EPHOR – an exposome approach for a healthy work life

The Exposome Project for Health and Occupational Research (EPHOR) is a five-year research project that studies the working life exposome as a key cause of non-communicable diseases (NCDs). As part of the European Human Exposome Network (EHEN), EPHOR consists of 20 partners who have bundled their individual strengths to develop a unique toolbox that uses evidence-based data to mitigate health risks at work. Scientists, policy makers and OSH practitioners can thus establish workplace processes that align with the EU’s ‘Vision Zero’ to protect workers against work-related diseases.
Working-life exposome explained

People are exposed to all kinds of factors throughout their lifetime, from the moment they are conceived until the end of their life. All those exposures together and how the human body responds, is generally referred to as the exposome. These exposures include factors such as air quality, infections, diet, socio-economic circumstances, and lifestyle. But also factors related to a person’s occupation such as chemical and physical exposures or work stress play a relatively large role.

To comprehend the causal pathways that lead to many common diseases, thorough research of the human exposome is paramount. Imagine the benefit for our society of reducing the number of work related NCDs such as cardiovascular and respiratory diseases, immunological disorders and mental illnesses. Within EPHOR we believe in a holistic and multi-disciplinary approach to collect data on the exposome and unravel the complex exposure patterns that workers across Europe are subjected to and how these relate to health.

WeExpose Toolbox

It is widely acknowledged that the exposome concept and related methods offer a real chance to mitigate and even prevent health risks at the workplace. Within EPHOR we develop the potentially game-changing toolbox called WeExpose (Working Life Exposome for Policy, OSH, and Science) which gives health scientists, OSH professionals, and policy makers direct and open access to:

  • Innovative methods to collect and store large pools of data and interpret that data at the individual level
  • Better knowledge about how the occupational exposome relates to NCDs by pooling European cohort studies as well as two case studies focussed on night shift work and respiratory disease
  • User-friendly models to help assess the economic and societal impact of working-life exposures
Human design thinking

It is a challenge to not only provide  these new innovative methods and data to OSH professionals and policy makers, but also to enable them to use these to successfully mitigate work related risks. Therefore, we used human design thinking on one of the innovative methods in the toolbox: sensor based exposure assessment for OSH professionals.

In short the human design thinking approach means arriving at a solution by first studying and understanding the needs of end users, and involving them from development until implementation.

Partnerships and co-creation

As part of the EPHOR project, TNO, KU Leuven and IOM have teamed up with Belgian occupational health and safety service IDEWE to explore what occupational hygienists need to better evaluate exposures and the related health risks and how sensors could add to this.

Project manager of innovation and co-creation at IDEWE, Janne Goossens, explains their role and aim in the project. “Like with all co-creation processes, we employ a people-oriented methodology that carefully considers the needs and wishes of all stakeholders. The EPHOR consortium approached us in 2022 based on our extensive experience and expertise to guide co-creation initiatives in several other (European) projects like BOCCA and BalanceCrafter.”

Co-creation or design thinking is an iterative, flexible human-centred design approach that focuses on the needs of the end user. The process is broken down into four main steps: Discover (empathy), Define, Develop (create) and Deliver.

In the first step we focus on clarifying the problem definition through research methodologies (“Discover”) and creating insights through the needs and requirements of our end-users. This leads to a specific problem definition (“Define”) laid down in a design brief with concrete objectives. The second step focuses on the solution where prototypes (i.e. solutions) are developed through idea generation (“Develop”) that are repeatedly tested with the end-user with the aim of arriving at a sustainable solution (“Deliver”).

As part of the EPHOR project, we organised a number of workshops (shown in the images) to introduce the consortium in 2022 to the various co-creation methods and have been involved in developing the WeExpose toolbox.

Maaike le Feber is Senior Scientist at TNO and an advocate of human design thinking and co-creation. “Involving stakeholders from the very start of the project prevents us from developing something that is scientifically sound, but practically not useful. By collaborating with OSH professionals and listening to their needs and current struggles we can develop tools and methodologies that can overcome the current challenges they face to further reduce the occupational disease burden.”

The sentiment of gaining input from specialists in the field also stands strong at IOM. “Co-creation focuses on the needs of the end-user”, says Miranda Loh, director of science at IOM. “For the EPHOR project, we engaged occupational hygienists to help us comprehend the current needs and perceptions when using sensors in occupational exposure monitoring. Targeted focus groups in Belgium, the Netherlands and the UK have enabled us to understand the ‘lived experiences’ of OSH professionals – including consultants, regulators and those within industry posts – across a range of occupational settings. Validated through an international on-line survey, consultation findings have enabled us to better define and discern the challenges that OSH professionals face in monitoring workplace exposure and using low-cost sensors. Current barriers to measure exposures include financial barriers, limited conventional measurements not covering the differences between workers and a lack of awareness on the risks. OSH professionals think sensors can help to raise awareness and to more effectively control exposures, but lack guidance on how to use these devices. Currently we are working on guidelines for the appropriate use of these devices.

Towards a healthier European workforce – EPHOR’s role

Over the past four years, the Exposome Project for Health and Occupational Research (EPHOR) has made significant progress in collecting, assessing and mapping the working-life exposome. Some tools are already available online on the WeExpose website. In order to enable professionals in various disciplines across the EU to make a positive health impact on people’s work life, the consortium will continue its efforts to reach out to relevant stakeholders and involve them in the development. Ultimately, the EPHOR project aims to leave a positive mark on European working life for many years to come. By enabling scientists to further expand the exposome research field, and apply the methods and models into the future. And by enabling OSH professionals and policy makers to improve workplace practices and guidelines based on data-driven evidence.

November 16, 2023