title: Biomonitoring-based environmental public health indicators.
abstract: This chapter discusses the use ofbiomonitoring-based indicators of exposure to environmental pollutants in environmental health information systems. Matrices for biomonitoring, organization and standardization of surveillance programs, the use of intake and body burden data, and the interpretation of surveillance data are discussed. The concept of environmental public health indicators is demonstrated using the "Persistent organic pollutants in human milk" indicator implemented in the Environment and Health Information System (ENHIS) of the WHO Regional Office for Europe. This indicator is based on the data from the WHO-coordinated surveillance of persistent organic pollutants in human milk as well as data from selected national studies. The WHO survey data demonstrate a steady decline in breast milk concentrations of dioxins across Europe. The data from biomonitoring surveys in Sweden also show a steady decline of breast milk concentrations of most persistent organic pollutants since 1970s with the exception of polybrominated diphenyl ethers (PBDEs) which increased rapidly until the late 1990s and then started to decline after the implementation of policy measures aiming at reducing exposures. The application of human biomonitoring data in support of environmental public health policy actions requires carefully designed standardized and sustainable surveillance, comprehensive interpretation of the data, and an effective communication strategy based on credible information presented in the form of indicator factsheets.
authors.affiliation: World Health Organization (WHO), Regional Office for Europe, European Centre for Environment and Health (ECEH), Bonn, Germany. egorovan@ecehbonn.euro.who.int
authors.forename: Andrey I
authors.initials: AI
authors.lastname: Egorov
authors.forename: Dafina
authors.initials: D
authors.lastname: Dalbokova
authors.forename: Michal
authors.initials: M
authors.lastname: Krzyzanowski
mesh_terms: D004147:Dioxins / Q000032:analysis; D004782:Environmental Health / Q000706:statistics & numerical data*; D004784:Environmental Monitoring / Q000379:methods*; D004785:Environmental Pollutants / Q000032:analysis; D005060:Europe; D055768:Halogenated Diphenyl Ethers / Q000032:analysis; D063005:Health Information Systems; D006305:Health Status Indicators; D006801:Humans; D033181:Information Dissemination; D008895:Milk, Human / Q000737:chemistry; D011634:Public Health / Q000706:statistics & numerical data*; D014944:World Health Organization
chemical_list: D004147:Dioxins; D004785:Environmental Pollutants; D055768:Halogenated Diphenyl Ethers