The Germans Trias Hospital is set to launch a paediatric environmental health unit

• The unit will address the prevention, detection, assessment and management of diseases and environmental risks that may affect children and adolescents
• Children are a population group that is more sensitive to exposure to environmental contaminants such as pesticides, plastics and other chemicals present in consumer products
• Through its Research Institute, the Hospital is also leading an international study in Spain to reduce children's exposure to endocrine disruptors and assess their impact on child health

The Germans Trias i Pujol University Hospital is finalising the details to launch a new service within its portfolio: a Paediatric Environmental Health Unit, a specialised clinic dedicated to the prevention, detection, assessment and management of diseases and environmental risks related to the health of children and adolescents.

With this initiative, the Hospital responds to the interest of the international scientific community in ensuring that paediatric professionals lead research, outreach and care in the face of a growing concern: children's exposure to environmental contaminants that are increasingly present in daily life -such as smoke, pesticides, plastics, electronic products, textiles or personal care items- and which are being linked to the development of certain chronic diseases.

In fact, the World Health Organization estimates that one quarter of childhood diseases are caused by environmental factors. In this regard, children are more vulnerable to environmental contaminants because they absorb proportionally more air, water and food than adults, their immune systems are still developing, and they go through critical stages of growth. Additionally, exposure begins during pregnancy and continues throughout childhood.

The Unit, which will be the first of Institut Català de la Salut in a university hospital within the province of Barcelona, has been encouraged by the inclusion of environmental health in the updated 'Créixer en salut' ('Growing up Healthy') program of the Public Health Agency of Catalonia. It also follows the model of already established units, such as the pioneering service created at the Hospital d'Olot and Comarcal de la Garrotxa, or the one launched last year at Arnau de Vilanova Hospital in Lleida, among others.

The Paediatric Environmental Health Unit at Germans Trias will care for patients referred from primary care in the Barcelonès Nord and Maresme areas, where the Hospital is a reference centre for the vast majority of specialties. The Unit will be led by two professionals covering both clinical and research aspects: Francesca Castiello, specialist in paediatric endocrinology and environmental health, and Paula Sol Ventura, also a specialist in paediatric endocrinology and environmental health and a researcher at the Germans Trias i Pujol Research Institute (IGTP).

Together with the Head of the Paediatrics Department at Germans Trias, Maria Méndez, they explain that the Unit will receive cases referred from primary care or other hospital consultations, either because the children are particularly exposed to these contaminants or because they present medical complications that may be influenced by environmental exposures. During the consultations, which may be in person or online, they will examine the source and degree of exposure to different contaminants -such as tobacco smoke, traffic-related pollution in urban areas, or pesticides in rural areas of the Maresme- and introduce measures to reduce exposure, promoting healthy habits and activities, such as spending weekends outdoors away from the home environment.

Investigating the impact of endocrine disruptors

Most of the cases seen at the Unit will involve respiratory problems such as asthma, which are clearly aggravated by exposure to environmental contaminants. However, in recent years there has also been an increase in cases of girls showing early pubertal development, a phenomenon that may be related to exposure to certain contaminants. These substances, both natural and synthetic -such as bisphenols, pesticides or heavy metals- act as endocrine disruptors (EDCs) in childhood and have been linked to obesity, thyroid disorders, metabolic changes and, in particular, the premature onset of puberty.

One of the most ambitious scientific research projects involving the Unit is HYPIEND, a pioneering project aimed at preventing children's exposure to endocrine disruptors. Coordinated by the technology centre Eurecat and supported by €6.6 million in European funding, the project will be carried out simultaneously in more than 700 boys and girls in Belgium and Spain. In Spain, the paediatric study is led by Paula Sol Ventura, Marta Ocaña and Anna Sala at IGTP, with support from the Badalona City Council.

The initiative proposes implementing an educational strategy in primary schools to reduce exposure to endocrine disruptors. In Catalonia, 350 pupils aged 6 to 8 from 17 schools located in Barcelonès Nord, Maresme, Vallès Oriental and Alt Pirineu are participating. Their families, as well as the schools, will receive information and practical recommendations to reduce exposure to these compounds. As part of the project, Eurecat has developed a digital platform, available as a website and mobile application, offering personalised guidance on healthy lifestyle habits and the prevention of exposure to endocrine disruptors. This tool will be progressively implemented during the project.

In addition, the presence of EDCs in the urine of participating children will be monitored throughout the project to assess the effectiveness of the strategy, and the children's health will be followed through questionnaires to identify potential developmental anomalies related to puberty.

HYPIEND also includes a second research strand, a study analysing how EDCs may affect the hormonal system of pregnant women and their babies during the first 18 months of life, while also testing the effectiveness of a strategy to minimise exposure. This perinatal study, conducted simultaneously in Spain, Poland and Belgium, aims to include 800 participants. In Catalonia, the research is led by the Woman & Health group at IGTP, headed by Inés Velasco, specialist in Obstetrics and Gynaecology. It will be carried out at Germans Trias Hospital with the participation of ASSIR Badalona and ASSIR Sant Adrià del Besòs, and aims to include more than 135 pregnant women and their babies.

Overall, through HYPIEND, Europe and Catalonia position themselves at the forefront of scientific research dedicated to protecting children's health from environmental contaminants and promoting safer environments for future generations.