The Mediterranean area have experienced a drastic increase in population, most of this urbanisation takes place in the coastal zone where people live in increasingly overcrowded coastal strips, exacerbating the pressures on the environment, such as through waste and wastewater generation. The Mediterranean costs host many human activity which cause important adaptive responses and that result in large-scale perturbations such as climate change affect the ecosystem at all biological levels. The Mediterranean region offers a unique opportunity to study the effects of pollution on cluster of populations. Most common human diseases represent the culmination of lifelong interactions between our genome and the environment. The research in the interaction between gene/genome activity and the impact of the environment on health and wellbeing at individual or population level is certainly one of the most promising areas for the future of precision medicine. Studies in functional genomics and epigenetic profiling of the Mediterranean population will be open new perspectives in understanding the interaction between genome and pollution in complex diseases. In this project the dynamic nature of genome and pollution will be simultaneously considered. We strongly believe that by focusing solely on environmental components or only on genetic/genomic factors will miss the most important consideration: the continuing genome-environment interplay in non communicable diseases. We are at the crossroad between theory and practice, all the Mediterranean partners could exchange experiences, share clinical protocols and data, and promote training of experts to deal with threats posed by genome-pollution interaction.