16 june 2009 / Special Edition

Human biomonitoring and environmental health


- Editorial - I have a dream - a European Biomonitoring Programme

- From human biomarkers to human biomonitoring in environmental health in Europe

- UBA's Health related environmental monitoring in Germany

- Human biomonitoring in Flanders: some aspects related to study design, future, communication and ethics[Read the abstract ]

- Biomonitoring as a policy lever: a case study of mercury and pesticide surveillance in New York City [Read the abstract ]

- Urinary biomarkers for pesticide exposure in pregnant women of the Pelagie cohort study conducted in Brittany, France (2002-2006) [Read the abstract ]

- Human biomonitoring in Cyprus : Cotinine in children – the impact of smoking, 2004-2008 [Read the abstract ]

- Box: A National Biomonitoring Programme in France [Read the abstract ]

I have a dream - a European Biomonitoring Programme
Matti Jantunen, National Institute for Health and Welfare (THL), Environmental Health, Kuopio, Finland

From human biomarkers to human biomonitoring in environmental health in Europe - Highlights of the Conference held in Paris on November 4-5, 2008

Ludwine Casteleyn (ludwine.casteleyn@health.fgov.be)1, Pierre Biot2, Anne-Catherine Viso3
1/ Centre for Human Genetics, University of Leuven, Belgium 2 / FPS Health, Food Chain Safety and Environment, DG Environment - Multilateral and Strategic Affairs, Brussels, Belgium
3 / Institut de veille sanitaire, Saint-Maurice, France

UBA's Health related environmental monitoring in Germany
The BEH asked Marike Kolossa-Gehring (marike.kolossa@uba.de), toxicologist and head of the Toxicology Section, Health-Related Environmental Monitoring of the German Federal Environment Agency (Umweltbundesamt - UBA), and Kerstin Becker, epidemiologist in the same Section, to give an overview in 10 points of the German biomonitoring programme (GerES) implemented since the mid 1980s.

Human biomonitoring in Flanders: some aspects related to study design, future, communication and ethics
Elly Den Hond1 (elly.denhond@vito.be), Hana Chovanova2, Birgit Dumez3, Hans Keune4, Greet Schoeters1, Caroline Teughels5, Karen Van Campenhout5
1 / Flemish Institute for Technological Research (VITO), Department of Environmental Risk and Health, Mol, Belgium
2 / Flemish Ministry of Welfare, Public Health and Family, Flemish Agency for Care and Health, Environmental Health Section, Brussels, Belgium
3 / Centre for Human Genetics, Katholieke Universiteit, Leuven, Belgium 4 / Faculty of Political and Social Sciences, University of Antwerp, Antwerpen, Belgium
5 / Environment & Health, Flemish Government, Environment, Nature and Energy Department, Brussels, Belgium

Flanders is one of the few places in Europe with a legal basis to perform human biomonitoring (HBM). The HBM study is commissioned, steered and funded by the Flemish government and is carried out by the Center of Expertise for Environment and Health. This research consortium includes scientists from all Flemish universities and two Flemish research institutes.
The main purpose of the Flemish HBM program is to establish a surveillance network to make it possible to measure environmental pollution in the population and to investigate the relation between exposure and early health effects. In the first campaign (2001-2006) the question was whether living in different areas in Flanders resulted in a different exposure to environmental pollution. To make the translation of the HBM results into policy measures, the phased action plan was developed.
The second cycle of the Flemish HBM programme (2007-2011) is built on two pillars. First, reference values for the Flemish population will be obtained in a representative population sample for a broad series of pollutants. Second, targeted HBM will be performed in specific groups with a concern for environmental pollution pressure, the so-called hot spots. In both parts of the project, emphasis is placed on open and transparent communication and relevant interaction between scientists, policy makers, authorities, stakeholders and the public through a participative process.
HBM requires the collaboration of volunteers to donate blood, urine or other bodily tissues, and thus raises inevitable ethical questions. Some aspects showing that communication is at the heart of ethics are presented, as well as some difficulties from within the practices that arise in transnational research context.

Key words
Human biomonitoring, biomarkers of exposure, biomarkers of effect, surveillance

Biomonitoring as a policy lever: a case study of mercury and pesticide surveillance in New York City
Daniel E. Kass (dkass@health.nyc.gov)
New York City Department of Health and Mental Hygiene, Bureau of Environmental Surveillance and Policy, New York, USA

Introduction - In 2004, the New York City (NYC) conducted a population based environmental biomonitoring study to characterize exposures to selected biomarkers and to inform the choice and conduct of public health and policy actions to reduce exposures.
Biomonitoring methods - The survey collected and analyzed urine and blood to evaluate inorganic and organic mercury and urinary metabolites of organophosphorus and pyrethroid pesticides (n=1,811).
Biomonitoring results - 95th percentile levels of inorganic mercury among those born in the Dominican Republic were higher than others, largely attributable to the use of illegally imported mercury containing skin lightening creams. Total mercury was three times higher in NYC than the United States (US), with population differences within NYC largely explained by varying frequencies of fish consumption. Pesticide exposures were 4 to 14 times higher in NYC than in the US.
Policy actions and discussion - Biomonitoring led NYC to actions that included the embargo of products, expanded inter-governmental oversight of mercury in fish, public and healthcare provider education campaigns, and local efforts to restrict the use and availability of pesticides. The article presents and discusses a policy framework to explain why environmental biomonitoring results appear to readily influence public policy.

Key words
Human biomonitoring, pesticides, mercury, New York City, policy analysis, NYCHANES

Urinary biomarkers for pesticide exposure in pregnant women of the Pelagie cohort study conducted in Brittany, France (2002-2006)*

Cécile Chevrier1 (cecile.chevrier@rennes.inserm.fr), Claire Petit1, Gwendolina Limon2, Christine Monfort1, Gaël Durand2, Sylvaine Cordier1
1 / Inserm U625 ; GERHM, Université de Rennes I, IFR140, Rennes, France 2 / IDHESA Bretagne Océane, Plouzané, France

* Translated from French

Although pesticides have many applications, they are primarily used for agricultural purposes. Pesticide exposure sources in humans are numerous. Overall pesticide impregnation levels in France and the majority of European countries have yet to be clearly established. One benefit of using biomarkers to assess exposure is that it covers all possible exposure routes. Given the high sensitivity of faetuses to toxic compounds measuring the exposure of
pregnant women has become a critical public health issue.
The Pelagie cohort has included nearly 3,500 pregnant women from Brittany (France) over the 2002-2006 period. Urine samples were taken in the early stages of pregnancy, 546 of which underwent testing for chemical pesticides. The objective was to assess pesticide impregnation levels and scope among pregnant women, more specifically in regards to herbicides of the triazine family, prohibited in France since late 2003 but still present in the environment, and to organophosphorous insecticides, used both for agricultural and non-agricultural purposes. Findings confirm the presence of pesticide residues in a majority of urine samples of pregnant women, some molecules being breakdown products remaining in the environment. These pesticide residues are usually numerous and their impact, either individually or jointly, on the foetus and its development has yet to be clearly established in epidemiological literature. They are soon to be assessed in the Pelagie cohort.

Key words
Biomarkers of exposures, pesticides, pregnancy, Britanny

Human biomonitoring in Cyprus : Cotinine in children – the impact of smoking, 2004-2008
Andromachi Katsonouri (akatsonouri@sgl.moh.gov.cy)1,3, Adamos Hadjipanayi2,3, Eleni Demetriou1, Nikos Michael1, Stella Canna-Michaelidou
1 / State General Laboratory, Ministry of Health, Nicosia, Cyprus 2 / Paediatric Clinic, Larnaca General Hospital, Ministry of Health, Cyprus
3 / Cyprus National Committee on the Environment and Children’s Health

Objectives – This study describes a comprehensive anti-smoking campaign carried out in Cyprus over 2004-2008 with the aim to reduce children exposure to passive smoking and prevent the related health impacts.
Methods – Questionnaires were used in 2005 to evaluate parents’ knowledge, attitudes and practices. Based on the results, an intervention program was developed and implemented up to 2008. The intervention was evaluated in a pilot study in which nicotine was assessed in indoor air and the total exposure of the children to environmental tobacco smoke (ETS) was evaluated from the cotinine level in their saliva.
Results – In 2005 at least one parent was an active smoker in 42% of the households and 72% of smokers smoked in their homes. Parents were not fully aware of the effects of ETS on children and had erroneous perceptions on how to protect them. Nicotine measurements in the air after the intervention (2008) showed a definite improvement in smokers’ practices since only 41% of the smokers smoked in their homes. Associated cotinine measurements in children’s saliva showed that 97% of children were exposed to ETS, regardless whether their parents smoked or not. No significant difference in the levels of cotinine was found between the two groups (smokers’ vs. non smockers’ children) and there was no correlation between cotinine levels and the levels of nicotine found in the family home.
Conclusion – The intervention led to an improvement in smoking parents’ practices at home, however children are still substantially exposed to ETS outside the family home.

Key words
Children, passive smoking, parents smoking behaviour, salivary cotinine, air nicotine, measures of precaution

Box: A National Biomonitoring Programme in France

The Draft Law for the implementation of the “Grenelle de l’environnement” states that the second National Environmental Health Action Plan (2009-2012) will include a biomonitoring programme that will integrate public health indicators and the state of the environment and help to evaluate policies related toenvironmental health. The Institut de Veille Sanitaire (i.e. the French Institute for Public Health Surveillance) has started to design this programme, under the umbrella of the ministries of Health and the Environment. The final programme will be presented in full details during the first quarter of the year 2010.


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