A pilot study on the feasibility of European harmonized human biomonitoring: Strategies towards a common approach, challenges and opportunities.
In 2004 the European Commission and Member States initiated activities towards a harmonized approach for Human Biomonitoring surveys throughout Europe. The main objective was to sustain environmental health policy by building a coherent and sustainable framework and by increasing the comparability of data across countries. A pilot study to test common guidelines for setting up surveys was considered a key step in this process. Through a bottom-up approach that included all stakeholders, a joint study protocol was elaborated. From September 2011 till February 2012, 17 European countries collected data from 1844 mother-child pairs in the frame of DEMOnstration of a study to COordinate and Perform Human Biomonitoring on a European Scale (DEMOCOPHES).(1) Mercury in hair and urinary cadmium and cotinine were selected as biomarkers of exposure covered by sufficient analytical experience. Phthalate metabolites and Bisphenol A in urine were added to take into account increasing public and political awareness for emerging types of contaminants and to test less advanced markers/markers covered by less analytical experience. Extensive efforts towards chemo-analytical comparability were included. The pilot study showed that common approaches can be found in a context of considerable differences with respect to experience and expertize, socio-cultural background, economic situation and national priorities. It also evidenced that comparable Human Biomonitoring results can be obtained in such context. A European network was built, exchanging information, expertize and experiences, and providing training on all aspects of a survey. A key challenge was finding the right balance between a rigid structure allowing maximal comparability and a flexible approach increasing feasibility and capacity building. Next steps in European harmonization in Human Biomonitoring surveys include the establishment of a joint process for prioritization of substances to cover and biomarkers to develop, linking biomonitoring surveys with health examination surveys and with research, and coping with the diverse implementations of EU regulations and international guidelines with respect to ethics and privacy.
KU Leuven, Belgium. Electronic address: Ludwine.Casteleyn@med.kuleuven.be.
L
L
Casteleyn
KU Leuven, Belgium.
B
B
Dumez
Federal Environment Agency (UBA), Germany.
K
K
Becker
Federal Environment Agency (UBA), Germany.
M
M
Kolossa-Gehring
VITO, Belgium.
E
E
Den Hond
VITO, Belgium.
G
G
Schoeters
Instituto de Salud Carlos III, Spain.
A
A
Castaño
Ruhr Universität Bochum, Germany.
H M
HM
Koch
Ruhr Universität Bochum, Germany.
J
J
Angerer
Instituto de Salud Carlos III, Spain.
M
M
Esteban
Public Health England, United Kingdom.
K
K
Exley
Public Health England, United Kingdom.
O
O
Sepai
Environmental Health Sciences International, The Netherlands.
L
L
Bloemen
Jožef Stefan Institute, Slovenia.
M
M
Horvat
Kobenhavns Universitet, Denmark.
L E
LE
Knudsen
BiPRO, Germany.
A
A
Joas
BiPRO, Germany.
R
R
Joas
Federal Public Service Health, Food chain safety and Environment, Belgium.
P
P
Biot
VITO, Belgium.
G
G
Koppen
Hainaut Vigilance Sanitaire (HVS) and Hygiene Publique in Hainaut (HPH), Belgium.
M-C
MC
Dewolf
State General Laboratory, Cyprus.
A
A
Katsonouri
Larnaca Hospital, Cyprus.
A
A
Hadjipanayis
National Institute of Public Health, Czech Republic.
M
M
Cerná
National Institute of Public Health, Czech Republic.
A
A
Krsková
VITO, Belgium.
G
G
Schwedler
VITO, Belgium.
U
U
Fiddicke
Kobenhavns Universitet, Denmark.
J K S
JK
Nielsen
Kobenhavns Universitet, Denmark.
J F
JF
Jensen
National Institute of Environmental Health, Hungary.
P
P
Rudnai
National Institute of Environmental Health, Hungary.
S
S
Közepésy
Health Service Executive, Ireland.
M
M
Mulcahy
Health Service Executive, Ireland.
R
R
Mannion
Centre de Recherche Public - Gabriel Lippmann, Luxembourg.
A C
AC
Gutleb
Laboratoire National de Santé, Luxembourg.
M E
ME
Fischer
Nofer Institute of Occupational Medicine, Poland.
D
D
Ligocka
Nofer Institute of Occupational Medicine, Poland.
M
M
Jakubowski
Faculdade de Medicina de Lisboa, Portugal.
M F
MF
Reis
Faculdade de Medicina de Lisboa, Portugal.
S
S
Namorado
Environmental Health Center, Romania.
I-R
IR
Lupsa
Environmental Health Center, Romania.
A E
AE
Gurzau
Urad Verejneho Zdravotnictva Slovenskej Republiky, Slovakia.
K
K
Halzlova
Urad Verejneho Zdravotnictva Slovenskej Republiky, Slovakia.
M
M
Jajcaj
Jožef Stefan Institute, Slovenia.
D
D
Mazej
Jožef Stefan Institute, Slovenia.
J
J
Tratnik Snoj
Instituto de Salud Carlos III, Spain.
M
M
Posada
Instituto de Salud Carlos III, Spain.
E
E
López
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
M
M
Berglund
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
K
K
Larsson
Federal Office of Public Health (FOPH), Switzerland.
A
A
Lehmann
Federal Office of Public Health (FOPH), Switzerland.
P
P
Crettaz
Federal Public Service Health, Food chain safety and Environment, Belgium.
D
D
Aerts
D015415:Biomarkers / Q000032:analysis; D003627:Data Interpretation, Statistical; D004781:Environmental Exposure / Q000032:analysis; D004782:Environmental Health / Q000379:methods*; D004784:Environmental Monitoring / Q000379:methods*; D005060:Europe; D005240:Feasibility Studies; D006801:Humans; D007391:International Cooperation; D010865:Pilot Projects; D016730:Program Development
D015415:Biomarkers
Environmental health policy; Ethics; European harmonization; Human Biomonitoring; Study protocol