Requirements for a European Human Biomonitoring programme for priority assessment of environmental chemicals

Transcription

1 European Conference on Human Biomonitoring Paris, November 4 th 5 th, 2008 Requirements for a European Human Biomonitoring programme for priority assessment of environmental chemicals Matti Jantunen, Terttu Vartiainen, Hannu Kiviranta KTL-Environmental Health, Kuopio, FINLAND If you need to know something to make the right decision, and if you can measure what you need to know, consider measuring it! Pros and cons of HBM Pros: HBM integrates the impacts of - all exposure media, - all pathways and routes of entry, - all geographic locations and microenvironments, - all activities and consumer products Cons: HBM is not applicable for all chemicals of interest HBM reflects exposures differently for different chemicals Biological guideline values (BGV) are available for only a limited set of chemicals Relationships of HBM to exposure and to health are poorly known for most chemicals 1

2 German Environmental Surveys Representative population study with 5000 subjects in each - GerES I 1985/6 - GerES II 1990/1 incl. children 6-14 y former GDR 1991/2 - GerES III GerES IV children, 3-14 y HBM: As, Pb, Cd, Hg, Ni Creatinine, cotinine, nicotine, cortisol, adrenalin, noradrenalin PCBs, DDE, HCB, HCH, PAHs, chlorophenols, pyrethroid metabolites, esters of phosphoric acid Fungi specific IgE Also: Noise, hearing and stress Domestic environment House dust Drinking water Chemical & biological pollutants in indoor air Interviews CDC National Reports on Human Exposure to Environmental Chemicals Nationally representative population study subjects (1-)6 y and older - 1 st Report, chemicals - 2 nd Report, chemicals - 3 rd Report, chemicals - 4 th Report, 2008 (?) ca. 200 chemicals HBM: 13 metals incl. Pb, Cd, Hg, U Cotinine 23 metabolites for PAHs incl. BaP 52 PCDDs, PCDFs and PCBs 12 phthalates 6 phytoestrogens 20 organochloride pesticides 6 metabolites for organophosphate pesticides 7 herbicides 5 pyrethroids 3 other pesticides 2 carbamate insecticides 2

3 Feasibility Study for EHES: European Health Examination Survey Proposal for nationally representative population health studies in Europe countries all EU subjects in each country y ( and older) Minimum - Physiological: Height, weight, waist circ. diastolic and systolic blood pressure, - Blood: Total and HDL cholesterol, fasting glucose - Questionnaire: SES, smoking, health; CV disease, hypertension, hyperlipidemia, diabetes General - Common protocols - Comparability across countries and time - EU funded coordination & QA/QC - Centralised database - National sampling nationally funded Tolonen et al. KTL:n julkaisuja B 22/ Encouraged use for public health and research What should a European HBM Programme give us - 1 Technical: - Body burdens (BB) of environmental chemicals - Time trends 3

4 Dioxin BBs (& exposures) of breastfeeding mothers in Finland are declining rapidly From 1987 to cumulative frequency (%) Cumulative distributions of TEQ BBs of Finnish women in (lower) vs 1987 (higher) Kiviranta H. et al Chemosphere 60(7): Valentini M MSc Thesis Univ Degli Studi di Milano 0 1,E-07 gteq/individual 1,E-06 What should a European HBM Programme give us - 1 Technical: - Body burdens (BB) of environmental chemicals - Time trends - Areal distributions (geographic, urban/industrial/ rural/traffic, proximity to sources) 4

5 Proximity to the source did not increase HpCDF and OCDF body burdens cumulative frequency (% ) Kiviranta H. et al Chemosphere 60(7): Valentini M MSc Thesis Univ Degli Studi di Milano Cumulative distributions of HpCDF BBs from Kuusankoski of women in Kymijoki basin vs. rest of Finland 45 % of women in Kymijoki basin and 25 % of all women in Finland do not eat fish ,E-11 1,E-10 1,E-09 1,E-08 1,E-07 HpCDF (gteq/individual) What should a European HBM Programme give us - 1 Technical: - Body burdens (BB) of environmental chemicals - Time trends - Areal distributions (geographic, urban/industrial/ rural/traffic, proximity to sources) - Population distributions (age, gender, SES, ethnicity, etc.) 5

6 Accumulation of PCDD/Fs in Finnish men over age WHO:TEQ (g/individual) 1,E-06 1,E-07 Male PCDD/F body burdens in Finland 1,E age (y) y = 2E-08x - 3E-07 R 2 = 0,35 1,E-08 Kiviranta H. et al Chemosphere 60(7): Valentini M MSc Thesis Univ Degli Studi di Milano What should a European HBM Programme give us - 1 Technical: - Body burdens (BB) of environmental chemicals - Time trends - Areal distributions (geographic, urban/industrial/ rural/traffic, proximity to sources) - Population distributions (age, gender, SES, ethnicity, etc.) - Links (occupation, housing, diet, consumer products, etc.) 6

7 Professional fishermen s s dioxin exposures are an order of magnitude higher than the other s Cumulative distributions of TEQ (PCDDs+PCDFs) in the fishermen (blue) and all men (brown) 100 cumulative frequency (%) ,E-07 1,E-06 1,E-05 gteq/individual Kiviranta H. et al Chemosphere 60(7): Valentini M MSc Thesis Univ Degli Studi di Milano What should a European HBM Programme give us - 1 Technical: - Body burdens (BB) of environmental chemicals - Time trends - Areal distributions (geographic, urban/industrial/ rural/traffic, proximity to sources) - Population distributions (age, gender, SES, ethnicity, etc.) - Links (occupation, housing, diet, consumer products, etc.) Policy: - Early warnings for emerging risks - Identification of vulnerable groups - Guidance for policy targeting and development - Assessments for policy effectiveness, accountability 7

8 What could a European HBM Programme give us - 2 Maps and graphics digestible for the public and decision makers Triad of chemical risks: I: Low concern Data for attribution of the - decreasing BBs, exposures to - no hot spots, sources products - no vulnerable groups, locations activities - BBs small fractions on NOAEL target groups - Keep in the HBM programme using factor analysis techniques, III: High concern e.g., PCA and PMF - BBs increase in time, Data to model past exposures using, e.g., regression modelling techniques - BBs high relative to BGVs for - certain region(s), hot spots - population group(s), - users of certain product(s), - Investigate, act, target research II: Intermediate concern Linking BBs of known toxins to health may surprise Total and disease specific mortality of Baltic fishermen and fishermen s spouses in Finland Mortality compared to total Fishermen (6410) Fishermen s wives (4260) male and female population SMR 95 % CI SMR 95 % CI All causes Circulatory diseases Malignant neoplasms Diabetes Respiratory diseases Back 8

9 Requirements for the European HBM programme - Representative population sample ca per year all Europe and subpopulations of interest - Continuous sampling and analysis programme - Blood & urine samples from each individual - Broad range of analyses of the known toxic but also harmless compounds - PBPK or simpler models to estimate BBs and doses from the measured HBM data Steering committee representing EC and MSs Independent programme management and QA/QC Centralised protocols, sample analysis and GIS database Inter-linguistically validated exposure questionnaires to collect environment characteristics natural and man made for the sampled individuals National population sampling and HBM sample collection Maximum data accessibility for the public, media, industry, public authorities and scientists This would be expensive! Who should, who would pay? - EHBM programme would cost in the order of M/yr - only a fraction of the costs of the current environmental monitoring programmes in Europe - Yet, the European HBM Programme data would much more directly serve chemical risk identification, assessment and prevention - If I am asked, EU should pay for the centralised programme development, management, sample analysis and database operations and the Member States should pay for the national sampling - The EHBM Programme benefits for Europe would exceed its costs by far via - early identification of public health risks, and - effective allocation of resources for the development, implementation and accountability assessment of chemical risk policies 9

10 EHBM EHES? Close collaboration between EHBM and EHES would - create a huge, diverse and not easily managed programme with many countries, interests, parties and obviously conflicts, - save cost and resources for both programmes, - improve the quality of, reduce the time and resource requirements for and enable otherwise unfeasible EH assessments, and - create unforeseen environmental health research, risk assessment, risk management and policy assessment opportunities. - For the European level HBM programme blood/urine samples from only 2..5 % of the EHES sample would be necessary - For national HBM interests regional, urban/rural/industrial-hot-spots, ethnic subpopulations, etc. a larger proportion of the domestic EHES population sample could be chosen. The moment for coordinating EHBM EHES is now! I appreciate your invitation & attention QUESTIONS? So, when you need to know something to make the right decision, and when you really can measure what you need to know, By all means, do measure it! 10

11 Privacy issues!? Aggregated,, unidentifiable individual or identifiable individual data? - That is the problem! - Identification of and attribution of exposures to sources is based on advanced statistical techniques PCA and PMF - These techniques require individual level data but not identification of the individuals - Consequently, with individual data on the BBs of chemicals, personal environments, activities and behaviour, we can attribute exposures to sources in the homes, workplaces, transport, consumer products and personal activities - but we do not need spatial resolution, and can, therefore, protect each individual s identity - EHBM programme s spatial coverage is anyway too low to identify and assess the impacts of local sources. If only aggregated data can be used, we have the data but are not allowed to analyse it! 11

12 Contribution from one industrial source of HpCDF and OCDF can be seen in the elevated HpCDF/PCDD+PCDF ratio in the human BBs Cumulative frequency (%) Valentini M MSc Thesis Univ Degli Studi di Milano ,E-04 1,E-03 1,E-02 1,E-01 HpCDF/WHO TEQ ratio 12