This topic aims at supporting activities that are enabling or contributing to one or several expected impacts of destination “Living and working in a health-promoting environment”. To that end, proposals under this topic should aim to deliver results that are directed at, tailored towards and contributing to most of the following expected outcomes:

• Researchers, policymakers, healthcare practitioners and the public have a more comprehensive understanding of the human exposome and the interactions between climatic, environmental and socio-behavioural factors, supported by FAIR^[1] data linking these exposures to disease and health outcomes.
• Researchers, governments, policymakers, social care services and healthcare practitioners have improved knowledge on the links between the climatic, social, lifestyle and environmental factors of the exposome and global health burden, supporting their efforts to adopt the exposome approach to identify and address relevant health impacts.
• The public has access to the latest information on the influence of global environmental exposures on health, enabling the adoption of health-promoting, climate-resilient and nature-positive behaviours.

Scope:

The exposome is the totality of exposures (and their interactions) experienced by an individual throughout their lifetime, including chemical, physical, biological, nutritional and psychosocial factors, from conception onwards. Many of these factors originate in the environment, including climate-related exposures such as extreme heat, heightened air pollution or drought. Climate change may amplify or interact synergistically with other better-established exposures, dynamically altering the human exposome and its health implications. Despite this, climate factors remain underrepresented in large-scale human exposome studies.

Research activities under this topic should strengthen the use of the exposome approach to study global exposures and generate evidence on their health implications. Proposals should focus on integrating climate-related factors into exposome research and understanding how the exposome changes in response to direct and indirect climate exposures. Moreover, research activities should be multiscale and multidisciplinary and account for the complexity and multifactorial nature of health determinants and the most pressing unmet medical needs in relation to environmental degradation and disrupted ecosystems. Proposals should include climate-relevant social determinants of health as part of their proposed activities.

More specifically, research actions under this topic should include all the following activities:

• Incorporate multiple climate exposures into exposomics studies and provide insights on their influence on disease burden, through interactions with other exposome factors.
• Predict, identify and monitor changes in the exposome (including environmental, social and occupational exposures) resulting from climate-related pressures and study their health implications to identify emerging health risks and potential benefits of climate change.
• Advance data generation, analysis, integration and interpretation in human exposomics, developing methodologies and integrating novel approaches (e.g. AI technologies and machine learning) for advanced data analytics, including for Real-World Data (RWD)^[2].

In addition, research actions should include several of the following targeted activities:

• Establish and investigate the biological pathways and mechanisms by which the exposome drives health impacts, jointly considering climate-related and other exposures. Build upon (when relevant) and study existing and/or newly generated longitudinal cohorts that combine individual exposome data with the corresponding medical, omics and biological data.
• Identify exposome-relevant indicators and biomarkers for exposome-related health risks and potential benefits using comprehensive exposome studies that combine climate, environmental, behavioural and social exposures. Account for disparities in individual trajectories and exposure patterns where relevant.
• Report on health-relevant exposome findings using, where possible, standardised metrics to ensure harmonised reporting of exposome-driven disease burden across regions and sectors. Build on existing exposome toolboxes and increase their robustness and coverage by integrating climate related exposures.
• Study the role of socioeconomic (e.g. income, energy poverty, occupation), demographic (e.g. gender, racial or ethnic origin^[3], age) and behavioural (e.g. public trust, risk perception) factors in determining patterns of exposure, using the exposome approach to generate knowledge on intersectional vulnerability and resilience to exposome-driven (including climate-driven) health impacts. Identify disproportionately affected populations and develop interventions to reduce disparities.

When handling vulnerability data and indicators, sex-, gender-, racial or ethnic origin^[3]-disaggregated data should be collected and analysed, incorporating intersectional factors where feasible and relevant.

International cooperation is encouraged, in particular with regions that are under-represented in human exposome research.

Projects should leverage the knowledge, data and tools already generated under past initiatives such as EHEN^[5] and ongoing initiatives such as IHEN^[6], ICOS ERIC^[7] and EIRENE RI^[8].

Proposals are encouraged to consider, where relevant, the data, expertise and services offered by European research infrastructures^[9] in the environment, climate and health domain. Projects should make the tools developed as part of their research available on the IHEN Exposome Toolbox^[10] and upload their data sets in the IHEN Data Catalogue^[11].

In order to maximise synergies and increase the impact of the projects, all proposals selected for funding from this topic will form a cluster and be required to participate in common networking and joint activities. Guidance on the potential activities to be developed can be obtained by consulting the ongoing clusters of projects under the Environment, Climate and Health research portfolio^[12].

Proposals should make sure that relevant activities, outcomes and outputs are shared with the European Climate and Health Observatory^[13] through the cluster that will be formed after the approval of the proposals.

This topic requires the effective contribution of social sciences and humanities (SSH) disciplines and the involvement of SSH experts, institutions as well as the inclusion of relevant SSH expertise, in order to produce meaningful and significant effects enhancing the societal impact of the related research activities.

Applicants envisaging to include clinical studies^[14] should provide details of their clinical studies in the dedicated annex using the template provided in the submission system.

[1] See definition of FAIR data in the introduction to this Work Programme part.

[2] EMA definition: “Real-World Data are routinely collected data relating to patient health status or the delivery of healthcare from a variety of sources other than traditional clinical trials (e.g. claims databases, hospital data, electronic health records, registries, mhealth data, etc.)”.

[3] The use of the term ‘racial or ethnic origin’ does not imply an acceptance of theories that attempt to determine the existence of separate human races.

[4] The use of the term ‘racial or ethnic origin’ does not imply an acceptance of theories that attempt to determine the existence of separate human races.

[5] https://www.humanexposome.eu

[6] https://humanexposome.net

[7] https://www.icos-cp.eu/about/organisation-governance/icos-eric

[8] https://eirene.eu

[9] The catalogue of European Strategy Forum on Research Infrastructures (ESFRI) research infrastructures portfolio can be browsed on the ESFRI website: https://ri-portfolio.esfri.eu

[10] https://bio.tools/t?domain=exposome

[11] https://data-catalogue.molgeniscloud.org/catalogue/catalogue

[12] https://research-and-innovation.ec.europa.eu/research-area/health/environment-climate-and-health_en

[13] https://climate-adapt.eea.europa.eu/en/observatory

[14] Please note that the definition of clinical studies (see introduction to this Work Programme part) is broad and it is recommended that you review it thoroughly before submitting your application.