Development of Policy Relevant Human Biomonitoring Indicators for Chemical Exposure in the European Population

Abstract

The European Union's 7th Environmental Action Programme (EAP) aims to assess and minimize environmental health risks from the use of hazardous chemicals by 2020. From this angle, policy questions like whether an implemented policy to reduce chemical exposure has had an effect over time, whether the health of people in specific regions or subpopulations is at risk, or whether the body burden of chemical substances (the internal exposure) varies with, for example, time, country, sex, age, or socio-economic status, need to be answered. Indicators can help to synthesize complex scientific information into a few key descriptors with the purpose of providing an answer to a non-expert audience. Human biomonitoring (HBM) indicators at the European Union (EU) level are unfortunately lacking. Within the Horizon2020 European Human Biomonitoring project HBM4EU, an approach to develop European HBM indicators was worked out. To learn from and ensure interoperability with other European indicators, 15 experts from the HBM4EU project (German Umweltbundesamt (UBA), Flemish research institute VITO, University of Antwerp, European Environment Agency (EEA)), and the World Health Organization (WHO), European Core Health Indicator initiative (ECHI), Eurostat, Swiss ETH Zurich and the Czech environmental institute CENIA, and contributed to a workshop, held in June 2017 at the EEA in Copenhagen. First, selection criteria were defined to evaluate when and if results of internal chemical exposure measured by HBM, need to be translated into a European HBM-based indicator. Two main aspects are the HBM indicator's relevance for policy, society, health, and the quality of the biomarker data (availability, comparability, ease of interpretation). Secondly, an approach for the calculation of the indicators was designed. Two types of indicators were proposed: 'sum indicators of internal exposure' derived directly from HBM biomarker concentrations and 'indicators for health risk', comparing HBM concentrations to HBM health-based guidance values (HBM HBGVs). In the latter case, both the percentage of the studied population exceeding the HBM HBGVs (PE) and the extent of exceedance (EE), calculated as the population's exposure level divided by the HBM HBGV, can be calculated. These indicators were applied to two examples of hazardous chemicals: bisphenol A (BPA) and per- and polyfluoroalkyl substances (PFASs), which both have high policy and societal relevance and for which high quality published data were available (DEMOCOPHES, Swedish monitoring campaign). European HBM indicators help to summarize internal exposure to chemical substances among the European population and communicate to what degree environmental policies are successful in keeping internal exposures sufficiently low. The main aim of HBM indicators is to allow follow-up of chemical safety in Europe.

Keywords: HBM; HBM4EU; groups of substances; health-based guidance value; human biomonitoring; indicator; science-policy translation.

Figure 1

Urinary levels (µg/L) of bisphenol A (BPA)-equivalents in mothers (50th and 95th percentile) in six EU countries (DEMOCOPHES) benchmarked against the German HBM-I guidance value below which no adverse health effects are expected according to current knowledge. BE: Belgium; DK: Denmark; LU: Luxembourg; SL: Slovenia; ES: Spain; SE: Sweden.

Figure 2

Urinary levels (µg/L) of BPA-equivalents in children (50th and 95th percentile) in six EU countries (DEMOCOPHES) benchmarked against the German HBM-I guidance value below which no adverse health effects are expected according to current knowledge.

Figure 3

Benchmarking HBM results for perfluorooctanoic acid (PFOA) in women and children (50th and 95th percentile) (DEMOCOPHES) against the German HBM-I guidance value. At concentrations below the HBM-I value no adverse health effects are expected according to current knowledge.

Figure 4

Benchmarking HBM results for perfluorooctanesulfonic acid (PFOS) in women and children (50th and 95th percentile) (DEMOCOPHES) against the German HBM-I guidance value. At concentrations below the HBM-I value no adverse health effects are expected according to current knowledge.

Figure 5

Time trend result indicator of PFOS, PFOA, perfluorononanoic acid (PFNA), and perfluorohexane sulfonate (PFHxS) for the Swedish population (men, women, and children, P₅₀). The per- and polyfluoroalkyl substance (PFAS) levels in blood, P₅₀ (ng/mL), of PFOA, PFNA, PFOS, and PFHxS were for each year, first summed for each of the age groups, and then averaged over the age groups, resulting in a group substance population indicator. The time trend shows a steady decrease since 1996 for the total PFAS HBM exposure levels, mainly driven by a decrease in PFOS levels. Note: older people were not included for the years 2012–2015.