A heat wave can leave its mark in a matter of days. To understand what can happen, however, when exposure to extreme climatic events occurs during pregnancy or in the very first years of life, researchers will even look at DNA methylation in the saliva of 400 children, comparing samples collected at 1 and 13 years of age.
It is just one of the pieces of E-CHANGE, the project that has just started at the University of Turin to understand how climate change affects health, from deaths during heat waves to the effects that could appear many years after a pregnancy spent under abnormal temperatures.
The project began on 1 September 2026, will last three years and is financed by the Italian Science Fund of the Ministry of University and Research with approximately 1.32 million euros. It is coordinated by Giovenale Moirano, researcher at the Department of Medical Sciences of the University of Turin. The program brings together epidemiology, biostatistics, molecular biology and climate science. The thermometer alone is not enough here. The official project sheet sets the deadline for completion on 31 August 2029.
From heat to West Nile, the calendar is getting longer
The first part of the research looks at effects that come quickly. E-CHANGE will correlate heat waves, floods and forest fires with the daily number of deaths, municipality by municipality, across the entire Italian territory. Then it will extend the observation time to the following months, studying temperature, precipitation and extreme events together with the spread of two diseases transmitted by vectors already present in our country: West Nile virus and Lyme neuroborreliosis.
Mosquitoes and ticks, moreover, also respond to the environmental conditions they find around them. Temperatures and rainfall can modify habitats, seasons of activity and possibilities of transmission. However, several other variables come into play here, so the project will analyze the associations without automatically transforming a climatic coincidence into a cause. The longest part even begins before birth.
Over 10 thousand children and a story that began during pregnancy
E-CHANGE will use data collected from two large Italian mother-child cohorts which, together, exceed 10 thousand participants. One is NINFEA, coordinated by the Epidemiology Unit of the University of Turin and the City of Health: since 2005 it has followed around 7,500 mothers and children through periodic questionnaires.
The other is PiccoliPiù, started in 2011 in hospitals in Florence, Rome, Turin, Trieste and Viareggio, which has followed around 3 thousand children from birth, collecting information over time on their environment, growth and state of health.
This data has already been accumulated over the years and will now be reinterpreted with a different question: what happens if pregnancy and the first two years of life coincide with repeated exposure to extreme heat, floods or other climatic events? The researchers will look for any associations with growth curves and respiratory health.
Then there are those 400 children and the saliva samples. E-CHANGE will compare DNA methylation patterns measured at 1 and 13 years, looking for possible molecular signals linked to early climate exposures. Methylation can change how some genes are regulated without changing the DNA sequence. If an association emerges, it alone will not be enough to demonstrate that a heat wave or a flood caused it: in thirteen years, many other things happen inside an organism.
Separate the climate we have from the one we would have had
Finally, there is perhaps the most ambitious part of the project: trying to put a number on the disease burden attributable to climate change caused by human activities.
The researchers will work with two climates. The first is the one actually observed, with the temperatures and extreme events recorded in recent years. The second will exist in the models: it will be a reconstruction of how those exposures could have been distributed in the absence of the anthropogenic forcings that warmed the planet. The epidemiological relationships between climate and health will be applied to both scenarios.
From that comparison E-CHANGE will try to estimate how much of the observed health effects can be attributed to anthropogenic warming. It is something more precise than counting how many people die during a very hot summer: it means asking how much of that risk would have remained even in the climate we would have had without the increase in temperatures produced by human activities.
Mortality data, infection surveillance systems, climatic, environmental and socioeconomic information, as well as the two birth cohorts, will be needed. The result should also be a reusable infrastructure for other research and, in the group’s intentions, to build early warning systems and more targeted health interventions towards those most exposed.
We will have to wait to get the answers. Meanwhile on the table there are deaths recorded day by day, infections transmitted by mosquitoes and ticks, over ten thousand children followed for years and 400 saliva samples stored long enough to tell the story of two very different ages of the same person. E-CHANGE will try to understand how much of that history also bears the imprint of the climate we have changed.
