Newspaper April 2022 HBM4EU - European Human Biomonitoring Initiative
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April 2022 HBM4EU Newspaper European Human Biomonitoring Initiative
2 Table of contents 3
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This project has received funding from the European Union’s Horizon 2020 research and innovation
programme under grant agreement No 733032
Funded by the European Union’s Horizon 2020 research and innovation programme, the European
Human Biomonitoring Initiative, led by the German Environment Agency, was jointly implemented
by 120 partners from 30 participating countries – 25 EU member states plus Norway, Switzerland, 4-5 6-7 8 - 11 12 - 13 14 - 15
Iceland, Israel and the UK, and the European Environmental Agency from 2017-2022. What is HBM4EU? Who are we Stakeholder’s Science to policy One substance, one
perspective assessment
For more information on the HBM4EU please get in touch with us:
6 7 8 9 10
HBM4EU Coordinator:
• German Environment Agency, HBM4EU@uba.de
HBM4EU Knowledge Hub:
• European Environment Agency, HBM4EU@eea.europa.eu
For further information visit us: www.hbm4eu.eu
16 - 19 20- 22 23 - 27 28 - 67 68 - 69
Health impacts of HBM4EU Aligned European HMB HBM4EU Priority Our scientific
Follow us on our social media channels at: chemicals studies Laboratory Substances achievements
Network
• Twitter: @HBM4EU
• Facebook: @HBM4EU
• LinkedIn: HBM4EU - Human Biomonitoring for Europe
11 12 13 14 15
• Instagram: hbm4eu
70 -73 74-75 76 - 81 82 - 83 84 - 85
National Hubs Outreach to the Insights Building capacities Measuring impact
public across Europe
16 1786 - 87
What is next?
88 - 91
Final Conference
4 What is HBM4EU? 5
HBM4EU
aims to advance human
biomonitoring in Europe by We are
providing evidence of the HBM4EU
exposure of EU citizens to
chemicals and their effects
on human health in order to
support policy making.
6 Who are we 7
HBM4EU - a strong network to
support human biomonitoring
and environmental health
policies in Europe
written by The German Environment Agency
Decision
The exposure of citizens to chemicals and related health Human Biomonitoring (HBM) is a key tool to investigate Making
impacts are in the center of public and political concern. the exposure of people, and to inform regulators and Scientific and
Reliable data are the prerequisite on which policies, citizens about the extent of the pollution of the human Administrative
Knowledge Ethics
regulation and information for the general public must body, the sources and meaningful protective measures. Management
Hub Board
be based to safeguard a healthy life in a healthy Europe. Project Coordinator,
Co-Coordinator, Secretariat
A
fter years of intense loops. With this new and innovative HBM Platform, which covers all and evidence were supplied
Governing
work from national HBM network, HBM4EU was not only components of HBM studies, and 3) by HBM4EU. The results show Science to
Board (GB) Policy
programmes in Europe able to react quickly to consulting Exposure and Health, which deals clearly that we need to put more
Programme Pilar 1
and the successfully finalised co- and research needs, but also to with the research of innovative effort into information for the Steering
general public and multipliers, as
Owners, EU
funded EU projects ESBIO, COPHES provide an excellent basis for methods to determine the relation
and DEMOCOPHES, the need to future partnerships and projects. between exposure and health. such for the consumer behaviour Agencies
establish a permanent HBM on a HBM4EU is a European Joint The respective expertise of each which results in a permanent European
European level became urgent. country is bundled in ‘National exposure of human bodies to HBM Exposure
Programme, funded by the
Plataform and Health
Since 2017, the German European Commission under Hubs’, which function as conduits plasticizers. Not only regulations
Pilar 2 Pilar 3
Environment Agency is its H2020 programme with 74M to both sides between HBM4EU for the environment are necessary,
coordinating the European Human EUR. The project is located on and the member countries to but also a clear plastic strategy
Biomonitoring Initiative which the intersection between science ensure that national requirements that focuses on human data and Management
comprises 116 partner institutions and policy. It was designed to use are fed. effectively prevents the pollution Board (MB)
from 30 members countries. gained scientific knowledge to The project’s large scale was of the human body. This serves Project Coordinator,
Over 5 and a half years, HBM4EU answer urgent policy questions quite a challenge for setting up just as an example and more Co-Coordinator, Pilar
established highly capable concerning prioritised substances an efficient and transparent conclusions like this can be drawn Leaders, Work
networks, which have developed and substance groups. The cooperation, but HBM4EU based on HBM4EU findings. Package Leaders,
a new mode of cooperation Governing Board which mainly produced data that can serve We as the coordination team at National Hub
including the generous, prompt consists of representatives of as a baseline to evaluate the the German Environment Agency Coordinator
Stakeholder
and free sharing of data. This the Ministries responsible for success of the measures taken would like to express our heartfelt
Forum
network ensures political support the national programmes is the to operationalise the Chemicals gratitude to the entire consortium
through the engagement of the ultimate decision-making body Strategy for Sustainability and of the HBM4EU project and all
National Hubs
national Programme Owners and of HBM4EU. The Management the Zero Pollution Agenda in the partners for putting endless hours
the EU Policy Board, and includes Board did the steering of the frame of the European Green in this fascinating and challenging
(NH)
scientific Europe-wide excellence project. Both boards are in close Deal. The results of HBM4EU project. The intensive and fruitful
Advisory
by involving governmental exchange with the Stakeholder clearly show that the levels of collaboration between all partners
Board
and research institutions alike. Forum and the Advisory Board, some substances in the human and national efforts dedicated
Valuable knowledge of the scientific which act as consulting bodies for body of the European population to HBM4EU during our journey
communities and EU agencies HBM4EU. The activities developed are still so high that adverse were the basis which made this
served as foundation for the under the project are organised health effects cannot be excluded project a success and made the
planning of work even before the in work packages clustered under according to current knowledge establishment of our network
beginning of the project, and have three pillars: 1) Science to Policy, and that there is an urgent need possible. In addition, it was a great
been continuously refined and which ensures the translation of to address mixtures effects in risk pleasure and honour for us to act HBM4EU governance structure
expanded by ongoing feedback results into policy, 2) European assessment. Accordingly, proposals as coordinators in this process.
8 Stakeholder’s perspective 9
In order to protect citizens from chemical risk, it is crucial to comprehensively
understand the compounds present in our living environment and their
“The role of HBM in a new effects. HBM4EU has been instrumental in advancing the field of human
biomonitoring and informing environmental protection policies in the EU.
European Chemicals Strategy Since its inception it has been working to build a strong knowledge base and
for Sustainability“
has contributed to important EU initiatives such as the Chemical Strategy for
Sustainability and the Zero Pollution Action Plan. HBM4EU has also served
in several consultations in the EU on the restriction of use of substances, by
— Carmen Laplaza Santos
C
providing evidence on the levels of exposure to compounds such as pesticides, Head of Unit ‘Health
— Thomas Jakl itizens have the right new substances and recently
Deputy Director-General of mercury, chromium VI and many others. It is for this reason that HBM4EU is Innovations’, People
to know what they detected toxicological effects, Directorate of the DG Research
the Ministry of Environment of a major tool to share harmonised information at the European level, limit
Austria, which is responsible are exposed to, what in particular to ensure a high and Innovation, European
for chemicals policy chemicals are in their bodies level of protection of vulnerable chemical exposure and prevent illnesses stemming from it. We hope to see this Commission
and how their health is affected. groups such as children. programme’s achievements used to expand knowledge and further protect
Understanding and responding On its way towards “zero people and the environment in the upcoming Partnership for the Assessme.
to citizens’ concerns, raising pollution“ Europe is relying on
public awareness and making a robust and sustained
science accessible were core comprehensive human
parts of the HBM4EU initiative, biomonitoring programme to
which I am regarding as a true assess the risk of chemicals in the The conclusions of the HBM4EU project are very timely. This year, the
masterpiece among all the bodies of European citizens and European Commission is busy defining policy options for revising key legislation
projects performed under the to assess the associated health such as REACH. We need to have a vision of which chemicals are present in
Horizon 2020 Programme. impacts. Human Biomonitoring the bodies of European people and in which quantities. This is key to improve
This project bridged science already today is the guardian
our understanding of their impact, and hence an important element in our
and policy while at the same angel for chemicals policy. And
policy making. Therefore the Commission will also continue to foster research
time equipping the European chemicals policy itself stands in
Union’s chemicals policy with the very centre of the Union’s and (bio)-monitoring to better understand and prevent chemicals-related
both an effective tool of quality flagship initiative: Within the risks and drive innovation in chemical risk assessment and regulatory science — Cristina de Avila
Head of Unit Sustainable
control as well as an intelligent framework of the Green Deal through our framework programme for research and innovation. Chemicals DG Environment,
“early warning system“. we all together have to join European Commission
HBM4EU tells us if the risk hands to accomplish transition
management measures we set towards a circular economy.
in place are doing their job and And it is beyond doubt that this
effectively reduce the chemical giant undertaking desperately
burden. It tells us to adjust needs a wise and well equipped
our instruments to embrace guardian angel.
10 Stakeholder’s perspective 11
Programmes like HBM4EU are crucial to detect what toxic chemicals Metals play a crucial role in society. They enable existing and emerging
accumulate in the human body. But they also show the presence of certain technologies and represent a strategic and recyclable resource. Managing the
toxic chemicals which should not be in the human body in the first place. potential risks associated with their manufacturing and uses is a key priority.
The message must be: Exposure to toxic chemicals needs to be stopped, This requires in-depth knowledge on exposure and understanding the possible
stronger regulation is needed. We know that women are affected differently impacts. HBM provides very useful information to achieve this and identify
by chemicals. Therefore, more gender disaggregated data is needed and had where to further reduce exposure, if so needed.
to be taken into account in decision making and risk assessments. We will
— Violaine Verougstraete
— Johanna Hausmann use HBM4EU data to call for action on the political agenda.
Senior Policy Advisor, Chemicals Management
Chemicals and Health, Director, Eurometaux
Consultant for WECF
The EEB welcomes the important HBM4EU results and we hope
HBM4EU is a sorely needed public health tool for providing real-life data that this project takes us one step closer to the establishment of a
to policy makers on the widespread daily exposure of Europeans to harmful permanent biomonitoring program in the EU. HBM4EU data is relevant
chemicals such as pesticides, phthalates, Bisphenol A and PFAS and the impact because it can support regulatory action to reduce exposure to highly
these may have on our health. HEAL is pleased that the project has successfully hazardous chemicals, such as those included in the EU Restriction
delivered the first comparable data to answer policy questions, which must Roadmap, PFAS and bisphenols. This biomonitoring project is a showcase for
be used to trigger new legislative measures to reduce people’s exposure and the benefits of prioritising, supporting and evaluating policy measures when it
protect our health, especially those most vulnerable. comes to reducing the exposure to hazardous chemicals and their mixtures. — Tatiana Santos
Policy Manager Chemicals &
— Dr Angeliki Lyssimachou Nanotechnology, European
Senior Science Policy Officer, Environmental Bureau
Health and Environment
Alliance
Being part of the HBM4EU’s journey was very exciting and educational for
HBM4EU is a good example of transparent and open collaboration between me. Now I am curious, how this area will develop further and to what extend
authorities, academia, civil society and industry. We were very pleased to actively it can support SME to navigate in a highly complex regulatory framework
support and contribute to the HBM4EU program. We use human biomonitoring like the EU’s chemicals legislation.
data as an appropriate tool for specific and key evaluations because they
offer complementary and distinct advantages over other exposure monitoring
methods currently in place or under development. As demonstrated during — Marko Susnik
all the work, while the work generate very useful information for experts, it is Senior Advisor Chemical Policy,
—Dr Michel Cassart Austrian Economic Chamber and
important to remain very careful about how to communicate and use the data Advisor to the Secretary General
Sustainability Director,
Plastics Europe because taken out of context and without the necessary scientific background, on Chemicals Policy, SMEunited
the generated information can be misused.
12 Science to policy 13
Bridging science and policy to
better protect human health
Protecting the health of European citizens is a priority of the European Union. In this context, the science-policy
interface of the HBM4EU is particularly important, ensuring up-to-date and coordinated science-based information
for policy makers responsible for managing risks to human health from chemical exposure.
O
ne of the overarching general population and workers Highly exposed groups like replaced by substitutes that HBM4EU partners are actively
goals of HBM4EU was to chemicals and their effects on workers present a concern, have entered the human body identifying windows of
to actively engage human health and provided new as occupational exposure to and that can now be quantified opportunities in regulatory
with policy makers to translate tools to facilitate the use of these specific chemicals may be several in a large proportion of the EU processes on chemicals where
scientific results into effective results. For instance, to allow times higher than environment population. Moreover, analysis of they might feed in evidence.
policies and make a step forward interpretation of HBM data in a exposures experienced by the exposure determinants reveals HBM4EU has fed results and data
in protecting citizens’ health health risk context, HBM4EU’s general population. Harmonized how the internal dose may be into chemical-specific regulatory
across Europe. Hence, HBM4EU scientists derived HBM Guidance occupation studies on exposure to attributed to multiple upstream processes led by the European
designed its research programme Values for the general public chromium VI, to diisocyanates and sources, emphasising the need to Commission, the European
to answer concrete policy and for workers for a number of to hazardous chemicals in e-waste consistently regulate substances Chemicals Agency, the European
questions from EU and national Food Safety Authority, and
substances. These health-based handling have yielded results that across policy domains.
policy makers. After 5 years of guidance values were widely All data from HBM4EU were Secretariat of the Minamata
support improved protection of
top-notch research, we have endorsed after a consultation shared with national and EU Convention on Mercury at the
workers.
answered key policy questions, United Nations Environment
process involving all HBM4EU To provide coherent datasets policy makers as soon as they
such as whether chemical bans Programme. HBM4EU is also
partners, with the methodology that can be used in decision were quality assured – to ensure
successfully reduced exposure supporting regulatory measures
and how exposure to substitutes
made available to the scientific making at European level, that they are available to support
addressing priority substances,
has evolved over time, whether
community. significant efforts were devoted for regulatory decision-making
as soon as possible. Additionally, such as the ongoing proposal to
people in certain regions are at Another tool is the set of to harmonising methodologies
HBM4EU established a trust- restrict a wide range of per- and
risk, and how the chemical body indicators, developed to assess and standardising data collection
based cooperation and data- polyfluoroalkyl substances
burden varies with sex, age, and time and spatial trends in the under HBM4EU. The HBM4EU
sharing process between all (PFAS) under REACH and the
socio-economic status. exposure of European citizens to Aligned studies have generated
parties to enable the consortium to recent EFSA draft opinion on
chemicals and to get a picture of new human biomonitoring data
HBM4EU results on human react on short notice to knowledge Bisphenol A.
the population at risk. HBM4EU on the current internal exposure
exposure to chemicals in needs, such as the request from Looking forward, HBM4EU
first developed an approach of the general population to a
products, such a phthalates and the Directorate-General for Health results will be used as baseline
to producing European HBM selection of HBM4EU priority
bisphenols, and potential health and Food for information on against which the success of
impacts, support regulatory action indicators and proposed two types substances and effect biomarkers
human exposure to copper. the EU Chemicals Strategy for
to make products safer. Health- of indicators, indicators of internal in over 10,000 European
Exploring the different ways Sustainability and Zero Pollution
based human biomonitoring exposure derived directly from citizens. The data is available
human biomonitoring and health Action Plan will be measured. We
guidance values provide biomarker concentrations and at the European Human
surveys might be combined is have also contributed to shaping
benchmark values against indicators of health risk, comparing Biomonitoring Dashboard,
another opportunity explored by the next research agenda for
which to compare exposure in the exposure concentrations to which also includes human
HBM4EU, as it would produce an chemical at European level -
general population, as well as in HBM guidance values. These biomonitoring data from previous
extensive database for research the European partnership for
the occupational context. Evidence indicators have been produced studies collated under the
to support policy decisions. the assessment of risks from
of exposure to multiple chemicals for bisphenol and per- and HBM4EU project. Furthermore,
Combined surveys are cost- chemicals (PARC).
at the same time supports efforts polyfluoroalkyl substances (PFAS), aggregate data is included in effective, reducing the resources
HBM4EU has realised the
to consistently address mixtures which both have high policy and the Information Platform for required to collect information
vision of a human biomonitoring
in risk assessments, while work to societal relevance, as well as for Chemical Monitoring (IPCHEM), and recruit participants, while at
programme in Europe to support
identify chemicals of emerging cadmium, phthalates, and DINCH, facilitating the use and reuse the same time collecting more
the delivery of chemical safety for
concern that may pose a health a non-phthalate plasticizer. These of human biomonitoring data information from each study
Europe’s population – it is now time
risk through non-target screening indicators can be used to assess in regulatory processes and participant. Guidelines for how to
to make it a permanent reality.
provides early warnings of the effectiveness of current EU research. combine cross-sectional health
potential risks. chemicals regulations and to HBM4EU results confirm surveys and human biomonitoring
HBM4EU generated scientific identify the need for additional that legacy chemicals subject to studies at general population level
knowledge on the exposure of the action to protect citizens. regulation are in many cases being are now available.
14 One substance, one assessment One substance, one assessment 15
Reconciling chemical
legislation with the state
of HBM science
written by Dr Robert Barouki
Scientists in the field of chemical safety often face highlight the mechanisms of action corresponding
a dilemma when they need to present the different to groups of substances? Depending on which
classes of chemicals and their regulation: should they classification is chosen, the outcome may end up being
first address the different professional sectors and quite different. These questions can be addressed by
legislations? Or should they focus on the substance filling the gap between regulation and exposure and
irrespective of its sources? Or even should they toxicological sciences.
T
he Chemical Strategy for sources and from different routes information both on the actual current legislation/sectors, but
sustainability has highlighted (ingestion, inhalation, skin). In the level of contamination that can also from the perspective of the
the “one substance one exposure science field, this is now initiate a health effect, and on substances themselves.
assessment” concept. This would referred to as the “Aggregated the contribution of the different Yet, this is not enough.
be a major improvement over Exposure Pathways” or AEP. exposure sources and pathways. The Chemicals Strategy also
the current situation in which the Furthermore, HBM takes into Clearly the combination of highlights the importance of
same substance can be evaluated consideration the physiological internal dose data and exposure certain mechanisms of action
and eventually regulated in steps that lead to internal pathway analysis is an important such as endocrine disruption
different sectors, sometimes with dose such as the absorption, contribution to decision making and immunotoxicity and of the
different conclusions. This is the distribution, metabolism and and to the protection of citizens. mixture issue. Therefore the
case for example if the substance excretion. In addition, in the case “one substance one assessment”
has different properties and should not be interpreted as an
applications, e.g. as a biocide approach that would not take
or in consumer products or in "The Chemicals Strategy for into consideration the grouping
cosmetics. This has been primarily of chemicals according to their
justified by the fact that legislations
Sustainability has highlighted
mechanisms of action or that
are sector-dependent and the one substance one would separate the assessment of
decisions are focused on acting assessment concept." substituents from that of parent
on the source of contamination chemicals. Au contraire, the
without taking into consideration “one substance one assessment”
the presence of multiple sources. of storage of persistent chemicals With this in mind, a sector-based approach is in fact the first step
Indeed, for a long time, the in the body (persistent organic decision making is not sustainable towards a mechanism-inspired
only available information was pollutants, some metals), HBM and may not be protective enough. assessment of chemicals and
the amount of contaminants also integrates the release of the By focusing on a substance towards an improved rational
in different sources with little chemicals from their storage sites, approach, HBM is an essential assessment of mixtures.
information on the impact of e.g. adipose tissue and bone, in step for the implementation of the
combinations of intakes. This has the bloodstream. Furthermore, it “one substance one assessment”
changed with the development of should be stressed that the internal promoted by the Chemical
human biomonitoring (HBM) and dose of contaminants is the actual Strategy for Sustainability. A
kinetic modeling. trigger for the adverse outcome straightforward implication of
By assessing the internal dose pathways. When combined with this conclusion is that data on
© Fulvio Ciccolo
of chemicals, HBM integrates the computational tools such as chemicals should be presented
intake of chemicals from different PBPK, HBM studies provide critical both from the perspective of the
16 Health impacts of chemicals 17
Health impacts of chemicals
The interest of assessing Chronic obstructive Reproductive health Brain development Cancer
exposure to chemicals pulmonary disease
Cancer is a group of diseases Several (16 out of 18) of the
in human biomonitoring Chronic obstructive pulmonary Reproductive health refers to the Thyroid hormone is important
HBM4EU priority substances have NOSE
male and female reproductive for brain development especially involving abnormal cell growth. BRAIN
is ultimately to evaluate disease (COPD) is a chronic carcinogenic properties, with varying AND NASAL
Acrylamide
systems including fertility, during the fetal and postnatal Majority of the cancers are due SINUSES
how it affects our inflammatory lung disease levels of evidence from studies. For Cadmium
Lead
menstruation, pregnancy, period. Thyroid hormone to genetic mutation and a small
health. HBM4EU priority causing no non-reversible example, acrylamides are shown SKIN
menopause, and several deficiency may cause retarded proportion due to inherited
breathing difficulties. COPD is to have a possible association LUNG Arsenic
substances were selected, chronic health problems such maturation, intellectual deficits, and genetics. In Europe, cancer is the Acrylamide PAHs
usually caused by a long-term with female breast, endometrial,
among other criteria, exposure inhaled irritants such as endometriosis. neurological impairment. most frequent non-communicable and ovarian cancers. The main
Pesticides
Arsenic BREAST
according to the level as tobacco smoke, which damage Pesticides are shown to be One cause for thyroid disease and the second most exposure sources for acrylamide are
Chromium
Cadmium
BPA
PAHs
of current knowledge lungs and airways. dysfunction may be EDCs which common cause of death. Common occupational exposures, smoking, Lead Pesticides
associated with an increased PAHs Benzophenones
about hazards they pose disrupt thyroid hormone of contributing factors are tobacco and diet in humans. Acrylamide
Exposure to pesticides, risk of female infertility and Pesticides
mothers and foetuses. Bisphenol smoking, diet and obesity, lack of occurs naturally in starchy foods LIVER
to human health. All the especially organophosphate miscarriage and cause increased Arsenic
A has been shown to affect thyroid physical activity and infections. during cooking processes at high KIDNEY
examined substances and carbamate insecticides length of the menstrual cycle.
temperatures such as frying, baking, Acrylamide
Benzophenones
hormone levels in pregnant women WHO estimates that around 20
have been associated and some herbicides, lead and They may also be associated Arsenic
STOMACH
% of the disease burden is due and grilling. Lead
PAHs has been associated with delayed pubertal onset. which implies that boys may have PFAS Lead
with some adverse health increased risk of ADHD-related to environmental (including In the meta-analysis, among Benzophenones
with increased risk of COPD. Among males, occupational
effects, including severe behaviours and girls internalising occupational) factors, and thus non-smokers, higher levels of dietary GASTROINTESTINAL
Cadmium, chromium, arsenic use of pesticides is shown to TRACT
impacts, depending on and externalising behaviours. preventable. About 120,000 work- exposure for acrylamide have shown BLADDER Acrylamide
and diisocyanates are possibly be associated with decreased Anilines
to have a possible association with
the dose and duration of associated with increased risk of sperm quality. Many pesticides exert related cancer cases and 80,000 Arsenic PROSTATE
endometrial and ovarian cancer but Arsenic
exposure. Affecting various toxicological effects, including on related fatalities occur each year as
COPD and/or decreased risk of New emerging chemicals, not with breast cancer. TESTICLES
BPA
organs and systems in the thyroid signalling. The mother/ a result of exposure to carcinogens Cadmium
lung function. such as replacement flame Cadmium (Cd) is one of the PFAS
child cohort studies have shown at work in the EU. Evidence supports
human body, this section retardants, have been shown to most toxic metals that is present
that organochlorine (OC) pesticides association between anilines,
introduces diseases linked have adverse health effects on in the environment naturally and
may exert significant thyroid arsenic, cadmium, chromium VI,
to the HBM4EU priority reproductive health by in vitro due to human activities in industry
hormone inhibitory effects. mycotoxins and PAHs and different and agriculture. In the general
substances. studies.
Organophosphorus pesticides cancers. For acrylamide, aprotic population, the main sources of Substances with
(OPPs) and carbamates have been solvents, benzophenones, flame cadmium are cigarette smoke, food, carcinogenic effects:
associated with thyroid dysfunction, retardants, lead, mercury, PFAS, Aprotic solvents, emerging
water and ambient air. Cd is an
chemicals, flame retardants,
increased hyperthorydism and pesticides, and phthalates there are endocrine-disrupting chemical that mercury, mycotoxins and
brain function impairment. possible associations with cancers. demonstrates estrogen like activity. phthalates have no specific data
18 Health impacts of chemicals 19
Bisphenols PFAS Phthalates PAH Pesticides Arsenic Mercury Cadmium
Glucose Lipid Blood
Obesity
metabolism metabolism pressure
Associations between metabolic syndromes and HBM4EU Priority Substances
(color of the line refers to the substance and line type to the component of the metabolic syndrome)
Endocrine disrupting Attention deficit hyperactivi- Alzheimer’s disease Asthma Scan the QR codes to access peer-reviewed
Osteoporosis Metabolic syndrome
chemicals ty disorder publications on the topic
Alzheimer’s disease (AD) is Asthma is one of the most
Osteoporosis is a disease affecting Metabolic syndrome (MetS) is a Endocrine disrupting chemicals Attention deficit hyperactivity
the most common form of common chronic diseases. Reproductive Metabolic
bone health of 200 milion people cluster of conditions: increased (EDCs) are chemicals or chemical disorder (ADHD) is a
dementia affecting memory. It is Mechanisms lying behind health syndrome
worldwide. Traditional risk factors blood pressure (hypertension), mixtures that interfere with the neurodevelopmental disorder
a progressive disease interfering asthma’s development are
for osteoporosis are high age, early diabetes/increased blood human endocrine system and characterised by hyperactivity,
with cognitive abilities, complex and include host
menopause, low body weight, diet sugar, obesity, and abnormal disrupt hormone levels, or how inattention, lack of focus, weak
behaviour and functioning of the
without sufficient calcium and cholesterol levels increasing our body reacts to different impulse control and exaggerated factors such as genetics and
affected person.
vitamin D concentration, smoking the risk of several diseases hormones. emotions. Its more common sex, and environmental factors,
Current evidence suggests the
and unhealthy drinking. Evidence including cardiovascular disease, A group of EDCs includes among children but also like exposure to allergens or
association between exposure
exists that certain environmental dementia, cancer, and type 2 pesticides, plasticizers such as diagnosed among adults. smoking. Various environmental
to pesticides and increased risk Cancer Asthma
substances may also increase the diabetes. phthalates, bisphenol A, heavy Current evidence indicate chemicals may also affect the risk
of AD. For mercury, cadmium,
risk of osteoporosis. Exposure to EDCs has been metals such as lead, brominated that several environmental of asthma development and can
arsenic, and lead a possible
A possible link between identified as an additional flame retardants and UV filters. chemicals and heavy metals may association has been observed escalate asthma symptoms.
osteoporosis and the body and inadvertent risk factor for Exposure to EDCs happens be associated with increased but more studies are needed. Exposure to PAHs and
burden of heavy metals, such metabolic disorders. Exposure through air, food and water, risk of ADHD. Moderately high some pesticides is associated
Current knowledge comes
as cadmium (Cd) and lead (Pb), starts already in utero and skin or in case of foetuses and association between ADHD and mainly from occupational studies with increased risk of asthma.
and industrial chemicals such continues throughout the human breastfed children, through the lead, phthalates and bisphenol where exposures are higher than Diisocyanates and Cr(VI) cause Alzheimer’s
as phthalates and per- and poly- lifespan. Highly vulnerable groups mother. EDCs are present in A has been observed while among the general population. asthma with specific sensitization. Osteoporosis disease
fluoroalkyl substances (PFAS) has are pregnant women, small pesticides, plastic, food storage more limited evidence suggest
been observed. children, certain occupational materials, electronics and possible association also with
groups, and people with low building materials, personal PAHs, flame retardants, mercury,
About 23% of osteoporosis
socioeconomic status. care products, sunscreens, and and pesticides.
cases could be attributed to
textiles.
cadmium exposure. Food is At least bisphenol A, PFAS,
the most significant source of phthalates, PAHs, pesticides, EDCs are associated with Chronic obstructive Attention deficit
pulmonary disease Brain hyperactivity disorder
exposure to Cd, nevertheless arsenic, mercury, and cadmium several health problems including
(COPD) development (ADHD)
other sources, contribute to the have been shown to be associated those linked to reproductive
total human exposure, such as with increased risk of MetS. health, child development,
the inhalation of tobacco smoke or immune system, cancers,
particulate matter from ambient metabolic syndrome, coronary
air for example. disease, and neurological and
learning disabilities.20 HBM4EU Aligned studies 21
Harmonizing human
biomonitoring surveys
across Europe
Human biomonitoring (HBM) is an important tool not only countries lack such a national programme and collect HBM
for understanding exposure to chemicals and supporting data in the frame of specific research projects. Hence, the
environmental and health policy development, but also studies are fragmented and heterogeneous. Up until now,
for awareness raising campaigns or remediation actions. there was not an overarching strategy within Europe, and
Some EU countries have HBM programmes that monitor current studies were not harmonized or aligned to meet
exposure to a wide variety of chemicals. Examples are the common goals. Therefore, to generate comparable HBM
German GerES studies the Czech-HBM (Czech Republic), data across Europe, ongoing and planned HBM studies
ELFE (France), PROBE (Italy), BIOAMBIENT.ES (Spain) or from different European countries and regions have been
FLEHS (Flanders, Belgium). However, most European aligned under the HBM4EU Aligned studies initiative.
T
he importance of this were set to include subjects of initiative. Each participating study
work is highlighted by the
A primary goal of different socio-economic status, contributed with a maximum of
European Commission’s HBM4EU was to for example, or living in areas with 300 samples per age group, except
announcement of the European build up an EU- different degree of urbanisation for a few studies that participated
Green Deal, the Chemicals’ (e.g. rural and urban). Specific with a reduced number of subjects”
Strategy for Sustainability and the
wide surveillance priority chemicals were nominated. reports Dr Eva Govarts, researcher
Zero-Pollution Action Plan for a of the exposure of For instance, pesticides were and statistician at VITO Health.
studied in children and adults, According to the expert, “individual
toxic-free environment. Having European citizens
bisphenols in adults and PFAS in biomonitoring data from more than
reliable and comparable HBM
exposure data representative of
to chemicals. teenagers. “Within each age group 43,000 analyses were performed,
covering 16 chemical groups”.
EU-wide coverage was achieved by
the EU population is crucial to feed
including a number of countries “The obtained exposure data
into chemical risk assessment and “In a first step this was meant show the current exposure levels
per European region - North,
support chemical policy making. aligning and harmonising
in European population. This
national HBM programmes as East, South, West - in proportion
“The HBM4EU Aligned studies to the number of inhabitants data can be used as a baseline for
much as possible. New EU-wide
is the first large scale survey in comparisons, for instance between
biomonitoring data have also of the regions” specifies Liese
which ongoing HBM initiatives in European regions and between
Gilles, researcher at VITO Health.
+ ISRAEL + CYPRUS
been generated in the HBM4EU existing, as well as new international
Europe are aligned and data “Samples were collected between
Aligned studies” stresses monitoring programmes. The data
and questionnaire information the expert. In order to select 2014-2021 to reflect recent
has been compared to existing
harmonized, laying the foundation participating studies, a theoretical exposure levels”, she adds.
health guidance values in order to
of a sustainable European sampling frame was developed “This resulted in 3431 samples assess whether observed exposure
HBM platform in support of defining criteria to obtain an EU- collected from children 6-11 years levels exceed safe limits. Generated
environmental and health representative sample. from 14 countries, 2950 samples exposure data are used in (mixture)
chemicals policy” states Prof For the samples, three age from teenagers aged 12-19 years risk assessment. Moreover, exposure
Greet Schoeters, University of groups were selected, a selection from 11 countries and 3716 data is being used for identifying
Antwerp, Environment and Health, that facilitated comparison with samples from adults 20-39 years exposure determinants and
Flemish Institute for Technological other international programmes from 12 countries. In total 37 studies investigating possible exposure-
Research (VITO Health). such as Health Canada. Criteria from 23 countries took part in this effect associations” explains Govarts.
@RNDR Studio22 HBM4EU Aligned studies European Human Biomonitoring Laboratory Network 23
The Human Biomonitoring
Laboratory Network, a key
asset in supporting human
biomonitoring and risk
assessment in Europe
Many European countries run human biomonitoring (HBM) biomonitoring data is limited. There is an urgent need for
programmes to monitor exposure levels of environmental harmonizing the design and implementation of human
chemicals, some of them on a regular basis. However, biomonitoring studies, as well as sample and data analysis
these programmes had previously worked independently across national borders to improve health protection and
of one another. As a result, the comparability of human chemical policies in Europe.
In March 2021, the European Human study population. This association
Biomonitoring Dashboard, which between smoking and higher The European Human Biomonitoring Dashboard
includes data:
T
visualises summary statistics from cadmium levels was already
62 human biomonitoring data reported as well. he one-of-a-kind European was created after inventorying Accident Insurance explains how human samples with a high
From existing HBM studies: Human Biomonitoring potential candidate laboratories the process played out for his quality and in a comparable
collections from 15 European “We are about to incorporate
countries was launched. all data from the HBM4EU Aligned
• 61 HBM data collections Laboratory Network includes with capacity to perform chemical institute. “Our lab participated way. Technical difficulties were
“We wanted to make human studies within the dashboard. • 15 countries 166 laboratories, together with the analysis of the samples coming as reference laboratory for some resolved, especially for certain
biomonitoring data accessible to Even though the project ends in • 17 substance groups Quality Assurance/Quality Control from the different studies in biomarkers supporting the QA/ groups of substances, such
a broader community, allowing June 2022, the website will remain • 152 biomarkers (QA/QC) programme, has been the HBM4EU. “The main goal of the QC programme, as well as in the as, organophosphate flame
users to explore levels and trends online for the next 10 years to • 13 unique matrices key to achieve comparable results HBM Laboratory Network was HBM4EU training school. In this retardants and phthalates. ”An
in the exposure of European ensure continuity and access of high quality in HBM4EU and to on one hand, to ensure the way, we helped other candidate important contribution has been
citizens to chemicals” highlights to the data”, reports Schoeters. From HBM4EU Aligned studies: connect human biomonitoring quality and comparability of the laboratories to fine tune their the development of materials,
professor Schoeters. Additionally, HBM4EU data is • 3431 samples collected from children 6-11 years from 14 laboratories in Europe. analytical results in HBM4EU methods, identify and solve such as the Standard Operating
openly accessible via IPCHEM, the countries, Professor Argelia Castaño, and on the other, to identify technical difficulties, and build Procedures for example, all of
The data in the dashboard
Information Platform for Chemical • 2950 samples from teenagers aged 12-19 years from 11 Director of the National Center for the analytical capacities in EU up capacities. The HBM4EU them available in the HBM4EU
also confirms earlier findings. For
Monitoring, available to risk countries Environmental Health (CNSA) at the Member States to support human QA/QC programme was very Online Library on the project
instance, observed concentrations
assessors and researchers for use, • 3716 samples from adults 20-39 years from 12 countries Instituto de Salud Carlos III (CNSA- biomonitoring”, declares Dr Marta labour intensive, but in the end, website”, explains Dr Susana
of perfluorooctane sulfonic acid
thus multiplying the added value ISCIII) in Spain and leader of the Esteban, senior scientist at CNSA- a great success story. Most of Pedraza-Díaz at CNSA-ISCIII and
(PFOS) in blood are generally
of this new evidence base. European Human Biomonitoring ISCIII and a leader of this activity the participating laboratories responsible for the library.
lower in female compared to
Platform, sets out the objective within HBM4EU. significantly improved their More than 43,000 analyses
male subjects within the same “We are thankful to the study
of the work. “We have built a The network, spanning across results over the four rounds, and have been performed by 34 of
study population. This was already coordinators and data owners
European platform for human 28 European countries, includes many succeeded in obtaining the the 74 qualified laboratories
reported in literature, explained by who managed and executed the
biomonitoring, with harmonized laboratories with experience in the HBM4EU certificate for various from 26 European countries.
the elimination of PFAS through studies within their country or
tools and laboratory networks to organisation of Interlaboratory exposure biomarkers”. The Trace Analytical Laboratory
menstruation, and for mothers region and shared their data,
also through delivery and lactation. making them widely available for provide comparable information Comparison Investigations (ICIs) The usefulness of this of the Research Centre for Toxic
Another example is cadmium. risk assessment and management. on the levels and determinants and External Quality Assessment network has been proven during Compounds in the Environment
Observed concentrations of We are also developing a protocol of chemical exposure in citizens. Schemes (EQUAS), laboratories the project since it has also at Masaryk University in Czechia,
cadmium in blood are generally enabling further use of the data The performance of HBM studies that participated successfully in supported capacity building the Department of Growth and
higher in smokers compared to in other projects via the VITO in a harmonised way and the the QA/QC programme, as well of national laboratories in the Reproduction at Rigshospitalet
non-smokers within the same data platform”. application of rigorous quality as expert laboratories that have participating countries. As Prof in Denmark and the Institute for
control measures ensure that acted as reference laboratories. Castaño explains, “overall, the Prevention and Occupational
observed differences in exposure Dr Holger Koch, scientific head programme has been a complete Medicine of the German Social
levels to chemicals are not related of laboratory at the Institute for success and has demonstrated the Accident Insurance at Ruhr-
to variability in analytical methods Prevention and Occupational capacity of European laboratories Universität Bochum in Germany
and protocols”. The network Medicine of the German Social to analyse contaminants in are three examples of laboratories24 European Human Biomonitoring Laboratory Network 25
1
Qualified laboratories in
HBM4EU QA/QC
2
5 Austria
Belgium
2
7
Croatia 0
Cyprus 1
4 Czech Republic
Denmark
3
5
6 Finland 2
9 1
France
Germany
Greece
7
13
1
Hungary 1
Iceland 0
25
1
3 5 Israel 0
2
17
Ireland 1
Italy 3
Latvia 1
1 4 Lithuania 1
6 Luxembourg 1
9
Norway 1
13
Poland 2
6 2 1
1 Portugal
Slovakia
1
4
Slovenia 2
Spain 7
8
Sweden 2
Switzerland 1
21
The Netherlands 3
8 1
UK
Total
2
74
2
The European Human Biomonitoring Laboratory 2
Network includes 166 laboratories in total
that belong to the network. across borders presented the in Europe, as well as the knowledge- The Human Biomonitoring
They were responsible for greatest challenge. Despite all the and technical gaps that need to Laboratory Network is the
analysing nearly 32% of the total difficulties, we have generated an be filled in the upcoming years project’s legacy for future human
number of samples. As Dr Holger impressive collection of European to support human biomonitoring biomonitoring actions in Europe.
Koch explains, “we analysed many human biomonitoring data, which studies. We have proven the value This network will also provide
samples for HBM4EU, from several will be used in many other research the arena for the exchange of
of such a network, and with that,
projects. In addition, during all
different countries”. the need to continue, extend expertise among high-skilled
these years the laboratories have
Hanne Frederiksen, senior and consolidate the network in laboratories and for supporting the
worked closely together, building
researcher at Rigshospitalet the future as it will be an asset in less experienced ones, providing
not only a network of competence,
identifies some key challenges. support of future HBM and risk solid evidence and data in support
but also establishing great working
“Sample and data transfer relationships to be sustained assessment studies. It will be the of policy making promoting the
agreements, securing permissions after HBM4EU”. focal point for analytical expertise protection of citizens’ health.
from countries and handling the By setting up the network, adds for development of new methods
individual contracts required by Castaño, we have identified the and be a guarantee for analytical
some countries to transfer samples inequalities of analytical capacities results of high quality.26 European Human Biomonitoring Laboratory Network 27
Phthalates/DINCH Flame retardants
Phthalates DINCH Bisphenols PAHs Arsenic Acrylamide Mycotoxins Pesticides UV filters OPFRs HFRs PFAS Mercury Cadmium Chromium
Urine Serum Hair Urine
+
Urine
+
Matrix Serum
Blood +
Blood
Number of biomarkers 15 2 3 13 6 2 1 9 2 4 6 12 1 1 1
Total number of
samples analysed 5616 5960 3613 3169 900 795 1304 2188 975 1875 728 1663 1242 2647 3596
Number of laboratories
that analysed the samples 9 9 8 7 2 3 4 2 1 6 3 7 1 9 9
Number of countries where
the laboratories are located 8 8 8 4 2 3 4 2 1 6 2 7 1 9 828 HBM4EU's priority substances HBM4EU's priority substances 29
Benzophe-
Arsenic Mycotoxins
Choosing our battles: the
nones
HBM4EU prioritisation
strategy
Flame
Cadmium Phthalates
HBM4EU has established a European Union-wide human improve health in Europe. A prioritisation strategy was retardants
biomonitoring programme to generate knowledge on necessary to determine and meet the most important
human internal exposure to chemical pollutants and their needs of both policy makers and risk assessors, as well
potential health impacts in Europe, in order to support as the needs of participating countries and a broad range
policy makers’ efforts to ensure chemical safety and of stakeholders.
“T
his strategy, published For the first step, relevant ministries For the second step, a panel for biomarker measurement.
at the International and agencies at European and of 11 experts in epidemiology, “Finally, in addition to the
Journal of Hygiene and national levels, as well as members toxicology, exposure sciences, and ranking and categorisation of Aprotic
Environmental Health, consisted of the Stakeholder Forum, which occupational and environmental the substances, the resources Mercury Lead
of three mains steps” explains Dr is made of non-governmental health scored each of the available for the project and the solvents
Joana Lobo, expert on Chemicals, organisations, industry and trade substances/substance groups alignment with the policy priorities
Environment and Human Health unions, each nominated up to 5 using prioritisation criteria including at European level were considered
substances/substance groups of hazardous properties, exposure to produce a final priority list of
at the European Environment
concern for policymakers. These characteristics, and societal substances/substance groups”
Agency. “Mapping of knowledge
nominations were collated into a concern. The scores were used to reports Lobo.
gaps identified by policy makers
preliminary list of 48 substances/ rank the substances/substance There were two prioritisation
was the first step, followed by the
substance groups, which was groups. In addition, substances processes finalised in HBM4EU,
prioritisation of substances using
a scoring system. Then a list of
subsequently shortened to a were categorised according to the and a third one that was initiated Per-/
priority substances reflective of the
list of 23 after considering the level of current knowledge about and included categorisation of
polyfluorinated Chemicals
total number of nominations their hazards, extent of human substances but not scoring. This
scoring, as well as of public policy process will be finalised in PARC, compounds of emerging Bisphenols
each substance/substance group exposure (through the availability
priorities and available resources received and the nature of the of HBM data), regulatory status and the follow-up partnership to (PFAS) concern
was generated”, she adds. nominating entities. availability of analytical methods HBM4EU.
Contaminants of food Chemical mixtures
and drinking water
Mercury
PHAs Polycyclic
Environmental Acrylamide
Lead
Chromium VI aromatic
contaminants Arsenic Mycotoxins
Acrylamide hydrocarbons
(PAHs)
Pesticides PFAS
Cadmium Phthalates
Bisphenols
Chemicals in
consumer goods
Occupational
chemicals Benzophenones
Flame retardants Diisocyanates
Diisocyanates and Aprotic solvents Chemical and Anilines
anilines family Pesticides
Chromium VI mixtures family
Chemicals of emerging concern30 HBM4EU's priority substances - Acrylamide 31
Dietary acrylamide may play
living in urban areas seemed to be data, we observed an increase of among pregnant women” states
associated to higher urinary levels acrylamide exposure between the the expert. Although a toxic effect
Main achievements
of acrylamide in children. “That year 2000 and 2018 in European of acrylamide on the neurological • One peer review
a role in cancer, fetal growth
might be explained by the fact non-smoking adults and children. system is known in animals publication published, two
that in those households, there is "However, a new study analyzing and occupationally exposed submitted, two drafted
poor awareness of healthy food adult samples collected after humans, there are no studies on
habits. Boiling or steaming is a 2018, does not show an increasing • Synthesis of the evidence
neurodevelopmental functional
and neurodevelopment: what
safer method of cooking in terms exposure levels, rather declining”. on the relationship
effects in the general population
of acrylamide, and healthy diet in 3 years after the implementation between acrylamide
exposed to acrylamide, thus there
general”. of the mitigation tools, our results and cancer risk, fetal
is an urgent need for further growth and neurological
do we know so far?
The food industry and local may show first slight effects of research to examine whether pre- alteration.
authorities have made efforts these new measurements, in and perinatal acrylamide exposure
since the discovery of acrylamide particular for adults. • Cancer risk assessment
might impair neurodevelopment
in foods in 2002 to reduce Foetal growth and neurological calculation for acrylamide
in humans”.
acrylamide formation during alterations due to acrylamide is
Despite a better understanding • Evaluation of time
food processing. However, only in another concern that has been trends and exposure
of the impact of acrylamide
Acrylamide is a chemical employed in the industry to population. It was found to form naturally in starchy November 2017, the EU legislation addressed during the project. determinants based on
established measures to reduce Acrylamide may cross the placenta on cancer, fetal growth, and
produce polyacrylamides that, in turn, are used for food cooked at high temperature and low moisture European studies (possibly
levels of acrylamide in food and set and lead to the exposure of the neurological system in humans,
different purposes such as flocculants, dyes, paper, including baking, frying, grilling, toasting or roasting as two papers, one is drafted)
safe benchmark levels for specific unborn child. “In a systematic there are still many uncertainties
and textiles. In 2002, acrylamide was first detected in well as in processed foods. Acrylamide is also produced that need further research. In the
foods. Food establishments must review of the literature, we found
foods, which arose a health concern for the general in tobacco smoking. identify food processing steps that high acrylamide exposure meantime, we strongly encourage
that can result in the formation during pregnancy is associated policies aiming to reduce the levels
of acrylamide in foods and take with reduced birth weight, birth of acrylamide exposure through
A
action to reduce those levels length and head circumference. targeted public health education
crylamide has toxic biomonitoring studies to obtain
to a minimum. “In a time-trend If confirmed, these findings and awareness.
effects on the nervous an accurate acrylamide exposure. Nervous system analysis of published and new suggest that dietary intake of
system, adverse effects Aside from occupational damage
European human biomonitoring acrylamide should be reduced
on foetal growth development, exposures and smoking, diet is
reproduction system and the the main source of exposure in
immune system and triggers humans. During the HBM4EU
skin reactions such as irritation Cancer
project, urine samples from
and allergy in humans. It causes children and adults collected
cancer in animals, although it has
between 2014 and 2021 in four
not been confirmed in humans. Immune
countries including Italy, Germany, system
“In HBM4EU we have performed
France and Norway and in six ones damage
a systematic review of the
including Portugal, Spain, France,
association between acrylamide
Luxemburg, Germany and Iceland
dietary intake and risk of different Skin irritation
respectively, were analysed to
type of cancers and we observed and allergies
assess current values and exposure
no association whatsoever”,
determinants. “We concluded
explains Dr Federica Laguzzi, who
that 96% of the adults and 99% of
works at the Karolinska Institutet. Impaired foetal
the children sampled had levels
However, a recent study indicates development
some evidence of a slight positive exceeding the European guidance
association between acrylamide values" explains Dr Federica
exposure and risk of endometrial Laguzzi. Regarding geographical Reproductive
and ovarian cancer, particularly differences, the highest values system
among never smokers, and of of acrylamide exposure were damage
breast cancer in pre-menopausal observed in Southern countries
women” says Prof. Marco Vinceti, for both children and adults.
from the Environmental, Genetic “Determinants of these differences
and Nutritional Epidemiology are still unclear, although dietary
Research Center in Italy. These factors such as fried potatoes and
studies are based on self-reported coffee were clearly associated
dietary questionnaires that may with higher urinary concentration
not capture acrylamide dietary of acrylamide in adults whereas
estimation well. Hence, further low socio-economic status and
research is needed using human demographic factors such asYou can also read
