I’ve often heard Flor Fröling herself say: You won’t get a PhD if you’re not really convinced of the research question. “She spends years focusing on a very specific subject. So it must be really interesting,” she said in a conference room of the Veterinary Faculty at Utrecht University. With that in mind, Froeling did something unusual four years ago: she applied for a PhD without knowing what she would actually be looking for.
The project is called CitieS-Health and it is a citizen research project funded by the European Union in five countries: Spain, Slovenia, Italy, Lithuania and the Netherlands. Idea: In these countries, scientists have conducted research with citizens. Citizens participate from the beginning of the research – devising the research question – to communicating the final results and all the steps between them. “Research really should be a co-creation, citizens are co-researchers. Our job is to set up research in a scientifically valid way.”
“I don’t want to do ivory tower science, and I’ve always thought it was important to do bottom-up research,” says Frolling. She lived in South Africa until she was 19 years old, where her parents were doctors in a town. In Maastricht, Froeling graduated in direction global health She is now a doctoral student at Utrecht University. I have learned from previous research in Pretoria towns that it is important to talk to the people your research is about, as they are experts in their living environment. “I want my research to be close to society. Citizens are worried about things, but they don’t have the network or funding to investigate. The academy does. Hopefully, this method will contribute to confidence in scientific institutions.”
There were really only two conditions. Research should be about environmental epidemiology: what makes people healthy or sick in their environment? And it had to meet scientific criteria. In Spain they studied the effect of polluted air on mental health, in Slovenia in the effect of noise pollution on mental health. In the Netherlands, smoke from wood-burning stoves has become a subject of study.
Froeling is used for something. But she didn’t anticipate that a wood-burning stove would be such a hot topic. A large group of Dutch people associate warmth with friendliness. In 2012, the government distributed subsidies to reduce carbon dioxide2A neutral replacement for a gas heater. The wood-burning stove has been on the rise in recent years, especially in environmentally conscious homes.”
Take, for example, IJburg in Amsterdam, a newly built neighborhood with well-insulated houses and many electrical connections. “Ten years ago it was a relatively clean part of Amsterdam,” says Frolling. “But according to estimates, more than half of the households there now have a wood-burning stove.” With energy prices skyrocketing, burning wood is also an inexpensive alternative to electric heating. We did our research last year in a relatively mild winter. I expect there will be more heating this year.”
Opposite the stove is a concerned group of asthmatics and chronic obstructive pulmonary disease patients who become short of breath as soon as the neighbors start burning. When Froehling and her team took to the streets across the Netherlands to talk to citizens about relevant research questions, the wood smoke kept coming. Every winter there is something about it in the papers, but there hasn’t been much real scientific interest in the Netherlands. Many people feel unheard of on this subject.”
Research group of participants
“The beauty of this research design is that citizens themselves choose which stage of the project they want to be involved in. People have come and gone, but we have consistently been able to connect a group of about twenty-five people with us.”
Participants were given a research kit that included a spirometer, a device that measures lung function. They would burst into poop three times a day, morning and evening. They collected saliva samples once a week. In addition, the participants kept a diary: when did they experience respiratory complaints and when did they smoke wood smoke? At one nearby site, a caravan was stopped with a large machine inside that measured the level of levoglucosan in the air each day, a reliable marker of wood smoke. In this way, the participants’ complaints could be compared with the actual level of wood smoke in the air at the time. What did it turn out? On days when there is a lot of heating, the locals are relatively short of breath. Participants used more medication on those days than they did on the wood-smoking days.
“Before I started this research, I had no opinion about wood stoves,” Frolling says. I wasn’t aware of the problem. But during the research, I learned that people who don’t start a fire at all suffer from complaints of wood smoke from their fellow residents’ stoves. They are exposed to it, but they don’t choose it. So it’s not really fun anymore.”