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Indoor contamination: Impact on international environmental regulatory policy on the flame retardant chemical Hexabromocyclododecane (HBCD)

Summary of the impact

In May 2013 the UN Environment Programme's Stockholm Convention on Persistent Organic Pollutants agreed to ban the widely-used flame retardant Hexabromocyclododecane (HBCD), following evidence that there may be harmful human exposure. Since the Convention came into force in 2004, only 21 compounds have had their use either banned or tightly restricted under its terms. Research findings from Stuart Harrad and his group at the University of Birmingham formed a significant element of the case used to support the ban on HBCD. Harrad's group provided the first measurements made anywhere in the world on concentrations of individual HBCD isomers in indoor dust leading to the realisation that the ingestion of indoor dust was a significant pathway of human exposure to HBCD. The group has also contributed important evidence of the capacity of HBCD to bioaccumulate and of its environmental persistence.

Submitting Institution

University of Birmingham

Unit of Assessment

Earth Systems and Environmental Sciences

Summary Impact Type

Environmental

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

S: Progesterone receptor modulators are effective in emergency contraception and therapy of heavy menstrual bleeding/fibroids

Summary of the impact

Impact: Health and wellbeing; commerce; studies and clinical trials of the effects of progesterone receptor modulators (PRMs) underpinned their application for the benefit of women of childbearing age.

Significance: UoE studies underpinned the application of PRMs as emergency contraception including over-the-counter availability and the treatment of heavy menstrual bleeding (HMB); changed clinical guidelines; influenced Pharma R&D.

Beneficiaries: Women of reproductive age; the NHS and healthcare delivery organisations; pharmaceutical companies.

Attribution: Studies were conducted by Critchley, Baird and colleagues (UoE).

Reach: Worldwide; annually 4M women seek emergency contraception in the USA, and in the UK 1M women seek help for HMB. Drugs targeting the PR are licenced in 67 countries. Multiple global Pharma are active in the field of PRM biology.

Submitting Institution

University of Edinburgh

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Paediatrics and Reproductive Medicine

H: Ovarian cryopreservation can restore fertility in women following cancer treatment that would otherwise irreversibly deny them children

Summary of the impact

Impact: Health and welfare; policy and guidelines. Anderson and colleagues demonstrated that cryopreservation of ovarian tissue could be used for preservation of fertility following cancer therapy. This step-change has been incorporated into guideline documents internationally and has been adopted into clinical practice world-wide.

Significance: Ovarian tissue has been preserved from many hundreds of women; this is now translating into a growing number of babies born worldwide (currently 24 in nine countries).

Beneficiaries: Women at risk of fertility loss including pre-pubertal girls newly diagnosed with cancer; clinicians; the NHS and healthcare delivery organisations.

Attribution: The underpinning research was performed entirely at UoE.

Reach: Worldwide: UK, Europe, US, Australia.

Submitting Institution

University of Edinburgh

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Oncology and Carcinogenesis, Paediatrics and Reproductive Medicine

G: Diagnosis from gene discovery – developmental disorders of eye, brain, nerve and skeleton

Summary of the impact

Impact: Health and welfare; policy and guidelines; public engagement. The identification of >20 genes linked to human developmental and childhood degenerative disorders.

Significance: Definitive diagnosis is essential for genetic counselling, prenatal screening and postnatal management.

Beneficiaries: People with developmental disorders and their families, prospective parents, the NHS and healthcare delivery organisations; public understanding of genetic disorders.

Attribution: Researchers from UoE identified/characterised all the genes described, and their mutation in disease.

Reach: Worldwide: these developmental disorders affect thousands of people. Genetic tests established as a result of the research are provided for people from 35 countries on all continents.

Submitting Institution

University of Edinburgh

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Biological Sciences: Genetics
Medical and Health Sciences: Neurosciences

Development of a Rational Framework to Evaluate the Toxicity of Drugs and Chemicals in Food and the Environment.

Summary of the impact

The safety assessment of drugs and other chemicals relies upon studies in experimental animals. Whilst these are useful surrogates, extrapolation to humans requires several assumptions. Professor Boobis led an international group under the auspices of the World Health Organisation (WHO), to develop a framework for the systematic and transparent assessment of such experimental data. Within this framework, the toxicological effect of a chemical is broken down into a series of intermediate steps, comprising a mode of action. This enables qualitative and quantitative comparison between experimental animals and humans. The framework has impacted on risk assessment policy both nationally and internationally, on product development, and on risk assessments of combined exposure to chemicals.

Submitting Institution

Imperial College London

Unit of Assessment

Clinical Medicine

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Pharmacology and Pharmaceutical Sciences

Influencing national and international health policies on early life nutrition.

Summary of the impact

Research at the University of Nottingham (UoN) has had influence on development of health policy in the UK and internationally. It is recognised that the risk of diseases related to obesity and insulin resistance, is partly determined by the nutritional environment experienced during early life. Against a background of scepticism researchers at the UoN have generated data that has been critical in demonstrating the biological plausibility of such associations. This has influenced expert panels and non-governmental organisations in framing their current recommendations for nutrition in pregnancy and infancy, which benefit women and children worldwide.

Submitting Institution

University of Nottingham

Unit of Assessment

Agriculture, Veterinary and Food Science

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Paediatrics and Reproductive Medicine, Public Health and Health Services

Antiepileptic Drug (AED) Safety in Pregnancy - epidemiological surveillance of congenital anomalies (birth defects)

Summary of the impact

(1) Enhancing the awareness of (i) women of childbearing age suffering from epilepsy and prescribed new and/or older generation AEDs, and (ii) their healthcare professionals. Empowering both to make informed decisions through evidence-based practice that will reduce/prevent the risk of harm to unborn children potentially exposed to AEDs in early pregnancy.

(2) A change in the process by which GlaxoSmithKline (GSK) practices post-marketing epidemiological surveillance of the new generation AED `lamotrigine' in pregnancy.

(3) Benefit to the methodological practice of other researchers in Europe involved with AEDs and epidemiological surveillance

(4) Contribution to building European system for reproductive safety evaluation

Submitting Institution

University of Ulster

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

H: Identification of transmission risk of variant Creutzfeldt-Jakob disease (vCJD) via blood and blood products defines critical changes to health policy

Summary of the impact

Impact: Changed public health policy by quantifying the level of asymptomatic vCJD infection in the population and the mechanism of its transmission, and by identifying cases of human-human transmission of vCJD via blood products.

Significance: UoE work informed the public and policy-makers of the risk of vCJD transmission, which resulted in policy changes and the implementation of precautions to prevent vCJD transmission and to limit the chance of a self-sustaining blood- or tissue-contamination-related secondary epidemic.

Beneficiaries: Patients, the NHS and healthcare delivery organisations, government, policy-makers.

Attribution: The work was carried out at UoE in the National Creutzfeldt-Jakob Disease Research and Surveillance Unit (NCJDRSU) and the Roslin Institute UoE (Roslin) with UK collaborators.

Reach: International, particularly UK and North America.

Submitting Institution

University of Edinburgh

Unit of Assessment

Psychology, Psychiatry and Neuroscience

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Medical Microbiology, Neurosciences

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