Professor Manolis Kogevinas is co-Director of the Centre for Research in environmental epidemiology (CReAL). He graduated from the Medical School of Athens, greece and did his PhD in epidemiology at the University of London (1989). He worked at the International Agency for Research on Cancer (IARC), Lyon, at the Municipal Institute of Medical Research (IMIM) in Barcelona and was Professor of Epidemiology at the Medical School in Heraklion, Crete and at the National School of Public Health in Athens. His major research interest relates to the evaluation of environmental and occupational exposures in relation to cancer, respiratory diseases and child health. He served on several WHO and other expert committees evaluating the toxicity of chemicals such as dioxins and drinking water contaminants. He is the Director of the european educational Programme in epidemiology (eePe-Florence course). He is President (2016-17) of the International Society of Environmental Epidemiology (ISEE).

ABSTRACT

Global climate change is the most important threat for humans in the next decades both regarding direct (e.g. heat waves and mortality), and indirect effects  (e.g. long term  availability of food and drinking water, disruption of communities due to disasters). In relation to cancer, environmental epidemiology has focused on proximal causes of health and disease and has shown clear effects of numerous exposures. These include outdoor and indoor air-pollution and lung cancer, exposure to radon, exposure to UV light and skin cancer, water contaminants such as arsenic in well-water in relation to bladder and other cancers, exposure to food contaminants such as dioxins and several cancers, environmental exposure to asbestos and erionite. For several widespread exposures there is still no consensus concerning the degree of evidence including endocrine disruption, pesticides, exposure to non-ionising radiation, exposure to water disinfection by-products and nitrates or effects of circadian disruption and environmental light-at-night. Serious difficulties in evaluating widespread low-level exposure, particularly when repeated sampling is necessary, and exposure to mixtures rather than single chemicals has hindered epidemiological research. In several areas, for example research on endocrine disruption, we have not made major breakthroughs in methodological approaches for several years. Major advances will come through the development of new technologies on exposure assessment including the use of personal devices (e.g. smartphones), use of massive population data, together with extended use of Geographic Information Systems. Understanding of mechanisms and use of biotechnology is the other main area of advance in studies evaluating environmental exposures. However, there exists extensive knowledge on major causes of cancer (e.g. air-pollution) that allows the prevention of prevalent cancers, particularly in many newly developed countries where high levels of exposure occur. The development of interventions will allow consolidation of the evidence and help application of preventive policies.