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1 Earth Observation and ENVironmental modelling for the mitigation of HEAlth risks FP Large-scale integrating project Call for a New Partner Date of call issue: 16/12/2010 Date of close of call: 23 February 2011 at 17:00 (Brussels local time)

2 Document Control Page Author Kym Watson Version number 1.6 Date 16/12/2010 Modified by Comments Status Draft Accepted Action requested 2/25

3 Table of Contents 1 Background and project context Overview of EO2HEAVEN Partners Concept Scientific and Technological Objectives & Expected Results EO2HEAVEN Scenarios Scenario 1: Environment effects on allergies and cardiovascular diseases in Dresden Scenario 2: Environmental challenges to health in the south Durban industrial basin Scenario 3: Investigating the impact of climatic variables on the outbreak of Cholera Proposal Terms of Reference Budget and EU Funding Contractual Conditions /25

4 1 Background and project context 1.1 Overview of EO2HEAVEN EO2HEAVEN is a large-scale integrating project co-funded by the European Commission under the 7th Framework Programme, theme 6, Environment (including Climate Change), Grant agreement no EO2HEAVEN CP-IP. The project duration is 3 years starting from February 1, Project Website for further information: EO2HEAVEN contributes to a better understanding of the complex relationships between environmental changes and their impact on human health. The project will monitor changes induced by human activities, with emphasis on atmospheric, river, lake and coastal marine pollution. EO2HEAVEN will follow a multidisciplinary and user-driven approach involving public health stakeholders who will work closely with technology and service providers in both the earth observation and in-situ environmental monitoring domain. The result of this collaboration will be the design and development of a GIS based upon an open and standards-based Spatial Information Infrastructure (SII) envisaged as a helpful tool for research of human exposure and early detection of infections. The key factors of the EO2HEAVEN system will be 1) an enhanced integration of remotely sensed and in-situ environmental measurements, and 2) the development of models to relate these environmental data to exposure and health data. Both factors will directly address current goals of GEOSS such that the resulting system will be integrated into the GEOSS infrastructure after successful validation already during the course of the project. Throughout the life span of the project the stakeholder requirements from three different scenarios (in Europe and Southern Africa) will be assessed and the technical solutions proposed by EO2HEAVEN will be evaluated through an iterative process, thus ensuring that the solutions can be applied on a global scale. EO2HEAVEN will specify and implement the SII as an open architecture based upon international standards and adaptive geospatial Web services in alignment with the large-scale initiatives INSPIRE and GMES. The SII will include bridging capabilities at the syntactic and semantic levels to and between environmental and health systems. Ongoing and recently completed research projects in the ICT, environmental and health domains will be studied and used in an integrative approach. 4/25

5 1.2 Partners No. 1 Participant organisation name Fraunhofer Institute of Optronics, System Technologies and Image Exploitation IOSB Part. short name IOSB Country Germany 2 Technische Universität Dresden TUD Germany North Initiative for Geospatial Open Source Software GmbH Atos Origin Sociedad Anonima Española 52 North ATOS Germany Spain 5 Spot Image SPOT France 6 NEV France European Commission DG JRC, Task Force for Environment and Health, Institute for Environment and Sustainability Council for Scientific and Industrial Research, Meraka Institute Open Geospatial Consortium (Europe) Limited Bureau de Recherches Geologiques et Minieres International Institute for Geo- Information Science and Earth Observation JRC CSIR OGCE BRGM ITC Belgium South Africa United Kingdom France The Netherlands 13 University KwaZulu-Natal UKZN South Africa Fraunhofer IOSB is Coordinator, ATOS is Research Coordinator and OGCE is Technical Manager. 5/25

6 1.3 Concept The key added value of EO2HEAVEN is the response to clearly defined user requirements on the causal relationships between environmental factors, population exposure, and health impacts with an open and modular architecture that enables distributed access, integration, and analysis of multidomain data, which is needed to address the multi-disciplinary scientific and policy-making questions. EO2HEAVEN follows a stringent open approach focused on sustainability: All essential specifications of the EO2HEAVEN architecture will be publicly available. All core components of the EO2HEAVEN spatial information infrastructure will be provided as Open Source. Methodological guidelines and tools for the development of additional environment and health applications will be developed. ICT standards from various bodies help to decrease diversity, but, due to their inherent complexity, universality and the constant technological progress, cannot fully resolve the problem of insufficient technical and semantic interoperability. In a systematic approach, the FP6 Integrated Project ORCHESTRA has specified a generic approach to achieve ICT interoperability. Its reference model has been adopted by the Open Geospatial Consortium (OGC) as a best-practices approach. The EO2HEAVEN project will follow this example and apply it to the multi-disciplinary domain of environmentally induced health risks. EO2HEAVEN follows a system of systems approach compliant with international standards of ISO, OGC, W3C and OASIS and is aligned with the initiatives INSPIRE, GEOSS and GMES. EO2HEAVEN is strongly user-driven and focuses on the need to develop a better understanding of the complex relationships between outdoor air pollution, water contamination and health outcomes in selected areas of Europe and Southern Africa. EO2HEAVEN develops an open implementation architecture and an operational spatial information infrastructure as a response to these scenarios and tests its re-usability. The EO2HEAVEN consortium is a team of partners with long-standing distinguished experience in project management, public health research, EO data provision, analysis and exploitation, distributed system architectures, standardization, European policy implementation, open source software and outreach activities. To support public health officials and stakeholders, the objective is to provide an overarching picture and actionable information that accounts for the distributed nature of cause and effect parameters, EO2HEAVEN will accommodate pre-existing approaches and results and work in close collaboration with key stakeholders to integrate environmental information gathered from Earth observation and insitu sensors and spatio-temporal analysis capabilities with information on health issues. The INSPIRE Directive (2007/2/EC) creates the legal framework to start addressing some of these problems, and make data and services more visible, accessible, and interoperable. This is an important step forward that needs to be underpinned by a concerted research effort particularly as new opportunities and challenges emerge with the Web enablement of in-situ as well as remotely monitoring facilities and devices. To ensure long term sustainability of the project results and promote quick and efficient uptake, EO2HEAVEN will open up its pilot implementation to external participation through the creation of an OGC Interoperability Testbed and by initiating a Pilot Implementation in response to GEO Task HE-09-02: Monitoring and Prediction Systems for Health in the GEO Work Plan. The consortium is committed to adhere to the GEOSS data sharing principle that all data, meta-data and products for use in education and research will be made available free of charge or no more than the cost of production whenever feasible; likewise all components developed in EO2HEAVEN will be registered in the GEOSS Components Registry (http://www.earthobservations.org/gci_cr.shtml). Hence EO2HEAVEN will significantly contribute to improving the understanding of environmental factors affecting health and well-being, which is one of the Societal Benefit Areas (SBA) of GEOSS. This 6/25

7 will also be supported by the frequent participation of consortium members in relevant concertation meetings and events of the major stakeholder initiative such as GMES, INSPIRE, GEO etc. 1.4 Scientific and Technological Objectives & Expected Results EO2HEAVEN contributes to a better understanding of the complex relationships between human induced environmental changes and human health. The following activities are carried out: Development of an interoperable GIS tool based upon a Spatial Information Infrastructure (SII). The GIS includes the following functionalities: o Elaborations of risk maps and launch of public health alerts. o Tools for studying links between environmental factors and human exposure/effect data. Elaboration and application of environmental causal models in epidemiology. Design robust methods for modelling and analysis needed to transform data into useful information products for public health. Integration of Earth Observation and in-situ environmental data: o Provide a specification of an open implementation architecture of the SII based upon international geospatial standards. o Establish a self organising observing network linked to a processing network for assimilation of environmental databases with new observations. Application of techniques to process data and characterize environmental conditions. The high-level objectives of EO2HEAVEN are: Foster interdisciplinary research between the environment and health domain by the provision of a methodological approach for cross-domain requirements analysis; Contribute to the Single Information Space for the Environment (SISE) through the development of an open architecture and a sustainable infrastructure in compliance with international standards and large-scale initiatives such as INSPIRE, Shared Environmental Information System (SEIS), GMES and GEOSS. 1.5 EO2HEAVEN Scenarios Scenario 1: Environment effects on allergies and cardiovascular diseases in Saxony and Dresden Saxony is the most eastern German state, bordering on Poland in the east and the Czech Republic in the south. With its 18, km² surface area it is the tenth-largest German state. The Free State has around 4.2 million inhabitants (2,159,396 female and 2,060,804 male) and a population density of 233 inhabitants per square kilometre. Dresden, the capital of Saxony, in Germany, with currently 508,000 inhabitants represents a typical midsized city in central Europe. The city of Dresden benefits from an economically and politically stable situation, even though the rural surroundings predominantly suffer from being economically underdeveloped (compared to central Europe s standards). Regarding air pollution the environmental quality in the area used to be very bad in GDR times due to the regional industry (in particular chemical, metal-working and energy industries). Especially air pollution was enormous. Today classical pollutants such as sulphur dioxide and dust do not cause severe problems any more whereas pollutants caused by traffic such as nitrogen oxide and ozone deserve critical attention. To analyse the relationship between environmental factors and health, the most common causes of death have been reviewed: cardiovascular diseases are the most common cause of death in the overall population in Germany, followed by cancer. Both are known to be driven to some extent by environmental aspects such as exposition to air pollution, particulate matter, tar, smoke etc. Cancer, due to the long potential latency, is not suitable for short term evaluation and should be discussed and evaluated in approx. 10 year intervals. On the other side, cardiovascular diseases in relation to respiratory diseases such as asthma have 7/25

8 been identified as a topic, which would allow direct correlations between environmental factors, such as ozone, particulate matter and pollen exposition and resulting symptoms on a comparatively short timescale. Allergic asthma is the most common chronic disease of childhood; approx 10 % of the children in Germany and approx. 5 % of the German adults suffer from asthma, the overall prevalence of the disease is given with 6.9 % for Germany. Each year about 5,000 death cases are attributed to asthma in Germany and a literature review suggests that this figure is representative of European levels. The main objective of this scenario is to develop a system for spatio-temporal monitoring and surveillance of environmental phenomena (air pollution, pollen) and health (allergies and cardiovascular effects), allowing regional health authorities to monitor health impacts of these environmental phenomena on a continuous basis. This could be used to plan specific measurements according to the specific risk profiles of patient groups, as for instance risk appropriate dosing of prophylactic medication for allergic patients or to prepare for an increased need of therapies. Moreover it will allow local authorities to track changes that may occur because of changes such as interventions to reduce traffic, heating, or production (e.g. electricity) related pollution. Introducing information that results from fusing in-situ measurement data and earth observation shall provide this information in a spatial and temporal resolution, which is currently not available. As a starting point the scenario will take environmental data and health data which is currently being collected and pre-processed in the frame of the HEREPLUS project. Thus a comprehensive health database for the city of Dresden is available that will be extended by health data from the German statutory health insurance to also cover the Freestate of Saxony. The existing environmental databases offer geographic base data (e.g. topography, traffic, vegetation) as well as environmental data (emission and immission cadastre, air pollution in-situ sensors, weather data, etc,). Both databases cover the period It is intended here to be as synergetic as possible with the HEREPLUS project. The Dresden scenario will focus on the following aspects: Relating Health Data with Environmental data to better explore relations between cardiovascular effects (heart attacks, apoplectic insults, peripheral arterial occlusive disease) caused by rapid progression of atherosclerosis and environmental exposition (weather, air pollution, etc.) as well as between allergic effects (especially asthmatic and pulmonary effects) and environmental exposition (weather, air pollution, vegetation status, etc.). This analysis will be based on existing medical data and environmental data in the period The findings about correlations between environmental expositions and health effects will be fed in robust spatiotemporal models that can be used for better adapting with stress situations and for alerting the respective stakeholders (patients as well as health professionals). WP3 will focus on developing these methodologies. Based on the findings of 1) an alerting system for health authorities will be developed to inform them about the current environmental exposition risks of their patients and to provide them with a tool to support planning prophylactic medication and preparing for an increased need of therapies. In a later step this system shall be extended to also alert allergic persons and persons suffering from cardiovascular diseases on their current risk exposure, to inform them with specific risk maps, and to provide them with individual health-related recommendations specifically adapted to their personal medical history and to prove the appropriateness of the recommendations. The findings from scenario 1 will be fed into guidelines for public health professionals, including recommendations on how to transfer the developed methodologies and tools to other regions. The available environmental data for Dresden and its surroundings differ enormously in terms of spatial and temporal and partly also thematic resolution. In this scenario data fusion methodologies will be developed, that can be (semi-)automatically applied to integrate in-situ data, earth observation data, and simulation data to achieve a better and homogeneous spatio-temporal resolution for the considered environmental data sets. The following methodologies will especially be considered: Fusing earth observation data, in-situ data and available simulation results (weather and air pollution forecasts) using geostatistical approaches (e.g. based on correlations between EO and in-situ) or artificial intelligent approaches (e.g. neuronal networks) to derive information on environmental exposure in a better spatial and temporal resolution. These concepts will focus on data being available from existing sources (geodatabases, satellites, sensor-networks and 8/25

9 operational simulation runs as provided by the German Weather Forecast or EURAD1) to be easily realizable in the context of operational systems (WP3). Development of a concept for a configurable micro-drone based sensor network for the local and temporal densification of satellite image based pollen risk prediction to provide an integrated satellite and airborne image sequence processing (WP3). Develop robust modeling tools (geostatistical models, diagnostic pollution models, etc.) that can be used to integrate environmental data from various distributed sources (in-situ, earth observing, and simulation) and to derive forecasts for considered variables (O3, PM 0.1, 2.5 and 10, pollen, tc.) in an automatic and near real-time fashion to provide adequate health risk maps (WP3). Integration of data quality and process quality measures in the above mentioned processing chains to provide the users with adequate information about the accuracy of the published processing results (WP4). Integration of the above mentioned components in a Spatial Decision Support Tool which is based on interoperable, web-based components and can be applied by health professionals to monitor health risk and to decide about adaption measurements (WP4). The following figure sketches the idea of the intended scenario: Figure 1: Graphical description of Scenario 1 1 See the Geoportal of Saxony (www.sachsenatlas.de) for examples of online available geodatabases and see the European Air Pollution Dispersion project (http://www.eurad.uni-koeln.de/index_e.html) as an example for an online available air pollution model. 9/25

10 The main users of this EO2HEAVEN developments will be the public health authorities and health care professionals at the hospitals as well as office-based physicians in Dresden and surroundings, the Environmental Department and the Health Department of the City of Dresden, the Saxonian Ministry of Social Affairs and the Saxonian Ministry of Environment as well as the citizens being affected by the considered diseases will benefit from an early warning system. This system will provide information about individual risk constellations to experience an acute cardiovascular event. Additionally a number of stakeholders can be expected ranging from public health research and authorities bodies and environmental planning departments to pharmacists. The objective of the scenario is to estimate and deliver via Internet air quality and population health risk maps to competent authorities and personalised messages (e.g. via SMS), and in a later step to susceptible individuals. Such advice could include the option to give advice to adopt the therapy regime to the specific situation. The system will provide information about patient and risk constellations for an exacerbation of certain diseases and recommendations about corresponding response e.g. increasing or decreasing the dosage of ß-adrenergics and or inhalative corticosteroids on asthmatic subjects Scenario 2: Environmental challenges to health in the south Durban industrial basin The south Durban Industrial Basin (DSIB) consists of approximately people living in 25 designated "suburbs", most of which have been carefully regionalised into white, Indian, African and Coloured areas, according to the apartheid era racial classification. The historical racially discriminatory apartheid town planning processes that resulted in residential areas in the Durban South Industrial Basin (DSIB) being subjected to the effects of a wide range of industrial activities, including petroleum refining, paper milling, transportation networks (including airport and harbour) and waste management. This residential-industrial complex arose during the era of racist governmental planning, and today represents a highly conflictual situation between stakeholders. This area has been reported to have a high unemployment rate, with approximately 52% of the population not economically active. The DSIB is bounded on the southeast by the Bluff ridge (70-100m high) and in the northeast by the Berea ridge (110m high). This allows for the drainage of cold night air along the Umhlatuzana and Umbilo rivers in the Durban south, damming against the Bluff ridge, and diverted northwards to the Berea ridge, and subsequently toward the sea. Through land warming during the day, sea currents direct the air back inland, causing continuous re-circulation. These lesion patterns are accompanied by temperature inversions from late autumn to early spring, limiting the vertical diffusion of pollutants. The DSIB is at particularly high risk for exposure to significant levels of ambient air pollution because of its geographic relationship with certain stationary sources of air pollutants. Specifically, two major petroleum refineries, Engen and Sapref, are within the community, together with a pulp and paper manufacturer, Mondi. Up to a few years ago, each of these refineries has emitted, on average, in the range of to kg of SO2 per day, (Ecoserv, 2000). Owing to a combination of its geographical relationship to the refineries, land contours, prevailing meteorological conditions, the use of a relatively short emissions stacks at these facilities ( meters), the lack of or relative ineffectiveness of emission control devices on refinery stacks, the many sources of so-called fugitive air emissions at refineries, emissions from industrial and passenger vehicles, as well as the proximity of other industries and the Durban airport, the community is believed to be at risk for intermittent substantial exposure to ambient air pollutants. The recognition of this risk is reflected in an industry-funded agency had been continuously monitoring sulfur dioxide at the Settlers' Primary School since June Continuous monitoring of oxides of nitrogen, carbon monoxide, total reduced sulfates, and PM10 at the school commenced in late October Available data on sulfur dioxide indicate that average and/or maximum exposures at the Settlers School have frequently exceeded World Health organization (WHO), the South African Department of Environmental Affairs (DEAT). In a study among students and teachers at the Settlers' Primary School, Robins et al have reported unusually high prevalence rates for asthma, with ranges of any type of non or probable asthma (symptoms assessed) from 53.5% to moderate to severe persistent asthma of 16.8%. In addition, approximately 20% of the study sample had marked airways hyperresponsiveness as diagnosed by methacholine challenge testing, the prevalence higher than any other population based reports in the scientific literature. This study found statistically significant associations between prior day and prior 48 hour 10/25

11 PM10, SO2, and NO2 levels (continuously measured at the school) and increased respiratory symptoms and diminished pulmonary function measures (measured by digital recording peak flow meters) among students with persistent asthma. These effects were observed during a time period when all ambient pollutant measures were well within national and international standards. This study, which was conducted by the same research team proposed for the current study, merits specific mention and prominence both because questionnaire based asthma diagnoses were corroborated by objective methacholine challenge testing, and because it is the only study carried out in the Durban metropolitan area which specifically examined associations between fluctuations in the air pollutants and fluctuations in health status. In a more recent study, ambient and indoor exposure monitoring was conducted in south and north communities during the study period, May 2004 to February Additional sources of pollutant and meteorological data covering January 2004 to October 2005 were accessed. Pollutants monitored included sulphur dioxide (SO2), carbon monoxide (CO), volatile organic compounds (VOCs), particulate matter in two size classes (PM10 and PM2.5), ozone (O3), metals, and semi-volatile organic compounds (SVOCs, including dioxins, furans, and polycyclic aromatic hydrocarbons). The health risk component of the study also utilized exposure data (nitrogen oxides, ozone, total reduced sulphur, particulate matter), and meteorological data (wind speed, wind direction, temperature, relative humidity, barometric pressure, and precipitation) from the ethekwini MultiPoint Plan monitoring sites (including Wentworth, Harbour, City Hall, Warwick, King Edward, Grosvener, Jacobs, Settlers, Alverston, Ganges, Southern Works, Prospecton, Illovo, Ispingo, Westville, Umhlanga and Turner) and stations managed by the Durban International Airport. Descriptive analysis of the exposure data revealed NO2 concentrations lowest in Ferndale in the north (mean of 11 ppb), highest in the city centre and industrial areas (19-24 ppb), and lower at Southern Works and Wentworth in the south (12-14 ppb). Average SO2 concentrations varied widely; with low concentrations (1-3 ppb) at sites in the north; medium to high concentrations (6-10 ppb) at central and south-central sites and (12-20 ppb) in the south. The SO2 spatial distribution reflects the location of emitting industries in the South Basin. Average PM10 concentrations measured using the continuous tapered element oscillating microbalance (TEOM) method were nearly identical, μm m-3, at four sites representing both north and south communities, and slightly elevated, 46 μg m-3, at Ganges. The average filter-based concentrations at the seven school sites were in the same range, μg m-3. Maximum 24-hr average concentrations approached or exceeded 150 μg m-3 at most sites. The highest concentrations were observed at Assegai (south), and Ngazana (north), two widely separated monitors. PM2.5 concentrations measured at three sites were nearly identical, μm m-3, with maximum 24-hr concentrations ranging from 79 to 131 µg m-3. PM10 and PM2.5 concentrations across the region were high relative to international norms and standards. While there is moderate correlation between PM2.5 and PM10, the ratio between these pollutants is not constant and different emission sources contribute fine (PM2.5) and coarse (PM2.5-10) particles. The highest CO concentrations were observed at Warwick, the traffic-oriented site. 24-hr levels at this site averaged 2.1 pm (maximum of 10 ppm). Measurements at other sites were much lower, averaging 0.7 ppm at two of the northern sites, 0.4 and 0.5 ppm at two southern sites, and <0.3 ppm at the remaining sits. O3 levels at Alverston (~30 km inland) averaged 26 ± 13 ppb, compared to 15 ± 11 ppb at Wentworth (south). A moderate correlation was observed between the two sites (R2 = 0.56). The health data from that study suggested high prevalence of respiratory disease. Caregivers reported that 14.7% of children had been diagnosed with asthma by a doctor, 10.9% with hayfever, and 4.0% with chronic bronchitis. Based on symptoms described by the caregiver, 31.5% of children had some grade of asthma, with 7.9% having mild persistent asthma, and 4.1% having moderate to severe persistent asthma. Objective lung function assessments using methocholine challenge testing were well correlated with these reported assessments, with 7.6 % having marked bronchial hyperreactivity (BHR) (PC20 < 2 mg/ml) and a further 17% having either probable or possible BHR. The covariate-adjusted prevalence of marked BHR varied substantially between the south (8.0%) and north (2.8%). Logistic regression models adjusting for age, gender, race, caregiver education, household income and the presence of smokers in the household, found that attending a school in the south was statistically signifi- 11/25

12 cantly associated with increased risk for persistent asthma (odds ratio [OR] and 95% confidence interval of 1.82 (1.05, 3.14)) and marked BHR (OR 2.55 (1.03, 6.28)). The relatively moderate ambient concentrations of NO2, NO, PM10, and SO2 were strongly and significantly associated with decrements in lung function among children with persistent asthma and/or genetic polymorphisms associated with reduced ability to respond to oxidative stress. Moreover, attending primary school in south Durban, as compared to the north, was significantly associated with increased risk for persistent asthma and for marked airway hyper reactivity in covariate-adjusted regression models. Scenario outcomes expected: Development of models relating environmental changes to health exposure Development of GIS, risk mapping and alerts. The actors involved are: The community based organisations Local and provincial government especially Departments of Health Academic institutions Community health centres and clinics Information needed: Meteorological parameters that could be used to predict periods of pollution trapping within the basin, particularly as a result of atmospheric inversion layers. In-situ environmental measures will be provided by the local government Department of Health s Air Quality Monitoring System (AQMS). Health data, particularly presentation of acute cardiac and respiratory diseases among adults and children respectively, will be available from local community clinics. The epidemiological data from the various studies conducted by the research team at UKZN is also available. The benefits are expected from combining available environmental pollutant data from the AQMS, together with meteorological and other earth observation data, GIS and geographical information and models that can predict elevated levels of pollution. Providing this early warning system to the communities affected by ambient pollution will allow for children with asthma, adults with cardiac and respiratory disease to take appropriate action such as staying indoors, or leaving the affected areas during the times of elevated pollution. The success of the prediction of the model will be by showing a defined drop in clinic attendances during times of elevated pollution Scenario 3: Investigating the impact of climatic variables on the outbreak of Cholera The main objective of this scenario is to research and develop an early warning system for cholera outbreaks in southern Africa. Remote sensing imagery, health data, data from in-situ sensors and data about environmental and demographic conditions will be combined in models to study the forming conditions conducive for cholera outbreak and spread. Cholera is an acute and potentially life-threatening intestinal disease caused by the bacterium Vibrio cholerae after ingestion of contaminated water or food (Kelley, 2001). The disease frequently strikes in the form of severe epidemics in developing countries in tropical and sub tropical regions, and occurs with a more or less annual periodicity. Currently, almost all the cholera cases reported in Europe are imported from affected areas with the exception of Russia. In certain areas in the world, cholera outbreaks occur on a yearly or even twice per year basis following a very strong seasonal pattern. This is indicative of the endemism of the bacteria in these areas. In other areas, outbreaks are potentially linked to the contamination of water sources by sick people who originally contracted the disease elsewhere resulting in sporadic cholera outbreaks in these areas. Africa, however, appears to be the continent affected mostly and most frequently by the disease. In 2007, 53 countries worldwide reported 12/25

13 cholera cases but more than 93% ( ) of all cases reported were from Africa (WHO, 2008) 2. In general, more than 90% of the total cases in the world are reported from the African continent on an annual basis for the period (WHO s ) 3. Interestingly, the pattern in the number of cases reported in Europe follows a pattern similar to that of Africa for 2006 and 2007 (WHO, 2007 and 2008). Cholera appears to be strongly influenced by climatic variables, the main reason being that Vibrio cholerae occurs naturally in marine and freshwater habitats in free floating form, or in association with certain plankton species and shell fish. Another important reason linking the occurrence and intensity of cholera outbreaks with climate change is the change in frequency of events such as floods and droughts. These events can lead to more people being exposed to contaminated water due to the failure of water treatment and supply infrastructure during a flood event or the scarcity of water during a drought situation. The general path of exposure to the bacteria is through the ingestion of contaminated water sourced from the natural environment or untreated water; or food (e.g. undercooked shell fish known to harbour V.cholerae or raw food washed with contaminated water or handled by an infected person). The environmental variables reported or known to play an important role in the patterns observed in the cholera case time series, the presence or absence of the bacteria in the aquatic environment and the ecology of V.cholerae are summarised in the table below. Ocean based Sea surface temperature Sea surface height Chlorophyll a concentrations Zooplankton Sunlight Macro scale variables Land based Rainfall Air temperature Relative humidity Freshwater surface temperature Sunlight Cholera cases reported in a certain area/location Micro scale variables Marine and freshwater water based ph Salinity Iron Nutrients (N, C, P) 2 WHO Cholera, Weekly Epidemiological Report. 83(31), WHO Cholera, Weekly Epidemiological Report. 77(31), WHO Cholera, Weekly Epidemiological Report. 78(31), WHO Cholera, Weekly Epidemiological Report. 79(31), WHO Cholera, Weekly Epidemiological Report. 80(31), WHO Cholera, Weekly Epidemiological Report. 81(31), WHO Cholera, Weekly Epidemiological Report. 82(31), /25

14 Water temperature Presence of V.cholerae in the aquatic environment in a given area/location Challenges addressed and contributions Very little information on the ecology of Vibrio cholerae in the African context has been published. Studies mainly focus on the socio-economic conditions contributing to cholera outbreaks or interventions before or during an outbreak, for example the cholera vaccine that has been deployed in Beira, Mozambique in 2004 (Lucas et al, 2006) 4. Although the vaccine campaign was very effective, it is an expensive intervention option and cholera outbreaks still occur in Beira on a yearly basis. Furthermore, modeling and data analyses studies usually focus on finding similar patterns in the time series data for cholera cases and environmental variables. This can be very useful to develop a prediction tool with a high level of accuracy especially if there is a high correlation between a specific environmental variable(s) and the cholera cases and the bacteria have been shown to be present in the natural environment in a specific area. In areas where cholera outbreaks are reported on a regular basis satellite data can be used to determine links and the strength of links between cholera cases and environmental variables. In order to investigate causation it will be necessary to ground truth the models and not only use cholera cases to accomplish this. This will involve the collection of water samples at different points at different depths and sediment samples at the same sampling points for a period of time covering all seasons of the year. Variables such as ph; salinity; nutrients (e.g. nitrogen, carbon and phosphorous) and iron have been shown to play important roles in the dynamics of V.cholerae. These variables in turn are influenced by environmental variables on the larger scale; for example, the cumulative effect of rainfall (Woodborne et al, 2008) 5 ; water temperature changes; coastal upwelling; sea currents and eddies. It is therefore important to conduct studies on both the macro (using remotely sensed data) and micro (using in situ data) level. Both inland lakes and marine environments will be considered. The objective of this scenario is to integrate earth observation data with demographic, and in-situ ecological data to research and develop simulation and prediction models for cholera outbreaks. For stakeholders and users, this application will provide an environment that facilitates rigorous and repeatable analysis and sharing of data from traditionally very disparate domains and sources. Specific challenges to be addressed include: acquisition and fusion of earth observation data with disparate spatial, temporal and spectral resolutions integration of heterogeneous laboratory and empirical data for disparate sources and domain the representation and management of models and algorithms related to cholera research execution of analytical and computational processes (simulations, etc) and their output in a controlled and sharable manner capturing, representation and maintenance of knowledge of cholera (models, algorithms, workflows) formulation and testing of new hypotheses related to the link between a given environmental variable or variables and the dynamics of the disease and the ecology of the bacteria in the African context. 4 Marcelino E.S. Lucas, M.Sc., Jacqueline L. Deen, M.D., M.Sc., Lorenz von Seidlein, M.D., Ph.D., Xuan-Yi Wang, M.D., Ph.D., Julia Ampuero, M.D., M.Sc., Mahesh Puri, M.S., Mohammad Ali, Ph.D., M. Ansaruzzaman, M.Sc., Juvenaldo Amos, M.D., M.P.H., Arminda Macuamule, M.S., Philippe Cavailler, M.D., M.Sc., Philippe J. Guerin, M.D., M.P.H., Claude Mahoudeau, Pierre Kahozi-Sangwa, M.D., M.P.H., Claire-Lise Chaignat, M.D., M.P.H., Avertino Barreto, M.D., M.P.H., Francisco F. Songane, M.D., M.P.H., M.Sc., and John D. Clemens, M.D Effectiveness of mass oral cholera vaccination in Beira, Mozambique. N Engl J Med. 352(8): Woodborne, S., Pienaar, M., Van der Merwe, MR Mitigating the future impacts of cholera. Conference proceedings: Science real and relevant: The 2nd CSIR Biennial Conference. Pretoria, South Africa, November ISBN /25

15 This application builds on an existing foundation of knowledge and expertise in this domain. The goal is to create an environment for researching simulation and prediction models for the understanding of cholera outbreaks such that sharing, rigor and repeatability of the processes involved are ensured. The platform will facilitate research on the correlation, and if possible influence of various climatic variables on the presence, survival, growth and potential change in the virulence status of the cholera bacterium. This scenario contributes to the purpose and objectives of the programme as follows: 1. Interoperable acquisition, analysis, and dissemination of new datasets and information for use by decision makers, researchers and communities. This will include: an environment for accessing data and models to research simulation and prediction models for cholera outbreaks such that sharing, rigour and repeatability of the processes involved are ensured. The platform will facilitate research on the influence of various climatic variables, for example the amount of sunlight reaching the earth s surface and penetrating water bodies on the virulence of the cholera bacteria. a Sensor Web environment that acquires data sources (such as remote sensors, weather and radar stations) needed to execute a given workflow in order to provide information about meteorological events indicative of a perceived risk of cholera. This work will involve collaboration with meteorology experts South Africa (e.g., SA Weather Service). 2. Strengthen the research capacity of scientists to understand the bio-complexity of the pathogen and to model and predict the impact of climate change and inter-annual climate variability on human health with special reference to cholera ecology. Improved understanding of the conditions for the onset of infectious disease can shed light on the role of ecological and environmental variables on water-borne infectious diseases in general. 3. An ICT platform that can be adapted for continuous monitoring of the occurrence and spatial location of cholera cases, information and location of sources of water used, and other observed changes in the natural environment in support and verification of cholera early warning functionality. 4. The enhancement of existing data collection methods and techniques to collect qualitative and quantitative data and information. This will include the use of earth observation data and software for the identification of areas as well as the development of an early warning system that incorporates data on the ecological drivers of cholera. Researchers and medical personnel can benefit from the use of rapid laboratory tests for detection and confirmation of cholera. 2 Proposal Terms of Reference The proposer is expected to join the EO2HEAVEN consortium as an additional beneficiary (cf contractual conditions below). The proposal shall address the following objectives: 1. To provide advice and guidance on the public health requirements for Earth observations in the design of the three case studies 2. To contribute to the dissemination and transfer of project results 3. To support, in close cooperation with the GEO Secretariat, the GEOSS HE-09-01/02 Pilot activity within the project 4. To assess and gather the requirements for environmental information for use in public health decision making. 5. To contribute to the methodological study of links between extracted environmental parameters and collected health data in close collaboration with scenario leaders 6. To contribute to the final reporting and recommendations for the future implementation of integrated health and environmental monitoring systems The proposer is expected to be either a public health authority or to be an organization with close links to public health authorities. The proposer shall have in depth knowledge of the requirements of public health authorities in several countries and in fields relevant to the Scenarios. Objectives 1-3 above are especially important. 15/25

16 The work covered by the proposal shall be carried out in years 2 and 3 of the EO2HEAVEN project, i.e. in the period 02/ /2013. These objectives shall be primarily achieved through contributions to existing EO2HEAVEN Tasks as follows: Proposal Objective 1 T2.1 2 T6.1 3 T6.4 EO2HEAVEN Task 4 T3.4, T3.5 5 T2.2, T2.3, T2.4 6 T3.6, T6.2 3 Budget and EU Funding The conditions for Commission funding contributing to the budget of the proposed work are laid down in The Guide for applicants participating in a competitive call for additional beneficiaries in the Project EO2HEAVEN, Section 1.2. The new partner shall be allocated a maximum Commission contribution of no more than Contractual Conditions The proposer selected to join EO2HEAVEN shall be required to accede to the EO2HEAVEN Grant Agreement and to sign the EO2HEAVEN Consortium Agreement. A model Grant Agreement together with its Annexes may be found at The Consortium Agreement is based on the DESCA model (http://www.desca-fp7.eu/ ). 5 Proposal Preparation The required form of the proposal is defined in the The Guide for applicants participating in a competitive call for additional beneficiaries in the Project EO2HEAVEN, Section 2. 6 Proposal Submission The rules for submission of proposals are specified in The Guide for applicants participating in a competitive call for additional beneficiaries in the Project EO2HEAVEN, Sections 2.3 and 2.4. Proposals shall be submitted to the address The deadline for proposal submission is Wednesday 23 February, 2011 at 17:00 (Brussels local time). 16/25

17 Annex This annex is an Excerpt from the current EO2HEAVEN Annex I (Description of Work). It is included to allow proposers to better focus their proposals in a well defined framework. Note that EO2HEAVEN may decide to modify details of these workpackage descriptions, in which case the proposal, if successful, may have to be modified during contract negotiation. Work Package number 2 Start date or starting event: Start: M1 - End: M36 Work Package title Activity type Use Case Specification and Validation RTD Objectives The overall objective of WP2 is to specify the requirements of EO2HEAVEN applications and to validate their developments, thus providing feedback to WP3, WP4, and WP5. Three use cases are specified, two in the field of air quality and one on vector-borne infectious disease, located in Europe and South Africa. These use cases will ensure sustainability of components developed within EO2HEAVEN. The final report on requirements which is delivered to WP4 includes functional and non-functional requirements from all use cases and defines boundary conditions with respect to INSPIRE, SEIS, GMES and GEOSS. Furthermore, WP2 will analyse state-of-art of glossaries in the domain of health and environment and analyse commonalities among the use cases (information and technological requirements: from task 2.1 and task 3.1). Description of work T2.1 - Collecting and harmonising specifications and validation results (Leader TUD) Collecting and harmonising user requirements from each use case specification (beginning of each cycle); Collecting and harmonising validation results from each use case (end of each cycle); Analyse feedback on suitability of the architecture and proposed methodologies (feedback for WP4); Analyse feedback on how the (functional as well as non-functional) user requirements are well met by applications (feedback for WP4 and WP5); Develop common glossaries and (multi-lingual) thesauri and re-utilization of existed thesauri in considered domains. T2.2 - T2.4 Use Case: Generic Structure The activities involved for tasks T2.2-T2.4 are the following: All tasks provide, in collaboration with users, a detailed specification of the use cases for each of the EO2HEAVEN development cycles, which they will feed into task 3.1. The specifications will include functional and non-functional requirements, criteria for the validation, descriptions of the technical environment, and ethical issues: Functional requirements for the delivery of timely and accurate/reliable information to relevant authorities and the general public through the implementation of the EO2HEAVEN approach; Data and meta-knowledge requirements for efficient processing of the information; 17/25

18 Quality requirements regarding the various data sets involved in an integrated assessment and the on-line monitoring and communication of early warnings to the concerned authorities or members of the public; Ethical issues related to the use of individual information on positioning, on the identification of timeactivity patterns including spatial information therein. T are provided with use case specific implementation after each development cycle, which they validate. The validation will be based on the methodology developed by WP4 and the criteria set in the use case specifications. The result is provided as input to task 3.1 T2.2 - Environment effects on allergies and cardiovascular diseases in Dresden (Leader TUD) This task will address the specific issues to develop a system for spatio-temporal monitoring and surveillance of environmental phenomena (air pollution, pollen) and health (allergies and cardiovascular effects) in the area of Dresden, Germany. The city of Dresden and reference regions as sparsely populated and rural areas in its surrounding will be considered. The use case will be based on environmental data and health data which is currently being collected and pre-processed in the frame of the HEREPLUS project. Further data requirements and resources will be identified, together with the necessary infrastructure requirements for acquisition. T2.3 - Environmental challenges to health in the south Durban industrial basin (Leader UKZN) This task will address the specific issues regarding air quality and health risk of the area of Durban (South Africa). Environmental pollutant data from the Air Quality Monitoring System that is in place in the city will be obtained. A system that will allow for prediction of changes in meteorological and other parameters which impacts on levels of pollution in the city and results in the development of specific respiratory health outcomes will be developed. Data requirements and resources will be identified, together with the necessary infrastructure requirements for acquisition. T2.4 - Use Case water-borne infectious disease in Southern Africa (Leader CSIR) This task will address specific issues regarding early warning indicators for cholera outbreaks. Specific coastal and inland areas in southern Africa will serve as test cases. Data requirements and resources will be identified, together with the necessary infrastructure requirements for acquisition. Deliverables Deliverables of Task 2.1: D Report on requirements and bounding conditions from relevant initiatives (R, PU, M6) D Harmonised use case specification and user requirements report each cycle (R, PU, M8, M19, M29) D Feedback report incorporating validation outcome of (functional and non-functional) user requirements and ethical issues after each cycle for WP2, WP4 and WP5 (R, RE, M16, M26, M33) Deliverables of Task 2.2: D Use case specifications report after each cycle (R, RE, M6, M18, M28) D Validation report and fitness-for-purpose assessment (R, RE, M15, M25, M32) D Final report on fitness-for-purpose assessment (R, PU, M36) Deliverables of Task 2.3: D Use case specifications report after each cycle (R, RE, M6, M18, M28) D Validation report and fitness-for-purpose assessment (R, RE, M15, M25, M32) D Final report on fitness-for-purpose assessment (R, PU, M36) Deliverables of Task 2.4: D Use case specifications report after each cycle (R, RE, M6, M18, M28) 18/25

19 D Validation report and fitness-for-purpose assessment (R, RE, M15, M25, M32) D Final report on fitness-for-purpose assessment (R, PU, M36) Milestones M2.1 - Harmonised use case specification and user requirements report no. 1 (M8) M2.2 - Harmonised use case specification and user requirements report no. 2 (M19) M2.3 - Harmonised use case specification and user requirements report no. 3 (M29) Work Package number 3 Start date or starting event: Start: M1 - End: M36 Work Package title Activity type Earth Observation for Health Monitoring RTD Objectives This Work Package should be seen as an analytical and methodological laboratory for the generation and the use of Earth Observation (EO) and Environmental Information (EI) data, products and services for performing health monitoring. This encompasses State-of-the-Art of the use of environmental parameters in health monitoring in previous or on-going RTD projects, current and best practices and pilot project analysis at the European Level with a detailed analysis of currently used and available environmental parameters. This iterative WP will result in a short list of relevant environmental information products and services that will be used or developed for the purposes of the USE CASES. A significant part of the activities in this WP will consist in defining and developing EI products and associated processing chains. The resulting EI products will be tested and validated in this WP in close collaboration with WP2 for later implementation through a web service enabled architecture. To finish with, EO2HEAVEN plans a detailed analysis of Health Data in a methodological point of view for spatialisation, sampling, fusion and correlation with environmental parameters. Defining both health data templates and models for risk prediction or disease propagation. EO data will be purchased by with the appropriated budget reserve (as consumables) to acquire with adapted licensing agreement: HR and VHR Optical and SAR images of the area of interest, MERIS data, Precise DEM on southern Africa, If possible 3D coverages of urban areas of interest in Dresden and Durban. It is anticipated to purchase data at no cost to the project under the agreement between the EC and ESA on coordinated access to space data. Standard and freely available EO products (under licensing conditions or not) will also be used extensively (SCIAMACHY derived products). Description of work T3.1 State of the art for environmental and health monitoring in air and water (Leader JRC) 19/25

20 This work will be focused on EO2HEAVEN Use Cases, with integration of State of the Art of previous R&T related projects. T3.2 From Global to Local EO products (Leader SPOT) From the list produced at Task 2.1 of major indicators or environmental parameters that has to be taken into account we will propose a matrix of EO data and products available and their characterization (frequency, resolution, precision, etc ) at different scales of analysis from global to local. This encompasses: Analysis of available standards EO products at present or in a near future (GMES context) Definition and Specification of dedicated EO products In particular we will focus on Earth Observation (EO) data derived from Space Sensors such as Air or Water parameters derived from sensors such as SCIAMACHY for Air pollution or MERIS for water parameters, Digital Elevation Models (from SRTM or Image Stereoscopy such as SPOT5 HRS sensor producing DEM product named Reference 3D ). The availability of these products respects to needs for Environmental parameters will be checked for each areas concerned by use cases. Anticipated parameters to be extracted are: Human settlements (population exposure to risk also as input for regional models for air flows) Water parameters (Water, water quality, flooding areas, ponds, hydrologic network). Coastal Zone Oceanic Parameters (could be relevant for Cholera analysis in coastal areas) Climatic parameters Air Pollution parameters All relevant parameters will be extracted from available or specifically developed environmental products through development of EI processing chains, to be then integrated into the global information system architecture (WP4) implemented within WP5. T3.3 Data fusion and assimilation Methodologies for dedicated EI products generation (Leader TUD) Once EO products have been specified, we will focus on the generation of integrated Environmental Information Products by assimilating and fusing non-eo data with EO products. We will first assess all other information available at the regional scales of our Use Cases: Relevant topographic and thematic geodatabases (comparable to the topics defined in the INSPIRE Annexes) Environmental Data from in-situ Sensors Data from mathematical and numerical models for environment simulation We will focus in particular on three specific EI services to be prototyped: Satellite and airborne sensor fusion for spatio-temporal pollen risk prediction Perform geometric referencing between satellite and micro-drone imagery. Choose suitable vegetation indices. Derive vegetation indices from multi-spectral satellite and micro-drone sensor data. Derive vegetation index adjustment factors from synchronized data. Establish a land-use map showing populations of relevant plants. Develop plant-specific regression models for pollen risk prediction based on the analysis of vegetation index gradients. Derive regression model parameters from data from past years (satellite and pollen flight data archives). Perform digital terrain model reduction to consider height, slope and azimuth of emitting areas. Combination with meteorological data and models for modelling spatio-temporal spreading Generation of plant-specific spatio-temporal pollen early warning maps. Cholera Modelling in southern Africa Perform satellite images acquisition from archives and at ongoing periodic intervals Acquire overlapping Climatic data from non-satellite sources Acquire DEM on the area of study 20/25

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