Human Biomonitoring in the UK

Transcription

1 Human Biomonitoring in the UK Dr Ovnair Sepai Health Protection Agency UK November 2008 Introduction UK, at present, does not have a Programme of Human Biomonitoring for Environmental/Population Exposure Assessment Why is one needed? Pros Pros What are we doing at present? Cons Cons 1

2 Introduction 1. Scoping Study 2. Selected Projects: HPA Reference range study Cefic Background incidence study ALSPAC Child of the 90s Standard Protocols- HPA Initiative. 3. Other large scale initiatives UK BIOBANK UK Health Surveys 4. UK Role in a Pan-EU HBM Pilot Study Scoping Study AIMS To document the Range and Scope of Projects across the UK Identify capabilities Identify possible over laps and opportunities for collaboration Develop a network Questionnaire to all contacts Academic Institutes Societies Web presence 2

3 Scoping Study Only 17 studies identified Vast under representation Each has a specific remit No harmonisation of - methodologies even for the same compounds - sample collection etc Scoping Study Title Assessment of cadmium dose and early kidney damage in a population sample: Pilot Study (Targeted Cross-sectional) Study of Eczema and Asthma to Observe the effect of nutrition (SEATON) (COHORT) A study of organohalogen chemicals in human blood from around the United Kingdom (Random) Age Group Adults 1-6 yrs Adults Funding Body SAHSU - London WWF Lead Body burden in children: A pilot study (Targeted Cross-sectional) 2-7 3

4 Reference Range Study; Medical Toxicology Centre* SPONSORED BY HEALTH PROTECTION AGENCY Purpose Provide exposure and uptake information to scientists, physicians, public health practitioners, etc, Scope- Blood samples -blood transfusion service Pros. & Cons Key environmental pollutants Aim- define the range and variation in human exposure to environmental chemical pollutants in the general population. Geographical distribution of exposure * Joint Newcastle University and Health Protection Agency Research Centre Reference Range Study Newcastle Medical Toxicology Centre 2 Ethical Approval Compounds Studied Metals lead, mercury, manganese, cadmium Organochlorines (18-20 componds)!endocrine distruptors genestine! Decabromo diphenyl ether (flame retardent) Commenced in samples analysed Gender Year of birth Post Code First set of RESULTS to be published early

5 Background Incidence of Key Biomarkers of Chemical Exposure -General UK population Len Levy Institute of Environmental Health and John Cocker Health Safety Laboratory*) Biological Monitoring by post Approved by Ethics Committee Volunteers selected from electoral register (>18 years old) >5500 invitation letters sent Lifestyle questionnaire Urine samples from 358 (8.3%) Results will be published early 2009 Chemical Benzene Cadmium Caffeine Chlorinated hydrocarbons Dithiocarbamates Mercury Naphthalene Nicotine Di-(2-ethylhexyl) phthalate (DEHP) Urinary biomarker Pyrethroids, synthetic Xylene S-Phenylmercapturic acid (S-MA) Cadmium Caffeine Trichloroacetic acid (TCAA) Ethylene thiourea (ETU) Mercury 1-Naphthol, 2-Napthol Cotinine Secondary phthalate metabolites Mono (2-Ethyl-5-Hydroxyhexyl) Phthalate (5OH-MEHP), Mono-(2- Ethyl-5-Oxohexyl) Phthalate (5oxo-MEHP) Cis- and trans-3-(2,2-dichlorovinyl)- 2,2- dimethylcyclopropanecarboxylic acid (c/t-cl 2CA) 3-Phenoxybenzoic acid (3-PBA) Methyl-hippuric acid (MHA) *sponsored by the Cefic (European Chemical Industry Council) Long-range Research Initiative (LRI-D2.1-MRCI-0405) Standard Biomonitoring Protocols (Acute Incidents) Standard Analytical Protocol Sample collection- volume etc Timing Storage Detection limits of methodology Analysis time i.e. Sampling KIT - To Do.: Protocols to be placed on Internet Expand the laboratory network Compounds addressed Ammonia, Arsenic, Benzene Cadmium, Carbon monoxide, Chlorine, Diesel, Ethylene Glycol Hydrogen Cyanide, Kerosene, Lead, Mercury, Methanol, Phenol, PAHs, Sodium Hypochlorite, Sulphuric Acid. Toluene, ChEAK Chemical Exposure Assessment Kit 5

6 National Study - Nearly there. We have capability Expertise And sources of funding.. So why do we not have a harmonised,. Integrated approach to Human Biomonitoring? The biggest hurdles for a National HBM Study are Non-Specific Ethical approval, Biobanking samples and sourcing samples. But we can do that. Avon Longitudinal Study of Parents and Children: (ALSPAC)* Started in 1991 Also known as Children of the 90s - is a long-term health research project. More than 14,000 mothers enrolled during pregnancy monitored health and development of their children The ALSPAC families have provided a vast amount of genetic and environmental information over the years. This resource is assisting scientists all over the world with research into a wide range of health problems. * 6

7 Some Key Findings: Eating fish in pregnancy improves a child's IQ and communication skills. Less than 3% of 11-year-olds do the 60 minutes of exercise a day recommended by the Government. Children brought up in very hygienic homes are more likely to develop asthma. Medical problems: Asthma Heart disease Cancer RESOURCE FOR THE FUTURE Hold a vast bank of information Samples urine, blood, hair and nails Lifestyle choices: Possible to tap into this Drugs resource:- Smoking Alcohol Psychological problems: Education: UK Biobank*: Gene-Environment Interactions 500,000 volunteers in the UK started in 2006 aged Follow up 25 years Should deliver enough cases to study range of cancers -stomach, ovarian, bladder, non- Hodgkins lymphoma, lung, prostate, colorectal and breast, heart attacks, heart disease, stroke, diabetes, hip fracture, rheumatoid arthritis, Parkinson s disease and dementia. The amount needed is 61 million GBP. * 7

8 UK Health Surveys 40,000 households 3000 ethnic minority boost Face-to-face questionnaires Interview of family members age 10 and over will support collection of a wider range of biomarkers and health indicators than any previous social-science focused survey. Summary - Fragmented approach HBM Health Health Indicators Environmental Geo.Info Systems Risk Assess. Policy Development 8

9 VISION - Integrated approach HBM Health Indicators Environmental Health Health Info Systems Risk Assess. P(p)olicy Development Its not that easy. 9

10 Science to Policy: Integrated approach Offering far wider scope for evidence-based policy. 1. Reference values / Background levels 2. Retrospective exposure assessment (Biobanks) 3. Geographical distribution 4. Trends temporal and spatial 5. Social/ ethnic differences 6. Emerging issues 7. Monitor existing policies Evidence Base Relax.. I know it all!! Science to Policy: Integrated approach Regulation - Environmental Contamination - Human Exposure and Uptake Public Health Policy - Contaminated land - Tolerable Dailey Intakes etc - Surveillance /Monitoring - Smoking EU- Policy Level - Cross boundary comparison and regulation 10

11 Balancing Act Benefit Cost Benefit Cost 11