International Journal of Hygiene and Environmental Health
Human Biomonitoring of food contaminants in Spanish children: Design, sampling and lessons learned
Introduction
Health can be jeopardised by exposure to a wide variety of chemicals through different routes, such as ingestion, inhalation and dermal absorption. Traditionally, the risk due to this kind of hazard has been assessed by determining the concentration of pollutants in specific matrices such as food, water and air. The main drawback of this method is that an accurate result for human exposure via multiple pathways requires both quantitation of pollutant levels in different matrices and data on individual behavioural patterns affecting exposure, such as the consumption of contaminated foods. In addition, these determinations do not provide data about real quantities absorbed by the human body (body burden), which depend on different factors such as the physicochemical properties of pollutants and their concentration in a specific environmental medium, time of exposure, as well as individual factors such as metabolism or excretion ratio characteristics (WHO, 2015).
Human Biomonitoring (HBM) is commonly understood as a method for assessing human exposure to natural and synthetic compounds based on the analysis of biomarkers (BM), which are defined as chemical substances or their metabolites measured in human biological matrices such as blood, urine, hair, adipose tissue, teeth, saliva, breast milk or nails (CDC, 2005, EFSA, 2015). Although HBM studies have been used for a long time in occupational health they are currently recognised as an appropriate tool for risk detection or trend controls in other fields such as public health, environmental health and food safety (Casteleyn et al., 2009).
The great advantage of HBM is that it permits an integrated measurement of the amount of a contaminant absorbed by the human body, through the different routes of exposure, from all sources of contamination and takes into account inter-individual variability such as metabolism, ratios of excretion and lifestyle (Angerer et al., 2007, Joas et al., 2012). In particular, cross-sectional HBM studies provide a snapshot of the exposure of a population at a specific time (Knudsen et al., 2012).
In 2003, the European Commission adopted the “European Strategy for Environment and Health” (SCALE Initiative), whose ultimate objectives were: to reduce the disease burden caused by environmental factors, to identify and prevent new health threats caused by environmental factors and to favor the development of health policies in the EU. One of the main goals of this strategy is to protect children against adverse health effects due to their vulnerability to environmental risks (EC, 2003). The SCALE Initiative was followed by the European Action Plan on Environment and Health from 2004 to 2010 (EHP, 2004–2010), where the need to develop a proper database to collect information was emphasised. The commission underlined the need to apply a coordinated approach to human biomonitoring (HBM) to increase the effectiveness of environmental impact assessments, including the effect of food. In this context, the EU promoted a human biomonitoring programme at a European level (COPHES/DEMOCOPHES) in which 17 European countries (including Spain) participated to create an HBM framework, harmonizing HBM procedures and creating a common baseline of results (Joas et al., 2012).
Likewise, the European Food Safety authority (EFSA, 2015) has emphasised that HBM provide an added value for exposure and risk assessment in food safety areas. This require the derivation of HBGV such as HBM values (Apel et al., 2017) and Biomonitoring Equivalents (BE) (Angerer et al., 2011).
The Public Health Department of the Valencian region (Spain) carries out an evaluation of the external exposure to food contaminants through a total diet study (Marin et al., 2017) and also using data from surveillance programmes (Quijano et al., 2016). To gain more insight into population and sub-populations exposure to food contaminants, and following the EFSA criteria on the usefulness of HBM in this field, we have developed a cross-sectional HBM study (BIOVAL), whose main objective is to evaluate the exposure and risk assessment of children (from 6 to 11 years of age) to the contaminants present in the diet.
In this work we review some methodological options for the design of a HMB study, and focus our attention on achieving the following aims: i) to describe the methodological framework of the BIOVAL study (Fig. 1), ii) to explain and discuss the pre-analytical results, and iii) to discuss the lessons learned from its design and implementation.
Section snippets
Objective
Following the international experience, provided by many relevant HBM programs such as those implemented in Canada (Haines and Murray, 2012), USA (Calafat, 2012), Germany (Schulz et al., 2011, Kolossa-Gehring et al., 2017), France (Fréry et al., 2014) or Czech Republic (Černa et al., 2012), the BIOVAL programme aims to achieve the following objectives: i) to establish reference values (RV) for the different biomarkers of exposure to the main food contaminants, focusing on the population of the
Results and discussion
We present here the pre-analytical results of BIOVAL, with special attention to the assessment of the field work carried out and the lessons learned from the main stages, such as training, the recruitment process, questionnaire use and sample collection. The different field-work stages were executed successfully in terms of achieving the goals of each phase, which confirmed the efficacy of the chosen study design and strategy. However, it also revealed certain limitations and aspects that could
Final remarks and conclusions
In this paper the study design and the main pre-analytical results of the HBM BIOVAL study was presented in order to make future results on concentration levels and determinants easy to understand and to contribute through our experience and lessons learned to the design of other regional and national HBM studies.
One of the characteristics of BIOVAL is that it is an HBM study linked with the food safety programmes, and need to be conceived as a tool to evaluate the exposure and risk of
Acknowledgements
The BIOVAL study forms part of the Food Contaminants Exposure and Risk Assessment Program of the Valencian Community (Spain). The authors are grateful to all food safety inspectors participating in sample collection, and the FISABIO-Biobank team for their advice on data protection and support in storing the biological samples. Our thanks to Dr. Joan Quiles for his contribution to designing the food surveys and to the families and children who kindly volunteered to participate in the study.
References (79)
- et al.
Human biomonitoring in the Czech Republic: an overview
Int. J. Hyg. Environ. Health
(2012) - et al.
Urinary levels of arsenic and heavy metals in children and adolescents living in the industrialised area of Ria of Huelva (SW Spain)
Environ. Int.
(2010) - et al.
Human biomonitoring: state of the art
Int. J. Hyg Environ. Health
(2007) - et al.
Human biomonitoring assessment values: approaches and data requirements
Int. J. Hyg. Environ. Health
(2011) - et al.
New HBM values for emerging substances, inventory of reference andHBM values in force, and working principles of the German HumanBiomonitoring Commission
Int. J. Hyg. Environ. Health
(2017) - et al.
Derivation of Biomonitoring Equivalets for di- n-butyl phthalate (BzBP and diethyl phthalate (DEO)
Regul. Toxicol. Pharmacol.
(2009) - et al.
Derivation of biomonitoring equivalets for di(2-ethyl hexylphthalate regul
Toxicol. Pharmacol.
(2009) - et al.
Review of PAH contamination in food products and their health hazards
Environ. Int.
(2015) - et al.
A systematic approach for designing a HBM Pilot Study for Europe
Int. J. Hyg. Environ. Health
(2014) - et al.
Urinary concentrations of organophosphate pesticide metabolites in adults in Israel: demographic and dietary predictors
Environ. Int.
(2013)
The U.S. national health and nutrition examination survey and human exposure to environmental chemicals
Int. J. Hyg. Environ. Health
Mercury, lead and cadmium levelsin the urine of 170 Spanish adults: a pilot human biomonitoring study
Int. J. Hyg. Environ. Health
A pilot study on the feasibility of European harmonized human biomonitoring: strategies towards a common approach, challenges and opportunities
Environ. Res.
Human and animal health risk assessments of chemicals in the food chain: comparative aspects and future perspectives
Toxicol. Appl. Pharmacol.
Trace element biomonitoring in hair of school children from a pollutedarea by sector field inductively coupled plasma mass spectrometry
J. Trace Elem. Med. Biol.
Non-invasive matrices in human biomonitoring: a review
Environ.Int
Mercury analysis in hair: comparability and quality assessment within the transnational COPHES/DEMOCOPHES Project
Environ. Res.
Guidelines for the derivation of biomonitoring equivalents: report from the biomonitoring equivalents expert workshop
Regul. Toxicol. Pharm.
Biomonitoring Equivalents for inorganic arsenic
Regul. Toxicol. Pharmacol.
Short communication: harmonised human biomonitoring in Europe: activities towards an EU HBM framework
Int. J. Hyg. Environ. Health
New Human Biomonitoring methods for chemicals of concer the Germanapproach to enhance relevance
Int. J. Hyg. Environ. Health
Biomonitoring equivalents for bisphenol a (BPA)
Regul. Toxicol. Pharmacol.
Biomonitoring short- and long-termexposure to the herbicide terbuthylazine in agriculture workers and in the general population using urine and hair specimens
Environ. Int.
Development of national biomonitoring programme in Slovenia
Int. J. Hyg. Environ. Health
Chronic cumulative risk assessment of the exposure to organophosphorus, carbamate and pyrethroid and pyrethrin pesticides through fruit and vegetables consumption in the region of Valencia (Spain)
Food Chem. Toxicol.
Biomonitoring exposure assessment to contemporary pesticides in a school children population of Spain
Environ. Res.
Biomonitoring of 20 elements in urine of children: levels and predictors of exposure
Chemosphere
Update of the reference and HBM values derived by the German Human Biomonitoring Commission
Int. J. Hyg. Environ. Health
Perfluorooctane sulphonate(pfos) and perfluorooctanoic acid (pfoa) in human breastmilk: results of a pilotstudy
Int. J. Hyg. Environ. Health
Methods for the determination of biomarkers of exposure to emerging pollutants in human specimens
Trends Anal. Chem.
Analytical methods for human biomonitoring of pesticides. A review
Anal. Chim. Acta
Guidance for Laboratories Biomonitoring Programmes
Predicting the performance of measures in a confirmatory factor analysis with a pretest assessment of their substantive validities
J. Appl. Psychol.
Pesticide urinary metabolite levels of children in eastern north carolina farmworker households
Environ. Health Perspect.
Urinary concentrations of pyrethroid metabolites in the general US population, NHANES 1999–2002
Epidemiology
GerES IV Pilot Study: assessment of the exposure of German children to organophosphorus and pyrethroid pesticides
Int. J. Hyg. Environ. Health
Third National Report on Human Exposure to Environmental Chemicals
Examination Survey Data .U.S. Department of Health and Human Services
Exposure classification and temporal variability in urinary bisphenol a concentrations among couples in Utah—The HOPE study
Environ. Health Perspect.
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