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Katsouyanni Klea


Medical Statistics

Professor Klea Katsouyanni , MSc, PhD, has a first Degree in Mathematics, an MSc in Statistics and obtained her PhD in Epidemiology from the Medical school of the National and Kapodistrian University of Athens (NKUA) under the supervision and mentorship of Professor Dimitrios Trichopoulos. She was appointed as a Lecturer in 1982, Assistant Professor, Associate Professor and, in 2005, was elected Professor of Medical Statistics and Epidemiology in the same School. She was a visiting Lecturer in Epidemiology at the Harvard School of Public Health from 1990 to 1999. In 2013 she was appointed Professor of Public Health (part time) at King's College London. She is teaching, for over 35 years, Biostatistics to students of the Medical School and the School of Dentistry at NKUA. She is the Director of the Postgraduate programme in Biostatistics (which started in 1998), where she also teaches Epidemiology, Environmental Epidemiology and Research Methods. She is a member of the Committee of the Special Account for Research and of the Steering Committee of the Quality Assurance Unit of NKUA. She is the Head of the Unit for Environmental Epidemiology and the Unit of Applied Biostatistics of the Department of Hygiene, Epidemiology and Medical Statistics of the Medical School, NKUA.  

Her research focuses on the health effects of environmental stressors, mainly outdoor air pollution. She has been the Coordinator of the EU network APHEA which provided European wide results on the short-term effects of air pollution and a Partner in several international projects investigating effects of exposure to air pollution and other environmental stressors, as well as their interactions, gene-environment interactions, air pollution effects in sensitive sub-populations, health impact assessment (e.g. PHEWE, AIRGENE, ESCAPE, ELAPSE, EuroHEAT, STEAM, EXHAUSTION, EXPANSE). Currently she is involved in the investigation of long-term effects of air pollution and the urban environment, the effects of ozone on children’s respiratory health, the effects of source-specific particles on health (such as forest fires and desert dust), the short-term effects of PM2.5 and ultrafine particles in Europe and the effects of extremely high temperatures on mortality. In the context of air pollution epidemiology she is especially focusing on the impact of exposure measurement error on the health effects estimates.  

She has contributed to several advisory committees (E.C., W.H.O. etc) in environmental health topics.  She was Chair of the Technical Working Group on Research Needs in the Framework of the European Environment and Health Strategy 2003-04. Member of the Oversight Committee of the NMMAPS project, funded by the US Health Effects Institute. Reviewer of E.C. applications for funding in Biomed and Environment Programmes in FP4, FP5, FP6 and FP7. Member of the ERC Panel for Starting & Consolidator Grants 2011-17.  


Leadership Roles:

Director of the post graduate Programme in Biostatistics, NKUA 

Director of the Department of Social Medicine, Psychiatry and Neurology, Medical School NKUA. 2018-19 

Head of the Environmental Epidemiology Unit, Laboratory of Hygiene, Epidemiology and Medical Statistics, NKUA  

Head of the Applied Biostatistics Unit, Laboratory of Hygiene, Epidemiology and Medical Statistics, NKUA  

Member of the Committee of the Special Account for Research, NKUA 

Member of the WHO Committee on the Air Quality Guidelines for the 2000 and 2005 revisions. 

Member of the WHO Advisory Board for the REVIHAAP and HRAPIE projects (2013) 

Member of the European Research Council Review Panel on Diagnostics, Therapies, Applied Medical Technology and Public Health for Starting (2011) and Consolidator Grants (2013,2015, 2017) 

Chair person of the Technical Working Group on Research Needs in the Framework of the European Environment and Health Strategy 2003-04 


Key Research Interests:

Environmental Epidemiology (air pollution, noise, climate change) 

Epidemiological Methods 


Key Research Projects:

APHEA, APHEA2 and APHENA projects, 1993-2010.  (Role: Coordinator  of the projects). In 1993 the multi-centre European funded project entitled "Short-term effects of air pollution on morbidity and mortality: a European approach using  epidemiologic time series data" (the APHEA project) started.This project involved  11 Research Groups in Europe. It confirmed and consolidated the effect of short-term exposures to gaseous and particulate pollution. It was followed by the APHEA2 project (Air Pollution and Health: a European Approach to methodology, dose-response assessment and Public Health significance), a collaboration of 22 Research Groups. The key publications of these projects (Katsouyanni et al, BMJ 1997; 314: 1658-63; Katsouyanni et al Epidemiology 2001, 12: 521-31) have received >1000 citations and several other papers (Anderson et al  1997, ERJ 10:1064-71; Atkinson et al 2001, AJRCCM 2001, 164: 1860-6; LeTertre et al JECH 2002, 56:733-9; Gryparis et al, AJRCCM 2004, 170:1080-7) more than 500. The APHEA network was additionally funded through a number of EC contracts based on accompanying measures. A related project, APHENA (Air Pollution and Health: a combined European and North American approach), funded by the EC and the U.S. Health Effects Institute (H.E.I. Report no 142, 2009) joined forces from Europe and North America (co-coordinated by K. Katsouyanni and J. Samet) and provided methodological insights and key results on the effects of short-term exposures of several pollutants on mortality which have repeatedly been used in health impact assessment.

PHEWE project(2004-08):  "Assessment and prevention of acute health effects and weather conditions in Europe". (Role: P.I. for Partner "National and Kapodistrian University of Athens and WP leader "). This was a multi-center EC funded study investigating the effects of meteorological factors on mortality and hospital admissions which has provided exposure-response associations with both cold (Analitis et al Am J Epidemiol 2008,168:1397-408) and warm weather (Baccini et al, Epidemiology 2008; 19: 711-9).

RUPIOH project (2002-2004): "Relationship between ultrafine and fine particulate matter in indoor and outdoor air and respiratory health".(Role: P.I. for Partner "National and Kapodistrian University of Athens "). RUPIOH implemented a panel study in four EU cities  (Amsterdam, Athens, Birmingham and Helsinki) in individuals with asthma or chronic obstructive pulmonary disease (COPD) to examine the distribution of various particle metrics including UFP, both indoors and outdoors, and assess their health effects, based on a detailed exposure assessment. 

AIRGENE project (2003-2005): "Air pollution and inflammatory response in myocardial infarctionsurvivors: gene-environment interactions in a high-risk group.(Role: P.I. for Partner "National and Kapodistrian University of Athens ")This was a study following myocardial infarction survivors in six EU cities (Athens, Greece, Augsburg, Germany, Barcelona, Spain, Helsinki, Finland, Rome, Italy and Stockholm, Sweden), investigating associations between exposure to air pollution and inflammatory responses as well as genetic susceptibility. 

HYENA study (2002-2005): “Hypertension and exposure to noise near airports (HYENA)”. (Role: P.I. for Partner National and Kapodistrian University of Athens and WP leader). This cross-sectional study, coordinated by IC (L. Jarup) was among the first large scale studies to investigate and provide evidence on the effect of noise exposure on blood pressure (BP) and hypertension. In the WP led by NKUA 200 individuals were followed up with personal monitoring of noise and BP and it was shown that increase in night-time noise, irrespective of source, leads to transient increase in BP (Haralabidiset al, 2008). 

EuroHEAT project (2005-2006): "Improving Public Health Responses to Heat Waves”. (Role: P.I. for Partner National and Kapodistrian University of Athens). This project focused on the effects of heat waves on mortality, providing a health based definition of a heat-wave, and quantitative evidence of its effects by geographical region of Europe as well as evidence on air pollution and temperature interactions. 

APHEIS and APHEKOM projects (1999-2011). These were both Health Impact Assessment projects which helped quantify the burden on mortality and morbidity and were among the first to compare the burden on health from short- medium- and long-term exposures. 

ESCAPE project (2008-2011): “European study of cohorts for air Pollution Effects”. (Role: P.I. for Partner National and Kapodistrian University of Athens). Within this project 22 European cohorts were analyzed after a coordinated and extensive air pollution measurement campaign to characterize exposure to PM2.5 and NO2. The results provided quantitative estimates of exposure and total mortality as well as lung cancer incidence in Europe.

MED-PARTICLES project (2011-2012). "Particles size and composition in Mediterranean countries: geographical  variability and short-term health effects”. (Role: P.I. for Partner National and Kapodistrian University of Athens). This was the first project in Europe to provide quantitative estimates on the effects of short-term exposure to PM2.5 on mortality and hospital admissions, focusing on the Mediterranean countries.

RESPOZE project (2012-2015). "Respiratory effects of ozone exposure in children". (Role: P.I. of the project). RESPOZE was a panel study in the two largest Greek cities (Athens and Thessaloniki) including 200 children aged 10-11 years old, with personal monitoring for ozone exposure during 5 weeks spanning a school year. It has resulted in several publications providing evidence of effects of short and long-term ozone exposure and decrease in lung function, increase in inflammation and in the occurrence of respiratory symptoms (Karakatsani et al 2017; Samoli et al 2017; Stergiopoulou t al 2018; Dimakopoulou et al 2020).


Research Collaboration:

APHEA, APHENA, STEAM and other projects: Prof Joel Schwartz (Harvard School of Public Health); Prof HR Anderson and Prof R. Atkinson (St George's University of London) 

APHEA projects: Dr S. Medina, Dr A. LeTertre (Sante Publique France); Dr P. Michelozzi (ASL Rome, Italy); Prof E. Wichman, Dr C. Spix (Helmholz Munich. Germany); Dr J. Pekkanen (NPHI, Kuopio, Finland); Dr J. Sunyer (ISGlobal, Barcelona, Spain); Dr F. Ballester (Un. of Valencia, Spain); Dr A. Paldy (J. Fodor National Public Health Centre, Budapest, Hungary); Dr C. Schindler (TPH Basel, Switzerland); Dr B. Wojtyniak (NIH Warsaw, Poland); E. Cadum (Regional Environmental Protection Agency, Piedmont, Italy). 

RUPIOH, ESCAPE, ELAPSE and other projects: Prof B. Brunekreef, Dr G. Hoek (Utrecht University, The Netherlands) 

ESCAPE and ELAPSE projects: O. Raaschou-Nielsen, Z. Andersen (Danish Cancer Society Research Center, Denmark); F. Forastiere, M. Stafoggia, G. Cesaroni (ALS Rome, Italy); Prof B. Hoffmann (Univ. of Dusseldorf); Prof A. Peters, K. Wolf (Helmholtz Zentrum, Munich, Germany);M. Nieuwenhuijsen, (ISGlobal, Barcelona, Spain); T. Lanki (NPHI, Kuopio, Finland); P. Schwartze (NIPH, Oslo, Norway); G. Pershagen, T. Bellander (Karolinska Institute, Stockholm, Sweden).  

PHEWE, EUROHEAT, PHASE and other projects: P. Michelozzi, F. de Donato, D. D' Ippoliti, M. Stafoggia, F. Forastiere (ASL Rome, Italy), B. Menne (WHO); A. Schneider (Helmholtz Zentrum, Munich, Germany); S. Kovats (LSHTM, UK). 

MED-PARTICLES project: M. Stafoggia,  P. Michelozzi, F. de Donato, , F. Forastiere (ASL Rome, Italy); E. Cadum (Regional Environmental Protection Agency, Piedmont, Italy); B. Jaquemin (ISGlobal) 

EUROHEALTHY project: P. Santana, C. Costa (U. Coimbra, Portugal); S. Vardoulakis, S. Dimitroulopoulou, C. Heaviside, C. Mitsakou (PHE, UK); C. Borrell (Public Health Agency, Barcelona, Spain); H. Pikhart, J. Morrison (UCL, UK).  

EXHAUSTION project: K. Aunan (CICERO, Oslo, Norway); A. Schneider, S. Breitner (Helmholtz Zentrum, Munich, Germany); M. Stafoggia (ASL Rome, Italy); A. Gasparrini (LSHTM, UK) 

EXPANSE project: R. Vermeulen, J. Vlanderen, G. Hoek (Utrecht University, The Netherlands); M. Chadeau (IC, UK).  


Teaching and Supervision:

Coordinator of undergraduate core course in Medical Statistics for Medical School students, Medical School, National and Kapodistrian University of Athens 

Contributor to the undergraduate core course in Biostatistics for Dental School students, Medical School, National and Kapodistrian University of Athens 

Director of the postgraduate programme in Biostatistics run jointly by the Medical School and the Department of Mathematics, National and Kapodistrian University of Athens 

Teaching Research Methodology, Epidemiology and Environmental Epidemiology in the above Programme and other postgraduate programmes.  

Contributing lecture in the Health Module of the MSc Programme in Air Pollution Science, ERG, King's College London. 


Postgraduate PhD Supervision:

Wood, D Novel exposure estimation for assessing the effects of long-term exposure to pollutants on cognitive decline in the elderly. 
2017 - date

Evangelopoulos, D Simulation of multi-pollutant models results in the presence of measurement error to aid interpretation of the magnitude of independent air pollutant effects in health impact assessment. 
2015 - 2019