Scientific publications
Publications from the ATHLETE project explore a wide range of environmental exposures – including urban, chemical, lifestyle, and social risk factors – during pregnancy, childhood, and adolescence. The research examines how these early-life exposures shape biological responses and influence cardiometabolic, respiratory, and mental health in children.
Browse ATHLETE’s publications by category:
- Full exposome and child health
- Chemical Exposome and child health
- Urban exposome and child health
- Determinants, trends, and sources of the exposome
- Omics signatures related to the exposome
- Reviews, evidence synthesis, impact assessment
- Statistical methods
- Data infrastructure and federated data analysis
- Other biomarkers and child health outcomes
Full exposome and child health
- Guimbaud JB et al. (2024). Machine learning-based health environmental-clinical risk scores in European children. Communications Medicine 4(98).
- Amine I et al. (2023). Environmental exposures in early-life and general health in childhood. Environmental Health 22(53).
- Cáceres A et al. (2023). Prenatal environmental exposures associated with sex differences in childhood obesity and neurodevelopment. BMC Medicine 21(142).
Chemical Exposome and child health
1. Pregnancy and birth outcomes
- Knox B et al. (2024). Prenatal exposure to per- and polyfluoroalkyl substances, fetoplacental hemodynamics, and fetal growth. Environment International 193:109090.
- Jovanovic N et al. (2024). Associations between synthetic phenols, phthalates, and placental growth/function: a longitudinal cohort with exposure assessment in early pregnancy. Human Reproduction Open 2024(2):hoae018.
- van den Dries et al. (2021). Prenatal Exposure to Nonpersistent Chemical Mixtures and Fetal Growth: A Population-Based Study. Environmental Health Perspectives 129(11).
- Santos S et al. (2021). Maternal phthalate urine concentrations, fetal growth and adverse birth outcomes. A population-based prospective cohort study. Environment International 151: 106443.
- Sol CM et al. (2021). Maternal bisphenol urine concentrations, fetal growth and adverse birth outcomes: A population-based prospective cohort. Environmental Health 20(1).
2. Cardiometabolic health & puberty
- Guil-Oumrait N et al. (2024). Prenatal Exposure to Chemical Mixtures and Metabolic Syndrome Risk in Children. JAMA Netw Open 7(5):e2412040.
- Freire C et al. (2024). Association of prenatal exposure to phthalates and synthetic phenols with pubertal development in three European cohorts. International Journal of Hygiene and Environmental Health 261:114418.
- Montazeri P et al. (2023). Prenatal Exposure to Multiple Endocrine-Disrupting Chemicals and Childhood BMI Trajectories in the INMA Cohort Study. Environmental Health Perspectives 131(10).
- Rouxel E et al. (2023). Prenatal exposure to multiple persistent organic pollutants in association with adiposity markers and blood pressure in preadolescents. Environment International 178:108056.
- Cano-Sancho G et al. (2023). Nutritional Modulation of Associations between Prenatal Exposure to Persistent Organic Pollutants and Childhood Obesity: A Prospective Cohort Study. Environmental Health Perspectives 131(3).
- Blaauwendraad SM et al. (2023). Fetal Organophosphate Pesticide Exposure and Child Adiposity Measures at 10 Years of Age in the General Dutch Population. Environmental Health Perspectives 131(8).
- Guil-Oumrait N et al. (2022). Prenatal exposure to mixtures of phthalates and phenols and body mass index and blood pressure in Spanish preadolescents. Environment International 169: 107527.
- Sol CM et al. (2020). Associations of maternal phthalate and bisphenol urine concentrations during pregnancy with childhood blood pressure in a population-based prospective cohort study. Environment International 138: 105677.
- Sol CM et al. (2020). Fetal exposure to phthalates and bisphenols and childhood general and organ fat. A population-based prospective cohort study. International Journal of Obesity 44(11): 3070565.
- Sol CM et al. (2020). Fetal phthalates and bisphenols and childhood lipid and glucose metabolism. A population-based prospective cohort study. Environment International 144: 106063.
- Stratakis N et al. (2020). Association of Fish Consumption and Mercury Exposure During Pregnancy with Metabolic Health and Inflammatory Biomarkers in Children. JAMA Netw Open 3(3): e201007.
3. Neurodevelopment
- Brennan Kearns P et al. (2024). Association of exposure to mixture of chemicals during pregnancy with cognitive abilities and fine motor function of children. Environment International 185:108490.
- Sarzo B et al. (2024). The impact of prenatal mercury on neurobehavioral functioning longitudinally assessed from a young age to pre-adolescence in a Spanish birth cohort. Environmental Research 118954.
- Ghassabian A et al. (2023). Prenatal exposure to common plasticizers: a longitudinal study on phthalates, brain volumetric measures, and IQ in youth. Molecular Psychiatry 28:4814-4822.
- Notario-Barandiaran L et al. (2023). Latent Childhood Exposure to Mixtures of Metals and Neurodevelopmental Outcomes in 4–5-Year-Old Children Living in Spain. Exposure and Health.
- Sprong C et al. (2023). A case study of neurodevelopmental risks from combined exposures to lead, methyl-mercury, inorganic arsenic, polychlorinated biphenyls, polybrominated diphenyl ethers and fluoride. International Journal of Hygiene and Environmental Health 251:114167.
- Soler-Blasco R et al. (2023). Genetic Susceptibility to Neurotoxicity Related to Prenatal Inorganic Arsenic Exposure in Young Spanish Children. Environ Sci Technol 57:15366−15378.
- Chatterjee M et al. (2022). Cadmium exposures and deteriorations of cognitive abilities: estimation of a reference dose for mixture risk assessments based on a systematic review and confidence rating. Environmental Health 21(69).
- de Leeuw V et al. (2022). Neuronal differentiation pathways and compound-induced developmental neurotoxicity in the human neural progenitor cell test (hNPT) revealed by RNA-seq. Chemosphere 304: 135298.
4. Respiratory health and allergies
- Karramass T et al. (2023). Bisphenol and phthalate exposure during pregnancy and the development of childhood lung function and asthma. The Generation R Study. Environmental Pollution 332:121853.
- Abellan A et al. (2022). In utero exposure to bisphenols and asthma, wheeze, and lung function in school-age children: a prospective meta-analysis of 8 European birth cohorts. Environment International 162: 107178.
- Maritano S et al. (2022). Maternal pesticides exposure in pregnancy and the risk of wheezing in infancy: A prospective cohort study. Environment International 163: 107229.
- Lemire P et al. (2022). Association between household cleaning product profiles evaluated by the Ménag’Score® index and asthma symptoms among women from the SEPAGES cohort. International Archives of Occupational and Environmental Health 95.
5. Multi-outcome
- Amine I et al. (2025). Early-life exposure to mixtures of endocrine-disrupting chemicals and a multi-domain health score in preschool children. Environmental Research 272:121172.
Urban exposome and child health
1. Pregnancy and birth outcomes
- Cadman T et al. (2024). Urban environment in pregnancy and postpartum depression: An individual participant data meta-analysis of 12 European birth cohorts. Environment International 185:108453.
- Essers E et al. (2024). Ambient air temperature exposure and foetal size and growth in three European birth cohorts. Environment International 186:108619.
2. Cardiometabolic health
- Gonçalves Soares A et al. (2024). Prenatal Urban Environment and Blood Pressure Trajectories From Childhood to Early Adulthood. JACC: Advances 3(2).
3. Neurodevelopment
- Essers E et al. (2025). Temperature Exposure and Psychiatric Symptoms in Adolescents From 2 European Birth Cohorts. JAMA Netw Open 8(1):e2456898.
- Binter AC et al. (2024). Urban environment during pregnancy and childhood and white matter microstructure in preadolescence in two European birth cohorts. Environmental Pollution 346.
- Binter AC et al. (2024). Urban environment during pregnancy, cognitive abilities, motor function, and externalizing and internalizing symptoms at 2–5 years old in 3 Canadian birth cohorts. Environment International 195:109222.
- Kusters MSW et al. (2024). Residential ambient air pollution exposure and the development of white matter microstructure throughout adolescence. Environmental Research 262:119828.
- Crooijmans K et al. (2024). Nitrogen dioxide exposure, attentional function, and working memory in children from 4 to 8 years: Periods of susceptibility from pregnancy to childhood. Environment International 186.
- Fernandes A et al. (2023). Availability, accessibility, and use of green spaces and cognitive development in primary school children. Environmental Pollution 334:122143.
4. Respiratory health
- Abellan A et al. (2024). Urban environment during pregnancy and lung function, wheezing, and asthma in school-age children. The generation R study. Environmental Pollution 344:123345.
- Guillien A et al. (2023). Associations between combined urban and lifestyle factors and respiratory health in European children. Environmental Research 242:117774.
- Marsal A et al. (2023). Prenatal Exposure to PM 2.5 Oxidative Potential and Lung Function in Infants and Preschool-Age Children: A Prospective Study. Environmental Health Perspectives, 131.1:017004.
- Lepeule J et al. (2023). Pre-natal exposure to NO2 and PM2. 5 and newborn lung function: An approach based on repeated personal exposure measurements. Environmental Research 2023;226:115656.
5. Multi-outcome
- Fernandes A et al. (2024). Green spaces and respiratory, cardiometabolic, and neurodevelopmental outcomes: An individual-participant data meta-analysis of >35.000 European children. Environment International 190:108853..
Social and lifestyle exposome and child health
- Warkentin S et al. (2024). Dietary patterns among European children and their association with adiposity-related outcomes: a multi-country study. International Journal of Obesity.
- González L et al. (2024). Socioeconomic position, family context, and child cognitive development. European Journal of Pediatrics.
- Notario-Barandiaran L et al. (2023). Association between Mediterranean diet and metal(loid) exposure in 4-5-year-old children living in Spain. Environmental Research 233:116508.
- Descarpentrie A et al. (2023). Lifestyle patterns in European preschoolers: Associations with socio-demographic factors and body mass index. Pediatr Obes 18:e13079.
Determinants, trends and sources of the exposome
- Samuelsson K et al. (2025). A comprehensive GPS-based analysis of activity spaces in early and late pregnancy using the ActMAP framework. Health & Place 91:103413.
- Pizzi C et al. (2024). Socioeconomic position during pregnancy and pre-school exposome in children from eight European birth cohort studies. Social Science & Medicine 359:117275.
- Moccia L et al. (2023). Modelling socioeconomic position as a driver of the exposome in the first 18 months of life of the NINFEA birth cohort children. Environment International 173:107864.
- Cserbik D et al. (2023). Concentrations of per- and polyfluoroalkyl substances (PFAS) in paired tap water and blood samples during pregnancy. J Expo Sci Environ Epidemiol.
- Lopez-Gonzalez U et al. (2023). Exposure to mercury among Spanish adolescents: Eleven years of follow-up. Environmental Research 231(Pt 2):116204.
Omics signatures related to the exposome
1. Multi-omics
- Stratakis N et al. (2025). Multi-omics architecture of childhood obesity and metabolic dysfunction uncovers biological pathways and prenatal determinants. Nature Communications 16:654.
- Maitre L et al. (2023). Integrating -omics approaches into population-based studies of endocrine disrupting chemicals: A scoping review. Environmental Research 228:115788.
- Fabbri L et al. (2023). Childhood exposure to non-persistent endocrine disrupting chemicals and multi-omic profiles: A panel study. Environment International 173:107856.
- Maitre L et al. (2022). Multi-omics signatures of the human early life exposome. Nature Communications 13:7024.
- Cosin-Tomas M et al. (2022). Prenatal Maternal Smoke, DNA Methylation, and Multi-omics of Tissues and Child Health. Current Environmental Health Reports 9: 502-512.
- Gallego-Paüls M et al. (2021). Variability of multi-omics profiles in a population-based child cohort. BMC Medicine 19 (1).
- Vives-Usano M et al. (2020). In utero and childhood exposure to tobacco smoke and multi-layer molecular signatures in children. BMC Medicine 18 (1).
2. Metabolomics
- Balcells C et al. (2023). Blurred lines: Crossing the boundaries between the chemical exposome and the metabolome. Current Opinion in Chemical Biology 78:102407.
- Stratakis N et al. (2022). Urinary metabolic biomarkers of diet quality in European children are associated with metabolic health. eLife 11:e71332.
3. Epigenetics
- Llauradó-Pont J et al. (2025). A meta-analysis of epigenome-wide association studies of ultra-processed food consumption with DNA methylation in European children. Clin Epigenet 17(3).
- Aguilar-Lacasaña S et al. (2024). Green space exposure and blood DNA methylation at birth and in childhood – A multi-cohort study. Environment International 188:108684.
- Isaevska E et al. (2022). Prenatal exposure to PM10 and changes in DNA methylation and telomere length in cord blood. Environmental Research 209: 112717.
- Carreras-Gallo N et al. (2022). The early-life exposome modulates the effect of polymorphic inversions on DNA methylation. Communications Biology 455(2022).
- Wang C et al. (2022). Genetic regulation of newborn telomere length is mediated and modified by DNA methylation. Frontiers in Genetics 13:934277.
- Ruiz-Arenas C et al. (2022). Identification of autosomal cis expression quantitative trait methylation (cis eQTMs) in children’s blood. eLife 11:e65310.
- Lozano M et al. (2021). DNA methylation changes associated with prenatal mercury exposure: A meta-analysis of prospective cohort studies from PACE consortium. Environmental Research 204:112093.
4. Biological aging
- Wang C et al. (2025). The multi-omics signatures of telomere length in childhood. BMC Genomics 26(1):75.
- Lozano et al. (2024). Early life exposure to mercury and relationships with telomere length and mitochondrial DNA content in European children. Science of the Total Environment 932:173014.
- Marques I et al. (2023). Associations of green and blue space exposure in pregnancy with epigenetic gestational age acceleration. Epigenetics 18(1):2165321.
- Robinson O et al. (2023). Associations of four biological age markers with child development: A multi-omic analysis in the European HELIX cohort. eLife 12:e85104.
- Prado-Bert P et al. (2021). The early-life exposome and epigenetic age acceleration in children. Environment International 155.
5. Proteins
- de Prado-Bert P et al. (2022). Short- and medium-term air pollution exposure, plasmatic protein levels and blood pressure in children. Environmental Research 2011:113109.
6. Microbiome
- Shah SN et al. (2024). Cerebrovascular damage caused by the gut microbe/host co-metabolite p-cresol sulfate is prevented by blockade of the EGF receptor. Gut Microbes 16(1).
- Pérez-Castro S et al. (2024). Influence of perinatal and childhood exposure to tobacco and mercury in children’s gut microbiota. Frontiers in Microbiology 14:1258988.
- Porru S et al. (2024). The effects of heavy metal exposure on brain and gut microbiota: A systematic review of animal studies. Environmental Pollution 348.
- Walker AW et al. (2023). Human microbiome myths and misconceptions. Nature Microbiology 8(8).
- Stachulski AV et al. (2022). A host-gut microbial amino acid co-metabolite, p-cresol glucuronide, promotes blood-brain barrier integrity in vivo. Tissue Barriers e2073175-2.
- Hoyles L et al. (2021). Regulation of blood–brain barrier integrity by microbiome-associated methylamines and cognition by trimethylamine N-oxide. Microbiome 9:235.
- Hu et al. (2021). A population-based study on associations of stool microbiota with atopic diseases in school-age children. The Journal of Allergy and Clinical Immunology 148(2).
7. Genetics
- Bustamante M, Balagué-Dobón L et al. (2024). Common genetic variants associated with urinary phthalate levels in children: A genome-wide study. Environment International 190:108845.
- Dack K et al. (2023). Genome-Wide Association Study of Blood Mercury in European Pregnant Women and Children. genes 14:2123.
- Soler-Blasco R et al. (2023). Influence of genetic polymorphisms on arsenic methylation efficiency during pregnancy: Evidence from a Spanish birth cohort. Science of The Total Environment 900:165740.
- Balagué-Dobón L et al. (2022). Fully exploiting SNP arrays: a systematic review on the tools to extract underlying genomic structure. Briefings in Bioinformatics bbac043.
- Fuentes-Paez G et al. (2022). Study of the Combined Effect of Maternal Tobacco Smoking and Polygenic Risk Scores on Birth Weight and Body Mass Index in Childhood. Frontiers in Genetics 13: 867611.
- Calvo-Serra B et al. (2020). Urinary metabolite quantitative trait loci in children and their interaction with dietary factors. Human Molecular Genetics 29(23).
Reviews, evidence synthesis, impact assessment
- Colzin S et al. (2024). A plausibility database summarizing the level of evidence regarding the hazards induced by the exposome on children health. International Journal of Hygiene and Environmental Health 256:114311.
- Wies B et al. (2024). Urban environment and children’s health: An umbrella review of exposure response functions for health impact assessment. Environmental Research 263:120084.
- Rocabois A et al. (2024) Chemical exposome and children health: identification of dose-response relationships from meta-analyses and epidemiological studies. Environmental Research 119811.
- Fernandes A et al. (2023). School‐Based Interventions to Support Healthy Indoor and Outdoor Environments for Children: A Systematic Review. International Journal of Environmental Research and Public Health 20(3):1746.
- Yang T et al. (2023). Interventions to Reduce Exposure to Synthetic Phenols and Phthalates from Dietary Intake and Personal Care Products: a Scoping Review. Current Environmental Health Reports.
- Guillien A et al. (2023). The exposome concept: how has it changed our understanding of environmental causes of chronic respiratory diseases? Breathe 19(2):230044.
- Vrijheid M et al. (2021). Advancing tools for human early life-course exposome research and translation (ATHLETE) – project overview. Environmental Epidemiology 5: e166.
Statistical methods
- Goodrich J A et al. (2024). Integrating Multi-Omics with environmental data for precision health: A novel analytic framework and case study on prenatal mercury induced childhood fatty liver disease. Environment International 190:108930.
- Anguita-Ruiz A et al. (2023). Beyond the single-outcome approach: A comparison of outcome-wide analysis methods for exposome research. Environment International 182:108344.
- Warembourg C et al. (2023). Statistical Approaches to Study Exposome-Health Associations in the Context of Repeated Exposure Data: A Simulation Study. Environ. Sci. Technol.
- Babin E et al. (2023). A review of statistical strategies to integrate biomarkers of chemical exposure with biomarkers of effect applied in omic-scale environmental epidemiology. Environmental Pollution 330: 121741.
- Maitre L et al. (2022). State-of-the-art methods for exposure-health studies: Results from the exposome data challenge event. Environment International 168: 107422.
- Guillien A et al. (2021). The Exposome Approach to Decipher the Role of Multiple Environmental and Lifestyle Determinants in Asthma. International Journal of Environmental Research and Public Health 18 (3).
- Cadiou S et al. (2021). Performance of approaches relying on multidimensional intermediary data to decipher causal relationships between the exposome and health: A simulation study under various causal structures. Environment International 153: 106509.
- Escriba-Montagut X et al. (2021). Software Application Profile: exposomeShiny: a Toolbox for exposome data analysis. International Journal of Epidemiology dyab220.
- Santos S et al. (2020). Applying the exposome concept in birth cohort research: a review of statistical approaches. European Journal of Epidemiology 35 (3): 193–204.
Data infrastructure and federated data analysis
- Cadman T et al. (2024). MOLGENIS Armadillo: a lightweight server for federated analysis using DataSHIELD. Bioinformatics.
- Escriba-Montagut X et al. (2024). Federated privacy-protected meta- and mega-omics data analysis in multi-center studies with a fully open-source analytic platform. PLOS Computational Biology 20(12): e1012626.
- Schmitt CP et al. (2023). A roadmap to advance exposomics through federation of data. Exposome 3(1).
- Avraam D et al. (2022). A deterministic approach for protecting privacy in sensitive personal data. BMC Medical Informatics and Decision Making 22 (24).
- Swertz M et al. (2022). Towards an Interoperable Ecosystem of Research Cohort and Real-world Data Catalogues Enabling Multi-center Studies. Yearbook of Medical Informatics 31(01):262-272.
- Escribà-Montagut X et al. (2022). Software Application Profile: ShinyDataSHIELD—an R Shiny application to perform federated non-disclosive data analysis in multicohort studies. International Journal of Epidemiology dyac201.
- Marcon Y et al. (2021). Orchestrating privacy-protected big data analyses of data from different resources with R and DataSHIELD. PLOS Computational Biology 17(3): e1008880.
- Avraam D et al. (2021). Privacy preserving data visualizations. EPJ Data Science 10(2).
Other biomarkers and child health outcomes
- Wu T et al. (2024). Abdominal fat and risk of impaired lung function and asthma in children: A population-based prospective cohort study. Pediatric Allergy and Immunology 35(2):e14079.
- Wu T et al. (2024). Body composition and respiratory outcomes in children: a population-based prospective cohort study. Thorax 79(5).
- Gonçalves R et al. (2024). Associations of fetal and infant growth patterns with behavior and cognitive outcomes in early adolescence. JCPP Advances 2024:e12278.
- Gonçalves R et al. (2024). Arterial Health Markers in Relation to Behavior and Cognitive Outcomes at School Age. Journal of the American Heart Association 13:e029771.
- Dypas L B et al. (2023). Blood miRNA levels associated with ADHD traits in children across six European birth cohorts. BMC Psychiatry 23:696.
- Quezada-Pinedo HG et al. (2023). Maternal hemoglobin and iron status in early pregnancy and risk of respiratory tract infections in childhood: A population-based prospective cohort study. Pediatric Allergy and Immunology 34(9):e14025.
- Quezada-Pinedo HG et al. (2022). Maternal iron status in early pregnancy and childhood body fat measures and cardiometabolic risk factors: A population-based prospective cohort. The American Journal of Clinical Nutrition 117(1):191-198.
- Blaauwendraad SM et al. (2022). Associations of Early Pregnancy Metabolite Profiles with Gestational Blood Pressure Development. Metabolites 12(12).
- Mensink-Bout SM et al. (2022). Associations of physical condition with lung function and asthma in adolescents from the general population. Pediatric Allergy and Immunology 33(6).
- Wiertsema CJ et al. (2021). First trimester fetal proportion volumetric measurements using a Virtual Reality approach. Prenatal Diagnosis 41(7): 868-876.
- Quezada-Pinedo HG et al. (2021). Maternal Iron Status in Pregnancy and Child Health Outcomes after Birth: A Systematic Review and Meta-Analysis. Nutrients 13(7).
- Mensink-Bout SM et al. (2020). Associations of Plasma Fatty Acid Patterns during Pregnancy with Respiratory and Allergy Outcomes at School Age. Nutrients 12(10): 3057.