Harmonized human biomonitoring in European children, teenagers and adults: EU-wide exposure data of 11 chemical substance groups from the HBM4EU Aligned Studies (2014-2021).

As one of the core elements of the European Human Biomonitoring Initiative (HBM4EU) a human biomonitoring (HBM) survey was conducted in 23 countries to generate EU-wide comparable HBM data. This survey has built on existing HBM capacity in Europe by aligning national or regional HBM studies, referred to as the HBM4EU Aligned Studies. The HBM4EU Aligned Studies included a total of 10,795 participants of three age groups: (i) 3,576 children aged 6-12 years, (ii) 3,117 teenagers aged 12-18 years and (iii) 4,102 young adults aged 20-39 years. The participants were recruited between 2014 and 2021 in 11-12 countries per age group, geographically distributed across Europe. Depending on the age group, internal exposure to phthalates and the substitute DINCH, halogenated and organophosphorus flame retardants, per- and polyfluoroalkyl substances (PFASs), cadmium, bisphenols, polycyclic aromatic hydrocarbons (PAHs), arsenic species, acrylamide, mycotoxins (deoxynivalenol (total DON)), benzophenones and selected pesticides was assessed by measuring substance specific biomarkers subjected to stringent quality control programs for chemical analysis. For substance groups analyzed in different age groups higher average exposure levels were observed in the youngest age group, i.e., phthalates/DINCH in children versus teenagers, acrylamide and pesticides in children versus adults, benzophenones in teenagers versus adults. Many biomarkers in teenagers and adults varied significantly according to educational attainment, with higher exposure levels of bisphenols, phthalates, benzophenones, PAHs and acrylamide in participants (from households) with lower educational attainment, while teenagers from households with higher educational attainment have higher exposure levels for PFASs and arsenic. In children, a social gradient was only observed for the non-specific pyrethroid metabolite 3-PBA and di-isodecyl phthalate (DiDP), with higher levels in children from households with higher educational attainment. Geographical variations were seen for all exposure biomarkers. For 15 biomarkers, the available health-based HBM guidance values were exceeded with highest exceedance rates for toxicologically relevant arsenic in teenagers (40%), 3-PBA in children (36%), and between 11 and 14% for total DON, Σ (PFOA + PFNA + PFHxS + PFOS), bisphenol S and cadmium. The infrastructure and harmonized approach succeeded in obtaining comparable European wide internal exposure data for a prioritized set of 11 chemical groups. These data serve as a reference for comparison at the global level, provide a baseline to compare the efficacy of the European Commission's chemical strategy for sustainability and will give leverage to national policy makers for the implementation of targeted measures.

HBM4EU results support the Chemicals' Strategy for Sustainability and the Zero-Pollution Action Plan.

One of the major goals of the European Human Biomonitoring Initiative (HBM4EU) was to bridge the gap between science and policy by consulting both policy makers and national scientists and generating evidence of the actual exposure of residents to chemicals and whether that exposure would be suggest a potential health risk. Residents' perspectives on chemical exposure and risk were also investigated. HBM4EU's research was designed to answer specific short-term and long-term policy questions at national and European levels, and for its results to directly support regulatory action on chemicals. A strategy was established to prioritise chemicals for analysis in human matrices, with a total of 18 substances/substance groups chosen to be investigated throughout the five-and a -half-year project. HBM4EU produced new evidence of human exposure levels, developed reference values for exposure, investigated determinants of exposure and derived health-based guidance values for those substances. In addition, HBM4EU promoted the use of human biomonitoring data in chemical risk assessment and developed innovative tools and methods linking chemicals to possible health impacts, such as effect biomarkers. Furthermore, HBM4EU advanced understand of effects from combined exposures and methods to identify emerging chemicals. With the aim of supporting policy implementation, science-to-policy workshops were organised, providing opportunities for joint reflection and dialogue on research results. I, and indicators were developed to assess temporal and spatial patterns in the exposure of European population. A sustainable human biomonitoring monitoring framework, producing comparable quality assured data would allow: the evaluation of time trends; the exploration of spatial trends: the evaluation of the influence of socio-economic conditions on chemical exposure. Therefore, such a framework should be included in the European Chemicals' Strategy for Sustainability and the data would support the Zero Pollution Action Plan.

One Health collaboration with and among EU Agencies - Bridging research and policy.

In the coming decade, Europe will dedicate billions of euros to the necessary research and innovation (R&I) to support a transition to safe and sustainable food systems. EU Agencies, individually and even more so collectively, can make a difference in supporting the European research agenda. EU Agencies are knowledge centres, bringing together know-how to inform policy makers. EU Agencies that have traditionally dealt with aspects of human health, animal health, plant health and ecosystem health in silos, now need to take a broader perspective and move towards a One Health (OH) approach. In this paper, the authors highlight the need for more transdisciplinary cooperation in support of the One Health approach, identify challenges in strengthening interagency cooperation and provide recommendations to address them. EU Agencies are natural bridges between the scientific community and policy-makers and need to dedicate time and effort in fostering this dialogue, e.g. by engaging with relevant initiatives, research projects and European Partnerships. Research generates evidence that can be used also for regulatory science, in support of policy-making. It is urgent to define transdisciplinary research needs and formulate a One Health research agenda. This would be facilitated by establishing transdisciplinary One Health Research & Innovation governance, both at national and EU levels. Ongoing large initiatives, such as the One Health European Joint Programme, have demonstrated that active dialogue with national ministries and EU agencies is beneficial for all parties. Involvement of EU Agencies in the programming of the EU Research Framework programmes is beneficial, because of their regulatory science perspective, their expertise and current or future tasks on research topics. It is timely for EU Agencies to demonstrate leadership in moving the One Health agenda forward and it is encouraging that EU Agencies have committed to establish a cross-agency task force on One Health.

Chemical prioritisation strategy in the European Human Biomonitoring Initiative (HBM4EU) - Development and results.

The European Human Biomonitoring Initiative (HBM4EU1) has established a European Union-wide human biomonitoring (HBM) programme to generate knowledge on human internal exposure to chemical pollutants and their potential health impacts in Europe, in order to support policy makers' efforts to ensure chemical safety and improve health in Europe. A prioritisation strategy was necessary to determine and meet the most important needs of both policy makers and risk assessors, as well as common national needs of participating countries and a broad range of stakeholders. This strategy consisted of three mains steps: 1) mapping of knowledge gaps identified by policy makers, 2) prioritisation of substances using a scoring system, and 3) generation of a list of priority substances reflective of the scoring, as well as of public policy priorities and available resources. For the first step, relevant ministries and agencies at EU and national levels, as well as members of the Stakeholder Forum each nominated up to 5 substances/substance groups of concern for policy-makers. These nominations were collated into a preliminary list of 48 substances/substance groups, which was subsequently shortened to a list of 23 after considering the total number of nominations each substance/substance group received and the nature of the nominating entities. For the second step, a panel of 11 experts in epidemiology, toxicology, exposure sciences, and occupational and environmental health scored each of the substances/substance groups using prioritisation criteria including hazardous properties, exposure characteristics, and societal concern. The scores were used to rank the 23 substances/substance groups. In addition, substances were categorised according to the level of current knowledge about their hazards, extent of human exposure (through the availability of HBM data), regulatory status and availability of analytical methods for biomarker measurement. Finally, in addition to the ranking and categorisation of the substances, the resources available for the project and the alignment with the policy priorities at European level were considered to produce a final priority list of 9 substances/substance groups for research activities and surveys within the framework of the HBM4EU project.

Leaving no one behind - understanding environmental inequality in Europe.

The European Union aims to deliver a healthy environment to its citizens, with significant progress achieved in tackling key environmental stressors in recent decades. At the same time, significant risks to health remain from air, soil and water pollution, noise, chemicals and the impacts of climate change. High quality environments - such as urban areas rich in green and blue spaces - offer significant benefits to health. The unequal distribution of these risks and benefits across society, whereby socially disadvantages groups are more likely to live in poorer environmental conditions, contributes to health inequity across Europe.The European Environment Agency (EEA) is exploring how environmental risks and benefits are distributed across society. Recent evidence produced by EEA indicated that poorer European regions are more likely to be exposed to environmental health hazards at levels that negatively affect health. At country level, the disproportionate exposure of lower socio-economic groups to air pollution, noise and high temperatures is seen in urban areas. We also see inequality in terms of who generates pollution and who suffers the consequences. While poorer countries are likely to be worse affected by climate change, high incomes are linked to high carbon footprints across Europe. Quality environments offer benefits to health, in particular in urban areas, and can contribute to reducing health inequalities. Environmental inequality also plays out across generations, whereby future generations will have to tackle environmental degradation resulting from the activities of past and current populations, such as the accumulation of persistent chemicals in the environment, biodiversity loss and climate change.New opportunities exist to explore the complex linkages between environmental quality, socio-economic status, and health and well-being. These include combining existing data from across these domains with data from new sources, such as citizen science initiatives, smart phones, social media and satellite observation data. Knowledge that integrates the social and environmental domains and explores the drivers behind environmental health inequity is crucial to supporting implementation of the United Nations (UN) 2030 Agenda for Sustainable Development, in particular the pledge of leaving no one behind.