• EcoFoodFertility: a new model for assessing the impact of environmental pollution on human health and improving strategies for primary prevention in the high risk areas

    Ecofoodfertility is a scientific project that has been launched in Campania with the aim of demonstrating a
    science-based link between environment, food and human health.

    A worrying increase in human infertility is underway and its relationships with human exposure to
    environmental pollution is a long-running issue within scientific community worldwide. Several studies
    have investigated the environmental impact on human health, with particular concern for fertility health. In
    most cases, important results in terms of knowledge and risk assessment have been achieved.
    Nonetheless, nobody heretofore has ever thought about the possibility to utilize human sperm as a
    “sensor” to monitor developments in environmental quality. The idea was first conceived by the
    andrologist Luigi Montano, expert in environmental medicine, who works for the local health unit based in
    Salerno. He founded EcoFoodFertility in 2015 and he is still coordinating it. The project has the objective to
    utilize the qualitative and quantitative alterations in sperm parameters as a key to understand both the
    level of environmental quality and its long term modifications. This could help to set out health risks for
    populations in relation with their living environment as well as diet and lifestyle. It involves a research
    network of about fifty people, including doctors, biologists, toxicologists, geneticists, veterinarians,
    engineers, digital experts, epidemiologists, nutritionists, all belonging to several Italian and European
    research institutes (namely CNR, ISS and IZSM) and universities. EcoFoodFertility has indeed a strong One-
    Health oriented nature, as it requires different professional figures working together towards the
    achievement of shared goals. With this respect, Italy can boast a long-standing multidisciplinary approach
    to public health issues, by providing a public healthcare service that engages professionals in different
    disciplines, each contributing with his own expertise to improve people’s well-being.

    The first phase of the project was completed with the publication in the journal Reproductive Toxicology of
    the results of a case-control study performed on two homogeneous groups of clinically healthy male
    volunteers living in two areas of the Italian region named Campania: the first area, so-called “Land of
    Fires”, is located between Naples and Caserta and is characterized by high environmental pressure; the low
    risk area is located in the southern part of the region and is known as “Alto-medio Sele”. Both blood and
    semen samples were collected and tested for heavy metals. The results highlighted some alterations in the
    pattern of chemical elements in both the male groups as well as in the biological matrices. However,
    researchers reported that it still cannot be ascertained whether the different concentrations of trace
    elements directly reflect the environmental exposures, or whether they are a consequence of other factors
    altering the metabolism of essential and non-essential elements. One of the most noteworthy findings was
    rather the evidence of qualitative abnormalities, such as reduced motility and increased DNA damage, in
    the “high risk” group’s spermatozoa when compared with the same “low risk” group’s parameters. A
    significant negative correlation between the percentage of immotile spermatozoa and the level of semen
    redOx markers (TAC and GSH) was observed as well, suggesting that these findings could represent early
    biological indicators of environmental pollution. A lower level of redOx stress markers, along with a lower
    antioxidant enzymes activity, was found in case’s semen, but not in blood. This indicates that, in this study,
    semen appears to respond quicker and more sensitively than blood to environmental pollution.

    Anyway, how do environmental pollutants affect human health? There are some exposure routes to human
    being: air, water, food. The choice of the “Land of fire” as high risk area was not accidental: it covers both
    the northern part of the metropolitan area of Naples and the southern cities in the province of Caserta and
    it is sadly known because of the criminal spillage of toxic and nuclear wastes that has taken place starting
    from the 1970s. Ancient Romans used to celebrate these territories, including Vesuvio volcano and
    Volturno river that used to provide fertile soils to agriculture, an extensive area that Plinio il Vecchio
    notoriously renamed Campania felix. Some of these lands have been silently and slowly contaminated
    owing to both intense anthropic pressure and illegal disposal of toxic waste. Soil remediation is going to
    require extremely costly and long-lasting efforts. The consequences are quite visible on the health of
    humans and animals inhabiting these territories, therefore the urge to provide a scientific basis for the
    association between exposure to environmental pollutants and staggering increase in chronic-degenerative

    The research above mentioned has been presented as pilot study, opening the doors to the next phase of
    EcoFoodFertility, that is working to implement educational and prevention initiatives. The objective is to
    encourage people to adopt healthy lifestyles in order to address the detrimental impact of a compromised
    living environment. From a preventive perspective, it must be stressed that food has a modulatory effect
    on bioaccumulation of xenobiotic compounds into the organism. Food has gained the twofold significance
    of either vehicle of contaminants, or key instrument for disease prevention, based on its nutritional
    composition. It is thus undisputed that a healthy life-style should embrace a diet rich in functional and
    detoxifying ingredients, such as vegetables, representing the main source of antioxidants, required to
    inactivate the reactive oxygen species, and to prevent oxidative stress conditions in biological cells and

    EcoFoodFertility recognises male fertility as an important health indicator. Due to some cultural
    backgrounds, men usually tend to underestimate the possibility that their own reproductive capability may
    be altered over the time as a result of external factors. However, it must be pointed out that reproductive
    function is not only referred to genotoxic xenobiotics or endocrine disruptors that may affect germ cell’s
    integrity and functionality, but also to heritable genetic and epigenetic alterations. It is therefore important
    to address properly the challenge of pollution, by urgently implementing environmental rehabilitation
    programmes. The project deals not only with risk evaluation, but also with risk communication and
    management which requires integrated action, covering as environmental emissions as food chains and
    individual life-styles.

    So far EcoFoodFertility has been experiencing a broad media attention, and it has been extended to other
    critical areas in Italy and in EU; recently, Italian Ministry of Health has funded part of the project on three
    pilot areas (Brescia-Caffaro, Sacco Valley and Land of Fires). The project’s success is undoubtedly aided by
    the fact that EU policies are agriculturally and environmentally minded all along. The preliminary results are
    encouraging, especially since public support participation serve as an incentive to build up a strong
    environmental consciousness, an ultimate condition in order to preserve the health and well-being of the
    environment, as well as present and future generations.







    Bergamo P., Volpe M.G., Lorenzetti S., Mantovani A., Notari T., Cocca E., Cerullo S., Di Stasio M., Cerino P.,
    Montano L., Human semen as an early, sensitive biomarker of highly polluted living environment in healthy
    men: A pilot biomonitoring study on trace elements in blood and semen and their relationship with sperm
    quality and RedOx status. Reproductive Toxicology, 66 (2016), pp. 1-9.
    Vecoli, C., Montano, L. & Andreassi, M.G., Environmental pollutants: genetic damage and epigenetic
    changes in male germ cells. Environmental Science and Pollution Research, (2016) 23: 23339.
    Montano L., Notari T., Raimondo S., Bergamo P., Rossi M., Luongo D., Volpe M.G., Iannuzzi L., Evaluation
    of Environmental Impact on Sperm DNA integrity by Sperm Chromatin Dispersion Test ad p53 Elisa:
    Preliminary data. (EcoFoodFertility Project). Reproductive Toxicology. Vol. 56: 20, 2015.
    Montano L., Iannuzzi L., Rubes J., Avolio C., Pistos C., Gatti S., Raimondo S., Notari T., EcoFoodFertility –
    Environmental and food impact assessment on male reproductive function. Andrology 2(Suppl.2):69, 2014.

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