Glyphosate is one of the most widely used herbicides, and its human health effects remain debated. Risk assessment requires robust human biomonitoring (HBM) data generated using validated analytical methods. However, recent population studies employing commercial enzyme-linked immunosorbent assays (ELISA) have reported urinary glyphosate concentrations higher than those measured by mass spectrometry (MS), raising concerns about potential overestimation and data comparability. This study compares two MS/MS-based methods, including a novel ion chromatography-MS/MS approach, with two ELISA methods across external quality assessment (EQA) urine samples (n = 13), spiked urine samples (n = 3, 0.1-0.3 ng/mL), and real-world human urine samples (n = 40). The evaluated ELISA methods overestimated urinary glyphosate concentrations below 1 ng/mL in EQA and spiked samples and exhibited poor repeatability (often >20%) relative to MS/MS-based methods. Analyses of real-world samples confirmed this trend, with ELISA yielding higher quantification frequencies (70-100% vs 45-63%), higher median concentrations (1.06-1.10 vs 30%) than MS/MS methods. These findings indicate that the evaluated ELISA methods lack sufficient reliability for quantifying urinary glyphosate at concentrations relevant to nonoccupational exposure, where matrix-related interferences may compromise analytical performance. These results support the preferential use of MS/MS-based methods for generating robust HBM data in research and regulatory contexts.

BACKGROUND:After an industrial accident, workers at the site of the accident, as well as workers from nearby companies and responders (such as firefighters and police officers), and the surrounding population could be exposed to hazardous chemicals. In these situations, human biomonitoring measures are required by the population to assess the impact of the accident. However, HBM studies are usually conducted to assess the chronic exposure of chemicals for the general population, and no frame exists to apply these measures to such accidental context. OBJECTIVE:Following a major industrial fire that occurred in Normandy in 2019, Santé publique France established a framework for HBM measurements following an industrial accident, in order to assess the relevance of such measurements and give operational guidelines to carry out these measures, from the sampling to the interpretation of the measures, in support to policy makers and health professionals. METHODS:A bibliographic search on HBM protocols in case of accidents and HBM studies already implemented worldwide following an accident was conducted as well as numerous consultations covering scientific aspects, ethical and deontological considerations, and practical aspects of implementing an HBM protocol in the event of an accident. RESULTS:The HBM framework designed includes an initial HBM phase within 48 h following the end of emissions from the accident. Given the short deadlines for this first phase, it is advisable to target the most exposed and impacted individuals, that is, all persons (workers, occupants, emergency services, etc.) who were present on site during the industrial accident, as well as all individuals who visit a healthcare facility from the day of the accident until 48 h after the end of accidental emissions and for circumstances related to the accident. Sampling kits have to be quickly deployed in the event of an industrial accident requiring the implementation of HBM. Following this initial phase, medium- and long-term biological monitoring may be considered based on available information about the emitted chemicals and observed environmental contamination. IMPACT STATEMENT:The assessment of exposure to chemical substances through HBM after an accident requires the development of a standardized framework, particularly for chemicals with short half-lives. Exposure to chemical substances, after an accident, affects the general population residing near the accident site, as well as workers and emergency services.

BackgroundChildren are exposed to acrylamide through diet, which may adversely impact cardiometabolic health. We investigated cross-sectional associations between urinary acrylamide metabolites and cardiometabolic health markers in children.MethodsParticipants from four HBM4EU Aligned Studies (n=1372, 6-12 years) with measured acrylamide metabolites in urine (N-acetyl-S-(2-carbamoylethyl)-L-cysteine [AAMA]), N-acetyl-S-(2-carbamoyl-2-hydroxyethyl)-L-cysteine [GAMA]), and cardiometabolic biomarkers (hormones, lipoproteins, lipids and liver enzymes, kisspeptin) in plasma. We used linear regression and meta-analysis to assess associations between acrylamide metabolites (AAMA and GAMA) standardised for creatinine, their sum (ΣAA) and ratio (GAMA:AAMA) and age- and sex-standardised BMI, blood pressure, waist circumference, and cardiometabolic biomarkers.ResultsEach interquartile range (IQR) increase in AAMA was associated with higher diastolic blood pressure z-score (β=0.08, 95% CI: -0.01, 0.17), larger waist circumference (β=0.07, 95% CI: -0.001, 0.13) and higher leptin z-score (β=0.12, 95% CI: 0.06, 0.17), similar for ΣAA. AAMA was not associated with BMI z-score or systolic blood pressure. GAMA was associated with 23% (95% CI: 6, 42%) higher odds of overweight/obesity, larger waist circumference (β=0.09, 95% CI: 0.01, 0.17), higher leptin (β=0.15, 95% CI: 0.09, 0.21) and triglycerides (β=0.14, 95% CI: 0.06, 0.22) z-scores. GAMA:AAMA ratio was associated with higher apolipoprotein B, total cholesterol, low-density lipoprotein cholesterol, triglycerides and phospholipids. Some sex differences were indicated.ConclusionThe results suggest a potential association between acrylamide exposure and cardiometabolic markers in children. Early-effect biomarkers provided a useful evaluation that complemented BMI and helped to identify acrylamide-related cardiometabolic associations. Longitudinal studies with long-term measures of acrylamide exposure could be useful.

BACKGROUND:Exposure to benzophenone-1 (BP-1) and benzophenone-3 (BP-3), widely used as UV filters in personal care products, has been associated with adverse health effects. However, epidemiological evidence is limited and inconclusive, particularly in vulnerable populations such as teenagers. OBJECTIVE:To examine the relation between BP-1 and BP-3 concentrations and obesity, cardiometabolic biomarkers, and asthma/allergy outcomes in European teenagers, including possible sex-specific associations. METHODS:A multi-country cross-sectional study was conducted using pooled data from six aligned studies from the Human Biomonitoring for Europe Initiative (HBM4EU). Sociodemographic data, cardiometabolic biomarkers, and asthma/allergy outcomes were collected through questionnaires. Anthropometric data and BMI z-scores were calculated (n = 1339). Plasma/serum cardiometabolic biomarkers and asthma/allergy outcomes were available for a subsample (n = 173-594). Urinary BP-1 and BP-3 concentrations were adjusted for creatinine dilution using the traditional standardization (trad.) and the covariate-adjusted creatinine standardization (CAS) method. Generalized additive models, linear, logistic, and multinomial mixed models were applied, and sex-interaction terms were tested. RESULTS:Each natural log-unit increase in urinary BP-3 (CAS) concentrations was associated with higher odds of obesity in the whole population (OR: 1.20; 95%CI: 1.04-1.38). Sex-specific associations were also found with BP-1 (CAS) and BP-3 (CAS) concentrations, which were associated with higher odds of obesity in male teenagers (OR: 1.25; 95% CI: 1.01-1.55; OR: 1.34; 95%CI: 1.09-1.65, respectively). Linear mixed models showed consistent findings toward higher BMI z-scores. A negative association was found between BP-1 (CAS) concentration and serum adiponectin levels in females (% change per loge-unit increase: -3.73, 95%CI: -7.32, -0.10). BP-3 (CAS) concentrations were also associated with higher odds of non-food allergies in males (OR: 1.27; 95%CI: 1.00-1.63). Traditional creatinine adjustment showed similar or slightly attenuated estimates compared to the CAS method. CONCLUSIONS:BP-1 and BP-3 exposure was cross-sectionally associated with higher odds of obesity in European male teenagers, highlighting the need to update regulations and keep exposure levels as low as practically achievable. Longitudinal studies are needed to confirm these findings.

Background: The purpose of the Esteban study was to describe levels of various biomarkers of exposure to several environmental pollutants, including metals and metalloids, among the French population. This paper describes the distribution of concentrations of 28 metals and metalloids in two different populations, and estimates the main determinants of exposure to total arsenic, the sum of inorganic arsenic (iAs) and its two metabolites monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA), cadmium, chromium, copper, mercury and nickel. Methods: Esteban is a cross-sectional study conducted between 2014 and 2016 on a random sample of 2503 adults (18 -74 years old) and 1104 children (6 -17 years old) from the general population. The data collected included biological samples (blood, hair, and urines), socio-demographic characteristics, environmental and occupational exposure, and information on dietary factors and lifestyle. The geometric mean and percentiles of the distribution were estimated for each metal. Multivariate analyses were performed to identify the determinants of exposure using a generalized linear model. Results: Only four metals had a quantification rate below 90% in adults (beryllium, iridium, palladium, and platinum), and three metals in children (beryllium, iridium, and platinum). The concentrations of total arsenic, cadmium, chromium and mercury were higher than those found in most international studies. The determinants significantly associated with exposure were mainly diet and smoking. Conclusions: Esteban provided a nationwide description of 28 metal and metalloid exposure levels for adults (some never measured before) and for the first time in children. The study results highlighted widespread exposure to several metals and metalloids. These results could be used to advocate public health decisions for continued efforts to reduce harmful exposure to toxic metals. The Reference values ( RV 95 ) built from Esteban could also be used to support future government strategies.

Biological monitoring is one way to assess human exposure to contaminants. Blood and urine are often used as biological matrices, but hair is an innovative and effective tool for quantifying more biomarkers over a wider exposure window. In order to improve the use of hair in exposure assessment, this article identifies relevant compounds in the literature to investigate hair contamination. Statistical analysis was performed to correlate the physical-chemical properties of the relevant compounds and their concentration levels in hair. Phthalates, pyrethroids and organophosphate flame retardants were chosen for further study of the interpretation of hair measurements for exposure assessment. No significant correlation was found between the average concentration levels in the literature and the physical-chemical properties of the selected compounds. This work also explores the properties of hair and the analytical process that may impact the quantification of organic contaminants in hair. The sample preparation method (sampling, storage, washing) were also studied and adaptations were suggested to improve the existing methods.

BACKGROUND:Bisphenol A (BPA; or 4,4'-isopropylidenediphenol) is an endocrine disrupting chemical. It was widely used in a variety of plastic-based manufactured products for several years. The European Food Safety Authority (EFSA) recently reduced the Tolerable Daily Intake (TDI) for BPA by 20,000 times due to concerns about immune-toxicity. OBJECTIVE:We used human biomonitoring (HBM) data to investigate the general level of BPA exposure from 2007 to 2014 of European women aged 18-73 years (n = 4,226) and its determinants. METHODS:Fifteen studies from 12 countries (Austria, Belgium, Denmark, France, Germany, Greece, Israel, Luxembourg, Slovenia, Spain, Sweden, and the United Kingdom) were included in the BPA Study protocol developed within the European Joint Programme HBM4EU. Seventy variables related to the BPA exposure were collected through a rigorous post-harmonization process. Linear mixed regression models were used to investigate the determinants of total urine BPA in the combined population. RESULTS:Total BPA was quantified in 85-100 % of women in 14 out of 15 contributing studies. Only the Austrian PBAT study (Western Europe), which had a limit of quantification 2.5 to 25-fold higher than the other studies (LOQ=2.5 µg/L), found total BPA in less than 5 % of the urine samples analyzed. The geometric mean (GM) of total urine BPA ranged from 0.77 to 2.47 µg/L among the contributing studies. The lowest GM of total BPA was observed in France (Western Europe) from the ELFE subset (GM=0.77 µg/L (0.98 µg/g creatinine), n = 1741), and the highest levels were found in Belgium (Western Europe) and Greece (Southern Europe), from DEMOCOPHES (GM=2.47 µg/L (2.26 µg/g creatinine), n = 129) and HELIX-RHEA (GM=2.47 µg/L (2.44 µg/g creatinine), n = 194) subsets, respectively. One hundred percent of women in 14 out of 15 data collections in this study exceeded the health-based human biomonitoring guidance value for the general population (HBM-GVGenPop) of 0.0115 µg total BPA/L urine derived from the updated EFSA's BPA TDI. Variables related to the measurement of total urine BPA and those related to the main socio-demographic characteristics (age, height, weight, education, smoking status) were collected in almost all studies, while several variables related to BPA exposure factors were not gathered in most of the original studies (consumption of beverages contained in plastic bottles, consumption of canned food or beverages, consumption of food in contact with plastic packaging, use of plastic film or plastic containers for food, having a plastic floor covering in the house, use of thermal paper…). No clear determinants of total urine BPA concentrations among European women were found. A broader range of data planned for collection in the original questionnaires of the contributing studies would have resulted in a more thorough investigation of the determinants of BPA exposure in European women. CONCLUSION:This study highlights the urgent need for action to further reduce exposure to BPA to protect the population, as is already the case in the European Union. The study also underscores the importance of pre-harmonizing HBM design and data for producing comparable data and interpretable results at a European-wide level, and to increase HBM uptake by regulatory agencies.

Background International research has recently shown an association between exposure to bisphenol A (BPA) and the risk of diabetes, although limited results are available for exposure to bisphenol S (BPS) and bisphenol F (BPF). The aim of this study was to examine the relationships between impregnation with BPA, BPS, and BPF and the prevalence of diabetes or prediabetes in the French adult population. Methods Based on the Esteban cross-sectional study, 852 adults aged 18 to 74 years living in France were included. To assess the link between urinary concentration of BPA, BPS and BPF and a state of dysglycemia (diabetes or prediabetes), logistic regression multivariable models were performed and adjusted for known risk factors for diabetes and urine creatinine concentration. Results The percentage of included individuals with diabetes or prediabetes was 17.8% (95% CI = [15.3–20.4]). Urinary BPA concentration was significantly higher in people with diabetes or prediabetes, independent of the known risk factors for diabetes (OR for an increase of 0.1 units in log-transformed concentration of BPA (μg/L) = 1.12; 95%CI = [1.05–1.19], p < 0.001). However, we did not find any significant independent association between urinary BPS and BPF levels and the prevalence of diabetes or prediabetes. Conclusions In this sample, considering the diabetes risk factors, diabetes or prediabetes was positively associated with higher urinary BPA concentration but not with urinary BPS and BPF concentrations. However, analysis of prospective longitudinal studies are still necessary to demonstrate a causal link between bisphenol exposure and the risk of diabetes or prediabetes.

Current approaches for the assessment of environmental and human health risks due to exposure to chemical substances have served their purpose reasonably well. Nevertheless, the systems in place for different uses of chemicals are faced with various challenges, ranging from a growing number of chemicals to changes in the types of chemicals and materials produced. This has triggered global awareness of the need for a paradigm shift, which in turn has led to the publication of new concepts for chemical risk assessment and explorations of how to translate these concepts into pragmatic approaches. As a result, next-generation risk assessment (NGRA) is generally seen as the way forward. However, incorporating new scientific insights and innovative approaches into hazard and exposure assessments in such a way that regulatory needs are adequately met has appeared to be challenging. The European Partnership for the Assessment of Risks from Chemicals (PARC) has been designed to address various challenges associated with innovating chemical risk assessment. Its overall goal is to consolidate and strengthen the European research and innovation capacity for chemical risk assessment to protect human health and the environment. With around 200 participating organisations from all over Europe, including three European agencies, and a total budget of over 400 million euro, PARC is one of the largest projects of its kind. It has a duration of seven years and is coordinated by ANSES, the French Agency for Food, Environmental and Occupational Health & Safety.

The environmental impact on health is an inevitable by-product of human activity. Environmental health sciences is a multidisciplinary field addressing complex issues on how people are exposed to hazardous chemicals that can potentially affect adversely the health of present and future generations. Exposure sciences and environmental epidemiology are becoming increasingly data-driven and their efficiency and effectiveness can significantly improve by implementing the FAIR (findable, accessible, interoperable, reusable) principles for scientific data management and stewardship. This will enable data integration, interoperability and (re)use while also facilitating the use of new and powerful analytical tools such as artificial intelligence and machine learning in the benefit of public health policy, and research, development and innovation (RDI). Early research planning is critical to ensuring data is FAIR at the outset. This entails a well-informed and planned strategy concerning the identification of appropriate data and metadata to be gathered, along with established procedures for their collection, documentation, and management. Furthermore, suitable approaches must be implemented to evaluate and ensure the quality of the data. Therefore, the 'Europe Regional Chapter of the International Society of Exposure Science' (ISES Europe) human biomonitoring working group (ISES Europe HBM WG) proposes the development of a FAIR Environment and health registry (FAIREHR) (hereafter FAIREHR). FAIR Environment and health registry offers preregistration of studies on exposure sciences and environmental epidemiology using HBM (as a starting point) across all areas of environmental and occupational health globally. The registry is proposed to receive a dedicated web-based interface, to be electronically searchable and to be available to all relevant data providers, users and stakeholders. Planned Human biomonitoring studies would ideally be registered before formal recruitment of study participants. The resulting FAIREHR would contain public records of metadata such as study design, data management, an audit trail of major changes to planned methods, details of when the study will be completed, and links to resulting publications and data repositories when provided by the authors. The FAIREHR would function as an integrated platform designed to cater to the needs of scientists, companies, publishers, and policymakers by providing user-friendly features. The implementation of FAIREHR is expected to yield significant benefits in terms of enabling more effective utilization of human biomonitoring (HBM) data.

Esteban is a nationwide cross-sectional study conducted in France in 2014-2016, including 2503 adults aged 18-74 years old and 1104 children aged 6-17 years old, as part of the French Human Biomonitoring programme. The present paper describes the biological levels of five families of pesticides analysed on random sub-samples of 900 adults and 500 children for urine concentrations, and 759 adults and 255 children for serum concentrations, and the determinants of exposure. Organophosphates, carbamates and herbicides were measured in urine by UPLC-MS/MS; chlorophenols and pyrethroids were measured in urine by GC-MS/MS; specific organochlorines were measured in serum by GC-HRMS. Multivariate analyses were performed to identify the determinants of exposure using a generalized linear model. Pyrethroid metabolites were quantified in 99% of adults and children, with the exeption of F-PBA, which was quantified in 31% of adults and 27% of children, respectively. Carbamates and some specific organophosphates were barely or not quantified. DMTP was quantified in 82% of adults and 93% of children, and gamma-HCH (lindane) was quantified in almost 50% of adults and children. Concentration levels of pesticide biomarkers were consistent with comparable international studies, except for beta-HCH, DMTP, and the deltamethrin metabolite Br2CA, whose levels were sometimes higher in France. Household insecticide use and smoking were also associated with higher levels of pyrethroids. All pyrethroids concentration levels were below existing health-based HBM guidance values, HBM-GVsGenPop, except for 3-PBA, for which approximately 1% and 10% of children were above the lower and upper urine threshold values of 22 mu g/L and 6.4 mu g/L, respectively. Esteban provides a French nationwide description of 70 pesticide biomarkers for the first time in children. It also describes some pesticide biomarkers for the first time in adults, including glyphosate and AMPA. For the latter, urine concentration levels were overall higher in children than in adults. Our results highlight a possible beneficial impact of existing regulations on adult exposure to organochlorine and organophosphate pesticides between 2006 and 2016, as concentration levels decreased over this period.

Exposure to chemical substances is common and comes from several sources (environmental, food, and occupational). It is often studied using a substance-by-substance approach. Although this method helps identify the determinants of exposure to a single chemical, it cannot accurately reflect exposure to multiple chemicals. In this study, we used the concept of exposure load (EL) to evaluate multi-chemical exposure in a representative sample of the general French population. EL corresponds to the number of substances (or metabolites) measured in body fluids above a defined concentration threshold. EL was calculated for adults and children separately for two groups of substances: those currently found in domestic environments (Group A) and pesticides (Group B). Although the EL does not assess the health impact linked to multi-chemical exposure, it does aid in the identification of particularly vulnerable populations. Accordingly, preventive actions specifically aimed at these subgroups could be useful. In Group A, we found that multi-chemical exposure was generalized since all the adults and children had an EL greater than or equal to 13 (out of 22 substances studied) when the LOQ (limit of quantification) was considered as the discretization threshold. In adults, men, smokers and people of working age (i.e., people under 60 years old) had a higher EL. In Group B, multi-chemical exposure was also generalized, since all the adults (15 substances studied) and children (13 substances studied) had a mean EL almost equal to 6 when the LOQ was considered as the discretization threshold. In adults, persons with occupational exposure to pesticide dust had a higher EL when the P90 was considered as the discretization threshold. This study highlights widespread multi-chemical exposure in adults and children in France, and the major impact of occupational exposure (Group B) and tobacco smoking (Group A) on EL.

Biomonitoring can be relevant for assessing pesticides exposure of residents living close to vineyards (LCTV). However, because xenobiotics are generally present at low levels in human biological matrices and the sources of pesticide exposure are multiple, several challenges need to be overcome to reliably assess exposure in residents LCTV. This includes particularly identifying the most appropriate exposure biomarkers, the biological matrices in which they should be measured, and analytical methods that are sufficiently sensitive and specific to quantify them. The aim of the present study was to develop a tiered approach to identify relevant biomarkers and matrices for assessing pesticide exposure in residents LCTV. We used samples from a biobank for 121 adults and children included in a national prevalence study conducted between 2014 and 2016 who lived near or far from vineyards. We analyzed five priority pesticides (folpet, mancozeb, tebuconazole, glyphosate, and copper) and their metabolites in urine and hair samples. We identified relevant biomarkers according to three criteria related to: i) the detection frequency of those pesticides and metabolites in urine and hair, ii) the difference in concentrations depending on residence proximity to vineyards and, iii) the influence of other environmental and occupational exposure sources on pesticide levels. This tiered approach helped us to identify three relevant metabolites (two metabolites of folpet and one of tebuconazole) that were quantified in urine, tended to be higher in residents LCTV than in controls, and were not significantly influenced by occupational, dietary, or household sources of pesticide exposure. Our approach also helped us to identify the most appropriate measurement strategies (biological matrices, analytical methods) to assess pesticide exposure in residents LCTV. The approach developed here was a prerequisite step for guiding a large-scale epidemiological study aimed at comprehensively measuring pesticides exposures in French residents LCTV with a view to developing appropriate prevention strategies.

Due to their extensive usage, organophosphorus flame retardants (OPFRs) have been detected in humans and in the environment. Human are exposed to OPFRs via inhalation of indoor air, dust uptake or dietary uptake through contaminated food and drinking water. Only recently, few studies addressing dietary exposure to OPFRs were published. In this study, we used human biomonitoring (HBM) data of OPFRs to estimate how much the dietary intake may contribute to the total exposure. We estimated by reverse dosimetry, the daily intake of tris (2-chloroethyl) phosphate (TCEP), tris (1-chloro-2-propyl) phosphate (TCIPP), tris (1,3-dichloro-2-propyl) phosphate (TDCIPP) for children using HBM data from studies with sampling sites in Belgium, Denmark, France, Germany, Slovenia and Slovakia. For estimating the dietary exposure, a deterministic approach was chosen. The occurrence data of selected food categories were used from a published Belgium food basket study. Since the occurrence data were left-censored, the Lower bound (LB)—Upper bound (UB) approach was used. The estimated daily intake (EDI) calculated on the basis of urine metabolite concentrations ranged from 0.03 to 0.18 µg/kg bw/d for TDCIPP, from 0.05 to 0.17 µg/kg bw/d for TCIPP and from 0.02 to 0.2 µg/kg bw/d for TCEP. Based on national food consumption data and occurrence data, the estimated dietary intake for TDCIPP ranged from 0.005 to 0.09 µg/kg bw/d, for TCIPP ranged from 0.037 to 0.2 µg/kg bw/d and for TCEP ranged from 0.007 to 0.018 µg/kg bw/d (summarized for all countries). The estimated dietary intake of TDCIPP contributes 11–173% to the EDI, depending on country and LB-UB scenario. The estimated dietary uptake of TCIPP was in all calculations, except in Belgium and France, above 100%. In the case of TCEP, it is assumed that the dietary intake ranges from 6 to 57%. The EDI and the estimated dietary intake contribute less than 3% to the reference dose (RfD). Therefore, the estimated exposure to OPFRs indicates a minimal health risk based on the current knowledge of available exposure, kinetic and toxicity data. We were able to show that the dietary exposure can have an impact on the general exposure based on our underlying exposure scenarios.

Human biomonitoring (HBM) is a crucial approach for exposure assessment, as emphasised in the European Commission's Chemicals Strategy for Sustainability (CSS). HBM can help to improve chemical policies in five major key areas: (1) assessing internal and aggregate exposure in different target populations; 2) assessing exposure to chemicals across life stages; (3) assessing combined exposure to multiple chemicals (mixtures); (4) bridging regulatory silos on aggregate exposure; and (5) enhancing the effectiveness of risk management measures. In this strategy paper we propose a vision and a strategy for the use of HBM in chemical regulations and public health policy in Europe and beyond. We outline six strategic objectives and a roadmap to further strengthen HBM approaches and increase their implementation in the regulatory risk assessment of chemicals to enhance our understanding of exposure and health impacts, enabling timely and targeted policy interventions and risk management. These strategic objectives are: 1) further development of sampling strategies and sample preparation; 2) further development of chemical-analytical HBM methods; 3) improving harmonisation throughout the HBM research life cycle; 4) further development of quality control / quality assurance throughout the HBM research life cycle; 5) obtain sustained funding and reinforcement by legislation; and 6) extend target-specific communication with scientists, policymakers, citizens and other stakeholders. HBM approaches are essential in risk assessment to address scientific, regulatory and societal challenges. HBM requires full and strong support from the scientific and regulatory domain to reach its full potential in public and occupational health assessment and in regulatory decision-making.

BACKGROUND:Used widely for centuries, lead is a common environmental pollutant. As a cumulative toxic, its presence in the body is always evidence of exposure, and health effects occur without threshold. Though regulated by European directives, lead requires close monitoring due to its environmental persistence and toxicity. METHODS:The first data source was the French surveillance system for monitoring childhood lead poisoning, which records the screening results of children (-18 years), providing data on their temporal and geographical distribution, characteristics, and risk factors. The second data source was Esteban, a cross-sectional study conducted in 2014-2016 on a random sample of the French population as part of the human biomonitoring program. The Esteban lead study concerns 904 children (6-17 years) and 999 adults (18-74 years), providing data on biological samples, sociodemographic characteristics, occupational exposure, environmental and dietary factors. RESULTS:The surveillance system highlighted that lead poisoning affected 10% of children screened between 2015 and 2018. The main risk factor remains housing. Esteban confirmed this observation, finding a general mean of blood lead level (BLL) at 9.9 and 18.5 μg/L for children and adults, respectively. In children, parents' occupation increased BLLs. In adults, the greatest exposure factors were smoking, age, place of residence, alcohol, bread-based products, and homegrown livestock products. In both, drinking tap water and year of housing construction increased BLLs. CONCLUSIONS:The surveillance system showed a high number of children with lead poisoning despite the implementation of prevention measures, which mainly concern lead paints in old and degraded homes. To help identify children at risk, healthcare providers need to know about exposure from housing and the emerging sources identified in the Esteban survey. Despite lower BLLs, the well-known risk factors of lead exposure persist, meaning prevention efforts must continue in order to limit their impact on the population.

L'approche géographique est une clé de compréhension des évènements sanitaires et c'est d'autant plus fort en santé environnement et santé travail (SET). Elle est décisive dans l'appréhension des exposomes et des inégalités environnementales de santé. La spatialisation des expositions est une aide à la compréhension du contexte environnemental d'un évènement de santé et de sa dynamique spatiale, à la définition d'une zone et d'une population à risque, à l'estimation d'un risque. Pour approcher les expositions des populations à leur environnement général et professionnel, la construction d'indicateurs géographiques d'exposition est un processus complexe constitué d’étapes; certaines en amont du traitement spatial (recueil des données, harmonisation, etc.); d'autres relevant d'un travail souvent réalisé dans un système d'information géographique capable de traiter de la donnée spatiale. A l'issue du processus de construction puis de croisement des données environnement santé se situe un enjeu de communication des indicateurs d'exposition aux travers de portails cartographiques pour représenter une réalité, comparer des situations dans le temps et dans l'espace et mieux comprendre les liens entre environnement et santé. Les sujets d'application sont variés : pesticides, industries, sols pollués, pollution atmosphérique, environnements favorables à la santé. Parmi les indicateurs d'exposition développés on trouve les grands types suivants : contextuels, de mise en cohérence d’échelle avec les données de santé, de proximité, de qualification et quantification du risque ou encore de caractérisation/typologies des zones étudiées. Dans les analyses épidémiologiques ils sont exploités comme facteurs d'exposition principale ou comme tiers facteurs. Leur combinaison est un enjeu pour la prise en compte des expositions multiples et des effets cocktail. La construction d'indicateurs géographiques d'exposition s'appuie sur les données d'une part, sur la méthodologie et la technique d'autre part pour la réalisation des calculs. Sur ces trois volets, les changements et les avancées sont constants. Les auteurs déclarent ne pas avoir de liens d'intérêts.

Human biomonitoring has become a pivotal tool for supporting chemicals’ policies. It provides information on real-life human exposures and is increasingly used to prioritize chemicals of health concern and to evaluate the success of chemical policies. Europe has launched the ambitious REACH program in 2007 to improve the protection of human health and the environment. In October 2020 the EU commission published its new chemicals strategy for sustainability towards a toxic-free environment. The European Parliament called upon the commission to collect human biomonitoring data to support chemical’s risk assessment and risk management. This manuscript describes the organization of the first HBM4EU-aligned studies that obtain comparable human biomonitoring (HBM) data of European citizens to monitor their internal exposure to environmental chemicals. The HBM4EU-aligned studies build on existing HBM capacity in Europe by aligning national or regional HBM studies. The HBM4EU-aligned studies focus on three age groups: children, teenagers, and adults. The participants are recruited between 2014 and 2021 in 11 to 12 primary sampling units that are geographically distributed across Europe. Urine samples are collected in all age groups, and blood samples are collected in children and teenagers. Auxiliary information on socio-demographics, lifestyle, health status, environment, and diet is collected using questionnaires. In total, biological samples from 3137 children aged 6–12 years are collected for the analysis of biomarkers for phthalates, HEXAMOLL® DINCH, and flame retardants. Samples from 2950 teenagers aged 12–18 years are collected for the analysis of biomarkers for phthalates, Hexamoll® DINCH, and per- and polyfluoroalkyl substances (PFASs), and samples from 3522 adults aged 20–39 years are collected for the analysis of cadmium, bisphenols, and metabolites of polyaromatic hydrocarbons (PAHs). The children’s group consists of 50.4% boys and 49.5% girls, of which 44.1% live in cities, 29.0% live in towns/suburbs, and 26.8% live in rural areas. The teenagers’ group includes 50.6% girls and 49.4% boys, with 37.7% of residents in cities, 31.2% in towns/suburbs, and 30.2% in rural areas. The adult group consists of 52.6% women and 47.4% men, 71.9% live in cities, 14.2% in towns/suburbs, and only 13.4% live in rural areas. The study population approaches the characteristics of the general European population based on age-matched EUROSTAT EU-28, 2017 data; however, individuals who obtained no to lower educational level (ISCED 0–2) are underrepresented. The data on internal human exposure to priority chemicals from this unique cohort will provide a baseline for Europe’s strategy towards a non-toxic environment and challenges and recommendations to improve the sampling frame for future EU-wide HBM surveys are discussed.