Flemish Biomonitoring Program 20022006

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Flemish Biomonitoring Program 2002-2006
Environment Health monitoring for action
Funded by the Flemish Government Governance by
the Flemish Ministers and Administrations Health
and Environment All Flemish Universities involved
in research Different Institutes for the field
work
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It is about monitoring

• What is the link between environmental pollution
  and health in Flanders?
• What is the concentration of pollutants in
  humans?
• 3 x 1600 participants (8 areas)
• How important is the region where people live?
• What are the health risks?
• growth and development of babys, adolescents?
• fertility
• astma and allergy

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it is about monitoring and research for policy
making

• Objectives
• to implement a monitoring system for early
  warning of problems
• to develop plans for action

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It is about complex issues .

• a lot of scientific uncertainties
• Environmental pollution
  possible health effects
• Life style
• Work
• Illness
• Individual susceptibility
• ??
• high expectations

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It is about dialogues

• between different disciplines
• Medical, environmental, statistics, social
  experts
• between scientists and policy makers
• Scientists also discuss priorities of action
• Policy makers discuss also research design and
  results
• between scientists and the public
• From risk communication to co-production of
  knowledge

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Biomarkers
2001-2006
http//www.milieu-en-gezondheid.be
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Comparison with Flemish reference values
 
Havens
Menen
Dioxine-achtigen (pg calux-TEQ/g vet)
PCBs (ng/g vet)  
38.3
61.2
Concentraties in navelstrengbloed - corrrectie
voor roken en leeftijd
105
ppDDE (ng/g vet)  
HCB (ng/g vet)  
13.3
16.2
32.9
Cadmium (µg/L)  
0.88
1.02
1.31
Lood (µg/L)  
12.7
14.1
 
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Dioxin-like activity pg TEQ/g fat
Lead µg/L
A AP G GP F O M R Alb
A AP G GP F O M R Alb
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Exposure-effect relations concerning the mother
Dioxin-like activity in cord blood vs probability
of having received treatment for infertility
Confounders smoking
Lead concentration in cord blood vs probability
of presently having asthma
Probability of hay fever
Confounders smoking familial asthma
Probability of treatment for infertility
Confounders age smoking
Probability of asthma
Lead concentration in cord blood vs probability
of having hay fever
Lead µg/L
Lead µg/L
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Measuring ? policy response
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Practice cycle

• Assessment criteria
• Severeness
• Policy feasibility
• Social feasibility

Weighing criteria
Jury
Policy choice
Government
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Legal framework

• (B.S. 03-02-2004) Preventiedecreet Art 51 1
• The Flemish government
• 1. can set up a network for surveillance of
  exposure (measured in humans) and/or effects of
  exposure to physical and chemical factors in the
  population, with the intention to take measures
  to protect public health.
• 2.takes at least measures for the development and
  execution of a program for biomonitoring.
• 3. can - in execution of 1 - set up a fund ().
  For this purpose a mandatory financial
  contribution can be imposed on industries or
  citizens that are responsible for the presence of
  physical or chemical factors harmful to health.

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Legal framework

• The POPs Convention1 in its Article 11
  announces that the Parties shall, within their
  capabilities, at the national and international
  levels, encourage and/or undertake appropriate
  research, development, monitoring and cooperation
  pertaining to persistent organic pollutants and,
  where relevant, to their alternatives and to
  candidate persistent organic pollutants,
  including on their presence, levels and trends in
  humans
• WHO Fourth WHO-coordinated survey of POPs in
  Human Milk to be launched soon. Human milk is
  considered as a preferred matrix for POPs. The
  sampling is non-invasive() and human milk
  reflects the integrated exposure from various
  sources, levels, frequencies and durations.()
  Such an effort, being consistent with the
  promotion of human milk as the optimal food in
  infants, could provide the ideal basis for
  possible source directed measures to ultimately
  reduce levels for POPs in milk 1 Stockholm
  Convention http//www.pops.int/

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based on SCIENCE focusing on CHILDREN aims at
raising AWARENESS uses LEGAL INSTRUMENTS
includes EVALUATION

• THE EUROPEAN ENVIRONMENT AND HEALTH STRATEGY
  (COM(2003)338 final) launched as the SCALE
  initiative by the European Commission, presents a
  NEW VISION on how to address environment and
  health in an integrated way and puts health in
  the centre of environment policy. The ultimate
  objectives of this Strategy are
• to reduce the disease burden caused by
  environmental factors
• to identify and to prevent new health threats
  caused by environmental factors
• to strenghten EU capacity for policymaking in
  this area

based on SCIENCE focusing on CHILDREN aims at
raising AWARENESS uses LEGAL INSTRUMENTS
includes EVALUATION
based on SCIENCE focusing on CHILDREN aims at
raising AWARENESS uses LEGAL INSTRUMENTS
includes EVALUATION
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EU ENVIRONMENT AND HEALTH ACTION PLAN 2004-2010

• The European Commission prepared the EU
  ENVIRONMENT AND HEALTH ACTION PLAN
  2004-2010(COM(2004)416 final) based on
  recommendations by expert groups
• ACTION 3 announces the development of a coherent
  approach to human biomonitoring in Europe in
  close cooperation with the Member States

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A HARMONISED HUMAN BIOMONITORING (HBM) APPROACH
will contribute to the EU Strategy for
Environment and Health by
Enable a more effective use of resources by
shared development of tools and strategies
Enable more meaningful results of national
surveys as the number of study subjects involved
becomes larger. Providing data on distribution
of exposure and related health impact across
EU definition of reference values detection of
spatial differences in exposure
(populations/regions at risk) detection of
temporal differences in exposure Providing
policy makers with better information on control
measures to be taken identification of
priorities in exposure reduction strategies
allowing follow up of the efficiency of
reduction strategies, allowing a
geographically differentiated EH policy Allow
for a more equal distribution of efforts amongst
European countries and a better respecting of the
equal right of each European citizen on healthy
environments

• A HARMONISED HUMAN BIOMONITORING APPROACH will
  contribute to the EU Strategy for Environment and
  Health by
• Providing data on distribution of exposure and
  related health impact across Europe
• definition of reference values
• detection of spatial differences in exposure
  (populations/regions at risk)
• detection of temporal differences in exposure
• Providing policy makers with better information
  on control measures to be taken
• identification of priorities in exposure
  reduction strategies
• allowing follow up of the efficiency of
  reduction strategies,
• allowing a geographically differentiated EH
  policy
• Enable a more effective use of resources by
  shared development of tools and strategies
• Enable more meaningful results of national
  surveys as the number of study subjects involved
  becomes larger. This would strengthen any
  observed correlation between exposure and health
  effects, which ultimately can point at potential
  causal relationships
• Allow for a more equal distribution of efforts
  amongst European countries and a better
  respecting of the equal right of each European
  citizen on healthy environments

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III Translate results into a response system

• Develop scenarios for translation of HBM data
  into a
• response system (policy measures)
• Such scenarios require
• integration of biological monitoring data with
  environmental monitoring and health data
• development of reference values health based
  action levels
• effective communication
• includes participation and exchange between the
  different stakeholders (general public, study
  participants, general practitioners, regulators,
  scientists, public interest NGOs, industry,
  others)
• will promote public awareness.
• A communication plan is an essential part of a
• HBM programme and should be part of the study
  design

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