Maintaining the highest possible level of public health protection, especially for an ageing population, is a key challenge for Europe in the changing global socio-economic landscape. Effective public health policies need to address a wide variety of complex issues, ranging from individual lifestyle choices to environmental exposure factors, as well as the affordability of medical and health-care facilities. There is a need for more coordinated efforts in the EU, both in the drive towards prevention of illnesses as well as in the harmonisation of procedures and promotion of best practices in diagnosis and treatment of illnesses.
The EU complements health actions conducted at national levels. This consists mainly of protecting people from health threats and disease, promoting healthy lifestyles and helping national authorities in the EU cooperate on health issues. The rise in various types of diseases, such as obesity, type II diabetes, cancer, or cardiovascular disorders presents particular challenges and would benefit from more coordinated approach both in tackling the underlying causes and in finding the most effective treatments.
JRC scientists are successfully developing new expertise to tackle these challenges. Activities address cancer and rare diseases, nutrition and healthy ageing, as well as behavioural science to find more effective solutions to tackling the health burden imposed by individual choice of diet and lifestyle.
They monitor emerging public health threats and they investigate daily environmental factors impacting on health. Drawing on a longstanding experience, they develop methods and tools to assess risks related to indoor air quality, chemicals (including pesticides and biocides) and environmental noise. All this is done in close collaboration with other European Commission services, relevant national organisations, the World Health Organisation (WHO) and other stakeholders.
Reliable, comparable, high-quality data and indicators on cancer are a key driver for improving prevention programmes and to evaluate efficacy of control and care processes across the EU. Harmonised cancer data is also an invaluable resource for cancer epidemiology, allowing greater understanding of the differences and related causes in population-based studies across regional and national boundaries. The JRC is spearheading the development of a harmonised cancer information system for Europe in collaboration with the European Network of Cancer Registries (ENCR) and important stakeholders, such as the International Agency for Research on Cancer (IARC), the EUROCARE group and others. This will generate a dynamic European cancer monitoring tool which will steer and support effective policies on cancer.
The JRC is setting up a European voluntary quality assurance scheme for breast cancer services which encompasses all breast cancer stages: from the first invitation to a woman for screening to diagnosis, surgery, treatment and post-treatment, including rehabilitation, palliative and psychosocial care. It will be underpinned by the legal frame of accreditation ensuring its consistent application in all countries; placing the woman / patient at the centre of the process and ensuring that appropriate communication and involvement in decisions occur whenever possible. In parallel, the JRC will develop new European Guidelines for Breast Cancer Screening and Diagnosis and create a platform for high-quality guidelines for other stages of care.
Within the EU, any disease affecting fewer than 5 people in 10 000 is considered rare. To date more than 6 000 rare diseases (RD) have been described, which affect approximately 30 million people in the EU. Together with other European Commission services, the JRC is developing the European Platform on Rare Diseases Registration to provide a central access point for information on RD, improve access to patient registries, harmonise data and promote interoperability between registries. The platform will help to build a critical mass of data for epidemiological and clinical trials to increase knowledge on RD, facilitate multidisciplinary research and stimulate networking and collaboration between RD registries and various stakeholders. This will be instrumental to steer EU health policy, plan health and social services for improving the quality of care and the quality of life for people living with a RD.
There is a clear link between eating habits and good health. Healthy nutrition and regular physical activity contribute to reducing the risks of non-communicable diseases such as heart disease, diabetes and certain forms of cancer.
Our nutritionists, behavioural economists and cancer experts work closely on disease prevention, healthier diets, active and healthy ageing, and empowering consumers to make sound nutritional and lifestyle choices.
EU policies on health aim to protect and improve the health of EU citizens and to ensure patient's access to safe and efficient health technologies.
Health technologies have been defined by WHO as "the application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures and systems developed to solve a health problem and improve quality of lives".
Health technologies have become fundamental for modern healthcare. They create a constant stream of new technologies and products with benefits for patients but also jobs, growth, innovation and investment. Innovation in this field needs to be supported by up-to-date scientific evidence of the safety and performance of products, in particular when used under "real-world" conditions once on the EU market.
The JRC actively supports the implementation of EU legislation on medical devices and in vitro diagnostic medical devices. Current focus is the establishment of scientific advisory bodies required under the new legislative framework for medical devices and in vitro diagnostic medical devices which entered into force in May 2017.
These bodies will comprise expert panels for advisory and routine regulatory tasks for certain high risk medical devices, EU reference laboratories (EURLs) for control and advisory tasks in the area of in vitro diagnostics and expert laboratories for providing specific laboratory expertise on medical devices.
Moreover, the JRC:
- performs activities in the area of post-market risk analysis and signal detection,
- provides advice in the area of clinical investigation / evaluation,
- explores the status and challenges of converging technologies and innovation in health products.
In 2017, the EU has adopted two new Regulations on medical devices:
- Regulation (EU) 2017/745 (MDR) of the European Parliament and of the Council on medical devices (MDs), amending Directive 2001/83/EC, Regulation (EC) No 178/2002 and Regulation (EC) No 1223/2009 and repealing Council Directives 90/385/EEC and 93/42/EEC
- Regulation (EU) 2017/746 (IVDR) of the European Parliament and of the Council on in vitro diagnostic medical devices (IVDs) and repealing Directive 98/79/EC and Commission Decision 2010/227/EU.
Both regulations entered into force on 25 May 2017. The new rules will fully apply after a transitional period of 3 years for the MDR (spring 2020) and 5 years (spring 2022) for the IVDR, respectively.
The behavioural economics team works to better understand people's responses to soft (e.g. nudges, prompts, incentives) and hard (e.g. regulation) policy interventions across a range of thematic areas. This work supports EU policies that seek to bring about changes in behaviour.
For example, obesity has become a growing health concern for European children and adolescents. Statistics show that one out of three children in Europe are overweight or obese. Participating in sports or other types of physical activity can help children maintain a balanced weight and prevent health conditions associated with physical inactivity. But what is the best way to motivate young people to exercise more? Recent studies on physical activity in adults have shown that 'social context' has a significant impact.
One of our studies entitled 'Peer Active' looks at the impact of different forms of social incentives (i.e. reciprocity, group cooperation, etc.) in order to ascertain which incentives work best in motivating children to be more active.
Behavioural Economics (BE) essentially studies the effects of social, cognitive and emotional factors on the economic decisions of individuals and institutions and the consequences for market prices, returns, resource allocations and public policy. Using experimental and advanced empirical techniques, BE identifies individual and group behaviours and social phenomena that are not adequately explained by traditional economic analysis. As a result, new models can be developed that are better able to explain 'irrational' economic behaviour. These models draw on the basic principles of game theory and incorporate aspects of emotions, reciprocity, fairness, social capital, bounded rationality, etc. BE is cross-disciplinary by its nature as it combines research findings across a wide range of scientific fields including psychology, sociology, medicine and neuroscience.
Environmental Quality Standards
Environmental Quality Standard (EQS) means the concentration of a particular pollutant or group of pollutants in water, sediment or in all living organisms of a given area, which should not be exceeded in order to protect human health and the environment. The Water Framework Directive describes how and when EQS for pollutants should be developed, and states that pollutants presenting a significant risk to water ecosystems or via water should be identified by the European Commission and classified as priority substances, with the most hazardous of these classified as priority hazardous substances. Since 2006 the JRC has been working on a comprehensive prioritisation scheme for these substances.
The JRC sells and develops suitable reference materials for substances on the priority list in fresh- and seawater and related matrices such as biota and sediment.
Exposure and health impact methodology
Various pieces of EU legislation require that the health impact of being exposed to chemicals and other physical and biological factors is accurately assessed. Analysing the effects of these factors over a sustained period is a highly complex process. The JRC develops methodologies and tools for systematic and standardised assessment of the health impacts of exposure to the chemicals referenced in EU legislation.
Human biomonitoring is an analytical approach which focuses on directly measuring the volume of toxic chemical compounds present in the body. Often, these measurements are done from blood and urine. The way the chemicals accumulate in air, soil or water may be quite different from their behaviour in the human body. Analysis of environmental chemicals in human tissues is the most effective way of knowing which environmental chemicals we should be most wary of. It is an important tool for assessing human exposure to environmental substances and in some cases their potential health risks. It is seen as an essential element in a strategy for environmental health impact assessment. The JRC helps developing a coherent approach to the collection and analysis of this important data.
We are exposed to environmental noise from transport, industrial and recreational activities whether we are at work, at home or outdoors. This can affect both our physical and mental . The JRC supports the EU noise policy with harmonised methods and tools to estimate the exposure level and the related health impacts.
Indoor air quality
We spend most of our time indoors, whether in homes, offices, schools, nurseries, shops or cars. In all these environments building materials and consumer products such as paints, furniture and fittings, printers, cleaning agents etc., can affect indoor air quality. They all emit chemicals, not to mention other environmental pollution caused by humidity or tobacco smoke. Prolonged exposure to any of these could result in a negative impact on health. The JRC, apart from direct research on pollutants' impact on the indoor air quality works towards harmonisation and standardisation of testing methods at the European level.
Medical Information System - MedISys
Internet surveillance systems are routinely used for early event detection, alerting and tracking of emerging public health threats. The Medical Information System (MedISys), developed by the JRC, helps to rapidly identify potential threats to public health. Statistical modelling techniques help to distinguish topics that appear regularly in the news from those that are suddenly reported, meaning that advance warning can be given if a topic of concern arises. Based on MedISys technology, the JRC also contributes to the Early Alerting and Reporting (EAR) project of the Global Health Security Initiative (GHSI).
Reference materials for microbiology and pathogens
The regular occurrence of food borne pathogen related outbreaks in the EU, the ongoing struggle with pathogens in health care and public health as well as the security threat related to the potential misuse of pathogens emphasise the need for an adequate and reliable monitoring system and preparedness against these risks. Consequently the JRC is aiming at maintaining a high level of quality of the measurements which have to be carried out in this context by developing and providing suitable quality assurance tools, such as reference materials, and measurement techniques.
Medical applications of radionuclides and targeted alpha therapy
Novel treatments to treat serious diseases are vital to ensure the health of our citizens. Targeted alpha therapy, also called alpha-immunotherapy, uses radioisotopes in the fight against cancer.