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Hrubá F, černá M, Chen C, Harari F, Horvat M, Koppová K, Krsková A, Laamech J, Li YF, Lina L, Lundh T, Lyoussi B, Mazej D, Osredkar J, Pawlas K, Pawlas N, Prokopowicz A, Rentschler G, Tratnik JS, Sommar J, Spěváčková V, Špirić Z, Skerfving S, Bergdahl IA. A regional comparison of children's blood cadmium, lead, and mercury in rural, urban and industrial areas of six European countries, and China, Ecuador, and Morocco. Int J Occup Med Environ Health 2023; 36:349-364. [PMID: 37681424 PMCID: PMC10663995 DOI: 10.13075/ijomeh.1896.02139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 05/30/2023] [Indexed: 09/09/2023] Open
Abstract
OBJECTIVES The authors aimed to evaluate whether blood cadmium (B-Cd), lead (B-Pb) and mercury (B-Hg) in children differ regionally in 9 countries, and to identify factors correlating with exposure. MATERIAL AND METHODS The authors performed a cross-sectional study of children aged 7-14 years, living in 2007-2008 in urban, rural, or potentially polluted ("hot spot") areas (ca. 50 children from each area, in total 1363 children) in 6 European and 3 non-European countries. The authors analyzed Cd, Pb, and total Hg in blood and collected information on potential determinants of exposure through questionnaires. Regional differences in exposure levels were assessed within each country. RESULTS Children living near industrial "hot-spots" had B-Cd 1.6 (95% CI: 1.4-1.9) times higher in the Czech Republic and 2.1 (95% CI:1.6-2.8) times higher in Poland, as compared to urban children in the same countries (geometric means [GM]: 0.13 μg/l and 0.15 μg/l, respectively). Correspondingly, B-Pb in the "hot spot" areas was 1.8 (95% CI: 1.6-2.1) times higher than in urban areas in Slovakia and 2.3 (95% CI: 1.9-2.7) times higher in Poland (urban GM: 19.4 μg/l and 16.3 μg/l, respectively). In China and Morocco, rural children had significantly lower B-Pb than urban ones (urban GM: 64 μg/l and 71 μg/l, respectively), suggesting urban exposure from leaded petrol, water pipes and/or coal-burning. Hg "hot spot" areas in China had B-Hg 3.1 (95% CI: 2.7-3.5) times higher, and Ecuador 1.5 (95% CI: 1.2-1.9) times higher, as compared to urban areas (urban GM: 2.45 μg/l and 3.23 μg/l, respectively). Besides industrial exposure, traffic correlated with B-Cd; male sex, environmental tobacco smoke, and offal consumption with B-Pb; and fish consumption and amalgam fillings with B-Hg. However, these correlations could only marginally explain regional differences. CONCLUSIONS These mainly European results indicate that some children experience about doubled exposures to toxic elements just because of where they live. These exposures are unsafe, identifiable, and preventable and therefore call for preventive actions. Int J Occup Med Environ Health. 2023;36(3):349-64.
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Affiliation(s)
- Františka Hrubá
- Regional Authority of Public Health, Banská Bystrica, Slovakia
| | - Milena černá
- Charles University, Third Faculty of Medicine, Prague, Czech Republic
| | - Chunying Chen
- Chinese Academy of Sciences, Institute of High Energy Physics and National Center for Nanoscience and Technology, Beijing, China
| | - Florencia Harari
- Institute for Development of Production and Work Environment (IFA), Quito, Ecuador
| | - Milena Horvat
- Institut Jožef Stefan, Department of Environmental Sciences, Ljubljana, Slovenia
| | - Kvetoslava Koppová
- Slovak Medical University Bratislava, Faculty of Health, Banská Bystrica, Slovakia
| | - Andrea Krsková
- National Institute of Public Health, Prague, Czech Republic
| | - Jawhar Laamech
- Abdelmalek Essaadi University, Laboratory of Chemistry and Biochemistry, Faculty of Medicine and Pharmacy, Tangier, Morocco
| | - Yu-Feng Li
- Chinese Academy of Sciences, Institute of High Energy Physics, Beijing, China
| | - Löfmark Lina
- Lund University, Division of Occupational and Environmental Medicine, Lund, Sweden
| | - Thomas Lundh
- Lund University, Division of Occupational and Environmental Medicine, Lund, Sweden
| | - Badiaa Lyoussi
- University Sidi Mohamed Ben Abdellah, Laboratory of Natural Substances, Pharmacology, Environment, Modelling, Health and Quality of Life, Fez, Morocco
| | - Darja Mazej
- Institut Jožef Stefan, Department of Environmental Sciences, Ljubljana, Slovenia
| | - Joško Osredkar
- University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Krystyna Pawlas
- Wroclaw Medical University, Department of Hygiene, Wrocław, Poland
| | - Natalia Pawlas
- Medical University of Silesia, Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Zabrze, Poland
| | | | - Gerda Rentschler
- Lund University, Division of Occupational and Environmental Medicine, Lund, Sweden
| | - Janja Snoj Tratnik
- Institut Jožef Stefan, Department of Environmental Sciences, Ljubljana, Slovenia
| | - Johan Sommar
- Umeå University, Department of Public Health and Clinical Medicine, Division of Sustainable Health, Umeå, Sweden
| | | | | | - Staffan Skerfving
- Lund University, Division of Occupational and Environmental Medicine, Lund, Sweden
| | - Ingvar A. Bergdahl
- Umeå University, Department of Public Health and Clinical Medicine, Division of Sustainable Health, Umeå, Sweden
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2
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Gerofke A, David M, Schmidt P, Vicente JL, Buekers J, Gilles L, Colles A, Bessems J, Bastiaensen M, Covaci A, Den Hond E, Koppen G, Laeremans M, Verheyen VJ, Černá M, Klánová J, Krsková A, Zvonař M, Knudsen LE, Koch HM, Jensen TK, Rambaud L, Riou M, Vogel N, Gabriel C, Karakitsios S, Papaioannou N, Sarigiannis D, Kakucs R, Középesy S, Rudnai P, Szigeti T, Barbone F, Rosolen V, Guignard C, Gutleb AC, Sakhi AK, Haug LS, Janasik B, Ligocka D, Estokova M, Fabelova L, Kolena B, Murinova LP, Petrovicova I, Richterova D, Horvat M, Mazej D, Tratnik JS, Runkel AA, Castaño A, Esteban-López M, Pedraza-Díaz S, Åkesson A, Lignell S, Vlaanderen J, Zock JP, Schoeters G, Kolossa-Gehring M. From science to policy: How European HBM indicators help to answer policy questions related to phthalates and DINCH exposure. Int J Hyg Environ Health 2023; 247:114073. [PMID: 36434900 PMCID: PMC9758616 DOI: 10.1016/j.ijheh.2022.114073] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/19/2022] [Accepted: 11/07/2022] [Indexed: 11/25/2022]
Abstract
Within the European Human Biomonitoring (HBM) Initiative HBM4EU we derived HBM indicators that were designed to help answering key policy questions and support chemical policies. The result indicators convey information on chemicals exposure of different age groups, sexes, geographical regions and time points by comparing median exposure values. If differences are observed for one group or the other, policy measures or risk management options can be implemented. Impact indicators support health risk assessment by comparing exposure values with health-based guidance values, such as human biomonitoring guidance values (HBM-GVs). In general, the indicators should be designed to translate complex scientific information into short and clear messages and make it accessible to policy makers but also to a broader audience such as stakeholders (e.g. NGO's), other scientists and the general public. Based on harmonized data from the HBM4EU Aligned Studies (2014-2021), the usefulness of our indicators was demonstrated for the age group children (6-11 years), using two case examples: one phthalate (Diisobutyl phthalate: DiBP) and one non-phthalate substitute (Di-isononyl cyclohexane-1,2- dicarboxylate: DINCH). For the comparison of age groups, these were compared to data for teenagers (12-18 years), and time periods were compared using data from the DEMOCOPHES project (2011-2012). Our result indicators proved to be suitable for demonstrating the effectiveness of policy measures for DiBP and the need of continuous monitoring for DINCH. They showed similar exposure for boys and girls, indicating that there is no need for gender focused interventions and/or no indication of sex-specific exposure patterns. They created a basis for a targeted approach by highlighting relevant geographical differences in internal exposure. An adequate data basis is essential for revealing differences for all indicators. This was particularly evident in our studies on the indicators on age differences. The impact indicator revealed that health risks based on exposure to DiBP cannot be excluded. This is an indication or flag for risk managers and policy makers that exposure to DiBP still is a relevant health issue. HBM indicators derived within HBM4EU are a valuable and important complement to existing indicator lists in the context of environment and health. Their applicability, current shortcomings and solution strategies are outlined.
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Affiliation(s)
- Antje Gerofke
- German Environment Agency (UBA), Corrensplatz 1, 14195, Berlin, Germany,Corresponding author.
| | - Madlen David
- German Environment Agency (UBA), Corrensplatz 1, 14195, Berlin, Germany
| | - Phillipp Schmidt
- German Environment Agency (UBA), Corrensplatz 1, 14195, Berlin, Germany
| | - Joana Lobo Vicente
- European Environment Agency, Kongens Nytorv 6, 1050, Copenhagen, Denmark
| | - Jurgen Buekers
- VITO – Flemish Institute for Technological Research, Unit Health, Boeretang 200, 2400, Mol, Belgium
| | - Liese Gilles
- VITO – Flemish Institute for Technological Research, Unit Health, Boeretang 200, 2400, Mol, Belgium
| | - Ann Colles
- VITO – Flemish Institute for Technological Research, Unit Health, Boeretang 200, 2400, Mol, Belgium
| | - Jos Bessems
- VITO – Flemish Institute for Technological Research, Unit Health, Boeretang 200, 2400, Mol, Belgium
| | | | - Adrian Covaci
- Toxicological Center, University of Antwerp, 2610 Wilrijk, Belgium
| | | | - Gudrun Koppen
- VITO – Flemish Institute for Technological Research, Unit Health, Boeretang 200, 2400, Mol, Belgium
| | - Michelle Laeremans
- VITO – Flemish Institute for Technological Research, Unit Health, Boeretang 200, 2400, Mol, Belgium
| | - Veerle J. Verheyen
- VITO – Flemish Institute for Technological Research, Unit Health, Boeretang 200, 2400, Mol, Belgium
| | - Milena Černá
- National Institute of Public Health, Prague, Czech Republic
| | - Jana Klánová
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic
| | - Andrea Krsková
- National Institute of Public Health, Prague, Czech Republic
| | - Martin Zvonař
- RECETOX, Faculty of Science, Masaryk University, Kotlarska 2, Brno, Czech Republic,Faculty of Sport Studies, Masaryk University, Kamenice 753/5, Brno, Czech Republic
| | - Lisbeth E. Knudsen
- Department of Public Health, University of Copenhagen Øster Farimagsgade 5 DK Copenhagen, Denmark
| | - Holger M. Koch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance − Institute of the Ruhr University Bochum (IPA), 44789, Bochum, Germany
| | - Tina Kold Jensen
- Faculty of Health Sciences, Department of Public Health, Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Loïc Rambaud
- Santé publique France, French Public Health Agency (SpFrance), Saint-Maurice, France
| | - Margaux Riou
- Santé publique France, French Public Health Agency (SpFrance), Saint-Maurice, France
| | - Nina Vogel
- German Environment Agency (UBA), Corrensplatz 1, 14195, Berlin, Germany
| | - Catherine Gabriel
- Environmental Engineering Laboratory, Department of Chemical Engineering, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece,HERACLES Research Center on the Exposome and Health, Center for Interdisciplinary Research and Innovation, Balkan Center, Bldg. B, 10th km Thessaloniki-Thermi Road, 57001, Greece
| | - Spyros Karakitsios
- Environmental Engineering Laboratory, Department of Chemical Engineering, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece,HERACLES Research Center on the Exposome and Health, Center for Interdisciplinary Research and Innovation, Balkan Center, Bldg. B, 10th km Thessaloniki-Thermi Road, 57001, Greece
| | - Nafsika Papaioannou
- Environmental Engineering Laboratory, Department of Chemical Engineering, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece,HERACLES Research Center on the Exposome and Health, Center for Interdisciplinary Research and Innovation, Balkan Center, Bldg. B, 10th km Thessaloniki-Thermi Road, 57001, Greece
| | - Denis Sarigiannis
- Environmental Engineering Laboratory, Department of Chemical Engineering, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece,HERACLES Research Center on the Exposome and Health, Center for Interdisciplinary Research and Innovation, Balkan Center, Bldg. B, 10th km Thessaloniki-Thermi Road, 57001, Greece,Environmental Health Engineering, Institute of Advanced Study, Palazzo del Broletto - Piazza Della Vittoria 15, 27100, Pavia, Italy
| | - Réka Kakucs
- National Public Health Center, Albert Flórián út 2-6., 1097, Budapest, Hungary
| | - Szilvia Középesy
- National Public Health Center, Albert Flórián út 2-6., 1097, Budapest, Hungary
| | - Péter Rudnai
- National Public Health Center, Albert Flórián út 2-6., 1097, Budapest, Hungary
| | - Tamás Szigeti
- National Public Health Center, Albert Flórián út 2-6., 1097, Budapest, Hungary
| | - Fabio Barbone
- Department of Medicine—DAME, University of Udine, Via Colugna 50, 33100, Udine, Italy
| | - Valentina Rosolen
- Institute for Maternal and Child Health - IRCCS "Burlo Garofolo", 34137, Trieste, Italy
| | - Cedric Guignard
- Luxembourg Institute of Science and Technology (LIST), Environmental Research and Innovation (ERIN) Department, 41, rue du Brill, L-4422 Belvaux, Luxembourg
| | - Arno C. Gutleb
- Luxembourg Institute of Science and Technology (LIST), Environmental Research and Innovation (ERIN) Department, 41, rue du Brill, L-4422 Belvaux, Luxembourg
| | | | | | - Beata Janasik
- Nofer Institute of Occupational Medicine, St. Teresy 8, Lodz, Poland
| | - Danuta Ligocka
- Nofer Institute of Occupational Medicine, St. Teresy 8, Lodz, Poland
| | - Milada Estokova
- Public Health Authority of the Slovak Republic, Trnavska cesta 52, 826 45, Bratislava, Slovakia
| | - Lucia Fabelova
- Slovak Medical University, Faculty of Public Health, Limbova 12, 83303 Bratislava, Slovakia
| | - Branislav Kolena
- Constantine the Philosopher University in Nitra, Tr. A Hlinku 1, 94901 Nitra, Slovakia
| | | | - Ida Petrovicova
- Constantine the Philosopher University in Nitra, Tr. A Hlinku 1, 94901 Nitra, Slovakia
| | - Denisa Richterova
- Slovak Medical University, Faculty of Public Health, Limbova 12, 83303 Bratislava, Slovakia
| | - Milena Horvat
- Jožef Stefan Institute, Department of Environmental Sciences, Jamova cesta 39, 1000, Ljubljana, Slovenia
| | - Darja Mazej
- Jožef Stefan Institute, Department of Environmental Sciences, Jamova cesta 39, 1000, Ljubljana, Slovenia
| | - Janja Snoj Tratnik
- Jožef Stefan Institute, Department of Environmental Sciences, Jamova cesta 39, 1000, Ljubljana, Slovenia
| | - Agneta Annika Runkel
- Jožef Stefan Institute, Department of Environmental Sciences, Jamova cesta 39, 1000, Ljubljana, Slovenia
| | - Argelia Castaño
- National Centre for Environmental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Esteban-López
- National Centre for Environmental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Susana Pedraza-Díaz
- National Centre for Environmental Health, Instituto de Salud Carlos III, Madrid, Spain
| | - Agneta Åkesson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sanna Lignell
- Swedish Food Agency, PO Box 622, SE-751 26, Uppsala, Sweden
| | - Jelle Vlaanderen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - Jan-Paul Zock
- National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Greet Schoeters
- VITO – Flemish Institute for Technological Research, Unit Health, Boeretang 200, 2400, Mol, Belgium
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Forysová K, Pinkr-Grafnetterová A, Malý M, Krsková A, Mráz J, Kašparová L, Čejchanová M, Sochorová L, Rödlová S, Černá M. Urinary Cadmium and Cotinine Levels and Hair Mercury Levels in Czech Children and Their Mothers Within the Framework of the COPHES/DEMOCOPHES Projects. Arch Environ Contam Toxicol 2017; 73:421-430. [PMID: 28526941 DOI: 10.1007/s00244-017-0412-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 05/06/2017] [Indexed: 06/07/2023]
Abstract
The COPHES/DEMOCOPHES twin project was performed in 2011-2012 in 17 European countries to harmonize all steps of the human biomonitoring survey. Urinary cadmium, cotinine, phthalate metabolites, and hair mercury were measured in children (N = 120, 6-11 years) and their mothers of reproductive age, living in urban or rural areas. Cadmium in mothers' and children's urine was detected at a geometric mean (GM) concentration 0.227 and 0.109 μg/L, respectively; 95th percentile (P95) was 0.655 and 0.280 μg/L in mothers and children, respectively. No age-related, education-related, or urban versus rural differences were observed within the frame of each population group. Cadmium urinary level in mothers was about twofold compared with children. Higher levels were obtained in all smoking mothers but not in occasionally smoking or mothers and children exposed to environmental tobacco smoke (ETS). Mercury values in mothers were significantly higher in urban than in rural populations but not in children. GM and P95 for mercury in children's hair were 0.098 and 0.439 μg/g and in mothers' hair were 0.155 and 0.570 μg/g. Concentrations for mercury in the Czech samples were lower than European average. Hair mercury increased significantly with consumption of fish or seafood and with number of amalgam tooth fillings (in children). A positive association was found with family educational level. No influence of age was observed. Urinary cadmium and hair mercury levels were lower than health-based guidelines with one exception. High levels of urinary cotinine were found in the 12 smoking mothers (GM approximately 500 μg/L); lower levels in occasionally smoking mothers, N = 11 (34.5 μg/L). The mean cotinine levels in nonsmoking mothers who reported daily exposure to ETS was 10.7 μg/L. A similar mean value (10.8 μg/L) was obtained in six children who had daily exposure to ETS. In children without exposure to ETS, the mean cotinine level was 1.39 μg/L urine. Cotinine in the urine of children demonstrates limited protection of the Czech children against exposure to ETS.
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Affiliation(s)
- Kateřina Forysová
- 3rd Faculty of Medicine, Charles University, Prague, Czechia
- Regional Public Health Authority in Liberec, Liberec, Czechia
| | | | - Marek Malý
- National Institute of Public Health, Prague, Czechia
| | | | - Jaroslav Mráz
- National Institute of Public Health, Prague, Czechia
| | | | | | | | - Sylva Rödlová
- 3rd Faculty of Medicine, Charles University, Prague, Czechia
| | - Milena Černá
- 3rd Faculty of Medicine, Charles University, Prague, Czechia.
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4
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Černá M, Krsková A, Šmíd J, Malý M. Exposure and risk assessment of the Czech population to chlorinated pesticides and polychlorinated biphenyls using archived serum samples from the period 1970 to 1990. Int J Hyg Environ Health 2016; 219:443-53. [PMID: 27212658 DOI: 10.1016/j.ijheh.2016.04.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 04/21/2016] [Accepted: 04/23/2016] [Indexed: 10/21/2022]
Abstract
The serum samples from the years 1970-1990 archived at the temperature of -20°C in the biobank primarily intended for serological survey performed in the CR since 1960 were pooled and analyzed for DDT, its metabolites, HCB, HCHs, and indicator PCB congeners using up-to-date GC/MS/MS methods to retrospectively assess health risks according to current health guidelines. Samples were pooled based on the decade of sampling, age, gender, and three geographical areas; in adults, one pooled samples consisted of ten and in children of twenty individual samples. Altogether 233 pooled samples were analyzed. For all organochlorine pesticides (OCPs), significant downward trends were observed in the period 1970-1990 (p<0.001). The levels of HCB exceeded the Biomonitoring Equivalent (BE) value. The hazard quotient (HQ) in Prague and Ostrava during the 1970s and 1980s was about 40 and in the 1990s it had dropped to about five. In Uherské Hradiště, the HQ in 1975 was one order of magnitude higher (about 170), and had decreased to approximately 12 by 1987. For both HCB and the DDT sum, the BE-related carcinogenic risk of actual concentrations in the past exceeded significantly the individually accepted cancer risk level of 10(-4). The levels of the main PCB congeners in the 1970s through 1990s revealed an upward time trend in all analyzed strata. The highest concentrations were found in the serum of residents from the hot-spot area Uherské Hradiště. Critical PCB sum concentration levels (700ng/g lipid for vulnerable population groups and 1800ng/g lipid for other population groups) were substantially exceeded with an increasing time trend. PCB sum had exceeded HBM II values of 7μg/L of serum since 1980 in all age strata. In conclusion, the body burden of the Czech general population relative to persistent organic pollutants (POPs) in the period 1970 through 1990 significantly exceeded currently existing health based limit values. The past exposure might adversely affect the health status of the Czech population.
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Affiliation(s)
- Milena Černá
- Charles University in Prague, Third Faculty of Medicine, CZ 100 00, Ruská 87, Prague, Czech Republic.
| | - Andrea Krsková
- National Institute of Public Health, CZ 100 42, Šrobárova 48, Prague, Czech Republic
| | - Jiří Šmíd
- National Institute of Public Health, CZ 100 42, Šrobárova 48, Prague, Czech Republic
| | - Marek Malý
- National Institute of Public Health, CZ 100 42, Šrobárova 48, Prague, Czech Republic
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5
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Fiddicke U, Becker K, Schwedler G, Seiwert M, Joas R, Joas A, Biot P, Aerts D, Casteleyn L, Dumez B, Castaño A, Esteban M, Angerer J, Koch HM, Schoeters G, Den Hond E, Sepai O, Exley K, Knudsen LE, Horvat M, Bloemen L, Katsonouri A, Hadjipanayis A, Cerna M, Krsková A, Jensen JF, Nielsen JKS, Rudnai P, Közepésy S, Gutleb AC, Fischer ME, Ligocka D, Kamińska J, Reis MF, Namorado S, Lupsa IR, Gurzau AE, Halzlová K, Mazej D, Tratnik JS, Rivas TC, Gómez S, Berglund M, Larsson K, Lehmann A, Crettaz P, Dewolf MC, Burns D, Kellegher A, Kolossa-Gehring M. Lessons learnt on recruitment and fieldwork from a pilot European human biomonitoring survey. Environ Res 2015; 141:15-23. [PMID: 25454101 DOI: 10.1016/j.envres.2014.08.039] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 08/12/2014] [Accepted: 08/15/2014] [Indexed: 06/04/2023]
Abstract
Within the European Environment and Health Action Plan an initiative to establish a coherent human biomonitoring approach in Europe was started. The project COPHES (COnsortium to Perform Human biomonitoring on a European Scale ) developed recommendations for a harmonized conduct of a human biomonitoring (HBM) survey which came into action as the pilot study DEMOCOPHES (DEMOnstration of a study to COordinate and Perform Human biomonitoring on a European Scale). Seventeen European countries conducted a survey with harmonized instruments for, inter alia, recruitment, fieldwork and sampling, in autumn/winter 2011/2012. Based on the countries' experiences of conducting the pilot study, following lessons learnt were compiled: the harmonized fieldwork instruments (basic questionnaire, urine and hair sampling) turned out to be very valuable for future HBM surveys on the European scale. A school approach was favoured by most of the countries to recruit school-aged children according to the established guidelines and country specific experiences. To avoid a low participation rate, intensive communication with the involved institutions and possible participants proved to be necessary. The communication material should also include information on exclusion criteria and offered incentives. Telephone contact to the participants the day before fieldwork during the survey can prevent the forgetting of appointments and first morning urine samples. To achieve comparable results on the European scale, training of interviewers in all issues of recruitment, fieldwork and sampling through information material and training sessions is crucial. A survey involving many European countries needs time for preparation and conduct. Materials for quality control prepared for all steps of recruitment, fieldwork and sampling proved to be important to warrant reliable results.
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Affiliation(s)
| | | | | | | | | | | | - Pierre Biot
- Federal Public Service Health, Food Chain Safety and Environment, Brussels, Belgium
| | - Dominique Aerts
- Federal Public Service Health, Food Chain Safety and Environment, Brussels, Belgium
| | | | | | - Argelia Castaño
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Marta Esteban
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Jürgen Angerer
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance-Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Holger M Koch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance-Institute of the Ruhr University Bochum (IPA), Bochum, Germany
| | - Greet Schoeters
- University of Antwerp, Belgium and Southern Denmark University, Denmark and Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Elly Den Hond
- Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Ovnair Sepai
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Oxfordshire, United Kingdom
| | - Karen Exley
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Oxfordshire, United Kingdom
| | | | | | - Louis Bloemen
- Environmental Health Science International, Hulst, The Netherlands
| | | | | | - Milena Cerna
- National Institute of Public Health (NIPH), Prague, Czech Republic and Charles University, Third Faculty of Medicine, Prague, Czech Republic
| | - Andrea Krsková
- National Institute of Public Health (NIPH), Prague, Czech Republic
| | | | | | - Peter Rudnai
- National Institute of Environmental Health (NIEH), Budapest, Hungary
| | - Szilvia Közepésy
- National Institute of Environmental Health (NIEH), Budapest, Hungary
| | - Arno C Gutleb
- Centre de Recherche Public-Gabriel Lippmann (CRP-GL), Belvaux, Luxembourg
| | | | - Danuta Ligocka
- Nofer Institute of Occupational Medicine (NIOM), Lodz, Poland
| | - Joanna Kamińska
- Nofer Institute of Occupational Medicine (NIOM), Lodz, Poland
| | - M Fátima Reis
- Institute of Preventive Medicine, Lisbon Faculty of Medicine (IMP/FML), Lisbon, Portugal
| | - Sónia Namorado
- Institute of Preventive Medicine, Lisbon Faculty of Medicine (IMP/FML), Lisbon, Portugal
| | | | - Anca E Gurzau
- Environmental Health Centre (EHC), Cluj-Napoca, Romania
| | - Katarína Halzlová
- Public Health Authority of the Slovak Republic (UVZ SR), Bratislava, Slovakia
| | | | | | - Teresa C Rivas
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Silvia Gómez
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Marika Berglund
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kristin Larsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Andrea Lehmann
- Federal Office of Public Health (FOPH), Berne, Switzerland
| | - Pierre Crettaz
- Federal Office of Public Health (FOPH), Berne, Switzerland
| | | | - Damien Burns
- National Environmental Health Office, Health Service Executive, Dublin, Ireland
| | - Anne Kellegher
- Health Service Executive, Environmental Health Department, Leitrim, Ireland
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6
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Castaño A, Cutanda F, Esteban M, Pärt P, Navarro C, Gómez S, Rosado M, López A, López E, Exley K, Schindler BK, Govarts E, Casteleyn L, Kolossa-Gehring M, Fiddicke U, Koch H, Angerer J, Den Hond E, Schoeters G, Sepai O, Horvat M, Knudsen LE, Aerts D, Joas A, Biot P, Joas R, Jiménez-Guerrero JA, Diaz G, Pirard C, Katsonouri A, Cerna M, Gutleb AC, Ligocka D, Reis FM, Berglund M, Lupsa IR, Halzlová K, Charlier C, Cullen E, Hadjipanayis A, Krsková A, Jensen JF, Nielsen JK, Schwedler G, Wilhelm M, Rudnai P, Középesy S, Davidson F, Fischer ME, Janasik B, Namorado S, Gurzau AE, Jajcaj M, Mazej D, Tratnik JS, Larsson K, Lehmann A, Crettaz P, Lavranos G, Posada M. Fish consumption patterns and hair mercury levels in children and their mothers in 17 EU countries. Environ Res 2015; 141:58-68. [PMID: 25667172 DOI: 10.1016/j.envres.2014.10.029] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 10/17/2014] [Accepted: 10/20/2014] [Indexed: 05/23/2023]
Abstract
The toxicity of methylmercury (MeHg) in humans is well established and the main source of exposure is via the consumption of large marine fish and mammals. Of particular concern are the potential neurodevelopmental effects of early life exposure to low-levels of MeHg. Therefore, it is important that pregnant women, children and women of childbearing age are, as far as possible, protected from MeHg exposure. Within the European project DEMOCOPHES, we have analyzed mercury (Hg) in hair in 1799 mother-child pairs from 17 European countries using a strictly harmonized protocol for mercury analysis. Parallel, harmonized questionnaires on dietary habits provided information on consumption patterns of fish and marine products. After hierarchical cluster analysis of consumption habits of the mother-child pairs, the DEMOCOPHES cohort can be classified into two branches of approximately similar size: one with high fish consumption (H) and another with low consumption (L). All countries have representatives in both branches, but Belgium, Denmark, Spain, Portugal and Sweden have twice as many or more mother-child pairs in H than in L. For Switzerland, Czech Republic, Hungary, Poland, Romania, Slovenia and Slovakia the situation is the opposite, with more representatives in L than H. There is a strong correlation (r=0.72) in hair mercury concentration between the mother and child in the same family, which indicates that they have a similar exposure situation. The clustering of mother-child pairs on basis of their fish consumption revealed some interesting patterns. One is that for the same sea fish consumption, other food items of marine origin, like seafood products or shellfish, contribute significantly to the mercury levels in hair. We conclude that additional studies are needed to assess and quantify exposure to mercury from seafood products, in particular. The cluster analysis also showed that 95% of mothers who consume once per week fish only, and no other marine products, have mercury levels 0.55 μg/g. Thus, the 95th percentile of the distribution in this group is only around half the US-EPA recommended threshold of 1 μg/g mercury in hair. Consumption of freshwater fish played a minor role in contributing to mercury exposure in the studied cohort. The DEMOCOPHES data shows that there are significant differences in MeHg exposure across the EU and that exposure is highly correlated with consumption of fish and marine products. Fish and marine products are key components of a healthy human diet and are important both traditionally and culturally in many parts of Europe. Therefore, the communication of the potential risks of mercury exposure needs to be carefully balanced to take into account traditional and cultural values as well as the potential health benefits from fish consumption. European harmonized human biomonitoring programs provide an additional dimension to national HMB programs and can assist national authorities to tailor mitigation and adaptation strategies (dietary advice, risk communication, etc.) to their country's specific requirements.
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Affiliation(s)
- Argelia Castaño
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III(ISCIII), 28220 Majadahonda, Madrid, Spain.
| | - Francisco Cutanda
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III(ISCIII), 28220 Majadahonda, Madrid, Spain
| | - Marta Esteban
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III(ISCIII), 28220 Majadahonda, Madrid, Spain
| | - Peter Pärt
- European Commission, Joint Research Centre (JRC), Institute of Environment and Sustainability, 21027 Ispra, Italy
| | - Carmen Navarro
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III(ISCIII), 28220 Majadahonda, Madrid, Spain
| | - Silvia Gómez
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III(ISCIII), 28220 Majadahonda, Madrid, Spain
| | - Montserrat Rosado
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III(ISCIII), 28220 Majadahonda, Madrid, Spain
| | - Ana López
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III(ISCIII), 28220 Majadahonda, Madrid, Spain
| | - Estrella López
- Instituto de Investigacion de Enfermedades Raras (IIER) Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Karen Exley
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, United Kingdom
| | - Birgit K Schindler
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance-Institute of the Ruhr-Universität Bochum (IPA), Germany
| | - Eva Govarts
- Environmental Risk and Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | | | | | - Ulrike Fiddicke
- Federal Environment Agency (UBA), Dessau-Rosslau, Berlin, Germany
| | - Holger Koch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance-Institute of the Ruhr-Universität Bochum (IPA), Germany
| | - Jürgen Angerer
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance-Institute of the Ruhr-Universität Bochum (IPA), Germany
| | - Elly Den Hond
- Environmental Risk and Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Greet Schoeters
- Environmental Risk and Health, Flemish Institute for Technological Research (VITO), Mol, Belgium
| | - Ovnair Sepai
- Public Health England, Centre for Radiation, Chemical and Environmental Hazards, Chilton, United Kingdom
| | - Milena Horvat
- Department of Environmental Sciences, Jožef Stefan Institute, Ljubljana, Slovenia
| | - Lisbeth E Knudsen
- Departament of Public Health, University of Copenhagen, Copenhagen, Demark
| | - Dominique Aerts
- DG Environment, Federal Public Service Health, Food Chain Safety and Environment, Brussels, Belgium
| | | | - Pierre Biot
- DG Environment, Federal Public Service Health, Food Chain Safety and Environment, Brussels, Belgium
| | | | - José A Jiménez-Guerrero
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III(ISCIII), 28220 Majadahonda, Madrid, Spain
| | - Gema Diaz
- Environmental Toxicology, Centro Nacional de Sanidad Ambiental (CNSA), Instituto de Salud Carlos III(ISCIII), 28220 Majadahonda, Madrid, Spain
| | - Catherine Pirard
- CHU of Liege, Laboratory of Clinical, Forensic and Environmental Toxicology, Liege, Belgium
| | | | - Milena Cerna
- National Institute of Public Health, Prague, Czech Republic
| | - Arno C Gutleb
- Luxembourg Institute of Science and Technology (LIST) Louxembourg
| | | | | | - Marika Berglund
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Katarína Halzlová
- Public Health Authority of the Slovak Republic (UVZ SR), Bratislava, Slovak Republic
| | - Corinne Charlier
- CHU of Liege, Laboratory of Clinical, Forensic and Environmental Toxicology, Liege, Belgium
| | - Elizabeth Cullen
- Department of Community of Health, Health Service Executive, Kildare, Ireland
| | | | - Andrea Krsková
- National Institute of Public Health, Prague, Czech Republic
| | - Janne F Jensen
- Departament of Public Health, University of Copenhagen, Copenhagen, Demark
| | - Jeanette K Nielsen
- Departament of Public Health, University of Copenhagen, Copenhagen, Demark
| | - Gerda Schwedler
- Federal Environment Agency (UBA), Dessau-Rosslau, Berlin, Germany
| | - Michael Wilhelm
- Department of Hygiene, Social and Environmental Medicine, Ruhr-University Bochum, Germany
| | - Peter Rudnai
- National Institute of Environmental Health, Budapest, Hungary
| | | | - Fred Davidson
- Public Analyst's Laboratory Health Service Executive, Cork, Ireland
| | | | - Beata Janasik
- Nofer Institute of Occupational Medicine, Lodz, Poland
| | | | | | - Michal Jajcaj
- Public Health Authority of the Slovak Republic (UVZ SR), Bratislava, Slovak Republic
| | - Darja Mazej
- Department of Environmental Sciences, Jožef Stefan Institute, Ljubljana, Slovenia
| | - Janja Snoj Tratnik
- Department of Environmental Sciences, Jožef Stefan Institute, Ljubljana, Slovenia
| | - Kristin Larsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Andrea Lehmann
- Federal Office of Public Health (FOPH), Berne, Switzerland
| | - Pierre Crettaz
- Federal Office of Public Health (FOPH), Berne, Switzerland
| | | | - Manuel Posada
- Instituto de Investigacion de Enfermedades Raras (IIER) Instituto de Salud Carlos III (ISCIII), Madrid, Spain
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7
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Casteleyn L, Dumez B, Becker K, Kolossa-Gehring M, Den Hond E, Schoeters G, Castaño A, Koch HM, Angerer J, Esteban M, Exley K, Sepai O, Bloemen L, Horvat M, Knudsen LE, Joas A, Joas R, Biot P, Koppen G, Dewolf MC, Katsonouri A, Hadjipanayis A, Cerná M, Krsková A, Schwedler G, Fiddicke U, Nielsen JKS, Jensen JF, Rudnai P, Közepésy S, Mulcahy M, Mannion R, Gutleb AC, Fischer ME, Ligocka D, Jakubowski M, Reis MF, Namorado S, Lupsa IR, Gurzau AE, Halzlova K, Jajcaj M, Mazej D, Tratnik Snoj J, Posada M, López E, Berglund M, Larsson K, Lehmann A, Crettaz P, Aerts D. A pilot study on the feasibility of European harmonized human biomonitoring: Strategies towards a common approach, challenges and opportunities. Environ Res 2015; 141:3-14. [PMID: 25746298 DOI: 10.1016/j.envres.2014.10.028] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Revised: 10/21/2014] [Accepted: 10/27/2014] [Indexed: 06/04/2023]
Abstract
In 2004 the European Commission and Member States initiated activities towards a harmonized approach for Human Biomonitoring surveys throughout Europe. The main objective was to sustain environmental health policy by building a coherent and sustainable framework and by increasing the comparability of data across countries. A pilot study to test common guidelines for setting up surveys was considered a key step in this process. Through a bottom-up approach that included all stakeholders, a joint study protocol was elaborated. From September 2011 till February 2012, 17 European countries collected data from 1844 mother-child pairs in the frame of DEMOnstration of a study to COordinate and Perform Human Biomonitoring on a European Scale (DEMOCOPHES).(1) Mercury in hair and urinary cadmium and cotinine were selected as biomarkers of exposure covered by sufficient analytical experience. Phthalate metabolites and Bisphenol A in urine were added to take into account increasing public and political awareness for emerging types of contaminants and to test less advanced markers/markers covered by less analytical experience. Extensive efforts towards chemo-analytical comparability were included. The pilot study showed that common approaches can be found in a context of considerable differences with respect to experience and expertize, socio-cultural background, economic situation and national priorities. It also evidenced that comparable Human Biomonitoring results can be obtained in such context. A European network was built, exchanging information, expertize and experiences, and providing training on all aspects of a survey. A key challenge was finding the right balance between a rigid structure allowing maximal comparability and a flexible approach increasing feasibility and capacity building. Next steps in European harmonization in Human Biomonitoring surveys include the establishment of a joint process for prioritization of substances to cover and biomarkers to develop, linking biomonitoring surveys with health examination surveys and with research, and coping with the diverse implementations of EU regulations and international guidelines with respect to ethics and privacy.
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Affiliation(s)
| | | | - K Becker
- Federal Environment Agency (UBA), Germany
| | | | | | | | - A Castaño
- Instituto de Salud Carlos III, Spain
| | - H M Koch
- Ruhr Universität Bochum, Germany
| | | | - M Esteban
- Instituto de Salud Carlos III, Spain
| | - K Exley
- Public Health England, United Kingdom
| | - O Sepai
- Public Health England, United Kingdom
| | - L Bloemen
- Environmental Health Sciences International, The Netherlands
| | - M Horvat
- Jožef Stefan Institute, Slovenia
| | | | | | | | - P Biot
- Federal Public Service Health, Food chain safety and Environment, Belgium
| | | | - M-C Dewolf
- Hainaut Vigilance Sanitaire (HVS) and Hygiene Publique in Hainaut (HPH), Belgium
| | | | | | - M Cerná
- National Institute of Public Health, Czech Republic
| | - A Krsková
- National Institute of Public Health, Czech Republic
| | | | | | | | | | - P Rudnai
- National Institute of Environmental Health, Hungary
| | - S Közepésy
- National Institute of Environmental Health, Hungary
| | | | | | - A C Gutleb
- Centre de Recherche Public - Gabriel Lippmann, Luxembourg
| | | | - D Ligocka
- Nofer Institute of Occupational Medicine, Poland
| | - M Jakubowski
- Nofer Institute of Occupational Medicine, Poland
| | - M F Reis
- Faculdade de Medicina de Lisboa, Portugal
| | - S Namorado
- Faculdade de Medicina de Lisboa, Portugal
| | - I-R Lupsa
- Environmental Health Center, Romania
| | | | - K Halzlova
- Urad Verejneho Zdravotnictva Slovenskej Republiky, Slovakia
| | - M Jajcaj
- Urad Verejneho Zdravotnictva Slovenskej Republiky, Slovakia
| | - D Mazej
- Jožef Stefan Institute, Slovenia
| | | | - M Posada
- Instituto de Salud Carlos III, Spain
| | - E López
- Instituto de Salud Carlos III, Spain
| | - M Berglund
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - K Larsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - A Lehmann
- Federal Office of Public Health (FOPH), Switzerland
| | - P Crettaz
- Federal Office of Public Health (FOPH), Switzerland
| | - D Aerts
- Federal Public Service Health, Food chain safety and Environment, Belgium
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8
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Černá M, Malý M, Rudnai P, Középesy S, Náray M, Halzlová K, Jajcaj M, Grafnetterová A, Krsková A, Antošová D, Forysová K, Den Hond E, Schoeters G, Joas R, Casteleyn L, Joas A, Biot P, Aerts D, Angerer J, Bloemen L, Castaño A, Esteban M, Koch HM, Kolossa-Gehring M, Gutleb AC, Pavloušková J, Vrbík K. Case study: Possible differences in phthalates exposure among the Czech, Hungarian, and Slovak populations identified based on the DEMOCOPHES pilot study results. Environ Res 2015; 141:118-124. [PMID: 25532669 DOI: 10.1016/j.envres.2014.10.025] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 09/23/2014] [Accepted: 10/15/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Phthalates and their metabolites are classified as endocrine modulators. They affect the hormonal balance in both children and adults. The aim of this publication was to compare the urinary levels of phthalate metabolites in selected populations of the Czech Republic (CZ), Slovakia (SK), and Hungary (HU) in relation to the sources of phthalate exposure identified by means of questionnaire (personal care products, floor and wall coverings, plastic toys, and some kinds of foods). METHODS Data were obtained through the twin projects COPHES (COnsortium to Perform Human biomonitoring on a European Scale) and DEMOCOPHES (DEMOnstration of a study to COordinate and Perform Human biomonitoring on a European Scale) from 2009 to 2012. The target groups were children aged 6-11 years old and their mothers up to 45 years of age. The metabolites of phthalates (monomethyl phthalate (MMP), monoethyl phthalate (MEP), monobenzyl phthalate (MBzP), mono-cyclohexyl phthalate (MCHP), mono-(2-ethylhexyl) phthalate (MEHP), mono-(2-ethyl-5-hydroxyhexyl) phthalate (5OH-MEHP), and mono-(2-ethyl-5-oxohexyl) phthalate (5OXO-MEHP)) were analysed in first morning urine samples. After enzymatic glucuronide cleavage, the urine sample analyses were performed using ultra-high-performance liquid chromatography-electrospray ionization tandem mass spectrometry (UHPLC-ESI-MS/MS) in one laboratory that qualified in the External Quality Assessment exercises organised by COPHES. RESULTS Significant differences in phthalate exposure between countries were revealed for children only but not for mothers. The concentrations of 5-OH-MEHP (P<0.001), 5OXO-MEHP (P<0.001), and their sum (P<0.001) were the highest in SK compared to CZ and HU. The health based guidance values for the sum of DEHP metabolites 5-OH MEHP and 5OXO-MEHP established by the German Commission for biomonitoring of 300 µg/L and 500 µg/L for women adults and children, respectively, were only exceeded in one mother and three boys. A significant difference was also found for MEP (P=0.0149), with the highest concentrations detected in HU. In all countries, the increasing frequency of using personal care products significantly elevated the concentrations of MEP. CONCLUSION Some differences were observed between countries in the concentrations of individual urinary phthalate metabolites in children. However, the questionnaire results give no direct explanation for the differences between the countries except the variation in using personal care products.
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Affiliation(s)
- Milena Černá
- National Institute of Public Health, Šrobárova 48, Prague 10 100 42, Czech Republic; Charles University, Third Faculty of Medicine, Prague, Czech Republic.
| | - Marek Malý
- National Institute of Public Health, Šrobárova 48, Prague 10 100 42, Czech Republic
| | - Peter Rudnai
- National Institute of Environmental Health, Budapest, Hungary
| | | | - Miklós Náray
- National Labour Office, Department for Occupational Health, Budapest, Hungary
| | - Katarina Halzlová
- Authority of Public Health of the Slovak Republic, Bratislava, Slovakia
| | - Michal Jajcaj
- Authority of Public Health of the Slovak Republic, Bratislava, Slovakia
| | - Anna Grafnetterová
- National Institute of Public Health, Šrobárova 48, Prague 10 100 42, Czech Republic
| | - Andrea Krsková
- National Institute of Public Health, Šrobárova 48, Prague 10 100 42, Czech Republic
| | - Danuše Antošová
- National Institute of Public Health, Šrobárova 48, Prague 10 100 42, Czech Republic
| | | | - Elly Den Hond
- Flemish Institute for Technological Research (VITO), Environmental Risk and Health, Belgium
| | - Greet Schoeters
- VITO, Environmental Risk and Health Unit, Boeretang 200, 2400 Mol, Belgium; Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium
| | | | | | | | - Pierre Biot
- Federal Public Service Health, Food Chain Safety and Environment-DG Environment, Brussels, Belgium
| | - Dominique Aerts
- Federal Public Service Health, Food Chain Safety and Environment-DG Environment, Brussels, Belgium
| | - Jürgen Angerer
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance-Institute of the Ruhr-Universität Bochum (IPA), Germany
| | - Louis Bloemen
- Environmental Health Sciences International, Hulst, The Netherlands
| | | | | | - Holger M Koch
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance-Institute of the Ruhr-Universität Bochum (IPA), Germany
| | | | - Arno C Gutleb
- Centre de Recherche Public-Gabriel Lippmann, Belvaux, Luxembourg
| | - Jana Pavloušková
- National Institute of Public Health, Šrobárova 48, Prague 10 100 42, Czech Republic
| | - Karel Vrbík
- National Institute of Public Health, Šrobárova 48, Prague 10 100 42, Czech Republic
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9
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Rambousková J, Krsková A, Slavíková M, Cejchanová M, Cerná M. Blood levels of lead, cadmium, and mercury in the elderly living in institutionalized care in the Czech Republic. Exp Gerontol 2014; 58:8-13. [PMID: 25016213 DOI: 10.1016/j.exger.2014.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 07/04/2014] [Accepted: 07/08/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is limited research examining the chemical load of toxic metals in the elderly. The aim of the present study was two-fold: to determine the body burden of lead, cadmium and mercury in association with age, gender, locality, lifestyle factors and potential health impacts among this population and to compare the values with blood values from the general Czech population aged 18-64 years. METHODS Lead, cadmium and mercury were examined in the blood of institutionalized senior citizens (46 males, 151 females aged 61-100 years) from two localities in the Czech Republic (Prague and Teplice) from 2009 through 2011. Measurements were made using inductively coupled plasma mass spectrometry (Pb, Cd) and a single purpose spectrometer AMA 254 (Hg). RESULTS Geometric means (GM) of whole blood lead (B-Pb), cadmium (B-Cd) and mercury (B-Hg) levels were 25.3μg/l, 0.55μg/l and 0.21μg/l, respectively. No age-related differences were found for B-Pb and B-Cd levels but a negative correlation with age was observed for B-Hg levels (p=0.04). B-Pb levels in men were significantly higher than in women (GM 29.9μg/l vs. 24.1μg/l). B-Cd was significantly higher in women (GM 0.57μg/l) than in men (0.50μg/l) (p=0.007) and in smokers (GM 1.29μg/l) than in nonsmokers (GM 0.53μg/l) (p=<0.001) and in seniors from Prague (GM 0.60μg/l) compared to those from Teplice (GM 0.43μg/l) (p=<0.001). Seniors with a history of chronic kidney disease, stroke and those using psycho-pharmaceuticals had higher B-Pb levels (p=0.008, 0.04 and 0.05, resp.), seniors diagnosed with atherosclerosis had higher B-Cd levels (p=0.002) and seniors using psycho-pharmaceuticals had higher B-Hg levels (p=0.07). B-Hg levels were also positively correlated with blood albumin levels (p=0.015). CONCLUSIONS This study provides data on levels of heavy metals in a group of elderly people. Such information is very scarce. Associations with diseases should be the subject of further investigation.
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Affiliation(s)
- Jolana Rambousková
- Centre for Research of Diabetes, Metabolism and Nutrition, Department of Nutrition, Third Faculty of Medicine, Charles University in Prague, Ruská 87, 100 00 Prague 10, Czech Republic.
| | - Andrea Krsková
- Environmental and Population Health Monitoring, National Institute of Public Health, Šrobárova 48, 100 42 Prague 10, Czech Republic
| | - Miroslava Slavíková
- Centre for Research of Diabetes, Metabolism and Nutrition, Department of Nutrition, Third Faculty of Medicine, Charles University in Prague, Ruská 87, 100 00 Prague 10, Czech Republic
| | - Mája Cejchanová
- Environmental and Population Health Monitoring, National Institute of Public Health, Šrobárova 48, 100 42 Prague 10, Czech Republic
| | - Milena Cerná
- Environmental and Population Health Monitoring, National Institute of Public Health, Šrobárova 48, 100 42 Prague 10, Czech Republic; Department of General Hygiene, Third Faculty of Medicine, Charles University in Prague, Ruská 87, 100 00 Prague 10, Czech Republic
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10
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Rambousková J, Slavíková M, Krsková A, Procházka B, Anděl M, Dlouhý P. Nutritional status assessment of institutionalized elderly in Prague, Czech Republic. Ann Nutr Metab 2013; 62:201-6. [PMID: 23485785 DOI: 10.1159/000346038] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Accepted: 11/21/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND There are few studies in the Czech Republic describing and evaluating the nutritional status of institutionalized elderly. METHODS Data were collected from 659 women and 156 men aged 65 years and older and living in retirement homes in and around Prague. Data included: a Mini-Nutritional Assessment (MNA questionnaire), anthropometric measurements and biochemical evaluations. RESULTS According to the MNA questionnaire, 10.2% of these elderly individuals were malnourished and 39.4% were at risk of malnutrition. More women than men were malnourished (OR = 0.59 and 95% CI 0.42-0.86). Mean BMI values were 25.5 for females and 27.5 for males. MNA was positively correlated mostly with immobility (r = 0.63; p < 0.001), BMI (r = 0.57; p < 0.001) and mid-arm circumference (r = 0.56; p < 0.001). Serum albumin levels were <28 g/l in 1.3% (1.3% of the women and 1.36% of the men) and between 29.0 - 34.0 g/l in 21% (22.5% of the women and 14.4% of the men). Statistically significant differences between groups according to MNA scores were found for albumin, prealbumin, transferrin and creatinine. Prevalence of smoking was significantly higher among males. CONCLUSION The study results confirmed that institutionalized elderly, especially women, should be considered a nutritionally vulnerable population group that needs attention.
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Affiliation(s)
- Jolana Rambousková
- Centre for Research of Diabetes, Metabolism and Nutrition, Department of Nutrition, Third Faculty of Medicine, Charles University, Prague, Czech Republic.
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11
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Mikeš O, Cupr P, Kohút L, Krsková A, Cerná M. Fifteen years of monitoring of POPs in the breast milk, Czech Republic, 1994-2009: trends and factors. Environ Sci Pollut Res Int 2012; 19:1936-1943. [PMID: 22767291 DOI: 10.1007/s11356-012-0798-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Accepted: 01/27/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND, AIM AND SCOPE The breast milk has been recommended to carry out as a monitoring tool for effectiveness evaluation of the Stockholm Convention on Persistent Organic Pollutants (POPs). Polychlorinated biphenyls (PCBs), dichlorodiphenyltrichloro-ethane (DDT) and its metabolites (DDX), hexachlorbenzene (HCB) and isomers of hexachlocyklohexane (HCHs) have been monitored in the breast milk of nursing mothers in the Czech Republic since 1994 as a part of The Environmental Health Monitoring System. Knowledge about long-term POPs distribution and accumulation in the human body is crucial to understanding uptake, degradation and subsequent effects as well as to conduct risk assessments. The main aim of this study is to evaluate 15-years long-term trends of selected POPs in human milk in the Czech Republic and to elucidate the questionnaire information about the age, parity and social habits, to the final concentrations. This effectiveness evaluation of POPs restriction is quite precisely after 15-years monitoring campaigns. MATERIALS, METHODS AND RESULTS The human milk samples (4,753 samples) were analysed for a number of chlorinated organic chemicals including PCBs and selected chlorinated pesticides (OCPs, HCB, HCHs, DDX). The relative change of concentration per year for all chemicals was analysed. The remaining percentages of POPs in breast milk in comparison to 1994 are also expressed. Czech population half-lives of POPs in breast milk, derived from either linear or exponential models were computed. CONCLUSIONS AND PERSPECTIVES The long-term data indicates a continuation of a decreasing trend of POPs concentrations on breast milk. Our study did not confirm lactation and parity as an important outflux resulting in the decrease in concentrations in mothers, which is in the antagonism with most of the studies. The higher BMI was associated with higher amounts of HCB and lower amounts of higher chlorinated PCBs. The results confirm the effectiveness of restrictions of POPs usage in the Czech Republic. This ongoing long-term study is very useful tool for parametric effectiveness evaluation of Stockholm Convention.
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Affiliation(s)
- Ondřej Mikeš
- Research Centre for Toxic compounds in the Environment, Faculty of Science, Masaryk University, Brno, Czech Republic.
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Čejchanová M, Wranová K, Spěváčková V, Krsková A, Šmíd J, Černá M. Human Biomonitoring Study - Toxic Elements in Blood of Women. Cent Eur J Public Health 2012; 20:139-43. [DOI: 10.21101/cejph.a3756] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Hrubá F, Strömberg U, Černá M, Chen C, Harari F, Harari R, Horvat M, Koppová K, Kos A, Krsková A, Krsnik M, Laamech J, Li YF, Löfmark L, Lundh T, Lundström NG, Lyoussi B, Mazej D, Osredkar J, Pawlas K, Pawlas N, Prokopowicz A, Rentschler G, Spěváčková V, Spiric Z, Tratnik J, Skerfving S, Bergdahl IA. Blood cadmium, mercury, and lead in children: an international comparison of cities in six European countries, and China, Ecuador, and Morocco. Environ Int 2012; 41:29-34. [PMID: 22257910 DOI: 10.1016/j.envint.2011.12.001] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 12/05/2011] [Accepted: 12/11/2011] [Indexed: 05/24/2023]
Abstract
Children's blood-lead concentration (B-Pb) is well studied, but little is known about cadmium (B-Cd) and mercury (B-Hg), in particular for central Europe. Such information is necessary for risk assessment and management. Therefore, we here describe and compare B-Pb, B-Cd and B-Hg in children in six European, and three non-European cities, and identify determinants of these exposures. About 50 school children (7-14 years) from each city were recruited (totally 433) in 2007-2008. Interview and questionnaire data were obtained. A blood sample was analyzed: only two laboratories with strict quality control were used. The European cities showed only minor differences for B-Cd (geometric means 0.11-0.17 μg/L) and B-Pb (14-20 μg/L), but larger for B-Hg (0.12-0.94 μg/L). Corresponding means for the non-European countries were 0.21-0.26, 32-71, and 0.3-3.2 μg/L, respectively. For B-Cd in European samples, traffic intensity close to home was a statistically significant determinant, for B-Hg fish consumption and amalgam fillings, and for B-Pb sex (boys higher). This study shows that European city children's B-Cd and B-Pb vary only little between countries; B-Hg differs considerably, due to varying tooth restoration practices and fish intake. Traffic intensity seemed to be a determinant for B-Cd. The metal concentrations were low from a risk perspective but the chosen non-European cities showed higher concentrations than the cities in Europe.
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Affiliation(s)
- Františka Hrubá
- Regional Authority of Public Health, Banská Bystrica, Slovakia.
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Cerná M, Krsková A, Cejchanová M, Spěváčková V. Human biomonitoring in the Czech Republic: an overview. Int J Hyg Environ Health 2011; 215:109-19. [PMID: 22014893 DOI: 10.1016/j.ijheh.2011.09.007] [Citation(s) in RCA: 97] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Revised: 06/11/2011] [Accepted: 09/22/2011] [Indexed: 11/25/2022]
Abstract
In the Czech Republic, the Human Biomonitoring Project (CZ-HBM) was launched in 1994 as an integral part of the nationwide Environmental Health Monitoring System (EHMS). Until now, the HBM covers two time periods: the first covered 1994-2003 and the second, 2005-2009. Altogether three population groups were included in the HBM: adults (blood donors aged 18-58 years), children aged 8-10 years, and breastfeeding primiparas. Sampling is organized on a yearly basis. Altogether three groups of biomarkers were analyzed: (a) selected heavy metals (Pb, Cd, Hg) and essential elements (Cu, Se, Zn) in blood and urine of adults and children, (b) indicator PCBs, DDT, DDE, HCB and HCHs in human milk and blood serum of adults and (c) cytogenetic changes in peripheral lymphocytes in blood of adults and children. This paper is focused on the general design of the CZ-HBM, the trends over time, and reference values. A significant downward time trend was observed for the blood lead levels in adults and children. Increased urinary cadmium levels were observed in Czech children compared to German children. The blood and urinary mercury levels were higher in women than in men. The levels of indicator PCB congeners in the Czech human milk samples were still higher than in most other European countries, because of existing hot spots. The levels of organochlorine pesticides showed a substantial continuous downward trend.
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Affiliation(s)
- Milena Cerná
- National Institute of Public Health, Šrobárova 48, 100 42 Prague 10, Czech Republic.
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Cerná M, Bencko V, Brabec M, Smíd J, Krsková A, Jech L. Exposure assessment of breast-fed infants in the Czech Republic to indicator PCBs and selected chlorinated pesticides: area-related differences. Chemosphere 2010; 78:160-168. [PMID: 19897227 DOI: 10.1016/j.chemosphere.2009.09.062] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2009] [Revised: 09/24/2009] [Accepted: 09/27/2009] [Indexed: 05/28/2023]
Abstract
The aim of our study was to obtain data on the exposure of breast-fed infants to polychlorinated biphenyls (PCBs) and selected organochlorine pesticides (OCPs) in different urban areas of the Czech Republic. The PCB and OCP levels were determined in 90 human milk samples collected in seven urban areas in 1999-2000 according to the WHO protocol. The estimated daily intake (EDI) was calculated for each of the analytes and compared with the respective tolerable daily intake (TDI). Significant local differences in the sum of 35 PCB congeners analyzed (total PCBs) as well as in the most prominent indicator congeners 138, 153, and 180 values were observed, with the highest levels being found in breast milk samples from mothers living in the vicinity of a former plant using PCBs in Uherské Hradiste (median and ranges 3410 and 1448-13,754 ng g(-1)lipid weight (lw)). Non-exposed mothers from the same area had about threefold lower levels (median and ranges 1073 and 757-2139 ng/g lw, respectively). The lowest levels of total PCBs were found in Telc (median and ranges 480 and 293-731 ng g(-1)lw, respectively). In all study areas, EDIs for PCBs in breast-fed infants exceeded the TDI of 0.4 microg kg(-1)bwd(-1) recommended in the Czech Republic. EDI for HCB exceeded the recommended TDI of 0.16 microg kg(-1), EDI for DDT was slightly below TDI of 10 microg kg(-1) bw d(-1) and HCHs EDI was negligible. The database of analytical results from this study was used for Bayesian modeling of breast-fed infant exposure to PCBs and OCPs during the recommended 6 months of exclusive breastfeeding.
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Affiliation(s)
- Milena Cerná
- Charles University in Prague, Third Faculty of Medicine in Prague, Czech Republic.
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