title: Interpreting biomarker data from the COPHES/DEMOCOPHES twin projects: Using external exposure data to understand biomarker differences among countries.
abstract: In 2011 and 2012, the COPHES/DEMOCOPHES twin projects performed the first ever harmonized human biomonitoring survey in 17 European countries. In more than 1800 mother-child pairs, individual lifestyle data were collected and cadmium, cotinine and certain phthalate metabolites were measured in urine. Total mercury was determined in hair samples. While the main goal of the COPHES/DEMOCOPHES twin projects was to develop and test harmonized protocols and procedures, the goal of the current paper is to investigate whether the observed differences in biomarker values among the countries implementing DEMOCOPHES can be interpreted using information from external databases on environmental quality and lifestyle. In general, 13 countries having implemented DEMOCOPHES provided high-quality data from external sources that were relevant for interpretation purposes. However, some data were not available for reporting or were not in line with predefined specifications. Therefore, only part of the external information could be included in the statistical analyses. Nonetheless, there was a highly significant correlation between national levels of fish consumption and mercury in hair, the strength of antismoking legislation was significantly related to urinary cotinine levels, and we were able to show indications that also urinary cadmium levels were associated with environmental quality and food quality. These results again show the potential of biomonitoring data to provide added value for (the evaluation of) evidence-informed policy making.
authors.affiliation: Flemish Institute of Technological Research (VITO), Environmental Risks and Health Unit, Boeretang 200, 2400 Mol, Belgium. Electronic address: roel.smolders@vito.be.
authors.forename: R
authors.initials: R
authors.lastname: Smolders
authors.affiliation: Flemish Institute of Technological Research (VITO), Environmental Risks and Health Unit, Boeretang 200, 2400 Mol, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Den Hond
authors.affiliation: Flemish Institute of Technological Research (VITO), Environmental Risks and Health Unit, Boeretang 200, 2400 Mol, Belgium.
authors.forename: G
authors.initials: G
authors.lastname: Koppen
authors.affiliation: Flemish Institute of Technological Research (VITO), Environmental Risks and Health Unit, Boeretang 200, 2400 Mol, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Govarts
authors.affiliation: Flemish Institute of Technological Research (VITO), Environmental Risks and Health Unit, Boeretang 200, 2400 Mol, Belgium.
authors.forename: H
authors.initials: H
authors.lastname: Willems
authors.affiliation: KU LEUVEN, Belgium.
authors.forename: L
authors.initials: L
authors.lastname: Casteleyn
authors.affiliation: Federal Environment Agency (UBA), Germany.
authors.forename: M
authors.initials: M
authors.lastname: Kolossa-Gehring
authors.affiliation: Federal Environment Agency (UBA), Germany.
authors.forename: U
authors.initials: U
authors.lastname: Fiddicke
authors.affiliation: Instituto de Salud Carlos III, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Castaño
authors.affiliation: Institute for Prevention and Occupational Medicine of the German Social Accident Insurance - Institute of the Ruhr-Universität Bochum (IPA), Germany.
authors.forename: H M
authors.initials: HM
authors.lastname: Koch
authors.affiliation: Institute for Prevention and Occupational Medicine of the German Social Accident Insurance - Institute of the Ruhr-Universität Bochum (IPA), Germany.
authors.forename: J
authors.initials: J
authors.lastname: Angerer
authors.affiliation: Instituto de Salud Carlos III, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Esteban
authors.affiliation: Public Health England, United Kingdom.
authors.forename: O
authors.initials: O
authors.lastname: Sepai
authors.affiliation: Public Health England, United Kingdom.
authors.forename: K
authors.initials: K
authors.lastname: Exley
authors.affiliation: Environmental Health Sciences International, The Netherlands.
authors.forename: L
authors.initials: L
authors.lastname: Bloemen
authors.affiliation: Jožef Stefan Institute, Slovenia.
authors.forename: M
authors.initials: M
authors.lastname: Horvat
authors.affiliation: University of Copenhagen, Denmark.
authors.forename: L E
authors.initials: LE
authors.lastname: Knudsen
authors.affiliation: BiPRO, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Joas
authors.affiliation: BiPRO, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Joas
authors.affiliation: FPS Health, Food Chain Safety and Environment, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Biot
authors.affiliation: FPS Health, Food Chain Safety and Environment, Belgium.
authors.forename: D
authors.initials: D
authors.lastname: Aerts
authors.affiliation: State General Laboratory, Ministry of Health, Cyprus.
authors.forename: A
authors.initials: A
authors.lastname: Katsonouri
authors.affiliation: Larnaca General Hospital, Ministry of Health, Cyprus.
authors.forename: A
authors.initials: A
authors.lastname: Hadjipanayis
authors.affiliation: National Institute of Public Health, Czech Republic.
authors.forename: M
authors.initials: M
authors.lastname: Cerna
authors.affiliation: National Institute of Public Health, Czech Republic.
authors.forename: A
authors.initials: A
authors.lastname: Krskova
authors.affiliation: Federal Environment Agency (UBA), Germany.
authors.forename: G
authors.initials: G
authors.lastname: Schwedler
authors.affiliation: Federal Environment Agency (UBA), Germany.
authors.forename: M
authors.initials: M
authors.lastname: Seiwert
authors.affiliation: University of Copenhagen, Denmark.
authors.forename: J K S
authors.initials: JK
authors.lastname: Nielsen
authors.affiliation: National Institute of Environmental Health, Hungary.
authors.forename: P
authors.initials: P
authors.lastname: Rudnai
authors.affiliation: National Institute of Environmental Health, Hungary.
authors.forename: S
authors.initials: S
authors.lastname: Közepesy
authors.affiliation: Health Service Executive (HSE), Ireland.
authors.forename: D S
authors.initials: DS
authors.lastname: Evans
authors.affiliation: University College Dublin (UCD), Ireland.
authors.forename: M P
authors.initials: MP
authors.lastname: Ryan
authors.affiliation: Centre de Recherche Public - Gabriel Lippmann, Luxembourg.
authors.forename: A C
authors.initials: AC
authors.lastname: Gutleb
authors.affiliation: Laboratoire Nationale de Santé, Luxembourg.
authors.forename: M E
authors.initials: ME
authors.lastname: Fischer
authors.affiliation: Nofer Institute of Occupational Medicine, Poland.
authors.forename: D
authors.initials: D
authors.lastname: Ligocka
authors.affiliation: Nofer Institute of Occupational Medicine, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Jakubowski
authors.affiliation: Faculdade de Medicina de Lisboa, Portugal.
authors.forename: M F
authors.initials: MF
authors.lastname: Reis
authors.affiliation: Faculdade de Medicina de Lisboa, Portugal.
authors.forename: S
authors.initials: S
authors.lastname: Namorado
authors.affiliation: Environmental Health Center, Romania.
authors.forename: I-R
authors.initials: IR
authors.lastname: Lupsa
authors.affiliation: Environmental Health Center, Romania.
authors.forename: A E
authors.initials: AE
authors.lastname: Gurzau
authors.affiliation: Úrad verejného zdravotníctva Slovenskej republiky, Slovakia.
authors.forename: K
authors.initials: K
authors.lastname: Halzlova
authors.affiliation: Úrad verejného zdravotníctva Slovenskej republiky, Slovakia.
authors.forename: E
authors.initials: E
authors.lastname: Fabianova
authors.affiliation: Jožef Stefan Institute, Slovenia.
authors.forename: D
authors.initials: D
authors.lastname: Mazej
authors.affiliation: Jožef Stefan Institute, Slovenia.
authors.forename: J
authors.initials: J
authors.lastname: Tratnik Snoj
authors.affiliation: Instituto de Salud Carlos III, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Gomez
authors.affiliation: Instituto de Salud Carlos III, Spain.
authors.forename: S
authors.initials: S
authors.lastname: González
authors.affiliation: Karolinska Institutet, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Berglund
authors.affiliation: Karolinska Institutet, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Larsson
authors.affiliation: Federal Office of Public Health (FOPH), Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Lehmann
authors.affiliation: Federal Office of Public Health (FOPH), Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Crettaz
authors.affiliation: Flemish Institute of Technological Research (VITO), Environmental Risks and Health Unit, Boeretang 200, 2400 Mol, Belgium; University of Antwerp, Belgium; Southern Denmark University, Odense, Denmark.
authors.forename: G
authors.initials: G
authors.lastname: Schoeters
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis* / Q000652:urine; D002104:Cadmium / Q000032:analysis / Q000652:urine; D002648:Child; D003367:Cotinine / Q000652:urine; D003627:Data Interpretation, Statistical; D004781:Environmental Exposure / Q000032:analysis* / Q000706:statistics & numerical data*; D004784:Environmental Monitoring / Q000379:methods / Q000706:statistics & numerical data; D004785:Environmental Pollutants / Q000032:analysis* / Q000652:urine; D005060:Europe; D005260:Female; D033161:Government Regulation; D006197:Hair / Q000737:chemistry; D006801:Humans; D008628:Mercury / Q000032:analysis / Q000652:urine; D012424:Rural Population / Q000706:statistics & numerical data; D017747:Seafood / Q000706:statistics & numerical data; D012907:Smoking / Q000331:legislation & jurisprudence / Q000652:urine; D011795:Surveys and Questionnaires / Q000592:standards; D014505:Urban Population / Q000706:statistics & numerical data
chemical_list: D015415:Biomarkers; D004785:Environmental Pollutants; D002104:Cadmium; D008628:Mercury; D003367:Cotinine
keywords: COPHES; DEMOCOPHES; External exposure data; Human biomonitoring; Interpretation