Author: Justine De Leus

        

In Georgia, the dedicated core team of the Center for Allergy and Immunlogy Research (CAIR) – Maia Gotua MD.PhD., Tamar Abramidze PhD., Maia Rukhadze MD. PhD. – has made impressive progress over the past six months together with the participating pilot schools, turning science into action for public health.

As part of SynAir-G, CAIR aims to uncover how daily exposure to air pollutants affects children’s lung function, wellbeing, and long-term health, and to generate solutions that empower schools, families, and policymakers to create healthier environments.

In the last six months, the CAIR team successfully engaged 133 children aged 8–9 years from five schools in Tbilisi. Each child and their family became active contributors to this important research — helping us capture valuable data on how air quality influences health.

Comprehensive health checks were carried out, including measurements of height and weight, lung function testing (using spirometry and FeNO), and completion of Pediatric Quality of Life surveys by the children. In addition, the CAIR team provided Garmin wearables and home spirometers to help continuously track the children’s physical activity, respiratory health, and exposure to air pollution over time. Students from the five schools also took part by exploring the educational, gamified mobile app Save the World, developed as part of the SynAir-G project. Indoor pollution is continuously monitored through the installation of environmental sensors in schools as well as by collecting environmental samples, such as dust, for more detailed analysis. To support overall data collection – including app usage and device functionality – the CAIR team maintains regular communication with the families.

                               

Despite challenges like delayed recruitment, technical device issues, and difficulties in maintaining long-term participant engagement, CAIR overcame these obstacles through strong partnerships and ongoing communication with schools and parents, making significant progress toward cleaner indoor environments and improving children’s health.

The data collected will help understand how air quality directly impacts lung function in school-aged children, inform public health policies and school interventions and raise awareness among families and communities about the invisible risks of air pollution. Continue to follow the work of Synair-G and CAIR as we continue to turn data into action, science into solutions, and challenges into progress!

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At the 2025 BEYOND Expo in Athens, CyRIC presented their ongoing work under SynAir-G on developing an integrated multi-sensor system for indoor air quality (IAQ) monitoring, highlighting their Internet of Things (IoT) solutions, which play a key role in enabling seamless system integration. 

By developing a real-time air quality monitoring system, the SynAir-G project helps addressing the urgent issue of air pollution with a focus on monitoring IAQ in classrooms and protecting children’s health, supporting the creation of effective interventions and policies. As a key SynAir-G partner, CyRIC contributes to both the technical development and the deployment strategy of the project’s air quality assessment system for schools.

At the event, CyRIC presented early field insights on IAQ sensing from 5 pilot countries in SynAir-G (Greece, France, Finland, Georgia and the UK), connecting stakeholders across research, policy, and innovation. As part of the SynAir-G project, CyRIC provided commercial IAQ sensors, which were installed in a school in Greece to support the collection of detailed exposure data. Based on the pilot run in Greece, more pilot sites will be set up in other schools of the project. The sensors measure a range of pollutants, including PM2.5, PM10, and Total Volatile Organic Compounds (TVOCs), as well as other indoor air quality parameters such as temperature, humidity, carbon dioxide (CO₂), illumination, and barometric pressure.

CyRIC’s presence at the event underscores their commitment to the SynAir-G project and their mission to deliver smart and sustainable solutions for a healthier environment for children and beyond.

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SynAir-G proudly presented updates on its work at the 2025 EAACI congress in Glasgow from 13 to 16 June. Next to presenting some preliminary results of the project, an internal meeting with the whole SynAir-G consortium was held to discuss ongoing work and future steps in the project.

Lecturer on early asthma triggers by SynAir-G coordinator Prof. Nikos Papadopoulos
Prof. Nikos Papadopoulos delivered a keynote lecture on “Asthma beginnings: Unraveling the early triggers.” Among other topics, the presentation emphasized the scope of the SynAir-G project in analyzing the effects of indoor air pollutants on children and its relevance to the early onset of childhood asthma.

Presentation on SynAir-G research on asthma biomarkers by Prof. Vicky Xepapadaki from NKUA
An insightful presentation was given by Prof. Vicky Xepapadaki on the ongoing SynAir-G study on “The Impact of Inflammatory Determinants on FeNO Levels in School-Aged Children in Greece.” Her presentation showcased important findings on airway inflammation biomarkers and how they are affected by environmental exposure in children participating in the Greek cohort in SynAir-G.

Updates on two ongoing studies under SynAir-G by Maria Kritikou from NKUA
Maria Kritikou presented on the ongoing research on “The Impact of Obesity on Pulmonary Function in School-Aged Children in Attica: Findings from the SynAir-G Study in Greece”, where she shared insights from the SynAir-G cohort on the association between an increased BMI and respiratory health.

Further, she presented the Save the World application developed under SynAir-G. Her presentation titled “Save the World – SynAir-G: Evaluation of Internal Reliability of an Innovative Application for Student Health Data Collection” introduced this digital health application, which is used by school-aged children to collect health data under the project. This presentation received first prize in the thematic poster session on Asthma, recognizing the project’s innovative contribution to research in lung health in children.

SynAir-G Consortium Meeting
An internal meeting of the SynAir-G consortium took place at the EAACI congress on 14 June with active participation from partners including GA²LEN, EFA, NKUA, CHUM, CAIR, UMAN, UTU, SIAF, and AUTH. It was an excellent opportunity to exchange views within the consortium and discuss in person on the impact of indoor air pollution on human health and well-being.

The discussion focused on progress in Work Package 2 (WP2) on health outcomes and the ongoing work on pollen data. Further, strategies for disseminating the results of the project were discussed, including the ongoing drafting of guidelines and the policy brief as part of the broader IDEAL Cluster project. The session concluded with an exchange on key future steps and timelines for both the project and the broader IDEAL Cluster.

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As SynAir-G partners, the Aerobiological team from the Department of Ecology, School of Biology, Aristotle University of Thessaloniki (AUTH), have been working on the challenging task of automation of bioaerosol monitoring.

Bioaerosols are airborne particles of biological origin that are a common part of the air we breathe indoors and outdoors, including pollen grains, fungal spores, bacteria, viruses, living and dead debris and fragments from plants. However, certain types of bioaerosols can trigger allergic reactions in sensitized individuals living with allergic conjunctivitis, allergic rhinitis or allergic bronchial asthma, while others can be infectious or harmful. Under certain environmental conditions, they can spread in large amounts, intensifying their potentially harmful effects. The challenge today is that current technology isn’t advanced enough to monitor them in real time or provide automated, reliable risk alerts for certain harmful types. Existing monitoring systems are either reliable and accurate but very expensive, or more affordable but not accurate or reliable enough to support operational risk alert systems and forecasts. This means that bioaerosol exposure, especially to aeroallergens, is not yet widely or openly communicated to the public. In most cases, information is available only for specific locations and is be based on unvalidated data.

Led by As. Prof. Thanos Damialis as the Principal Investigator (PI) and Dr. Thanasis Charalampopoulos as co-leading researcher, the Aerobiology Unit from the Department of Ecology, School of Biology at AUTH is working on a new mid-range automatic bioaerosol sensor, the same type already installed and operating in 25 schools across Europe as part of the SynAir-G project. AUTH is in charge of investigating its technical specifics, how it currently works and the results the sensor produces. Most importantly, AUTH is responsible for evaluating, cross-validating and optimizing its operation, regarding both its hardware and software. By the end of the SynAir-G project, AUTH aims to deliver the first operational, low-cost, automated, near-real-time bioaerosol sensor that provides the most reliable and accurate data, meaning with minimal data gaps and the highest precision for bioaerosol identification. It should also feature traits that make it suitable for sampling indoors, such as being compact, low-weight, and quiet.

This work is the first of its kind, given that most efforts worldwide, but also in terms of European funding, have been focusing on high reliability sensors that are high-cost, large and heavy, making them difficult to be used indoors. These approaches create a gap in public awareness and information, as the data they generate only cover a small part of European or global exposure and therefore, cannot support global aeroallergen forecasting. The SynAir-G bioaerosol sensor aims to bridge this gap, as it is being developed for wide use not only by health and environmental organizations, but also by smaller businesses, municipalities, and even individual users like physicians, to better inform and support allergic patients.

To support this effort, AUTH has been classifying thousands of images of known and highly allergenic plants, developing an image database. Some are unique and clinically important in specific regions – such as birch (Betula) pollen for Central and Northern Europe, and olive (Olea), wall pellitory (Parietaria), and cypress pollen for the Mediterranean – while others are major allergens globally, such as grass pollen (Poaceae) and fungal allergens (e.g. Alternaria spores), linked with respiratory allergies worldwide (Figure 1). This image database supports optimizing the performance of the sensor and improve its commercial classification algorithm, with the goal of achieving a new level of accuracy. This is expected to provide a unique value for money. AUTH is expected to show concrete results of their work under SynAir-G in some forthcoming annual meetings in November.

Figure 1. Images of different pollen grain and fungal spore taxa as seen under the microscope (x400 magnification)

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Currently, patients with asthma and allergies are recommended to have in place a personalised strategy to help them reduce exposure to environmental pollutants, as part of their management plan. Building on this, the SynAir-G project aims to create practical guidelines for healthcare professionals, providing them with a set of specific recommendations that can be shared with their patients.

Led by SynAir-G partners from GA²LEN, these guidelines will be integrated in a publication intended for a broader audience including government bodies and industry leaders. It will give an overview of the current regulatory framework, knowledge gaps, challenges, and unmet needs regarding indoor air quality (IAQ) and propose a roadmap for improving IAQ for all children, and especially those with asthma and allergies.

Given the wide range of activities within the IDEAL cluster focused on setting standards, policies, and guidelines, the value of bringing these efforts together to develop a single, overarching guidance was also discussed during the cluster’s 2025 Annual Meeting.

Interested in learning more about these activities? Contact us!

Developed within the SynAir-G project, the Save the World app combines gamification with healthcare to educate and monitor health, raising awareness about environmental health and sustainability challenges. Utilizing an iterative Living Lab (LL) methodology, the app was co-created with stakeholders including children, parents, teachers, healthcare professionals, and developers. Field-testing events in Sweden and Denmark evaluated the app’s usability, technical performance, inclusivity, and engagement, revealing significant improvements in user experience. The app was designed to help promote healthcare innovation among children aged 8–10 years.

Save the World will be a topic of discussion during the Health and Wellbeing Living Lab Symposium & Smart Healthy Environments World Conference on 13 May 2025. During the conference, it will be highlighted how researchers emphasized ethical engagement, inclusive design, and robust data protection in the development of the app. The study behind the app’s development highlights the effectiveness of LL methodologies in fostering user-centric healthcare innovation, demonstrating the potential of gamified approaches to create impactful digital tools for healthcare and education.

Interested in learning more about Save the World? Contact us!