Joas Anke, Schöpel Miriam, David Madlen, Casas Maribel, Koppen Gudrun, Esteban Marta, Knudsen Lisbeth E, Vrijheid Martine, Schoeters Greet, Calvo Argelia Castaño, Schwedler Gerda, Kolossa-Gehring Marike, Joas Reinhard
BiPRO GmbH, Werinherstr. 79, 81541 Munich, Germany.
German Environment Agency, Berlin, Germany.
Arch Public Health. 2018 Jun 28;76:27. doi: 10.1186/s13690-018-0272-6. eCollection 2018.
To date Health information (HI) in the European Union does not comprise indicators or other information related to impacts of hazardous chemicals in consumer products, food, drinking water or air on the health status of the population. Therefore, we inventorised and evaluated the potential of environmental health surveillance and research data sources in the European population to provide HBM-based indicators of internal human exposure and health impact of relevant chemicals.
We established an up-dated inventory of European cross-sectional Human Biomonitoring (HBM) surveys and of birth cohorts, and compared chemicals and chemical groups addressed by HBM with indicators and health end points collected via European Core Health Indicators (ECHI), in birth registries, as well as in environmental and food data bases and health registries to see on how data collection could be aligned. Finally, we investigated study designs of HBM survey and health examination surveys for potential synergies.
The inventory covers a total of 11 European cross-sectional national programmes and a large number of birth cohorts and includes information on study population, age groups, covered substances, sampled matrices, and frequency. The comparison of data collections shows that there are many overlaps between environmental chemicals with environmental and health reporting. HBM data could be linked with ECHI indicators for work-related risks, body mass index (BMI), and low birth weight, with perinatal disease, neurologic disorders, and some chronic diseases, or with data bases for e.g. indoor air, food, or consumer products. Existing initiatives to link data collections at European Environment Agency (EEA) and Joint Research Center (JRC) or at World Health Organization (WHO) are good options to further develop linkage of HBM with exposures sources and health end points.
There is potential to use HBM based information in a number of public health policies, and this would help to align reporting to international commitments. Environmental health surveillance based on HBM and HBM-based indicators, is an excellent tool to inform public health policies about risks from environmental chemicals, and the EU health information system would benefit from additional HBM-based indicators for monitoring exposure burden from environmental chemicals. Considerable efforts are needed to align and establish routine data collections and to develop a surveillance system and indicators which may inform public health policies.
迄今为止，欧盟的健康信息并不包含与消费品、食品、饮用水或空气中的有害化学物质对人群健康状况的影响相关的指标或其他信息。因此，我们清查并评估了欧洲人群环境健康监测和研究数据来源的潜力，以提供基于健康风险评估（HBM）的人体内部暴露及相关化学物质健康影响的指标。
我们建立了一份更新的欧洲横断面人体生物监测（HBM）调查和出生队列清单，并将HBM涉及的化学物质和化学类别与通过欧洲核心健康指标（ECHI）、出生登记处以及环境和食品数据库及健康登记处收集的指标和健康终点进行比较，以了解如何使数据收集保持一致。最后，我们研究了HBM调查和健康检查调查的研究设计，以寻找潜在的协同效应。
该清单涵盖了总共11个欧洲横断面国家项目和大量出生队列，并包括有关研究人群、年龄组、涵盖物质、采样基质和频率的信息。数据收集的比较表明，环境化学物质与环境和健康报告之间存在许多重叠。HBM数据可与ECHI中与工作相关风险、体重指数（BMI）和低出生体重相关的指标、围产期疾病、神经系统疾病和一些慢性病相关联，或与例如室内空气、食品或消费品的数据库相关联。欧洲环境局（EEA）和联合研究中心（JRC）或世界卫生组织（WHO）现有的数据收集链接倡议是进一步发展HBM与暴露源和健康终点之间联系的良好选择。
在一些公共卫生政策中使用基于HBM的信息具有潜力，这将有助于使报告与国际承诺保持一致。基于HBM和基于HBM的指标的环境健康监测是一种极好的工具，可让公共卫生政策了解环境化学物质带来的风险，并且欧盟健康信息系统将受益于更多基于HBM的指标，用于监测环境化学物质的暴露负担。需要做出相当大的努力来协调和建立常规数据收集，并开发一个可让公共卫生政策了解情况的监测系统和指标。
