Review of the state of the art of human biomonitoring for chemical substances and its application to human exposure assessment for food safety

Integration of National Chemical Hazards Monitoring, Total Diet Study, and Human Biomonitoring Programmes for Food Safety Exposure Assessment in Singapore

Food safety and food security can impact the quality of human life, and these two aspects are interrelated alongside many influencing external factors. Global stressors such as climate change, recent pandemic, and geopolitical tensions have demonstrated tangible impacts on food security and safety. Food and food system innovation is a key strategy towards feeding the world in a more sustainable and climate-resilient manner. This paper highlights the use of a science-based risk assessment and management in Singapore's food safety system, specifically in the integration of exposure assessment approaches to support evidence-based food safety risk analysis and decision-making. The use of complementary top-down and bottom-up exposure assessment approaches through the market monitoring programme, total diet study and human biomonitoring forms a comprehensive integrated exposure assessment strategy which can ultimately inform policy and measures in ensuring and securing a supply of safe food. The discussion on such application for chemical food safety in Singapore offers additional insights into the synergistic inter-relationships contributing to the exposure assessment associated with chemicals in food.

Cross-sectional biomonitoring of urinary deoxynivalenol, T-2 and HT-2 toxins, and zearalenone in Japanese adults

BACKGROUND

Among the more than 300 mycotoxins that are known to have toxic effects on animals and humans, Fusarium toxins deoxynivalenol (DON), T-2 and HT-2 toxins (T2/HT2), and zearalenone (ZEN) are frequently detected in domestic agricultural products. This study aimed to assess DON, T2/HT2, and ZEN exposure in Japanese adults by measuring urinary mycotoxins, observing their distributions, and making comparisons with data from other countries.

METHODS

A total of 201 individuals participated in the study. Twenty-four-hour urine samples were collected from young adults (34 men and 35 women) in the Tokai region (urban area) and spot urine samples were collected from middle-aged and elderly adults (64 men and 68 women) in the Donan area of Hokkaido Prefecture (rural area). Urinary DON, T2/HT2, and ZEN levels were measured using a validated liquid chromatography-tandem mass spectrometry method.

RESULTS

For DON, T2/HT2, and ZEN, the detection frequencies above the limit of detection (LOD) level (0.15, 0.13, and 0.01 µg/L, respectively) in all the samples were 53%, 26%, and 71%, respectively. The median concentrations (95th percentile) of urinary DON, HT2, and ZEN were 0.19 (3.93),

CONCLUSIONS

This study represents the first comprehensive exposure assessment for DON, T2/HT2, and ZEN in Japanese adults using human biomonitoring methods. These data provide valuable information for a better understanding of mycotoxin exposure in Japan.

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Key Words

• Human biomonitoring
• Japanese adults
• Liquid chromatography–tandem mass spectrometry
• Mycotoxin
• Urine

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MESH Headings

• Humans
• Male
• Female
• Adult
• Japan
• Middle Aged
• Biological Monitoring/methods
• Zearalenone/urine
• Zearalenone/analysis
• Trichothecenes/urine
• Aged
• T-2 Toxin/urine
• T-2 Toxin/analogs & derivatives
• Cross-Sectional Studies
• Young Adult
• East Asian People

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Affiliation(s)

Toshiki Tajima Department of Biomolecular Sciences, Field of Omics Health Sciences, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-minami, Higashi-ku, Nagoya 461-8673, Japan
Tomohiko Isobe Health and Environmental Risk Division, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba 305-8506, Japan
Isao Saito Department of Biomolecular Sciences, Field of Omics Health Sciences, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-minami, Higashi-ku, Nagoya 461-8673, Japan
Takaaki Kondo Department of Biomolecular Sciences, Field of Omics Health Sciences, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-minami, Higashi-ku, Nagoya 461-8673, Japan
Koji Suzuki Department of Preventive Medical Sciences, Fujita Health University School of Medical Sciences, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan
Ryosuke Fujii Department of Preventive Medical Sciences, Fujita Health University School of Medical Sciences, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan
Yoshiki Tsuboi Department of Preventive Medical Sciences, Fujita Health University School of Medical Sciences, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake 470-1192, Japan
Yoshiko Sugita-Konishi Faculty of Applied Biosciences, Tokyo University of Agriculture, 1-1-1 Sakuragaoka, Setagaya-ku, Tokyo 156-8502, Japan
Jun Ueyama Department of Biomolecular Sciences, Field of Omics Health Sciences, Nagoya University Graduate School of Medicine, 1-1-20 Daiko-minami, Higashi-ku, Nagoya 461-8673, Japan

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A systematic evidence map protocol for mapping global exposure to bisphenols and their alternatives and social and environmental justice implications

BACKGROUND

Bisphenol A (BPA) is one of the highest-volume chemicals produced worldwide, and human exposure to BPA is thought to be ubiquitous. Stricter regulations around the use of BPA have led many manufacturers to switch to other bisphenol chemicals with similar functions such as bisphenol S and F. Even though exposure to BPA, other bisphenol chemicals and bisphenol alternatives poses a health risk for humans, very little is known about the granular exposure levels of different populations around the world.

AIM

This systematic evidence map (SEM) will identify human studies reporting concentrations of bisphenols and their alternatives measured in human bio-samples with the aim to chart the global human exposure levels by country and population characteristics to identify research gaps and discuss any social and environmental injustice implications.

SEARCH STRATEGY AND ELIGIBILITY CRITERIA

MEDLINE®, Embase and Web of Science (WoS) databases as well as grey literature sources will be searched using predefined search strings. The database search results will be supplemented by backward and forward citation tracking on included studies. A scoping exercise conducted during planning identified 90 bisphenol chemicals and alternatives used in plastics. These include BPA, other bisphenol chemicals with/without similar functions to BPA as well as alternatives with similar functions to bisphenol chemicals. Eligible studies must measure concentrations of at least one relevant bisphenol chemical/alternative in human bio-samples.

STUDY SELECTION

Only primary studies published in English since 2010 will be considered. The title, abstract and keywords will be screened by the DistillerAI tool and two independent reviewers. Grey literature will be screened by two reviewers for inclusion and exclusion. The full text of the included studies will then be screened by two independent reviewers.

STUDY APPRAISAL

Study quality will not be evaluated in this SEM.

DATA EXTRACTION AND CODING

Data extraction and coding will be performed by two independent reviewers. Parameters of interest will include the following: study characteristics (e.g., year of publication, sampling timepoints and study design), population information (e.g., country, age, sex, ethnicity, number of participants) and exposure information (sources of exposure, bio-sample analyzed, chemical name, concentration, and detection frequencies).

SYNTHESIS AND VISUALIZATION

The results will be presented using a narrative summary, tables, bar plots and color-coded maps. The interactive database will be available on a dedicated freely accessible website.

SYSTEMATIC MAP PROTOCOL REGISTRY AND REGISTRATION NUMBER

This protocol has been registered on Open Science Framework (OSF) and is available at https://doi.org/10.17605/OSF.IO/MNWTD.

Exposure to environmental pollutants: A mini-review on the application of wastewater-based epidemiology approach

Wastewater-based epidemiology (WBE) is considered an innovative and promising tool for estimating community exposure to a wide range of chemical and biological compounds by analyzing wastewater. Despite scholars' interest in WBE studies, there are uncertainties and limitations associated with this approach. This current review focuses on the feasibility of the WBE approach in assessing environmental pollutants, including pesticides, heavy metals, phthalates, bisphenols, and personal care products (PCPs). Limitations and challenges of WBE studies are initially discussed, and then future perspectives, gaps, and recommendations are presented in this review. One of the key limitations of this approach is the selection and identification of appropriate biomarkers in studies. Selecting biomarkers considering the basic requirements of a human exposure biomarker is the most important criterion for validating this new approach. Assessing the stability of biomarkers in wastewater is crucial for reliable comparisons of substance consumption in the population. However, directly analyzing wastewater does not provide a clear picture of biomarker stability. This uncertainty affects the reliability of temporal and spatial comparisons. Various uncertainties also arise from different steps involved in WBE. These uncertainties include sewage sampling, exogenous sources, analytical measurements, back-calculation, and estimation of the population under investigation. Further research is necessary to ensure that measured pollutant levels accurately reflect human excretion. Utilizing data from WBE can support healthcare policy in assessing exposure to environmental pollutants in the general population. Moreover, WBE seems to be a valuable tool for biomarkers that indicate healthy conditions, lifestyle, disease identification, and exposure to pollutants. Although this approach has the potential to serve as a biomonitoring tool in large communities, it is necessary to monitor more metabolites from wastewater to enhance future studies.

Human biomonitoring and toxicokinetics as key building blocks for next generation risk assessment

Human health risk assessment is historically built upon animal testing, often following Organisation for Economic Co-operation and Development (OECD) test guidelines and exposure assessments. Using combinations of human relevant in vitro models, chemical analysis and computational (in silico) approaches bring advantages compared to animal studies. These include a greater focus on the human species and on molecular mechanisms and kinetics, identification of Adverse Outcome Pathways and downstream Key Events as well as the possibility of addressing susceptible populations and additional endpoints. Much of the advancement and progress made in the Next Generation Risk Assessment (NGRA) have been primarily focused on new approach methodologies (NAMs) and physiologically based kinetic (PBK) modelling without incorporating human biomonitoring (HBM). The integration of toxicokinetics (TK) and PBK modelling is an essential component of NGRA. PBK models are essential for describing in quantitative terms the TK processes with a focus on the effective dose at the expected target site. Furthermore, the need for PBK models is amplified by the increasing scientific and regulatory interest in aggregate and cumulative exposure as well as interactions of chemicals in mixtures. Since incorporating HBM data strengthens approaches and reduces uncertainties in risk assessment, here we elaborate on the integrated use of TK, PBK modelling and HBM in chemical risk assessment highlighting opportunities as well as challenges and limitations. Examples are provided where HBM and TK/PBK modelling can be used in both exposure assessment and hazard characterization shifting from external exposure and animal dose/response assays to animal-free, internal exposure-based NGRA.

Characterization of nickel levels considering seasonal and intra-individual variation using three biological matrices

Nickel compounds are classified as group 1 carcinogens by the International Agency for Research on Cancer. However, only a few exposure assessment studies have been conducted on such compounds to date. In this study, we investigated the distribution of nickel in three biological types of samples (blood, serum, and urine) and its temporal variability through repeated measurements. From 2020 to 2021, blood and urine samples were collected for four times from 50 healthy participants. Nickel concentrations were determined using inductively coupled plasma mass spectrometry, and inter-individual correlation was calculated from linear mixed model. The overall geometric mean of nickel was 1.028 μg/L in blood, 0.687 μg/L in serum, and 1.464 μg/L in urine. Blood nickel was the highest in November (blood: 1.197 μg/L), and the geometric mean of nickel concentrations in the serum and urine were the highest in March (serum: 1.146 μg/L; urine: 1.893 μg/L). This matched seasonal trends for fine particulate matter concentrations from 2020 to 2021. Thus, seasonal effects significantly affect nickel levels in blood, serum, and urine. The inter-individual correlations were low as 0.081 for blood and 0.064 for urine. In addition, the correlation of nickel levels between each biological sample was low. It was also found that age, gender, commuting time, and different matrices affect concentrations. Blood and serum nickel levels were high in this study compared to other nationwide data, with urinary nickel ranking the second highest among the six countries examined. Therefore, biomonitoring study in the general population should be conducted, and finding a suitable matrix that can reflect nickel exposure to set exposure guideline levels is imperative.

Application of human biomonitoring data to support policy development, raise awareness and environmental public health protection among countries within the HBM4EU project

Most countries have acknowledged the importance of assessing and quantifying their population's internal exposure from chemicals in air, water, soil, food and other consumer products due to the potential health and economic impact. Human biomonitoring (HBM) is a valuable tool which can be used to quantify such exposures and effects. Results from HBM studies can also contribute to improving public health by providing evidence of individuals' internal chemical exposure as well as data to understand the burden of disease and associated costs thereby stimulating the development and implementation of evidence-based policy. To have a holistic view on HBM data utilisation, a multi-case research approach was used to explore the use of HBM data to support national chemical regulations, protect public health and raise awareness among countries participating in the HBM4EU project. The Human Biomonitoring for Europe (HBM4EU) Initiative (https://www.hbm4eu.eu/) is a collaborative effort involving 30 countries, the European Environment Agency (EEA) and the European Commission (contracting authority) to harmonise procedures across Europe and advance research into the understanding of the health impacts of environmental chemical exposure. One of the aims of the project was to use HBM data to support evidence based chemical policy and make this information timely and directly available for policy makers and all partners. The main data source for this article was the narratives collected from 27 countries within the HBM4EU project. The countries (self-selection) were grouped into 3 categories in terms of HBM data usage either for public awareness, policy support or for the establishment HBM programme. Narratives were analysed/summarised using guidelines and templates that focused on ministries involved in or advocating for HBM; steps required to engage policy makers; barriers, drivers and opportunities in developing a HBM programme. The narratives reported the use of HBM data either for raising awareness or addressing environmental/public health issues and policy development. The ministries of Health and Environment were reported to be the most prominent entities advocating for HBM, the involvement of several authorities/institutions in the national hubs was also cited to create an avenue to interact, discuss and gain the attention of policy makers. Participating in European projects and the general population interest in HBM studies were seen as drivers and opportunities in developing HBM programmes. A key barrier that was cited by countries for establishing and sustaining national HBM programmes was funding which is mainly due to the high costs associated with the collection and chemical analysis of human samples. Although challenges and barriers still exist, most countries within Europe were already conversant with the benefits and opportunities of HBM. This article offers important insights into factors associated with the utilisation of HBM data for policy support and public awareness.

Developing human biomonitoring as a 21st century toolbox within the European exposure science strategy 2020-2030

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.

Citizens’ Perception and Concerns on Chemical Exposures and Human Biomonitoring—Results from a Harmonized Qualitative Study in Seven European Countries

Exposure to different chemicals is an inevitable part of our everyday lives. Within HBM4EU, focus group discussions were conducted to gather data on citizens’ perceptions of chemical exposure and human biomonitoring. These discussions were hosted in Cyprus, Denmark, Hungary, Israel, Latvia, the Netherlands, and North Macedonia following a protocol developed in the first round of discussions. Results indicate the very high concern of European citizens regarding food safety and the environment. Focus group participants were well aware of potential uptake of chemicals through food consumption (e.g., preservatives, flavor enhancers, coloring agents, pesticides, fertilizers, metals), drinking water, or from polluted air and water. One of the positive aspects identified here, is the high interest of citizens in awareness and education on personal measures to control exposure. The promotion of personal behavioral changes requires active involvement of society (e.g., commuting habits, energy choices, waste disposal, dietary habits). Activities should focus on raising awareness of the general public, implementation of policy measures, and mainstreaming of related topics into the education system. Raising awareness of the general public may promote engagement of citizens, which in turn may empower them to put pressure on politicians to take effective actions. There is also a need for further research which might focus on the impact of country-specific situations and of the COVID-19 pandemic on the exposure of citizens to chemicals.

Urinary bisphenol concentrations and its association with metabolic disorders in the US and Korean populations

Bisphenol A (BPA) is a representative endocrine disrupting compound used in a vast array of consumer products, and are being frequently substituted by its analogues, bisphenol S (BPS) and bisphenol F (BPF). We aimed to examine the association between urinary bisphenol levels with obesity and lipid profiles in the general population to comprehensively evaluate its potential of metabolic disturbance. A representative sample of 1046 US adults from the National Health and Nutrition Examination Survey (2013-2016) and 3268 Korean adults from the Korean National Environmental Health Survey (2015-2017) was analyzed. We examined the exposure levels of bisphenols and determined their associations with obesity, high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels, and hypercholesterolemia prevalence through multiple linear, and binary/ordinal logistic regression models. In both populations, high BPA levels (lowest tertile vs. 2nd, 3rd tertiles) showed corresponding associations with lipid profile and obesity. BPA levels were associated with decreased HDL-C levels (Q3: β = -0.053, p = 0.08 (US); Q2: β = -0.030, p-0.03), increased TG levels (Q3: β = 0.121, p = 0.029 (US); Q3: β = 0.089, p = 0.021, and higher odds for obesity (Q3: OR = 1.58, 95% CI: 1.06, 2.35 (US); Q3: OR = 1.41, 95% CI: 1.11, 1.78). Higher BPS levels were positively associated with obesity status, especially in US men (Q2: OR = 1.84, 95% CI: 1.15, 2.96) and Korean women (Q3: OR = 1.27, 95% CI: 0.99, 1.64). A significant decrease in HDL-C (Q3: β = -0.088, p = 0.01) and elevated odds for obesity at higher BPF levels (Q3: OR = 1.60, 95% CI: 1.00, 2.56) was observed in US women. The findings of our study indicate that BPA and its analogues, BPS and BPF, are associated with lipid metabolism disorders in addition to obesity in adults. Given the increase in exposure to BPA alternatives, continuous biomonitoring, and further investigation of their health effects through prospective cohort studies are warranted.

Human Biomonitoring of Selected Hazardous Compounds in Portugal: Part I-Lessons Learned on Polycyclic Aromatic Hydrocarbons, Metals, Metalloids, and Pesticides

Human biomonitoring (HBM) data provide information on total exposure regardless of the route and sources of exposure. HBM studies have been applied to quantify human exposure to contaminants and environmental/occupational pollutants by determining the parent compounds, their metabolites or even their reaction products in biological matrices. HBM studies performed among the Portuguese population are disperse and limited. To overcome this knowledge gap, this review gathers, for the first time, the published Portuguese HBM information concerning polycyclic aromatic hydrocarbons (PAHs), metals, metalloids, and pesticides concentrations detected in the urine, serum, milk, hair, and nails of different groups of the Portuguese population. This integrative insight of available HBM data allows the analysis of the main determinants and patterns of exposure of the Portuguese population to these selected hazardous compounds, as well as assessment of the potential health risks. Identification of the main difficulties and challenges of HBM through analysis of the enrolled studies was also an aim. Ultimately, this study aimed to support national and European policies promoting human health and summarizes the most important outcomes and lessons learned through the HBM studies carried out in Portugal.

Human Biomonitoring of Selected Hazardous Compounds in Portugal: Part II—Lessons Learned on Mycotoxins

Human biomonitoring (HBM) data provide information on total exposure regardless of the route and sources of exposure. HBM studies have been applied to quantify human exposure to contaminants and environmental/occupational pollutants by means of determining the parent compounds, their metabolites, or even their reaction products in biological matrices. HBM studies performed among the Portuguese population are dispersed and limited. Thus, to overcome this knowledge gap, this work reviews the published Portuguese HBM information concerning mycotoxins detected in the urine, serum, milk, hair, and nails of different groups of the Portuguese population. This integrative approach to the available HBM data allows us to analyze the main determinants and patterns of exposure of the Portuguese population to the selected hazardous compounds, as well as to assess the potential health risks. We also aimed to identify the main difficulties and challenges of HBM through the analysis of the enrolled studies. Ultimately, this study aims to support national and European policies in promoting human health by summarizing the most important outcomes and lessons learned through the HBM studies carried out in Portugal.

Participant Experiences in a Human Biomonitoring Study: Follow-Up Interviews with Participants of the Flemish Environment and Health Study

Communicating individual human biomonitoring results to study participants has been the subject of debate for some time. This debate is dominated by ethical considerations from a researchers’ perspective on whether or not to communicate, thereby overlooking more practice-based questions from a participants’ perspective on what and how to communicate. We conducted a small scale follow-up study based on eleven face-to-face interviews with mothers participating in the third cycle of the Flemish Environment and Health Study (FLEHS III 2012–2015) to investigate how they experienced and interpreted individual biomonitoring results. Key findings indicate that respondents were generally satisfied with participating in the biomonitoring study, but the report-back process especially lacked contextualized information and interactive communication options to better comprehend and cope with personal results. These findings also argue in favor of a more tailored approach in which report-back methods, formats and content are diversified according to the type of results and the preferences of participants. A reflexive research practice with active engagement in follow-up research is crucial to improve participants’ understanding and use of personal biomonitoring results.

Mycotoxins-Biomonitoring and Human Exposure

Mycotoxins are secondary metabolites produced by fungal species that commonly have a toxic effect on human and animal health. Different foodstuff can be contaminated and are considered the major source of human exposure to mycotoxins, but occupational and environmental exposure can also significantly contribute to this problem. This review aims to provide a short overview of the occurrence of toxigenic fungi and regulated mycotoxins in foods and workplaces, following the current literature and data presented in scientific papers. Biomonitoring of mycotoxins in plasma, serum, urine, and blood samples has become a common method for determining the exposure to different mycotoxins. Novel techniques are more and more precise and accurate and are aiming toward the simultaneous determination of multiple mycotoxins in one analysis. Application of liquid chromatography (LC) methodologies, coupled with tandem mass spectrometry (MS/MS) or high-resolution mass spectrometry (HRMS) has become a common and most reliable method for determining the exposure to mycotoxins. Numerous references confirm the importance of mycotoxin biomonitoring to assess the exposure for humans and animals. The objectives of this paper were to review the general approaches to biomonitoring of different mycotoxins and the occurrence of toxigenic fungi and their mycotoxins, using recent literature sources.

Presence of 19 Mycotoxins in Human Plasma in a Region of Northern Spain

This study was conducted to investigate human exposure to 19 compounds (mycotoxins and their metabolites) in plasma samples from healthy adults (n = 438, aged 19-68 years) from Navarra, a region of northern Spain. Samples were analyzed by LC-MS/MS, before and after enzymatic hydrolysis for the detection of possible glucuronides and/or sulfates (Phase II metabolites). The most prevalent mycotoxin was ochratoxin A (OTA), with an incidence of 97.3%. Positive samples were in the concentration range of 0.4 ng/mL to 45.7 ng/mL. After enzymatic treatment, OTA levels increased in a percentage of individuals, which may indicate the presence of OTA-conjugates. Regarding ochratoxin B, it has also been detected (10% of the samples), and its presence may be related to human metabolism of OTA. Sterigmatocystin was detected with a high incidence (85.8%), but only after enzymatic hydrolysis, supporting glucuronidation as a pathway of its metabolism in humans. None of the other studied mycotoxins (aflatoxins B1, B2, G1, G2 and M1; T-2 and HT-2 toxins; deoxynivalenol, deepoxy-deoxynivalenol, 3-acetyldeoxynivalenol, 15-acetyldeoxynivalenol; zearalenone; nivalenol; fusarenon-X; neosolaniol; and diacetoxyscirpenol) were detected in any of the samples, neither before nor after enzymatic treatment. To the best of our knowledge, this is the first report carried out in Spain to determine the exposure of the population to mycotoxins and some of their metabolites using plasma, and the obtained results justify the need for human biomonitoring and metabolism studies on mycotoxins.

Physiologically based kinetic (PBK) modelling and human biomonitoring data for mixture risk assessment

Human biomonitoring (HBM) data can provide insight into co-exposure patterns resulting from exposure to multiple chemicals from various sources and over time. Therefore, such data are particularly valuable for assessing potential risks from combined exposure to multiple chemicals. One way to interpret HBM data is establishing safe levels in blood or urine, called Biomonitoring Equivalents (BE) or HBM health based guidance values (HBM-HBGV). These can be derived by converting established external reference values, such as tolerable daily intake (TDI) values. HBM-HBGV or BE values are so far agreed only for a very limited number of chemicals. These values can be established using physiologically based kinetic (PBK) modelling, usually requiring substance specific models and the collection of many input parameters which are often not available or difficult to find in the literature. The aim of this study was to investigate the suitability and limitations of generic PBK models in deriving BE values for several compounds with a view to facilitating the use of HBM data in the assessment of chemical mixtures at a screening level. The focus was on testing the methodology with two generic models, the IndusChemFate tool and High-Throughput Toxicokinetics package, for two different classes of compounds, phenols and phthalates. HBM data on Danish children and on Norwegian mothers and children were used to evaluate the quality of the predictions and to illustrate, by means of a case study, the overall approach of applying PBK models to chemical classes with HBM data in the context of chemical mixture risk assessment. Application of PBK models provides a better understanding and interpretation of HBM data. However, the study shows that establishing safety threshold levels in urine is a difficult and complex task. The approach might be more straightforward for more persistent chemicals that are analysed as parent compounds in blood but high uncertainties have to be considered around simulated metabolite concentrations in urine. Refining the models may reduce these uncertainties and improve predictions. Based on the experience gained with this study, the performance of the models for other chemicals could be investigated, to improve the accuracy of the simulations.

Human Biomonitoring of Trace Elements in Scalp Hair from Healthy Population of Pakistan

The present study deals with the assessment of essential trace and toxic elements in biological samples (scalp hair) of healthy smoker and non-smoker residents of Lahore (the second most populous city), Pakistan. Human biomonitoring of various trace elements like zinc (Zn), iron (Fe), copper (Cu), chromium (Cr), cadmium (Cd), nickel (Ni), lead (Pb), and arsenic (As) was evaluated in human hair samples of smokers and non-smokers (males and females) as per IFCC criteria. For the purpose of comparison, scalp hair samples of age- and sex-equivalent healthy persons were also analyzed. The results of this study show that the concentrations (P95 values) of As (0.17, 0.81, and 0.91 μg/g), Cd (2.80, 3.81, and 3.16 μg/g), Cr (4.1, 4.2, and 5.3 μg/g), Cu (20.0, 21.0, and 21.9 μg/g), Ni (3.9, 4.6, and 4.3 μg/g), Pb (4.0, 4.8, and 5.0 μg/g), and Fe (49.0, 49.0, and 59.3 μg/g) were significantly higher in scalp hair samples of smokers than in referents, for various age groups (16-32 years, 33-50 years, and 51-62 years), respectively. The concentrations of Zn (165, 163, and 173 μg/g various age groups, respectively) in similar age group were found lower in the scalp hair samples of smokers than referents. Exposure of high toxic metal level through smoking and deficiency of Zn could be synergistic with the risk factors associated with the use of tobacco. Correlation studies for the elements in cigarette with the elements in scalp hair of male smokers show a highly positive correlation between Cr-Cd, Cr-Ni, Cu-Fe, and Ni-Zn.

Human Biomonitoring of Mycotoxins in Blood, Plasma and Serum in Recent Years: A Review

This manuscript reviews the state-of-the-art regarding human biological monitoring (HBM) of mycotoxins in plasma serum and blood samples. After a comprehensive and systematic literature review, with a focus on the last five years, several aspects were analyzed and summarized: a) the biomarkers analyzed and their encountered levels, b) the analytical methodologies developed and c) the relationship between biomarker levels and some illnesses. In the literature reviewed, aflatoxin B1-lysine (AFB1-lys) and ochratoxin A (OTA) in plasma and serum were the most widely studied mycotoxin biomarkers for HBM. Regarding analytical methodologies, a clear increase in the development of methods for the simultaneous determination of multiple mycotoxins has been observed. For this purpose, the use of liquid chromatography (LC) methodologies, especially when coupled with tandem mass spectrometry (MS/MS) or high resolution mass spectrometry (HRMS), has grown. A high percentage of the samples analyzed for OTA or aflatoxin B1 (mostly as AFB1-lys) in the reviewed papers were positive, demonstrating human exposure to mycotoxins. This review confirms the importance of mycotoxin human biomonitoring and highlights the important challenges that should be faced, such as the inclusion of other mycotoxins in HBM programs, the need to increase knowledge of mycotoxin metabolism and toxicokinetics, and the need for reference materials and new methodologies for treating samples. In addition, guidelines are required for analytical method validation, as well as equations to establish the relationship between human fluid levels and mycotoxin intake.

Citrinin biomarkers: a review of recent data and application to human exposure assessment

The mycotoxin citrinin (CIT) deserves attention due to its known toxic effects in mammalian species and a widespread occurrence in food commodities, often along with ochratoxin A, another nephrotoxic mycotoxin. Human exposure, a key element in assessing risks related to these food contaminants, depends upon mycotoxin levels in food and on food consumption. Yet, data available for CIT levels in food are insufficient for reliable intake estimates. Now biomonitoring, i.e., analysis of parent compound and/or metabolites in human specimen (blood, urine, breast milk), is increasingly used to investigate mycotoxin exposure. Biomonitoring requires sensitive methods for determining biomarkers of exposure, combined with kinetic data to conclude on the absorbed internal dose in an individual. Recent advances in LC-MS/MS-based analytical techniques have facilitated biomonitoring studies on the occurrence of CIT biomarkers in body fluids, mainly in urine samples. This review compiles evidence on human exposure to CIT in different countries, on CIT kinetics in humans, and on biomarker-based CIT intake estimates. Human CIT exposures are discussed in light of an intake value defined as 'level of no concern for nephrotoxicity' by the European Food Safety Agency, and some uncertainties in the toxicological data base. Further studies on CIT, including biomarker-based studies are warranted along with regular food surveys for this mycotoxin to protect consumers against undesirable health effects.

Occupational Exposure to Mycotoxins in Swine Production: Environmental and Biological Monitoring Approaches

Swine production workers are exposed simultaneously to multiple contaminants. Occupational exposure to aflatoxin B₁ (AFB₁) in Portuguese swine production farms has already been reported. However, besides AFB₁, data regarding fungal contamination showed that exposure to other mycotoxins could be expected in this setting. The present study aimed to characterize the occupational exposure to multiple mycotoxins of swine production workers. To provide a broad view on the burden of contamination by mycotoxins and the workers' exposure, biological (urine) samples from workers (n = 25) and 38 environmental samples (air samples, n = 23; litter samples, n = 5; feed samples, n = 10) were collected. The mycotoxins biomarkers detected in the urine samples of the workers group were the deoxynivalenol-glucuronic acid conjugate (60%), aflatoxin M₁ (16%), enniatin B (4%), citrinin (8%), dihydrocitrinone (12%) and ochratoxin A (80%). Results of the control group followed the same pattern, but in general with a lower number of quantifiable results ( Collapse

Key Words

• biomonitoring
• mycotoxins
• mycotoxins mixture
• occupational exposure
• swine production

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MESH Headings

• Adult
• Air Pollutants/analysis
• Air Pollutants/urine
• Animal Feed/analysis
• Animal Husbandry
• Animals
• Biomarkers/urine
• Environmental Monitoring
• Feces/chemistry
• Female
• Food Contamination/analysis
• Humans
• Male
• Middle Aged
• Mycotoxins/analysis
• Mycotoxins/urine
• Occupational Exposure/analysis
• Portugal
• Swine

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Affiliation(s)

Susana Viegas H&TRC-Health & Technology Research Center, ESTeSL-Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, 1990-096 Lisbon, Portugal. Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal.
Ricardo Assunção Food and Nutrition Department, National Institute of Health Doutor Ricardo Jorge, I.P. (INSA), Av. Padre Cruz, 1649-016 Lisbon, Portugal. Centre for Environmental and Marine Studies (CESAM), University of Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal.
Carla Martins Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal. Food and Nutrition Department, National Institute of Health Doutor Ricardo Jorge, I.P. (INSA), Av. Padre Cruz, 1649-016 Lisbon, Portugal. Centre for Environmental and Marine Studies (CESAM), University of Aveiro, Campus de Santiago, 3810-193 Aveiro, Portugal. Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal.
Carla Nunes Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal. Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal.
Bernd Osteresch Group of Prof. Humpf, Institute of Food Chemistry, Westfälische Wilhelms-Universität Münster Corrensstraße 45, 48149 Münster, Germany.
Magdalena Twarużek Faculty of Natural Sciences, Institute of Experimental Biology, Department of Physiology and Toxicology, Kazimierz Wielki University, 85-064 Bydgoszcz, Poland.
Robert Kosicki Faculty of Natural Sciences, Institute of Experimental Biology, Department of Physiology and Toxicology, Kazimierz Wielki University, 85-064 Bydgoszcz, Poland.
Jan Grajewski Faculty of Natural Sciences, Institute of Experimental Biology, Department of Physiology and Toxicology, Kazimierz Wielki University, 85-064 Bydgoszcz, Poland.
Edna Ribeiro H&TRC-Health & Technology Research Center, ESTeSL-Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, 1990-096 Lisbon, Portugal.
Carla Viegas H&TRC-Health & Technology Research Center, ESTeSL-Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa, 1990-096 Lisbon, Portugal. Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública, Universidade NOVA de Lisboa, 1600-560 Lisbon, Portugal.

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Exposure Assessment to Mycotoxins in a Portuguese Fresh Bread Dough Company by Using a Multi-Biomarker Approach

Mycotoxins are toxic mold metabolites that can persist in environment long after the fungi species responsible for their production disappear. Critical workplace for mycotoxins presence has already been studied and nowadays it is possible to recognize that exposure to mycotoxins through inhalation occurs due to their presence in dust. This study aimed to assess occupational co-exposure to multiple mycotoxins in a fresh bread dough company, an occupational setting not studied until now. Occupational exposure assessment to mycotoxins was done using a LC-MS/MS urinary multi-biomarker approach. Twenty-one workers and nineteen individuals that were used as controls participated in the study. Workers/controls (spot-urine) and environment (settled dust) samples were collected and analyzed. Concerning workers group, DON-GlcA, and OTA were the most prevalent biomarkers (>LOD), 66% and 90.5%, respectively. In the control group, OTA was also one of the most detected (68%) followed by CIT (58%) and DON-GlcA (58%). DON was the mycotoxin measured in high amounts in the settled dust sample (58.2 ng/g). Both workers and controls are exposed to several mycotoxins simultaneously. The workers group, due to their high contact with flour dust, revealed a higher exposure to DON. Considering these results, risk management measures must be applied including specific and adequate health surveillance programs in order to avoid exposure and consequently the associated health consequences.

Serum concentrations of selected organochlorine pesticides in a Lebanese population and their associations to sociodemographic, anthropometric and dietary factors: ENASB study

Organochlorine pesticides (OCPs) were banned by the Stockholm Convention many years ago; however, they are still detected in the environment due to their high persistence, their current illegal use, and their import from countries where they have not been banned. We evaluated the serum concentrations of selected OCPs (hexachlorobenzene (HCB), β-hexachlorocyclohexanes (β-HCH), p,p'-dichlorodiphenyltrichloroethane (DDT) and its metabolite p,p'-dichlorodiphenyldichloroethylene (DDE) in a sample of Lebanese adults using gas chromatography coupled to an ion trap mass spectrometer detector. The mean concentrations of HCB, β-HCH, DDT, and DDE were 7.1, 8.6, 2.1, and 18.9 ng/g of lipids, respectively, and the major contributor among the four OCPs was DDE. The OCP levels in the present study were in general lower than the values observed in several countries worldwide and their concentrations at the 95th percentile were lower than the biomonitoring equivalents (BEs) excluding any appreciable health risk. We observed an inverse association between HCB concentrations and body mass index (BMI) as well as HCB, β-HCH, and DDE levels, and smoking habits. Milk consumption however was positively associated with an increased serum level of β-HCH. This study, which was the first to investigate OCP serum levels in a Lebanese population, provides a baseline to which future measurements can be compared.

Serum concentrations of polychlorinated biphenyls (PCBs) in a Lebanese population: ENASB study

Polychlorinated biphenyls (PCBs) are persistent organic pollutants that are still routinely detected 30 years after their restriction in many countries. PCBs have been associated with several non-communicable diseases. They are best measured via human biomonitoring (HBM). The concentrations of six indicator PCBs (PCBs 28, 52, 101, 138, 153, and 180) were measured in the serum samples of 316 Lebanese students and employees from Saint Joseph University of Beirut, Lebanon, using gas chromatography coupled to an iron trap mass spectrometer detector. PCBs were detected in 56.3 to 59.2% of the serum samples. The sum of PCB (∑PCBs) levels ranged from <LOD to 338.84 ng/g lipids, with a geometric mean level of 10.34 ± 0.98 ng/g lipids. The major contributor to the ∑PCBs was PCB 180. In the present study, the levels were, in general, lower than the values observed in several Western and European countries. No association was found between age and concentration of any of the PCBs. In terms of risk for health, the highest levels were lower than critical limits such as HBM I and II values. We observed an inverted U-shaped association between levels of serum PCBs and the risk of overweight/obesity (OR = 2.140; CI = 1.095-4.185; p = 0.026). Regarding potential food contributors, we found no relation between PCB levels and fish consumption and a moderate relation with dairy product consumption (moderate consumers of dairy products had higher PCB levels compared to lower consumers) (16.92 ± 0.1/6.92 ± 0.12; p = 0.025). The present study is the first to provide information regarding PCB levels in a Lebanese population. Larger studies are required in order to estimate the PCB exposure parameters of the Lebanese population.

Biomonitoring of the mycotoxin Zearalenone: current state-of-the art and application to human exposure assessment

Zearalenone (ZEN), a mycotoxin with high estrogenic activity in vitro and in vivo, is a widespread food contaminant that is commonly detected in maize, wheat, barley, sorghum, rye and other grains. Human exposure estimates based on analytical data on ZEN occurrence in various food categories and food consumption data suggest that human exposure to ZEN and modified forms of ZEN may be close to or even exceed the tolerable daily intake (TDI) derived by the European Food Safety Authority (EFSA) for some consumer groups. Considering the inherent uncertainties in estimating dietary intake of ZEN that may lead to an under- or overestimation of ZEN exposure and consequently human risk and current lack of data on vulnerable consumer groups, there is a clear need for more comprehensive and reliable exposure data to refine ZEN risk assessment. Human biomonitoring (HBM) is increasingly being recognized as an efficient and cost-effective way of assessing human exposure to food contaminants, including mycotoxins. Based on animal and (limited) human data on the toxicokinetics of ZEN, it appears that excretion of ZEN and its major metabolites may present suitable biomarkers of ZEN exposure. In view of the limitations of available dietary exposure data on ZEN and its modified forms, the purpose of this review is to provide an overview of recent studies utilizing HBM to monitor and assess human exposure to ZEN. Considerations are given to animal and human toxicokinetic data relevant to HBM, analytical methods, and available HBM data on urinary biomarkers of ZEN exposure in different cohorts.