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Review
. 2023 Jan:247:114073.
doi: 10.1016/j.ijheh.2022.114073. Epub 2022 Nov 23.

From science to policy: How European HBM indicators help to answer policy questions related to phthalates and DINCH exposure

Antje Gerofke  1 , Madlen David  2 , Phillipp Schmidt  2 , Joana Lobo Vicente  3 , Jurgen Buekers  4 , Liese Gilles  4 , Ann Colles  4 , Jos Bessems  4 , Michiel Bastiaensen  5 , Adrian Covaci  5 , Elly Den Hond  6 , Gudrun Koppen  4 , Michelle Laeremans  4 , Veerle J Verheyen  4 , Milena Černá  7 , Jana Klánová  8 , Andrea Krsková  7 , Martin Zvonař  9 , Lisbeth E Knudsen  10 , Holger M Koch  11 , Tina Kold Jensen  12 , Loïc Rambaud  13 , Margaux Riou  13 , Nina Vogel  2 , Catherine Gabriel  14 , Spyros Karakitsios  14 , Nafsika Papaioannou  14 , Denis Sarigiannis  15 , Réka Kakucs  16 , Szilvia Középesy  16 , Péter Rudnai  16 , Tamás Szigeti  16 , Fabio Barbone  17 , Valentina Rosolen  18 , Cedric Guignard  19 , Arno C Gutleb  19 , Amrit Kaur Sakhi  20 , Line Småstuen Haug  20 , Beata Janasik  21 , Danuta Ligocka  21 , Milada Estokova  22 , Lucia Fabelova  23 , Branislav Kolena  24 , Lubica Palkovicova Murinova  23 , Ida Petrovicova  24 , Denisa Richterova  23 , Milena Horvat  25 , Darja Mazej  25 , Janja Snoj Tratnik  25 , Agneta Annika Runkel  25 , Argelia Castaño  26 , Marta Esteban-López  26 , Susana Pedraza-Díaz  26 , Agneta Åkesson  27 , Sanna Lignell  28 , Jelle Vlaanderen  29 , Jan-Paul Zock  30 , Greet Schoeters  4 , Marike Kolossa-Gehring  2
Affiliations
Review

From science to policy: How European HBM indicators help to answer policy questions related to phthalates and DINCH exposure

Antje Gerofke et al. Int J Hyg Environ Health. 2023 Jan.

Abstract

Within the European Human Biomonitoring (HBM) Initiative HBM4EU we derived HBM indicators that were designed to help answering key policy questions and support chemical policies. The result indicators convey information on chemicals exposure of different age groups, sexes, geographical regions and time points by comparing median exposure values. If differences are observed for one group or the other, policy measures or risk management options can be implemented. Impact indicators support health risk assessment by comparing exposure values with health-based guidance values, such as human biomonitoring guidance values (HBM-GVs). In general, the indicators should be designed to translate complex scientific information into short and clear messages and make it accessible to policy makers but also to a broader audience such as stakeholders (e.g. NGO's), other scientists and the general public. Based on harmonized data from the HBM4EU Aligned Studies (2014-2021), the usefulness of our indicators was demonstrated for the age group children (6-11 years), using two case examples: one phthalate (Diisobutyl phthalate: DiBP) and one non-phthalate substitute (Di-isononyl cyclohexane-1,2- dicarboxylate: DINCH). For the comparison of age groups, these were compared to data for teenagers (12-18 years), and time periods were compared using data from the DEMOCOPHES project (2011-2012). Our result indicators proved to be suitable for demonstrating the effectiveness of policy measures for DiBP and the need of continuous monitoring for DINCH. They showed similar exposure for boys and girls, indicating that there is no need for gender focused interventions and/or no indication of sex-specific exposure patterns. They created a basis for a targeted approach by highlighting relevant geographical differences in internal exposure. An adequate data basis is essential for revealing differences for all indicators. This was particularly evident in our studies on the indicators on age differences. The impact indicator revealed that health risks based on exposure to DiBP cannot be excluded. This is an indication or flag for risk managers and policy makers that exposure to DiBP still is a relevant health issue. HBM indicators derived within HBM4EU are a valuable and important complement to existing indicator lists in the context of environment and health. Their applicability, current shortcomings and solution strategies are outlined.

Keywords: DINCH; HBM4EU; Human biomonitoring (HBM); Phthalates; Science-policy uptake; indicator.

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Conflict of interest statement

Declaration of competing interest The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Development of HBM indicators within HBM4EU. *phthalates and DINCH were used to exemplify the process of indicator development. **there were not sufficient data to derive this indicator for phthalates and DINCH.
Fig. 2
Fig. 2
Result indicator for geographical differences of P50 values (and 95% confidence intervals) in DiBP exposure (MiBP in μg/L) in children (6–11 years) in the HBM4EU Aligned Studies. Country names, study names and sampling years (in brackets) are given. DiBP metabolite levels were either measured in first morning or random spot urine samples.
Fig. 3
Fig. 3
Result indicator for geographical differences of P50 values (and 95% confidence intervals) for DINCH exposure (∑(OH-MINCH + cx-MINCH) in μg/L) in children (6–11 years) in the HBM4EU Aligned Studies (collected in the years 2014–2021). Country names, study names and sampling years (in brackets) are given. DINCH metabolite levels were either measured in first morning or random spot urine samples.
Fig. 4
Fig. 4
Result indicator regarding sex differences of P50 values (and 95% confidence intervals) of DiBP exposure (MiBP in μg/L) in children (6–11 years) in the HBM4EU Aligned Studies (collected in the years 2014–2021). Country names, study names and sampling years (in brackets) are given. DiBP metabolite (MiBP) levels were either measured in first morning or random spot urine samples.
Fig. 5
Fig. 5
Result indicator regarding sex differences of P50 values (and 95% confidence intervals) of DINCH exposure ((∑(OH-MINCH + cx-MINCH) in μg/L) in children (6–11 years) in the HBM4EU Aligned Studies (collected in the years 2014–2021). Country names, study names and sampling years (in brackets) are given. DINCH metabolite levels were either measured in first morning or random spot urine samples.
Fig. 6
Fig. 6
Result indicator regarding age differences of P50 values (and 95% confidence intervals) of DiBP exposure (MiBP in μg/L) in children (6–11 years) and teenagers (12–18 years) in the HBM4EU Aligned Studies (collected in the years 2014–2021) measured in 11 countries in children and in 9 countries in teenagers. Country names, study names and age range of participants (in brackets) are given. DiBP metabolite levels were either measured in first morning or random spot urine samples.
Fig. 7
Fig. 7
Result indicator regarding age differences of P50 values (and 95% confidence intervals) of DINCH exposure (∑(OH-MINCH + cx-MINCH) in μg/L) between children (6–11 years) and teenagers (12–18 years) in the HBM4EU Aligned Studies (collected in the years 2014–2021) measured in 11 countries in children and 9 countries in teenagers. Country names, study names and age range of participants (in brackets) are given. DINCH metabolite levels were either measured in first morning or random spot urine samples.
Fig. 8
Fig. 8
Result indicator regarding different periods in time showing differences of P50 values of DiBP exposure (MiBP in μg/L). Direct comparison of DiBP exposure from two projects in different time periods in Europe: 1) in children (6–11 years) from 8 studies between 2011 and 2012 (DEMOCOPHES project) and 2) 11 studies in children between 2014 and 2021 (HBM4EU Aligned Studies). DiBP metabolite (MiBP) levels were either measured in first morning or random spot urine samples.
Fig. 9
Fig. 9
Result indicator regarding different periods in time in showing differences of P50 values of DINCH exposure (sum OH-MINCH + cx-MINCH in μg/L). Direct comparison of DINCH exposure from two projects in different time periods in Europe: 1) in children (6–11 years) from 6 studies between 2011 and 2012 (DEMOCOPHES project) and 2) 11 studies between 2014 and 2021 (HBM4EU Aligned Studies). DINCH metabolites (OH-MINCH and cx-MINCH) levels were either measured in first morning or random spot urine samples. 95% confidence intervals are only shown for the HBM4EU Aligned Studies as for DEMOCOPHES confidence intervals for the sum of the metabolites were not given for the aggregated data.
Fig. 10
Fig. 10
Impact indicator for DiBP in children (P95 MiBP levels in μg/L with their corresponding 95% confidence intervals) in urine samples from children (age 6–11 years) from different European regions compared with the HBM-GV. The dotted line indicates the HBM-GVchildren of 160 μg/L. Studies are part of the HBM4EU Aligned Studies in children. Country names and sampling years (in brackets) are given. In three of these studies (i.e. Slovakia, Greece and France), P95 values exceed this guidance value, representing 5% of the most highly exposed children.
Fig. 11
Fig. 11
Impact indicator for DiBP in children showing the percentage of children exceeding the HBM-GVchildren for DiBP of 160 μg/L. The sampling years are given in brackets after the study names. The different regions are highlighted by specific colours (north: blue, east: green, south: orange, west: yellow). n = number of samples/participants exceeding the HBM-GV, N = total number of samples/study participants. . (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)
Fig. 12
Fig. 12
Impact indicator for DINCH exposure in children (P95 ∑OH-MINCH + cx-MINCH in μg/L and their correspong 95% confidence intervals) in urine samples from children (age 6–11 years) from different European regions compared with HBM-GVchildren. The dotted line indicates the HBM-GVchildren of 3000 μg/L. Country names and sampling years (in brackets) are given.
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