
==== Front
Environ Epidemiol
Environ Epidemiol
EE9
Environmental Epidemiology
2474-7882
Lippincott Williams & Wilkins Hagerstown, MD

EE-D-24-00060
00007
10.1097/EE9.0000000000000339
3
Short Communications
The Multi-Country Multi-City Collaborative Research Network: An international research consortium investigating environment, climate, and health
https://orcid.org/0000-0002-2271-3568
Gasparrini Antonio a*
Vicedo-Cabrera Ana Maria bc
Tobias Aurelio d
on behalf of the MCC Collaborative Research Network
a Environment & Health Modelling (EHM) Lab, Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
b Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
c Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
d Institute of Environmental Assessment and Water Research, Spanish Council for Scientific Research, Barcelona, Spain
Gasparrini Antonio London School of Hygiene & Tropical Medicine, London, UK

Bell Michelle Yale University, New Haven CT, USA

Guo Yuming Monash University, Melbourne, Australia

Honda Yasushi National Institute for Environmental Studies, Tsukuba, Japan

Huber Veronika LMU Munich, Munich, Germany

Jaakkola Jouni J. K. University of Oulu, Oulu, Finland

Urban Aleš Czech Academy of Sciences, Prague, Czech Republic

Vicedo-Cabrera Ana Maria University of Bern, Bern, Switzerland

Masselot Pierre London School of Hygiene & Tropical Medicine, London, UK

Sera Francesco University of Florence, Florence, Italy

Abrutzky Rosana Universidad de Buenos Aires, Buenos Aires, Argentina

Tong Shilu Chinese Center for Disease Control and Prevention, Beijing, China

de Sousa Zanotti Stagliorio Coelho Micheline University of São Paulo, São Paulo, Brazil

Hilario Nascimento Saldiva Paulo NSPER, São Paulo, Brazil

Lavigne Eric University of Ottawa, Ottawa, Canada

Matus Correa Patricia Universidad de los Andes, Santiago, Chile

Valdés Ortega Nicolás Universidad Católica de Chile, Santiago, Chile

Kan Haidong Fudan University, Shanghai, China

Osorio Samuel University of São Paulo, São Paulo, Brazil

Roye Dominic Climate Research Foundation, Madrid, Spain

Achilleos Souzana University of Nicosia Medical School, Nicosia, Cyprus

Kyselý Jan Czech Academy of Sciences, Prague, Czech Republic

Orru Hans University of Tartu, Tartu, Estonia

Indermitte Ene University of Tartu, Tartu, Estonia

Maasikmets Marek Estonian Environmental Research Centre, Tallinn, Estonia

Ryti Niilo University of Oulu, Oulu, Finland

Pascal Mathilde Santé Publique France, Saint Maurice, France

Schneider Alexandra Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany

Breitner Susanne LMU Munich, Munich, Germany

Katsouyanni Klea National and Kapodistrian University of Athens, Greece, and Imperial College, London

Analitis Antonis National and Kapodistrian University of Athens, Greece

Samoli Evangelia National and Kapodistrian University of Athens, Greece

Krage Carlsen Hanne University of Gothenburg, Gothenburg, Sweden

Mayvaneh Fatemeh University of Münster, Münster, Germany

Entezari Alireza Hakim Sabzevari University, Khorasan Razavi, Iran

Goodman Patrick Technological University Dublin, Ireland

Zeka Ariana UK Health Security Agency, London, UK

Raz Raanan The Hebrew University of Jerusalem, Israel

Michelozzi Paola Lazio Regional Health Service, Rome, Italy

de’Donato Francesca Lazio Regional Health Service, Rome, Italy

Scortichini Matteo Lazio Regional Health Service, Rome, Italy

Stafoggia Massimo Lazio Regional Health Service, Rome, Italy

Hashizume Masahiro The University of Tokyo, Tokyo, Japan

Kim Yoonhee University of Tokyo, Tokyo, Japan

Fook Sheng Ng Chris The University of Tokyo, Tokyo, Japan

Alahmad Barrak Harvard University, Boston, MA, USA

Paul Cauchy John Malta

Hurtado Diaz Magali National Institute of Public Health, Cuernavaca, Mexico

Elizabeth Félix Arellano Eunice National Institute of Public Health, Cuernavaca, Mexico

Overcenco Ala National Agency for Public Health of the Ministry of Health, Labour and Social Protection of the Republic of Moldova, Moldova

Klompmaker Jochem National Institute for Public Health and the Environment, Bilthoven, the Netherlands

Rao Shilpa Norwegian Institute of Public Health, Oslo, Norway

Carrasco Gabriel Universidad Peruana Cayetano Heredia, Lima, Peru

Seposo Xerxes Hokkaido University, Sapporo, Japan

Lester Carlos Chua Paul The University of Tokyo, Tokyo, Japan

Pereira da Silva Susana das Neves Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal

Madureira Joana Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal

Holobaca Iulian-Horia Babes-Bolay University, Cluj-Napoca, Romania

Cvijanovic Ivana Barcelona Institute for Global Health, Barcelona, Spain

Mistry Malcolm London School of Hygiene & Tropical Medicine, London, UK

Scovronick Noah Emory University, Atlanta, USA

Acquaotta Fiorella University of Torino, Italy

Garland Rebecca M. University of Pretoria, Pretoria, South Africa

Kim Ho Seoul National University, Seoul, South Korea

Lee Whanhee Pusan National University, Yangsan, South Korea

Tobias Aurelio Spanish Council for Scientific Research, Barcelona, Spain

Íñiguez Carmen Universitat de València, Spain

Forsberg Bertil Umeå University, Umeå, Sweden

Ragettli Martina S. Swiss Tropical and Public Health Institute, Allschwill, Switzerland

Guo Yue Leon National Taiwan University College of Medicine, Taipei, Taiwan

Pan Shih-Chun National Health Research Institutes, Zhunan, Taiwan

Li Shanshan Monash University, Melbourne, Australia

Armstrong Ben London School of Hygiene & Tropical Medicine, London, United Kingdom

Colistro Valentina University of the Republic, Montevideo, Uruguay

Zanobetti Antonella Harvard University, Boston, MA, USA

Schwartz Joel Harvard University, Boston, MA, USA

Ngoc Dang Tran Duy Tan University, Da Nang, Vietnam

Van Dung Do University of Medicine and Pharmacy, Ho Chi Minh City, VietNam

Fratianni Simona University of Torino, Italy

Cesar Cruz Julio National Institute of Public Health, Cuernavaca, Mexico

Ameling Caroline National Institute for Public Health and the Environment, Bilthoven, Netherlands

Oudin Åström Daniel Umeå University, Umeå, Sweden

*Corresponding Author. Address: Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, 15-17 Tavistock Place WC1H 9SH, London, United Kingdom. Email: antonio.gasparrini@lshtm.ac.uk (A. Gasparrini).
10 2024
10 9 2024
8 5 e33913 6 2024
08 8 2024
Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The Environmental Epidemiology. All rights reserved.
2024
https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

Research on the health risks of environmental factors and climate change requires epidemiological evidence on associated health risks at a global scale. Multi-center studies offer an excellent framework for this purpose, but they present various methodological and logistical problems. This contribution illustrates the experience of the Multi-Country Multi-City Collaborative Research Network, an international collaboration working on a global research program on the associations between environmental stressors, climate, and health in a multi-center setting. The article illustrates the collaborative scheme based on mutual contribution and data and method sharing, describes the collection of a huge multi-location database, summarizes published research findings and future plans, and discusses advantages and limitations. The Multi-Country Multi-City represents an example of a collaborative research framework that has greatly contributed to advance knowledge on the health impacts of climate change and other environmental factors and can be replicated to address other research questions across various research fields.

Environmental epidemiology
Climate change
Temperature
Air pollution
Multi-city
Two-stage
Time series
OPEN-ACCESSTRUE
SDCT
==== Body
pmcWhat this study adds

This is the first contribution that presents the Multi-Country Multi-City (MCC) Collaborative Research Network, detailing the origin and purpose of the collaboration and the research work undertaken so far. In addition to information on the data collection and the multi-location database gathered over the years, this contribution illustrates the study protocol and the mode of collaboration adopted by the MCC Network, based on a flexible framework that promotes data sharing and collective participation. The article also offers an overview of the publications by MCC on different research topics, as well as the methodological developments supporting these works. Finally, this article kickstarts an article collection, with a series of epidemiological works to be published in Environmental Epidemiology, featuring the latest contributions from the MCC Network on topical environmental research issues.

A global perspective on environmental risks, climate change, and health

Climate change and environmental degradation are widely considered the biggest threats faced by humanity in the 21st century.1,2 These phenomena have been linked to an increase in exposure to several environmental hazards, such as nonoptimal temperature, air pollution, wildfires, floods, and other extreme weather events.3 Their health impacts vary across regions and populations due to differences in exposure levels and vulnerability, and proper assessments require epidemiological studies that can provide both global comparisons and reliable estimates of local impacts. This contribution illustrates the experience of the Multi-Country Multi-City (MCC) Network, an international collaboration that has performed important multi-location epidemiological analyses in this research area. This piece kickstarts an article collection featuring the latest contributions from the MCC Network on various research topics relevant to environmental health.

The Multi-Country Multi-City Network

The MCC Collaborative Research Network is an international consortium working on a global research program aiming to produce epidemiological evidence on associations between environmental stressors, climate, and health (http://mccstudy.lshtm.ac.uk/). The collaboration started informally in a meeting at the annual conference of the International Society for Environmental Epidemiology in Basel in 2013, and it has developed over the years through correspondence between the participants and additional meetings held at other scientific conferences. The MCC sets a collaborative framework for developing multicenter epidemiological assessments by collecting health and environmental data from different locations across countries. The foundations of the network define that each member can use the MCC database under the premise that they contribute with data from a specific country.

The Multi-Country Multi-City database

Through this consortium, the MCC Network has gathered the largest epidemiological database ever assembled for studying the health effects of environmental factors, including information from hundreds of locations within dozens of countries. The main database consists of daily time series of environmental measurements, including various weather indices and pollution levels, mortality counts for all and specific causes, and location-specific meta-variables on climatological, socio-economic, demographic, and infrastructural characteristics. At the time of writing, the database includes datasets from 1150 locations in 54 countries in largely overlapping periods between 1969 and 2021, totaling over 200 million deaths. These data are complemented by a wide collection of environmental measures gathered from global reanalysis databases and remote-sensing instruments and linked to each site. The set of MCC locations covers a wide range of regions, populations, and climates, including high, middle, and low-income countries, and spans from arid and tropical areas to temperate and cold latitudes (Figure 1). The database is continuously updated by the MCC participants and complemented with data from additional countries/locations. An inventory of the available datasets is kept centrally and shared with all the participants.

Figure 1. Map of current MCC locations.

Study protocol, data sharing, and mode of collaboration

The key feature of the MCC partnership is to provide researchers with opportunities for pursuing specific research questions at a global scale in a flexible collaborative framework. The method of collaboration is defined by a study protocol drafted at the beginning of the collaboration. Briefly, the work is organized around subproject proposals that can be submitted independently by any participant, who will then lead on analyses and publications. Each proposal states the objectives of the subproject and identifies the relevant data, and it is circulated among the participants responsible for each dataset, who can agree on its use and can contribute as coauthors. The protocol sets guidelines that limit the use of the data to agreed subprojects, outlines authorship rules, and prevents overlap between subprojects. This formal yet flexible mode of collaboration offers scientific independence in addressing a variety of research topics using a massive multi-country database while ensuring collective participation, control of the use of data, and consistency of designs and methods. The work is supervised and coordinated by the MCC Scientific Committee.

Activities within the MCC Network promote a collaborative environment based on data sharing. The participation in the consortium is conditional on the provision of original data in a format consistent with the MCC database, and the willingness to share them. Each participant retains the rights to their data and responsibility regarding their use, stipulated separately with the original data providers. The data-sharing agreement is limited to each subproject. While each participant allows others to use these data in their analyses, they have access to the full database and enjoy the benefits of collaborating in various subprojects and publications. To the extent possible, examples reproducing published results, including code, software, and subsets of data, are made available as Supplemental material; http://links.lww.com/EE/A299 and in publicly accessible repositories, thus increasing transparency and facilitating replication.

Methodological contributions

The availability of such a massive database allows standardized analyses of local/regional data based on state-of-the-art epidemiological designs and statistical methods. Indeed, the MCC Network has contributed to the development and application of a number of techniques for environmental epidemiological studies. These include first the use of time series regression analysis and distributed lag linear and nonlinear models to describe complex health associations with environmental stressors, the extension of two-stage designs and meta-analytical models to perform pooled analyses on multi-center data,4,5 the use of self-matched designs with conditional regression models,6–9 and sample size studies.10 Further work within MCC has led to the development of analytical frameworks for climate change impact projections,11 measures of attributable risks,12 global reconstructions of air pollution exposures,13 and detailed risk mapping.14,15 More focused methodological contributions have focused on the definition of heatwaves,16 heat stress, and temperature variability indices,17 the analysis of temporal and geographical variation in risks,18 interactive effects,19 the identification and analysis of minimum mortality temperature,20 seasonal patterns,21,22 and the use of data reanalysis for epidemiological studies.23–25

Research topics, published work, and future directions

The MCC Network has already contributed key evidence on the associations between various environmental stressors, climate, and health (Figure 2). The extensive evidence has been presented through peer-reviewed publications in leading environmental, epidemiological, and medical journals, and contributions in thematic conferences. The works published so far are summarized below by research topic, with individual articles listed in eTable 1 in the Supplementary Material (Appendix; http://links.lww.com/EE/A299).

Figure 2. Main research areas and topics investigated by the MCC Network.

Temperature-related risks

The MCC Network kickstarted its work with two seminal publications presenting a multi-country analysis of the health risks of nonoptimal temperature and the associated excess mortality due to heat and cold.26,27 These contributions provided novel results on the relative magnitude of cold- and heat-related impacts and the importance of nonextreme nonoptimal temperatures. The following works investigated other aspects, such as mortality risks associated with heat waves,28 long-term impacts and mortality displacement,29 effects of hot nights,30 the role of temperature in seasonal mortality,31 and the geographical variation of the minimum mortality temperature.32 Other analyses focused on temperature-related risks on cause-specific mortality outcomes, such as various cardiovascular endpoints,33 stroke,34 and suicides.35,36 A series of articles presented evidence of associations with alternative indices, such as inter- and intra-day temperature change.37–40 More recent studies applied design extensions to comprehensively map mortality risks associated with heat and cold across European cities or the whole globe.14,15 Similar methods were also used to reconstruct the global impacts of heat waves,41 cold spells,42 and temperature variability.43 Finally, other works evaluated the health effects using different heat stress metrics,17 and compared estimates using weather station and climate reanalysis data.23,24

Assessment of vulnerability to nonoptimal temperature

In a related line of research, the MCC researchers have tried to characterize differences in vulnerability across geographical areas and populations. Two initial studies assessed long-term variations and changes in susceptibility across the summer in heat-mortality risks, respectively.18,44 A following study then assessed changes across cities related to various urban characteristics.45 Other analyses focused on effect modification by environmental factors, such as humidity,46 air pollution,47 and greenness.48 More recent studies examined the role of temperature fluctuation and frequency on heat-mortality associations.49,50

Short-term effects of air pollution

A second phase of the work of the MCC Network extended the scope of the research beyond temperature-related risks, in particular assessing the short-term effects of air pollution in multi-country analyses. Influential works presented evidence on mortality risks associated with various pollutants, specifically particulate matter,51,52 nitrogen dioxide,53 ozone,54 carbon monoxide,55 and sulfur dioxide.56 The following works tried to differentiate risks depending on particulate composition,57 and explore interactive effects between pollutants and heat, respectively.19,58 Another study examined the lagged effects of air pollution on acute kidney injury.59 Finally, a recent article compared risk estimates obtained using observed and modeled air pollution measures.25

Health impacts of climate change

Another important part of the work of the MCC consortium has focused on climate change and the projection of health impacts in scenario-based assessments. A first set of studies provided projections of excess mortality due to heat and cold under various pathways of greenhouse gas emissions and global temperature thresholds consistent with the Paris Agreement, respectively.60,61 Other studies quantified the future impacts of heat waves and diurnal temperature range,62,63 examined potential adaptive mechanisms to cold and heat in a changing climate,64 and assessed the role of population aging.65 A pivotal work of MCC quantified the burden of heat-related mortality attributable to recent human-induced climate change.66 Two studies projected potential future changes in seasonal mortality and excess deaths due to short-term exposure to ozone, respectively.67,68 Finally, other analyses predicted global health burdens induced by temperature increases,69 and performed probabilistic estimates of impacts in future summer seasons.70

Other environmental hazards

More recently, the work of the MCC network has extended to the global analysis of other environmental hazards and health endpoints. Specifically, the modeling framework has been adapted to examine the mortality risks associated with wildfire-related pollution,71 floods,72 and tropical cyclones.73,74 Another study instead assessed the role of environmental factors on the incidence of COVID-19.75

Current and planned work will significantly extend the research scope of MCC. First, there is an ongoing process to update and extend data collection on cause-specific mortality outcomes, as well as morbidity records, primarily hospital admissions and birth outcomes, to replicate analyses on other health associations. In addition, the modeling framework is currently being applied to examine health risks associated with other environmental factors, such as desert dust, airborne pollen, and rainfall. Planned analyses are meant to offer a better characterization of health risks across populations, identifying drivers of vulnerability, as well as detecting health-relevant air pollution components and weather stress indices. An important line of research is to improve projections of health impacts under climate change scenarios and to identify effective adaptation pathways. This work will be complemented by specific methodological extensions that will improve the existing design and modeling framework.

Important aspects

The MCC study presents several advantages if compared to previous epidemiological investigations on the same topic area. First, its multi-country multi-center framework offers a dual local/global perspective that is critical in planetary health and climate change research. The analytical scheme involves the application of consistent analytical procedures to estimate associations across hundreds of locations characterized by various climates, diverse demographic and socio-economic features, and different levels of development and infrastructure. This two-stage design preserves the possibility of inspecting interesting local features, while at the same time allowing global comparisons of environmental impacts across areas of the world. Most of the previous studies on the same research subject were limited to specific cities or regions with relatively homogeneous populations,76–78 or included a few locations across several areas, with issues of representativeness and insufficient statistical power to inspect more subtle effects.79 While the coverage of the MCC database is incomplete, with entire areas of the world such as most parts of Africa and the Middle East that are not represented (see Figure 1), the scope of the study is truly global, and recent extensions have allowed comprehensive risk mapping through extrapolation techniques.14,15

Another important advantage of the MCC network is its mode of collaboration, inspired by principles of openness and data sharing. This has contributed to the collection and freedom of use of the massive database described above while preserving control over the use of the data provided by each participant. This approach can be adopted more broadly in climate change research and more generally in environmental health research to perform global epidemiological analyses on various risk factors. However, it must be acknowledged that the use of data other than aggregated time series can present more severe confidentiality issues, which must be accounted for and can pose limitations to this collaborative scheme.

Finally, the MCC Study benefits from a flexible protocol of work that maximizes research independence within a collaborative environment. The focus on subproject proposals independently submitted by each participant allows more freedom when compared to rigid research schedules discussed collectively and prespecified at the beginning of the study. However, it should be acknowledged that this mode of collaboration has also some limitations, such as the absence of a coherent plan with a linked set of research hypotheses to be addressed during the course of the study, and difficulties in ensuring consistent methodological approaches across subprojects.

Conclusions

The MCC Network has provided an important contribution to research on the health risks associated with environmental hazards, and to understand and quantify the health impacts of climate change. Past, ongoing, and planned activities within the MCC Network form a program of research that explores key aspects of environment and climate-health associations, and it has already provided original evidence that significantly extends our knowledge on the topic. In particular, the collaborative scheme and study designs proposed by the MCC network offer a way to perform epidemiological investigations at a global scale, while at the same time illustrating geographical and temporal differences across populations and areas determined by local characteristics. This duality is vitally important in climate change research, where global policies to mitigate global warming and its health risks must be implemented through and complemented with local-scale initiatives, legislations, and interventions, which account for area-level differences in projected impacts, resilience potential, and resources.

This contribution is an introductory piece of an article collection that will be published in Environmental Epidemiology in the next weeks, featuring the latest works by MCC on topical environmental research issues. The multi-center collaborative framework adopted by the MCC Network, based on mutual contribution and data sharing, will be hopefully reproduced and extended more broadly for addressing other environment-related issues and for extending the research capability in this area.

Conflicts of interest statement

The authors declare that they have no conflicts of interest with regard to the content of this report.

ACKNOWLEDGMENTS

The MCC Collaborative Research Network: Antonio Gasparrini, London School of Hygiene & Tropical Medicine, London, UK; Michelle Bell, Yale University, New Haven CT, USA; Yuming Guo, Monash University, Melbourne, Australia; Yasushi Honda, National Institute for Environmental Studies, Tsukuba, Japan; Veronika Huber, LMU Munich, Munich, Germany; Jouni J. K. Jaakkola, University of Oulu, Oulu, Finland; Aleš Urban, Czech Academy of Sciences, Prague, Czech Republic; Ana Maria Vicedo-Cabrera, University of Bern, Bern, Switzerland; Pierre Masselot, London School of Hygiene & Tropical Medicine, London, UK; Francesco Sera, University of Florence, Florence, Italy; Rosana Abrutzky, Universidad de Buenos Aires, Buenos Aires, Argentina; Shilu Tong, Chinese Center for Disease Control and Prevention, Beijing, China; Micheline de Sousa Zanotti Stagliorio Coelho, University of São Paulo, São Paulo, Brazil; Paulo Hilario Nascimento Saldiva, NSPER, São Paulo, Brazil; Eric Lavigne, University of Ottawa, Ottawa, Canada; Patricia Matus Correa, Universidad de los Andes, Santiago, Chile; Nicolás Valdés Ortega, Universidad Católica de Chile, Santiago, Chile; Haidong Kan, Fudan University, Shanghai, China; Samuel Osorio, University of São Paulo, São Paulo, Brazil; Dominic Roye, Climate Research Foundation, Madrid, Spain; Souzana Achilleos, University of Nicosia Medical School, Nicosia, Cyprus; Jan Kyselý, Czech Academy of Sciences, Prague, Czech Republic; Hans Orru, University of Tartu, Tartu, Estonia; Ene Indermitte, University of Tartu, Tartu, Estonia; Marek Maasikmets, Estonian Environmental Research Centre, Tallinn, Estonia; Niilo Ryti, University of Oulu, Oulu, Finland; Mathilde Pascal, Santé Publique France, Saint Maurice, France; Alexandra Schneider, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany; Susanne Breitner, LMU Munich, Munich, Germany; Klea Katsouyanni, National and Kapodistrian University of Athens, Greece, and Imperial College, London; Antonis Analitis, National and Kapodistrian University of Athens, Greece; Evangelia Samoli, National and Kapodistrian University of Athens, Greece; Hanne Krage Carlsen, University of Gothenburg, Gothenburg, Sweden; Fatemeh Mayvaneh, University of Münster, Münster, Germany; Alireza Entezari, Hakim Sabzevari University, Khorasan Razavi, Iran; Patrick Goodman, Technological University Dublin, Ireland; Ariana Zeka, UK Health Security Agency, London, UK; Raanan Raz, The Hebrew University of Jerusalem, Israel; Paola Michelozzi, Lazio Regional Health Service, Rome, Italy; Francesca de’Donato, Lazio Regional Health Service, Rome, Italy; Matteo Scortichini, Lazio Regional Health Service, Rome, Italy; Massimo Stafoggia, Lazio Regional Health Service, Rome, Italy; Masahiro Hashizume, The University of Tokyo, Tokyo, Japan; Yoonhee Kim, University of Tokyo, Tokyo, Japan; Chris Fook Sheng Ng, The University of Tokyo, Tokyo, Japan; Barrak Alahmad, Harvard University, Boston, MA, USA; John Paul Cauchy, Malta; Magali Hurtado Diaz, National Institute of Public Health, Cuernavaca, Mexico; Eunice Elizabeth Félix Arellano, National Institute of Public Health, Cuernavaca, Mexico; Ala Overcenco, National Agency for Public Health of the Ministry of Health, Labour and Social Protection of the Republic of Moldova, Moldova; Jochem Klompmaker, National Institute for Public Health and the Environment, Bilthoven, the Netherlands; Shilpa Rao, Norwegian Institute of Public Health, Oslo, Norway; Gabriel Carrasco, Universidad Peruana Cayetano Heredia, Lima, Peru; Xerxes Seposo, Hokkaido University, Sapporo, Japan; Paul Lester Carlos Chua, The University of Tokyo, Tokyo, Japan; Susana das Neves Pereira da Silva, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon, Portugal; Joana Madureira, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal; Iulian-Horia Holobaca, Babes-Bolay University, Cluj-Napoca, Romania; Ivana Cvijanovic, Barcelona Institute for Global Health, Barcelona, Spain; Malcolm Mistry, London School of Hygiene & Tropical Medicine, London, UK; Noah Scovronick, Emory University, Atlanta, USA; Fiorella Acquaotta, University of Torino, Italy; Rebecca M. Garland, University of Pretoria, Pretoria, South Africa; Ho Kim, Seoul National University, Seoul, South Korea; Whanhee Lee, Pusan National University, Yangsan, South Korea; Aurelio Tobias, Spanish Council for Scientific Research, Barcelona, Spain; Carmen Íñiguez, Universitat de València, Spain; Bertil Forsberg, Umeå University, Umeå, Sweden; Martina S. Ragettli, Swiss Tropical and Public Health Institute, Allschwill, Switzerland; Yue Leon Guo, National Taiwan University College of Medicine, Taipei, Taiwan; Shih-Chun Pan, National Health Research Institutes, Zhunan, Taiwan; Shanshan Li, Monash University, Melbourne, Australia; Ben Armstrong, London School of Hygiene & Tropical Medicine, London, United Kingdom; Valentina Colistro, University of the Republic, Montevideo, Uruguay; Antonella Zanobetti, Harvard University, Boston, MA, USA; Joel Schwartz, Harvard University, Boston, MA, USA; Tran Ngoc Dang, Duy Tan University, Da Nang, Vietnam; Do Van Dung, University of Medicine and Pharmacy, Ho Chi Minh City, VietNam). Past members: Simona Fratianni, University of Torino, Italy; Julio Cesar Cruz, National Institute of Public Health, Cuernavaca, Mexico; Caroline Ameling, National Institute for Public Health and the Environment, Bilthoven, Netherlands; Daniel Oudin Åström, Umeå University, Umeå, Sweden.

Supplementary Material

Published online 10 September 2024

The MCC Network has worked since 2014 on a purely collaborative basis and has not so far received direct funding for its activities.

Supplemental digital content is available through direct URL citations in the HTML and PDF versions of this article (www.environepidem.com).
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