10, PN2.5, so we will have the filters to make the characterization. We will take a sample of water once in a day to make the characterization of metals and of bacteria in water. It should be sanitized, but better to check. And then we will make scrub from the, swabbing from the surface to check if the surface of the hospital can add bacteria or release other contaminants. We also thought to recover outdoor data from the local, if it's available, our quality network to check if indoor air is however better than outdoor. And of course the patient's data from the hospital record and again the data of water quality from local authority. For the health outcomes or health assessments of health impact, we have to take the data of the frequency of infections due to indoor pollutants, which means nosocomial respiratory infections acquired in the hospital during their patient's stay. The frequency of respiratory symptoms and the frequency of onset of allergy symptoms, the expected results, we're going to see the differences in the exposure level and health outcomes between the rural and the urban environment. And the indoor aerosol concentration may be important, more important than the outdoor ones. And the compounds of indoor aerosols are more complex. Recommendations? Yeah, if the results were going to be positive, the recommendation we thought where if outdoor pollution is affecting indoor, check ventilation and climatization. I mean ventilation and climatization should provide clean air to the hospital. If this is not the case, please check it. If urban hospital is more polluted than rural, review the hospital guidelines. Maybe hygiene ventilation is different, maybe being in a really crowded urban area. It's more likely that the windows are always open, that the doors for entering the hospital are always open, so there is a huge exchange of pollution. Or maybe the rules within the hospital are not so strict as they should be. And if hospital contaminates outside, we also thought maybe from some specific gases there is leakage, so it's important to check if you have also a sort of side effects. It means the hospital is contaminating outside just to check leaks and isolation of the hospital. And that's it. So comments from the audience? I have several. But first of all, thank you very much because in a very short time the protocol is really good. One, there is some concern about the outcomes because you should be in this in a studio like that. You have to be sure that the infections or the other respiratory defects are because of the indoor pollution. So if you decided to have an hospital based hospital, the good idea is to choose a word which is not connected with the respiratory problems. So maybe trauma or other centers, because maybe people with respiratory disease are in the hospital. Or if you cannot do that, a very good questionnaire in order to assess the health status of the patients at the beginning of the stay in the hospital. Because we want to say that this is, I have to say, worsening because of the indoor air quality. That's a long, I mean just... Probably the variable would be the time of stay. So if the patient had the onset of the symptom in a couple of hours, it's really not from the hospital. And the nature of the germ he acquired and its level of resistance to antibiotic is a very good indicator as well, if it is a hospital acquired, the infection or not. It's everything that can be judged against the severity of the disease at the beginning of the entering. The idea is that from acquiring the data from the hospital, if the patients start to have respiratory symptoms, being already in the hospital, so... It can be related to the reason of the why they are in the hospital. So thank you. We have no extra time. Oh, maybe one? Okay, short. Good morning. And it was really nice. But every time I give the example from India that maybe not good for me or my country, but that is important to know for all. My university has a medical college and hospital as well. And many a times, many a times we start vomiting on the street outdoor from, say, smell of a dead body rotting inside. So you can estimate the level of indoor pollution about the infection. So how to separate this kind of, say, pollution and with, say, general environment, indoor environment? Yes. We forgot to say one thing about our sampling protocol. We thought to sample for one week at least. So to divide weekdays and weekend days, because during weekend days we expect to have more visitors. So we can also check if the presence of a lot of persons actually bring the clouds, their clouds, into the hospital. So a more relevant outdoor pollution due to visits, not to the... So sorry, we forgot it. Be much different because, sorry, one second. Because in our case the weekends are closed, the hospitals are closed in weekend. So if you are sick on Sunday you will die. As Karla was saying, as Karla was saying, if the patient is hospitalized for an abdominal surgery, for example, and after three days he shows symptoms of respiratory disease, then this is definitely acquired in the hospital and not from the outside. Yeah. Where to go? Where to go? Thank you. Before the other group, but if there is room for two, I should have left it there. Okay, and... You have the memory stick? No, there is none. Okay, so... Look at the sample. So let's put the gold that they speak at once. Just need someone here for the camera and just for the mic. Someone here or someone else? Right, we just... Could you tell them which one? Where they come? Someone can recognize the fight? The fight today? Yeah, so the fight, yeah, exactly. This one? Is this one of these ones, as I know? Just a small pose for technical reasons. This one was in the fight five minutes ago. This one was in the fight five minutes ago. Okay, are you ready? Are you ready? Okay, the presentation is finished. Next time. Okay, we're going to try to find it again. So... So, this time... Okay, this one? This one? This one? Yes, this one. Okay, fantastic. Sorry. We are sorry for lateing. I'm sorry. Our case study will be at Brangman School in Cairo, which is Miga City, with high-population numbers. We will try to assess the health risk of indoor population. Ali Zainab, Mustafa Diaz, Gamil Mariam, Muhammad Al-Sa'a. Okay, it's a pass. As indoor quality has gained greater attention in recent years, which is concerning to human health. As we spent most of our daily time in indoor, in home, in hospital, in school, in work, etc. So, indoor quality affecting the human health. Also, it is affecting by outdoor air, including the stairs, interway, soil, and root dust, and entering the indoor environment, which contaminates the outdoor air pollutants and the falls, the major source of indoor air pollution. In the same case, it is important to consider indoor air quality inside a school, where children with different ages and spend most of their time in a school, which is a long period, I think. It started from mid-September. This is the case. We specified this date because in September, in Uttam, in Cairo, we have an event of burning rice ash, which is increasing the anthropogenic activities by burning rice ash. And up to June of the next year, to put a possibility to compare the extreme events of air pollution in that area. Location, it is a high-traffic nuclear area in Cairo. The subject is or the target will be the student with age from 7 to 12 years. The type of study we stated before, reasons because it affects the student with different ages and it is easier to count the number of students in a school. It's easy. Yeah, maybe. In Cairo only. Okay. The number of students that will be easy to find the exposure assessment. As there are various sources of air pollution, wallpins, dust from the ground, smoke from vehicles, laboratories, libraries, consumables of food and water, which may affect by outdoor pollution and transferring to indoor pollution. Teacher smoking is available, I think, tools of teaching. The student also smoke. It's a case in Cairo. Yeah, it is a wall of a school. As a one. As a one. Yeah, yeah, in Cairo. Yeah. As a one. The student is asking for clear, clean environment. Hypothesis. The hypothesis of this presentation, of this study, is to study the indoor pollution is to find if the indoor pollution, air pollution, is adversely affected with human health or no. The general objective of this study is assessing the environmental health risk related to the indoor air pollution and learning the ability through the IQ test. We can start by taking sampling from each class monitoring of air quality inside the school. These types of expected pollutants BMI 2.5, CO, O3, NOx, SO2, Volatile Organic Component Evaluation. We will statistical analysis for this pollutants with the period per day. Evaluation of temperature variability and concentration. Estimation of the health impact of the evaluated pollutants using the concentration response function in three shapes recommended by WHO. Three shapes log linear log linear. This to estimate the morbidity maybe because due to exposure for this pollutants but my colleague can evaluate this experimentally by taking some blood analysis of the bio as you see testing of learning ability and IQ test. This is our expected result that the high level of the pollution will have a correlation in increasing the number of cases of respiratory and cardio diseases and also infectious diseases and we assume that the food and the drink also contaminated by the pollutant that it will be consumed by the student while they are in the school. So we also trying that the expected result that beside the health impact to the student it also will impact the learning ability of the student in that school. So what is the controlling option we offer maybe? Control the pollution should be filter for the water and air limiting the hours of the school increasing green space around the building of the school and the student should put mask during the dust storms and make general alarm system in Egypt for high pollution. Nice presentation. You set out by saying that exposure to air pollution impacts academic performance. Even though not directly, I think you mentioned that even the last speaker also said that how are you going to measure the impact of the air pollution on academic performance? We can do it by IQ test and learning test, periodical learning test and IQ test so that we can change because of the pollution. Just briefly on that point there is a study that was done all over Europe nearly and they used the two parameters that are the school grades of the students and the days of absence from school that might be due to respiratory symptoms or disease or onset of allergy and asthma. Any other? I have one for your conclusion. Remove, please, limit the number of hours in school and put masks because the only remediation should be put a label is forbidden to smoke, especially the teacher because it is an example for the students and the second one the area. Yes. Don't let any message say as is dirty, let children stay less in that area because they have to go to school, they have to stay in a nice and safe environment. So clean the school and don't smoke when at school, especially the adults. I mean teachers and parents if they go to, you know... Smoking is not allowed inside schools in the school but limited areas. It's forbidden to smoke inside schools in Egypt or I think in any way my country make mitigations control for revolution. I think revolution is a global problem. We increase green space around schools, make shelters to protect schools from any dust storms or pollutants from around. Also lately we open to renewable energy stations, solar energy in South Egypt and also another one when the power station in Red Sea to increase renewable energy, which maybe reduces the you know that Cairo one of the world megacities and populated maybe by 10 to 20 million people. So it is a big problem to solve a problem as a pollution of it. Okay. Thank you very much. Thank you so much. Instead of my short presentation at the beginning of the conference we can do with another group. Yes. Okay. Let's finish with the group. The lady group. This is the next one. This one. Yes. This is yours. Yeah, very nice. Good morning everyone. We will present our presentation. We were thinking to study also a case study about inside school what's happening there. We form small but modest group of girls. I am Katalina Merculet. Here is Zornica and Alia and Afra. We will go further. I will introduce you in our consideration. We consider the indoor condition of some primary school could be a generally primary school for example in Eastern Europe like Romania, Bulgaria or maybe their country. We are looking at some risk factor some sources could affect the health of children. We will think much of our children could be there some risk situation because the children they bread more air comparison with adults. They could often bread with mouth because of the effort. They are running and moving a lot. So in this way they are not allowed to the respiratory system to act and to prevent the role of some disease, some flu or some other causes. They are situated closer to the floor and they are prone to some risk factor so many dangers are accumulated there. We put here the hypothesis we think about what could be there and we also know some cases in our country for example the water pipes for drinking water it's made from lead so it will be a risk factor also. Some low respiratory infection come up here at some students coming into classes instead of they are ill. So the people taking care of school they use chlorine substance also in the water in general drinking water system in the city or they use such substance chlorine for cleaning the floor or the people could come around with the shoes dirty by dust and pollen also. We were thinking could be some mold on the walls doesn't take care much on the walls during the year or we consider fire resistant substance used on the chair and to the desk and we also were thinking about dust from the cartons so this is our hypothesis. So we concluded to choose some of these and we are stopping at these three main sources. I will invite my colleagues to continue. These six hypothesis we classify just three sources as can say top priority related to this point. From these six hypothesis we just take three for example more high risk sources. Mainly the first one they let come from the water by drinking because we are known that let is very toxic and also have accumulation factors in the plot the children may be affected by the sooner or late. The other thing is low respiratory inspections because we know that the dispersion of diseases among children has become very soon especially in summer and in winter. Also the third more risk sources is the chlorine has been used in the surface even the disc or in the floor also chlorine is mainly used as disinfectant agent in water but if it exceeds certainly the effect will be oppositely in the other way. So the solution may be what could be done the control options for let from drinking water pipes is to use filtered water you can let's say parents can collect money for the children to subside the school with mineral water so they can use this water instead of drinking water from the pipes or if there is such a problem all the pipes could be changed with PVC pipes or filtered water also for the respiratory infections for example in Bulgaria at the kindergarten I call this face control like a nurse stays at the door and don't allow children to come if they have some visible symptoms of flu or other diseases thus preventing children to get sick and this doesn't exist that much in school so this is something that could be done also during the epidemic periods you can use masks and very efficient meeting in Bulgaria so to stop the school for let's say one week or more usually one week works so the epidemic is stopping at the school provide of course the hygienic conditions and vaccinations also during the period of epidemics for Bulgaria in particular this is the very lowest percentage of people who are vaccinating but it could be done with some programs for the school children because they are much more in contact and in risk than other for high substances for service and floor cleaning we can change the chemicals with using for cleaning before proceeding the comments I am thankful to ICTV for having me following are the comments upgrading the health conditions of children in the school propose it to the municipality to change the network of water pipes and propose to have control at the entrance of school in order to prevent epidemics and to use natural cleaning materials at the school and it's the end thank you very much so is there any question for Sinti well okay sorry thank you for the presentation I saw somewhere you talked about epidemic is it epidemic or epidemic health or episodic I didn't understand well outbreaks I have my question then so you are talking about the control to use natural products for the cleaning and so how do we know natural is better and is it really a control how do you know that using natural substances to clean is better I think we need study like the one you proposed because it's useful to provide the decisions to data quantification of the impact how many children how they are and what is it related or not to the indoor exposure because you know having clean water is a right and maybe if they found that the level in the pipes can affect the quality of the water that's really a serious problem in public health so a quantification of the impact we need study like that in the future I will be always available if you want to discuss with me some protocols or something maybe quick cross sectional analysis with cheap with few resources and this for all of you so please stay in touch okay thank you we switch to your presentation Anna Carla sorry someone during the week ask me about the experience I mean how actually researcher can do or not in this field and I'm going to talk about an area that we have in Lazio Lazio is the region surrounding Rome I'm from Rome what happened and what we did to measure the exposure and the health status of people living in that area now we know it's a complex issue a lot of aspects have to take into account and this is the area you can see Italy and now we are here in Trieste the red is Rome and the blue is Civitavecchia it's a coastal area so we have a few of industrial play farms because we have thermoelectric plants very very big one once they use oil now they use coal then we have the coastal deposits for the oils then we have an arbor and we talk briefly about the problem of ships emissions in affecting the quality of air and this is a coastal area but we have mountains over here so people in the mountains mainly use mass combustion during winter for civil eating and because of the arbor the arbor is now used mainly for cruise you know when you say a beautiful cruise in the Mediterranean area they stop for two days in Civitavecchia because they want to bring tourists to see the pope in Rome or the Colosseum so this very big ships 4000 people in each stay in the arbor and those ships have to provide electricity to the people living there 4000 people so there are really little industrial point that stay in that area so the quality of air is affected and we can tell that because we did a lot of epidemiological studies and all the studies show a relation without say nothing about the exposure we simply found high mortality and morbidity risk for lung cancer, methotelioma and respiratory disease so we say maybe something is in the air maybe something in the air affect the health status of people both working occupational exposure of course in this industry the arbor people work every day but also in the general population including children so we publish some paper everybody knows but data about individual exposure to pollutants from the disaffirmed sources at that moment were not available so we said what we can do can we start a program in order to have dispersion modeling or we can use human biomonitoring the pros and the cons of the two approaches we have discussed in the previous day of this course human biomonitoring provide the through is the gold standard because if you find the tracer into the urine or the blood or other fluids of the body and this contaminates is exogenous is not biological product but the human body you can tell that something from external courses enter into the body and we saw can be through the food chain through the water through the air but also we can use the dispersion modeling techniques in the dispersion modeling techniques you don't have to ask people you don't have to measure people is something that people from the exposure side can do you need the skill the technology the software and the data the emission data the knowledge about weather condition and orography or the area but in comparison they are really much more cheaper so maybe suitable in place where you don't have such a lot found for research so we did the two because we ask as I told you I work in a public health department so it wasn't us it wasn't me but we ask it in our network colleagues coming from the environmental agency to do the dispersion model we had discussed a lot about that what you need are the emissions the orography and the weather condition in that area remember we are talking about sea but then the mountains so the air starting from the plants goes through the mountains and go back in a way the other thing that maybe we haven't discussed which is the proper tracer because we know that from an industry plant or from a combustion Michelinus of pollutants are going into the air as it's quite impossible to follow each of them in a dispersion model so we decided to use particular matter for combustion coming both for industry harbour and biomass burning which is reasonable we know that there are other contaminants affecting the air but to have a map we decided to use particular matter PN10 and then we use NOx, NO2 particularly for the traffic and because in that area it's an urban area so we have vehicular traffic coming from cars trucks, pullmen, whatever and the model that you use what is Lagrangian models called spray because spray can follow the path of the particles but can take into account also the chemical reactions that the particles have in the atmosphere so at the end as you now know the dispersion model provides you a concentration so an amount that you can measure in microlambar could be meter in points in the area and as I told you a few days ago our the proxy for the individual exposure was the individual address where you live in the area and those are the results of the dispersion modeling the first one comes from the coal power plant it's a very high chimney 200 meters high so I can tell that maybe where in Rome is influenced by that plant so the people are very very concerned about the coal power plant because they see every day the tower and they see the smoke but I don't know if you can read or not I invite you to read the value we are talking about 0.000 something and so the contribution of the emissions coming from the coal power plants are really low we can say they are low under the the limit that the legislatures say they have proper filter systems so because we have to take into account the perception of people the environmental worries that they are suffering from so we have and anyhow we have described the impact by the maps and oh sorry I don't want to rush the harbour more local value maybe a little bit much higher but extremely local comparing to to go back this is the chimney the very high one the dispersion modelling here we have concentration mainly in the zone very close to the harbour because the chimney coming from a ship is I don't know 10 metres maybe even less and this is the related dispersion modelling then civil heating, biomass burning is mainly in the cities about 5 municipalities very close one each other and mainly coming from the area in the mountain here look at the value 10 plus something so the contribution of PM coming from biomass is much more higher that one comes from industry and finally urban traffic a new exhibition they are following the main street that we have in the area of course talking about carts and look again at the value but all these pollutants are going in the air affecting the quality of air and probably that we know and affecting the health status of residents then we perform ok this was done now let's do the biomonitor study so how to sample who is going to be biomonitored by us sample can be representative of the general population this is the very crucial point the selection of the sample the prefaces because if you are wrong in the selection if you may maybe ask people only here maybe when you put the dispersion modelling results up to a map with the JIS method you cannot find anything something very bad going in that area but as you fail to select your sample you are not going to see results if they are or you are going to see results that are not false because they are not represented from the population so what we did is ok let's say that everybody in the area are at risk to be sampled so we ask the municipality please provide us your file with all the addresses of the people a certain point remember that biomonitoring reflect recent exposure so let's say 6 months one year so please measure of my city give me the data of the residents they are anonymous just an address so we don't need any private information and we put all the address in the map and as you can imagine where the cities are the dots are more crowded and here we have rural area a lot of rural or empty spaces so we had at the beginning 17,000 more people aged just adults because for some problems it's not good to ask children to provide blood better to avoid them it's really extremely necessary so we ask adults our period was a couple of three years ago and so we sample just by chance randomly selected randomization guarantees the representatives because we have no a prioriary approaches we put the data in the software and we ask another software please select as 2000 people and that's what we said and we start the biomonitoring following a very strict protocol of inclusion they were very well informed at the beginning for the objective of the study they have to sign the letter I want to be in the study or not someone refused and we just asked for some blood and we also start to build a biobank because it's all if you have money in the future if you have money please do the biomonitoring study but also please put some frozen specimen in the fridge because you never know maybe in a few years you can still say something about the population maybe new technique are coming maybe have the samples the frozen samples so those are the result of our people we started from 2000 but at the end we just had half 1,141 availability of people 600 of them refused they refused for several reasons and we ask them because it was a telephone why they refuse because it's important also to go on with people in the study but also say describe why they are not for people who are not going to participate because what if people not attending our study are really residents in area where the concentration is very high we are missing part of the exposure people so we cannot do anything towards them but at least it's good to describe and we were lucky because there were not differences in exposure between people in the sample and people outside the sample not different between sex same percentage male females in the people sample and the people that refused same percentage of age distribution it was by chance because you cannot say anything the refusal they have the right not to be in the study now we are lucky so we collect blood urine, nails and hair because our biomarkers were mainly metals how to decide what I'm going to measure in biomanitoral study you have to choose elements related to the exposure otherwise there is no sense and how you can say that the elements are related to the exposure by the literature by studying the the topic so we collect more than 15 less than 20 heavy metals also we collect some benzene metabolic cotinine because of the smoke because sometimes they say I don't smoke anymore but you find very high level of cotinine in their urine and also page we also measure that I'm almost finished about the metals but for example cadmium lead and nickel their toxicity is well known we know that they can damage they are related to coal combustion to smoking, to combustion in general and why we can say that because there are a lot of studies maybe in USA or in Europe that we use to say that those are results the other thing that you have to do when you perform your biomonitoral study is to compare in the first line I'm sorry is in Italy maybe Latin name more or less is similar to English but let's say the second row arsenic because we have also that is also a volcanic area so probably arsenic is in the water that they drink because of the natural situation they have filtered in the water distribution system but still some higher level of arsenic has be proved but also arsenic come from combustion and we found for example in the second row a level of microgram by gram creatinine in the urine of people how much is it 20 it's a lot no it's a reasonable value so we first we compare our results with other situation in Italy there are not a lot of biomonitoring studies so what you have you use and we have Turin which is an industrial city in the north of Italy where the major fiat the major car industry that we have in Italy is located and also incinerator and also traffic and also other and a general mean coming from all other a mean of biomonitoring study so we say we are observing almost 20 in small cities but a very big industrial city in Italy has 16 so less so maybe something is going up here because our industry is not so big as the industry in Turin and then this is our results those are local comparison with Italian standard then we went to the NENES which is a very big survey conducted in America I don't know how many people of person are in and they found in this USA survey a medium level of arsenic of 8 so we have double the dimension so double it means something so we when you have the results find a comparison I didn't care that the comparison comes from America that was the biggest that is published in literature so we can say that in Civitavecchia in our our population for example are suffering very high level of arsenic then this is the now I'm sorry this is my field but I don't have time to explain how it was possible to say that but we simply compare through a regression analysis the concentrations at individual level just to explain now for each individual we have their own biomonitor level let's say of arsenic because we are measured so we know Karla has his own level then we have the Karla's address the level of contamination coming from dispersion modelings the related we have four column for values one from the industry the thermoelectric plant one from the arbor one from pollutants coming for traffic and one for pollutant coming from civility so for each person we have five value the biomonitoring and for concentration coming from the dispersion model so simply put it in the relation we found something now it's complicated to explain the graph so I put it in in words we found some relationship significantly significantly emission between coal combustion and some heavy metals that a priori we know has been already associated with that exposure and same for traffic for coming both from Rome and from ships and in for these not for only but for these elements we found that dispersion modeling are good enough to estimate the concentration so why performing costly biomonitoring study if you can have the dispersion modeling we are going to publish this so can be you know something that can be used as reference in future in future work but sometimes if you don't have this is one that there are few experience like that but this one of the study that says that maybe can be valuable use dispersion model instead of biomonitoring that's it answer question if any now or at the coffee level thank you very much Carla for your presentation I want to find out those who participated did I mean did they get compensation like money like because sometimes this one also is okay we off I mean I had some experience in several surveys sometimes we use a small ticket that you can use to go to a supermarket and buy something but in this case we offer the full bloody evaluation test results so they can have you know the clean the clinical so you have you know cholesterol triglyceride that everything so we are you we don't have them the screening and they were very happy because we are under crisis and it was a good day for free is very difficult thank you Carla for the presentation I have just one question you say that you related those medals to the mission from the coal power plant for from literature studies therefore you don't have the fingerprint of that specific power plant so you don't know exactly if tell you for example the rise really from the power plant because you have I don't know maybe sample the really the real is that we have all the the chimney the the environmental agency checked for some of the components the one that have to be they are under regulation so because they have to stay in below the limits we have all the all this so is not for sure but for the main we can say yes because they are also emitted the and we have the value because we have the authorized value I mean in Italy if you want to create your own industry you have to provide data about the emissions at least the authorized I mean you say you are not going to emit more than thought Thank you for presentation but yes I have just question you mentioned that you are using coal power plant for this generation and also you have a cement plant and the simulation that result about the particulate metal concentration it less than recommended level this boy in all three something and boy in all one seven and in the last slide you mentioned that you have very to some extent a very high concentration of toxic element so in this case how I can believe on the modeling here first you also you said you have a low concentration of particulate metal but at the end you mentioned that we have very toxic element deposited that's they okay so people don't know exactly I mean I was the I'm not leaving that area and that was the sample sample number one because I say let's test on me and I found on myself very high concentrations of some metals and I'm not leaving in an industrial area so my opinion is the traffic coming from cars because I live in the center of Rome is probably the most important killer here also considering the concentration level at that moment that we control for everything here for having had I don't know a barbecue the day before because we had a lot of questionnaires to guarantee that about the food have you had because we have mercury and arsenic have you eaten fish for in the last in the few days before the collection of urine so people they don't know exactly the I mean we let them know but there is no appeal against the level of arsenic in your body so it's an issue what what what and we don't know about the individual toxicity what will be me I have I know that I have a lot of precious metals such as gold you can sell me in the market coming from the catalytic marmite help me Maurizio the okay the from the emission of the carts and but I don't know how to cope with that I simply have and it's not the level of lead or other very serious high to toxic toxic materials they have in their blood so we say them has you have those results please go frequently to your physician and check your health status and try to have an eldest style of life that's what because there is not appeal against this they some of them are in the fat tissue so you are not going to excrete them very easily so go to the check your state so they are healthy individual because they are aged 35 to 60 so adults and check your health status I mean free with as much as you can okay thank you Carla I have two questions the first one maybe I miss your presentation is it necessary in your case also maybe in my case we should take the control of the respondent outside of the industrial in your case in that side should we take outside of the the control I mean so you have you can compare between the contaminated industrial and non contaminated area is it necessary for us to take some control sample in this okay is it important and you want to assess an effect now it is just for exposure but the objective of this study was to decide whether to use bio monitoring or dispersion modeling so I'm not really interested in the result of the dispersion modeling or in the results of the bio monitor so I don't really care what I would like to know in my hypothesis was to detect at the residential address of each participant of the study if the concentration estimation from the dispersion models and the question is if I have high level of arsenic which is for me the tracer industry and also the concentration estimated from the industry by the dispersion model are high and high I can say okay I can use but if they go in the opposite direction something is wrong so then who we have to choose and the gold standard is the bio monitor maybe the dispersion model is not good for that so in this case it's not a comparison it's not exposed or not exposed it's just at the residential address if they go both go to the same direction up or down or in the opposite direction I hope I haven't spread I can maybe say a little bit later Thank you Carla for presentation I have three questions the first one is about the samples did you collect samples once or many times in science during the project you mean for the bio monitoring not just once it's extremely you need a lot of money because the measurements 20 metals plus the metabolites of benzene and the pH was it cost around maybe three or four hundred for each subject we have 2000 so now it was a problem but if you found money I would like to repeat because it was spot just once in this case I did samples three times I think but how many people you had 15 15 I had 1100 just a remark have you paid anything for those people have you paid anything for those people I paid what I mean not me the local authorities decided to put money on this because the arbor was really a crucial aspect in their environment this was my second question how did you do for convinced the authority to collaborate with you it was a governmental program or just a search project no it was very difficult they don't want to put money but for some reason they had some extra money when you close your budget plan and you find that you have still some money to invest in something and you decide that maybe but we asked for as we have been asked after a few years now we can probably do something because we have found money just public money no industry money never performed studies okay you can do that if you don't have any other but it's better to find independent money if you want to say something about the relation between the industry and the health my last question is about the assumptions that you have chosen for this special model you have chosen that PM10 as a tracer the bio mass burning I thought for example in european countries the average of the black carbon as used as a tracer for the burning mostly it's constructed in PM10 maybe you use PM10 as tracer for the burning but as we have in mind to do the epidemiological study we choose a tracer that we have the sponsor response function available so we have for PM not for black carbon you are right but the epidemiological study provide now at this moment I don't know in the future provide consolidated evidence concerning PM so we choose PM also because we don't really need a tracer a tracer also if it's another one it can be different it can be more or less that one so just we want to characterize the area in level different level we are not really interested in the amount of concentration the specific points because what we need was a special distribution of the phenomena I'm available I've got the last question from internet so this one I've got to ask you because it turns into seven minutes just very simple questions the user is waiting for 10 minutes for the question Samanet and then him and then Kofi she said as you concluded the dispassion model can be replaced by HBM but in dispassion model just PM was modeled isn't it needed to model a dispassion of each heavy metal and toxic material individually? I am already responsible now at the question sorry Samanet that was exactly the question we answer now okay for your interesting presentation just I have very two simple questions I think you said depends on your results of the model the limitation of pollutant is under the permission extremely under but I think you have four point source in the same area I think you should collect for this four point source together because it's in the same area excellent this is what we have done in epidemiological study we call it PM coming from industry independently of desserts and there's no time I can show you maybe in the slides we already did it because that's the point and that's what we did we collected simply some it's a sum because so we had each address PM coming from industry independent on the source which was 40 plus something because the contribution specific on the industry and the arbor or 0.00000 so what second is this model is kind of blue model or buff model buff model thank you okay just to remind you yesterday yes you know this little game I told you about when we had this round table the blackboard posted if you want to answer the question which is asked what is the action you you want to commit to doing when coming back to your country to bring better health to your fellow citizens back at 11 yes 11