 risk assessments. So, Kala, you said you wanted to make some kind of creative... Yeah, I mean, no, not really, any creative at all, but as we are a class... Yeah, no, I want to move. It's okay for you. Ah, because of the... Okay. As we are a class and as we have to stay together for a week, I think it's nice for you to introduce yourself. So, please say who you are from where you are from and what is your main research field. Just, you know, to start to knowledge. How long do we give that little exercise? The exercise? What? Yeah, for people to speak. We don't... Not too long each one. No, just the name from where and the main field. You're perfect. So I am going around and I will handle the... Oh, they can, you know, pass the microphone like that. Hello, my name is Kwadu Kwame. I'm a medical doctor. I'm working at the Pasteur Institute of Côte d'Ivoire working in environmental health and I've been starting... I've been started working on air pollution and health recently with Isabella team and with Miriam. Nice to meet you. Thank you. Hello, I'm Alia Syed from Pakistan. I'm a bachelor's student and working on work-turbine disease. Thank you. Hello, everyone. I am Lazy Zilam Rawi from Meteor France. I am a researcher in the field of pollution and the air quality. So for many years I have worked in this field and now I want to see what is the application of the air quality fields on the Hilton Pact. Only the participants or only the lecturers? I'm a research professor in France, both at French Institute for Research in Developing Countries and the French Institute for Agriculture and Agronomy. I will give a talk next. Hi, I'm Miriam Rad. I'm an assistant professor at the Faculty of Health Sciences at the University of Balamand in Lebanon. I work on the effect of air pollution on health and I will be presenting the study on Beirut on Thursday. It's Raymond Haj. I'm an instructor at the same faculty, same university. I'm currently a PhD student. My project is about air quality, indoor air quality actually and health effects. My expertise, I come from a microbiology background. Good afternoon, everyone. My name is Alis Rour. I come from Lebanon. I work at the Lebanese Atomic Energy Commission as a researcher at the accelerator laboratory. One of our topics is the... we use ISAP as a sampler to collect the aerosol samples, basically 2.5 micrometer. We work also on archaeological samples and some other environmental samples. Thank you. Thank you. Hi, I'm Elena de Angelis. I'm from Italy. I'm an environmental engineer and I'm a PhD student in technology for health at the University of Brescia and I work in the environmental control system group in the mechanical department. And my research field is the use of integrated assessment modeling to evaluate the effective air quality policies. Hello, everyone. I'm Praveen Kumar from Patna, India. And I am working as a post-doctoral fellow there. And my area of research is climate change, its impact to climate-driven vector-bound diseases. And I basically do deal with the climate models and simulations and climate-driven disease modeling. Hello, everyone. Myself Sadafadima. I am from Delhi, India. And I am working on the topic atmospheric aerosols and associated human health effects. Thank you. Hello, everyone. I'm Atar Singh from Agra, India. And I am working on physicochemical properties of atmospheric aerosols and its impact on climate as well as human health. Thank you. Thank you. Sorry, Eric. Thank you. No, no, it's just... My name is Hannah Elfum from Ghana. I work with the Ghana Atomic Energy Commission. And I'm involved in air quality dispersion modeling as well as monitoring. And we are also involved with the application of the XRF as well as accelerator and the reactor for profiling of elements. Thank you. Good afternoon. My name is Bethul Mutay from the Department of Meteorology of the University of Nairobi. I'm a meteorologist by training with research implications in remote sensing and air pollution. I just finished my PhD on the linkage between climate change, air pollution and respiratory system. My name is Mohamed Burai. I'm beginning my PhD in the field of atmospheric and environmental physics, especially the relation between air quality and health impact. This study will be in Cairo in Egypt. Thank you. Good afternoon. My name is Mustafa Nazir, assistant professor in the National Research Center in Egypt. My field of research is astrophysics. And recently, I am redirecting to the health impact and its relation with climate change. I am Ali Waheda from Egypt, associated professor, specialist in atmospheric physics and work on climate change and air quality and its impact on health. Thank you. Gamel Gamel, lecturer of meteorology, climateology, Cairo University. My current research activities study extreme events, climate change projections from GCM RCM cortex models over Egypt and Nile basin countries. My name is Ornita Spasova, assistant professor in the National Center of Public Health and Analysis in Sofia, Bulgaria. My background is climatology from Geography Department of the University of Sofia Geology and Geography Faculty. I am interested in climate change and public health issues. Hello everybody. My name is Cyril Mizzoui. I come from Cameroon. I am working on air pollution, particularly urban air pollution. And now looking how to relate urban air pollution to health. Okay, thank you. My name is Komkwa Bienda. I am assistant professor at the University of Chang in Cameroon. I am working on climate variability, especially my research have to do with the impact of anthropogenic aerosol on climate variability over Central Africa. Thank you. Hi, my name is Sarah. I'm from Iran. And I work at air pollution forecasting department of Tehran. Hello, my name is Maria. I'm from Iran. I'm a pleasure student in remote sensing and GIS and we use them as a tool in environmental monitoring. Hello, I am Madhav Giri from Nepal. I teach in Tribune University there in Kathmandu, Nepal. And my background is environmental science. Thank you. Hello, my name is Dia. I come from Indonesia. I'm a researcher from National Nuclear Energy Agency of Indonesia. And I'm doing a research on the application of nuclear analytical technique in the chemical composition characterization of airborne particulate matter, especially in PM 2.5. And actually my institution have a collaboration to do the air quality monitoring in 17 sites in Indonesia and it's still going on. And it's very... I'm interested in making an assessment of health impact because we have a lot of data of PM 2.5, but we cannot further utilize for the health impact. And that's why I'm here to know more about the health impact assessment. Thank you. Hello, I am Katalina Markulet. I am from Romania. I'm working in the Institute of Geography of the Romanian Academy. And my main research activity is in climatology and climate risks. Thank you. Hey, all. My name is Maurizio Gualchieri. I'm from Italy, from the National Agency for New Technologies and Sustainable Development. I work mainly in aerosol characterization and in vitro toxicology of particles. Thank you. Hello, good afternoon. I am Massimo Stafoggia. I am a statistician as a background and I'm a senior epidemiologist in the Department of Epidemiology of the Lazio Region in Rome. I will speak later about quality modeling and measurements and today about population rates and the basic... we need to do health impact assessment. Okay, so... I think there is one... There is someone else? Sorry. Yeah, two more questions. Good afternoon. I'm Benjtif Abteh from Morocco, from the National Center of Energy Sciences and Nuclear Techniques. I'm interested in application of nuclear techniques for characterization of aerosol in urban cities. And then I worked actually on the use of modeling tools for forecasting the behavior of aerosols. Thank you. Good afternoon. I am Dr. Ramiz Shubbar from Iraq. I am chief of physics and refinery and I also give lectures in Al-Mustansariya University in Baghdad. Last year I finished my PhD in South Korea. I work in air pollution and modeling of air pollution and I used very complex model named Kalbaf. After six months I control on this model. Thank you. There is one more person. I think at the last, but not the least, as we said. Another continent. Hi, I'm Cara Maisano. I'm originally from the U.S. but I live and work in France, in Paris, which is now the Sorbonne University. I work in environmental epidemiology, focusing mainly on air pollution including health impact assessment. I think the variety of the world is guaranteed. We met someone from Australia. Go back. We have a good mix between climate change people and air pollution people, which is very nice. I'm afraid we have few people just from the health side. So, me, I'm one from the health effect evaluation. So, I'm afraid, not to get you so bored, but the course is on the why we are measuring the exposure because we want to do something about the health effects. So, it's important. I think we'll be brief, let's say half an hour, because I want just to summarize and maybe start to introduce some definition. And then you will have other specific lessons on one of these topics. It's important to understand the base because otherwise, as we use, sometimes there is not so clear about epidemiology when we are talking about health impact. So, I want to try to just to start and try to define. As I told you this morning, I'm an environmental epidemiologist working in Rome, both on environmental studies, but more recently on the health impact study, especially on air pollution. You will see a lot of example coming from the air pollution, but the importance is to understand the methodology. Then you can change the exposure but all the other stuff will be like the one we are going to present. Okay. What are we talking about? Let's say that we have an exposure. This exposure can be a chimney, so an industry, or can be noise as Isabella told this morning. This is Rome. The acoustic map of the traffic noise in Rome, in Italy, traffic comes from cars, so you can see a nice map of the main streets in Rome. Noise is an exposure in environmental epidemiology. Or you can have PM, yes, PM 2.5 air quality. So the maps of concentrations on the ground coming from this particular matter, pollutants of the air. So we have an exposure. We can measure or estimate that and we have people living in these areas. So our question is, is this exposure to this noise, air pollution, climate or what else, industry, environmental factor associated with an effect or a change in the health status of population exposed? I say a change because sometimes the exposure can be a benefit. Let's think about green, blue, water, trees. We know that they can bring beneficial effects of the population exposed. But when we talk about pollutants coming from industry or from traffic, we are talking with an effect an adverse effect. So a change. We are talking about the change in the health status of population exposed. So all this week will be to create knowledge, evidence-based knowledge to let our politicians, this is not just for science. This is not only to write a very good, very well-published paper, but health impact assessment is about to provide people who have to decide evidence-based knowledge that they can use to do something. Health impact is related to interventions. It's not just the description of the health effect. So let's start about that. We are working because we want that someone else, not us as technicians or scientists, use our results to do something. So what we need is a recipe. We need an exposure that could be measured or estimate and we will talk later with Massimo and also tomorrow how we can estimate the exposure. Then we need a completed pathway. This morning someone, probably Bernard, asked how we can say that this disease is related to that outcome. That should be a biological possibility of course, and we have to study or let experts to study on that, but there will be a complete pathway that start from the exposure and finish at the health status of the population. And then we want a comparison. We want to compare people exposed with people non-exposed. So if in this comparison people exposed have a higher rates of mortality, morbidity, drug consumption which you can choose the outcomes depending on the data that you have. But if the exposure is related to the outcomes we will find a higher increase of the morbidity or mortality status in the people exposed. And then this effect should be plausibly related to the exposure. Otherwise I think garbage not science. So at the very beginning we should have a hypothesis that we want to test. And how can we assess exposures? I'm not a technician in exposure. The majority of you in the audience are better than I. So you probably can agree with me in this table that put in a scale starting from the best which is the biomonitoring because if we found in human body fluids, blood nasal fluid something that is exogenous that we cannot have biologically in our body it comes from the external. So the biomonitoring is the perfect exposure assessment study when we want to define the individual exposure of a population. Because for sure they are like monitorings. There are people living in an area with an industry or with a high level of air pollution if we found in their body metals or dioxin or whatever you want to test that's the best way to define the exposure. But biomonitoring studies are very expensive we need a lot of money the sample size is an issue and it's related to the amount of money that you have so it's impossible to biomonitor the whole population. So we have you know the validity of our study and we can measurements we have by routine monitoring monitoring the air quality of let's talk about air pollution as an example we can estimates and Massimo is going to explain how and we can use at the very end but so bad if you don't have anything else it's nice to start a study asking people sometimes also other kind of science such as I don't know focus group or social science can be important if you don't have data because we know the people from US as every every I mean also people coming from the north from Rome in the Mediterranean and I can tell there is some differences between USA and south Europe and then to Africa or East so it's good to have data and to work hard to collect data to you know to let your data become every year better and better and better so you can use you can use them in future so exposure then we will have plenty of lessons on that biomonitoring is a definition the definition is the concentration of biomarkers in blood or urine it's the perfect indicator of human contamination and we will have a specific lesson on human biomonitoring and another one on plants and ecological biomonitoring why we want because we know for sure that the contamination of soil or plants of animals can act with the human body through the shade because we eat vegetables coming from that contaminated soil we can drink water with some contamination and we breath so everybody can come enter our body and produce an health effects that we want to estimate exposure assessment we can start simply with monitony but we will have nowadays the knowledge is extremely enhanced and maximal in half an hour we talk about satellites data to define the exposure and also sensor arriving at the data fusion which is the new frontier of the knowledge in exposure assessment but also the estimation the dispersion modeling because we can using the models and we will have the tomorrow day dedicated on how you can use dispersion modeling because there are a lot of materials for free from the internet so you can you just have to bring your own data but you can use meteorological fields available in the data sets that are for free and it's easy to obtain and we will talk tomorrow about that but how the general idea is that we have an emission source can be a chimney can be an area let's talk about waste for example waste disposal sites and we can follow the particles through into the atmospheres the particle starts to react with other particles transforming something else everything depends of meteorological conditions and orography and so we can wow are we saying that because at the end these particles emitted from our source will end on the ground and in the ground there are people living so we can provide in our research a concentration a quantity an amount of particles that can be measured and can be associated with people using for example the residential address so we don't have to ask people or to biomonitor in them or to do something else just simply having the address of all the people residents in that sites the results of the dispersion modeling using a JIS system we can provide a sign to each individual and we can use an annual average concentration monthly whatever we want so we need emissions we need the meteorological files and we need information about the orography and those sorry here some example this is a test simulation we have two sorts and as you can see depending it's an hour image so in 24 hours depending on orography is the same but depending on the meteorological condition the particles will disperse in different ways so can concentrate in one side of the area or another one this is another example in a city Florence in Italy we have this vertical building which is Campanile di Giotto one of the main beautiful church that we have in Italy and this is traffic and as you can see the Campanile which is I don't know the English for Massimo Help clock no it's not clock it's the well the bell of a church is I don't know but it's at the vertical building maybe I don't know bell tower of a church and the traffic coming from the main street the emissions and then the constructions are influenced by the orography in this case the size of the building and this is another simulation horizontal level but you can see how the pollutants can react and surrounding the buildings and this is extremely important when we talk about people living in urban context we will have maybe one main street and other streets with less traffic, less car traffic but still influence and the dispersion modelling can help you in define the exposure both of people living in the high traffic zone and people living not in maybe in a quiet because air is everything it's not noise for noise if you have a barrier that's it more or less the decibels stopped but for air pollutants is not like that and at the end what we will have we will have this one which is the medium average in a year concentrations maps this is the city of Rome the violet is where the pollutants are more concentrated this is NO2 so traffic and depending on the traffic yellow and green area so in each square people live and if we have the addresses of the people we can assign the estimated is not the true way the estimated exposure of people living in that square so in the last 20 years we have learned some lessons from dispersion models and biomonitoring they are both very useful biomonitoring will be the perfect choice but it depends on how much money you have to start the campaign but any they are two different methods to estimate the exposure and what is important is to define the spatial concentration people living in violet are more exposed the people living in green so it's something that you can tell I mean it's they are differently exposed which is important for epidemiology because we need the contracts exposed and not exposed to define if these pollutants is related with the outcomes or not and very important biomonitoring reflects recent exposures so if you if we start a biomonitoring campaign we found maybe high level of metals, cadmium or I don't know, arsenic in the urine of people this is a very recent exposure let's say three up to six months not more and it's important and the human contamination come mainly from the food some other definition global burden of disease this morning we we we look at some results but what is this exactly is an amount is the magnitude of the impact because in blue we have the exposed and they not exposed the attributable effect the risk the extra risk is you know the red part which is completely attributable to the exposure which means that if we remove the exposure we cannot tell difference between exposed and not exposed so that this is what global burden of disease want to indicate the magnitude of the impact of the pollutant I'm sorry for boring you with very very easy definition but I think it's important for those who maybe are not familiar with the definition to listen and global burden of disease 2010 now there is another release more recent but just to say that ambient air pollution is one of the 10 risk factor for the health of people the global burden of disease means globally considering all the factors coming from environmental factors and not environmental for example first row we have high blood pressure which is the most heavy the determinants of the health of a person then we have tobacco smoking then we have alcohol use individual risk factors are the first three and we can do something because we could not don't smoke reduce the alcohol consumption do sports to decrease the high blood pressure but what about our pollution individually what we can do is something that we cannot do I mean we have to breath so it's something that someone else let's say the politicians or people take decision have to do but just to say that ambient particular matter pollution is one of the first in the first lines so global burden of disease is the amount what is health risk assessment is a process that we use to define the toxicity of an element is there a relation with this element and the risk for health of people involved it comes from the very beginning was related this is the first USA EPA definition it was related to chemicals so the toxicity of the chemicals we can use the risk assessment formula to define the risk for a lot of cancer and this use also for radiation for nutritional factors for socioeconomic factors and mainly on cancer is a process the objective is to estimate toxicity and this is a tool for translating the findings of research into science based risk management risk management what we can do to reduce the exposure of the population exposed in occupational epidemiology for example this is a very common practice because we want to reduce the level of this toxic toxicant element because in order to prevent the health status of people exposed so it's a process start from the hazard identification then the exposure assessment you will see a lot of GIS example because everything is impractical GIS based approach because our goal is to define if there is an association between an exposure and an outcome then we can calculate the number of attributable cases as just explained this morning for climate and air pollution and we can talk of the year so I've lost or the dailies or attributable mortality cases and that's it so anyhow this is we are talking about a scientific process so we need the protocol we have to take into account a very well defined hypothesis at the very beginning because through our process we want to answer that question and risk assessment depends of the amount of chemical in the soil, water or air and the contact to be a toxic there should have been a contact between this particular element and a human body epidemiology my field again the aim is to estimate the effect of exposure of interest so this is a chimney all living around this is a real real example that we perform in Italy the dots black dots are the residential address that we ask at the municipality so they provide a very nice file with the address with all the change of address because when we talk about 20 years 30 years 40 70 I mean we are talking about the general population in there we can take into account also of address when they change address because it's important so we have the maps coming from the dispersion modeling this chimney you know the in orange and in green you can tell some differences in exposure the maps strongly depend on the wind and the meteorological aspects so we can have when we in the past in environmental epidemiology we used distance from the search so we define a point the search and then radius one kilometer two three four because the the hypothesis is that living close to a industry is bad for your health but now we know that everything when we talk about pollutants in the air everything depend of the meteor so you can see that maybe the people living very close are less exposed than people living so far and that's something now we can tell because we have the availability of the dispersion model and how we can tell that that this industry that those chimneys are an odds are the full delta of people because we will have people exposed and cases I don't know lung cancer among them and people on exposed and cases lung cancer because we have to take into account that all the disease have multifactorial factorial determinants so you can have lung cancer both because you smoke and you live close to the industry and you have an occupational job risk at the occupational level and so we will have cases among the exposed people and cases among those not exposed and the epidemiology is very simple because it's a comparison we put at the numerator the number of cases coming from the exposed and at the denominator the number of cases so simply algebra is mathematics simply compare this ration if this ration is higher than one it means that we have more cases in the exposed people and the opposite if so we can tell very easy well I mean it's a PhD ten years but just to understand the principle is a comparison so in epidemiology what we don't have to be wrong is in the exposure because if you failed to define very well the exposure we can do you know provide wrong messages and the ambition of all the epidemiologists would be to measure causal relationships we would like that these determinants has been the major causes of the disease that we are measuring this morning they said how what are the organs and Isabella explained very well that for example of particular matter the PM2.5 or the ultra fine they are so small that they can go directly into the blood and we can have damage of all the Isabella already explained this morning and also when we are exposure now we know that we are exposure all steps of our life even before we in a very very early stage ok so the goal of epidemiology is to assess relationships we want to have the perfect curve the increase of the exposure we observe an increase of the outcome but not always the relationships is so clear those are example coming from the study our study in Rome you can see I'm not going to explain but just to say that relations sometimes is not clear is difficult the interpretation is difficult and just to told you that we need the comparison also with other groups internationally that maybe are working on the same topic so we can compare if two different studies very well conducted big cohort say the same maybe is something going on so that's not we would like the perfect exposure relationships but sometimes is not like that and we can have we can use short term long term effects of air pollution we can use a lot of outcomes depending on what we have because sometimes if you have only mortality ok let's go that use mortality now there are a lot of other that can be used for acute effects we usually the study are temporal differences when in a scale of one year 10 years, 20 years we have a lot of information of the exposure and we can see that maybe the mortality or the morbidity follow the patterns just comparing that is always a comparison and also we can study chronic effects using the maps the general differences in exposed and not exposed person so why we perform an epidemiology study because we want to provide this decision and we want we would like to have them translated into intervention is not always like that and I think you all agree with me now health impact assessment is not the same as epidemiology we conduct a study we measure the exposure we provide the dose response relationships at the end we will have a risk or I don't know attributable risk I mean but a number of the estimation on the risk health impact assessment use results coming from epidemiological study so we don't have to start a cohort study because in epidemiology the best study design is the cohort approach because it's prospective one we will be sure that the exposure and then the outcomes because we are following the people in our data but it's extremely long period and we need money because sometimes to conduct a prospective one it will take 1, 2, 3 years and sometimes we don't have so much time to take a decision if an industry is killing the people living nearby they always they prefer to put money for an epidemiological study in order to postpone the time of decision because when an industry or the levels of pollution are so high the only thing that you can do to prevent the effect is to cut the emission to reduce the population emission so an action is needed because how we can do individually so and then HIA use epidemiological results coming from the study and can be used to compare the policies if any scenarios and we have to decide we have to compare so it's in theory we can do an health impact assessment in your office you don't need anything just the relationships between exposure and outcomes coming from literature so you need a library you need a computer and you need Word and an Excel to perform the calculation and tomorrow we will show you how it works we have major steps but the important thing is that we need number 4 available set of exposure response functions coming from epidemiology so coming from other people study and number 6 the background disease rates of your population because what you want is to calculate the extra risk due to your specific pollutants starting from a background rate because people you die because likely it's age related but you can have cancer you can die from cancer but in some area of the world these rates are really higher than expected so what we want to calculate is the extra risk due to the environmental contaminants because we would like to remove that part and let people to live as the natural history of the disease so we can calculate the burden of disease so an amount again same pathway policy to compare policies we need to know the emissions the concentrations, the map emission is what is emitted in the pollutants, concentration is what is a ground level or what you want and using exposures coming from the literature and calculating above the background disease rates you can have the effects and the impacts that you want finally this is my last part integrated environmental health impact assessment because we can estimate effects it's a more complicated strategy I'm sure someone will give you all the slides so don't take notes but I want you to go through the entire project materials especially the tool because you can use the tool to calculate your own health impact assessment the difference between health impact assessment the integrated environmental health impact assessment that this one is complex take into account both positive and negative effect you can evaluate different scenario and we have people involved also the stakeholders are politicians scientists maybe people living in that area and it has been proved that the participatory process is one of the excellence of the methods so this is the framework we need one month to explain but we will talk about that for all the week so don't worry this is just the introduction again the hypothesis test the question is the very important and then also we sometimes I work not in an academia I work in an institutional place so I work from the government of my region sometimes they care about environment not so often and sometimes they ask me what we have to do it's me I don't know what you have to do but they want help in order to create the scenarios because they don't want they don't know exactly how they want so our also our scope is to provide realistic scenarios so we need a protocol so please also if it's not epidemiology but we still need a very rigorous protocol because we want someone else to replicate your results and then there will be I will have another talk at the end of the week because reporting and communication is crucial because we don't in this context we we are not going to report in a scientific paper it will be a great literature it will be a paper that everybody the cities and the politicians all they have to read so the language should be extremely different and also the communication phases in a public arena when they you know through stones to you if they don't agree with the results so it's very important to have onboard people helping us to communicate because as a scientist we are bad communicators so we need an extra an extra help authority and so is it complex yes in my opinion is it but we can do that just to some of the aspect is complex because in real life we have multiple sources because people live in an urban setting with car with noise with industry with everything else the pathways are different we can take the pollutants from the soil the water the air the time of contamination now I'm working on waste in Africa it's kind of recent issue in environmental epidemiology everything comes from the computer of all around the world it's simply through in an open air and what about the health of people living there population size is an issue and justice please take into account always that the environmental justice is an issue in this topic of this poor when I say poor I say less educated mostly people have to live close to this place because how the price of houses are less so they have no choice they have to stay there blocked this is important if you have an amount of money you don't have to distribute in an equal way of the population but you should put money where the need is more deep that you know divided the cake in regular pieces occupational exposure sometimes people live in a bad environment and also have a very bad occupational I'm talking about worldwide context and you have to take into account the occupational exposure and also and last but not least the environmental worries and media pressure the opinions sometimes we have to start the room or start maybe there is nothing in that area but they are so worried about that that in any case we have to reassure them and so that's very important when we talk as scientists we are not talking about our own personal opinion we should provide evidence based results that's important I know this I choose myself again because I'm saying maybe banal but in environmental epidemiology is really important there is no room for the opinions we need facts evidence based facts so is it multidisciplinary context yes it is and this room we probably have one person from one lie at the end I put law because for example now in Italy we are conducting epidemiological study in environmental bad place because a court asked them which is a mess I mean I don't want to talk now about that and the discipline requires well trained experts that's why I'm really happy again I say thank you to the organisators I mean included me because even the education can be integrated so we can talk each other and exchange our mood so integration the net this is the Italian net a little bit advertisement it took a while to create this net now all the Italian people in environment and delta are connected each other and it's nice I would like to create a network from this classroom because from now on we could participate in maybe in international research project together we'll be nice so in conclusion a close collaboration of researchers so the network is a must I mean no room for people of health staying sitting in the building and people from exposure climate in one building air pollution when we talk about climate change air pollution should be in and the other way around and because our goal is to provide long term positive international health I also want to stress that I don't have any conflict of interest because when you talk about environmental epidemiologists pretend to the speaker to define if they have or not I thank you very much thank you very much Kala I would like to have a question but I will stay with you for all the week so maybe I can leave Massimo we will save a little time it's just for as an introduction because we are going to talk piece by piece for the next days so unless you don't want to say maybe something more precise I think we can move to some working questions but not in the introduction of the court so I don't like the courts ok because let's go to Massimo Massimo Staffordia