Exposure determinants of cadmium in European mothers and their children.

The metal cadmium (Cd) is a widespread environmental pollutant with documented adverse effects on the kidneys and bones from long-term environmental exposure, but with insufficiently elucidated public health consequences such as risk of cardiovascular disease, hormone-related cancer in adults and developmental effects in children. This study is the first pan-European human biomonitoring project that succeeded in performing harmonized measurements of Cd in urine in a comparable way in mother-child couples from 16 European countries. The aim of the study was to evaluate the overall Cd exposure and significant determinants of Cd exposure. A study population of 1632 women (24-52 years of age), and 1689 children (5-12 years of age), from 32 rural and urban areas, was examined within a core period of 6 months in 2011-2012. Women were stratified as smokers and non-smokers. As expected, smoking mothers had higher geometric mean (gm) urinary cadmium (UCd; 0.24 µg/g crea; n=360) than non-smoking mothers (gm 0.18 µg/g crea; n=1272; p<0.0001), and children had lower UCd (gm 0.065 µg/g crea; n=1689) than their mothers at the country level. Non-smoking women exposed to environmental tobacco smoke (ETS) at home had 14% (95% CI 1-28%) higher UCd than those who were not exposed to ETS at home (p=0.04). No influence of ETS at home or other places on UCd levels was detected in children. Smoking women with primary education as the highest educational level of the household had 48% (95% CI 18-86%) higher UCd than those with tertiary education (p=0.0008). The same observation was seen in non-smoking women and in children; however they were not statistically significant. In children, living in a rural area was associated with 7% (95% CI 1-13%) higher UCd (p=0.03) compared to living in an urban area. Children, 9-12 years had 7% (95% CI 1-13%) higher UCd (p=0.04) than children 5-8 years. About 1% of the mothers, and 0.06% of the children, exceeded the tolerable weekly intake (TWI) appointed by EFSA, corresponding to 1.0 µg Cd/g crea in urine. Poland had the highest UCd in comparison between the 16 countries, while Denmark had the lowest. Whether the differences between countries are related to differences in the degree of environmental Cd contamination or to differences in lifestyle, socioeconomic status or dietary patterns is not clear.

Policy recommendations and cost implications for a more sustainable framework for European human biomonitoring surveys.

The potential of Human Biomonitoring (HBM) in exposure characterisation and risk assessment is well established in the scientific HBM community and regulatory arena by many publications. The European Environment and Health Strategy as well as the Environment and Health Action Plan 2004-2010 of the European Commission recognised the value of HBM and the relevance and importance of coordination of HBM programmes in Europe. Based on existing and planned HBM projects and programmes of work and capabilities in Europe the Seventh Framework Programme (FP 7) funded COPHES (COnsortium to Perform Human Biomonitoring on a European Scale) to advance and improve comparability of HBM data across Europe. The pilot study protocol was tested in 17 European countries in the DEMOCOPHES feasibility study (DEMOnstration of a study to COordinate and Perform Human biomonitoring on a European Scale) cofunded (50%) under the LIFE+ programme of the European Commission. The potential of HBM in supporting and evaluating policy making (including e.g. REACH) and in awareness raising on environmental health, should significantly advance the process towards a fully operational, continuous, sustainable and scientifically based EU HBM programme. From a number of stakeholder activities during the past 10 years and the national engagement, a framework for sustainable HBM structure in Europe is recommended involving national institutions within environment, health and food as well as European institutions such as ECHA, EEA, and EFSA. An economic frame with shared cost implications for national and European institutions is suggested benefitting from the capacity building set up by COPHES/DEMOCOPHES.

Sources of variability in biomarker concentrations.

Human biomonitoring has become a primary tool for chemical exposure characterization in a wide variety of contexts: population monitoring and characterization at a national level, assessment and description of cohort exposures, and individual exposure assessments in the context of epidemiological research into potential adverse health effects of chemical exposures. The accurate use of biomonitoring as an exposure characterization tool requires understanding of factors, apart from external exposure level, that influence variation in biomarker concentrations. This review provides an overview of factors that might influence inter- and intraindividual variation in biomarker concentrations apart from external exposure magnitude. These factors include characteristics of the specific chemical of interest, characteristics of the likely route(s) and frequency of exposure, and physiological characteristics of the biomonitoring matrix (typically, blood or urine). Intraindividual variation in biomarker concentrations may be markedly affected by the relationship between the elimination half-life and the intervals between exposure events, as well as by variation in characteristics of the biomonitored media such as blood lipid content or urinary flow rate. Variation across individuals may occur due to differences in time of sampling relative to exposure events, physiological differences influencing urinary flow or creatinine excretion rates or blood characteristics, and interindividual differences in metabolic rate or other factors influencing the absorption or excretion rate of a compound. Awareness of these factors can assist researchers in improving the design and interpretation of biomonitoring studies.

Sensitizing events as trigger for discursive renewal and institutional change in Flanders' environmental health approach, 1970s-1990s.

BACKGROUND: Sensitizing events may trigger and stimulate discursive renewal. From a discursive institutional perspective, changing discourses are the driving force behind the institutional dynamics of policy domains. Theoretically informed by discursive institutionalism, this article assesses the impact of a series of four sensitizing events that triggered serious environmental health concerns in Flanders between the 1970s till the 1990s, and led onto the gradual institutionalization of a Flemish environmental health arrangement. METHODS: The Policy Arrangement Approach is used as the analytical framework to structure the empirical results of the historical analysis based on document analysis and in-depth interviews. RESULTS: Until the 1990s, environmental health was characterized as an ad hoc policy field in Flanders, where agenda setting was based on sensitizing events - also referred to as incident-driven. Each of these events contributed to a gradual rethinking of the epistemological discourses about environmental health risks and uncertainties. These new discourses were the driving forces behind institutional dynamics as they gradually resulted in an increased need for: 1) long-term, policy-oriented, interdisciplinary environmental health research; 2) policy coordination and integration between the environmental and public health policy fields; and 3) new forms of science-policy interactions based on mutual learning. These changes are desirable in order to detect environmental health problems as fast as possible, to react immediately and communicate appropriately. CONCLUSIONS: The series of four events that triggered serious environmental health concerns in Flanders provided the opportunity to rethink and re-organize the current affairs concerning environmental health and gradually resulted into the institutionalization of a Flemish environmental health arrangement.

Approaches to integrated monitoring for environmental health impact assessment.

Although Integrated Environmental Health Monitoring (IEHM) is considered an essential tool to better understand complex environmental health issues, there is no consensus on how to develop such a programme. We reviewed four existing frameworks and eight monitoring programmes in the area of environmental health. We identified the DPSEEA (Driving Force-Pressure-State-Exposure-Effect-Action) framework as most suitable for developing an IEHM programme for environmental health impact assessment. Our review showed that most of the existing monitoring programmes have been designed for specific purposes, resulting in narrow scope and limited number of parameters. This therefore limits their relevance for studying complex environmental health topics. Other challenges include limited spatial and temporal data availability, limited development of data sharing mechanisms, heterogeneous data quality, a lack of adequate methodologies to link disparate data sources, and low level of interdisciplinary cooperation. To overcome some of these challenges, we propose a DPSEEA-based conceptual framework for an IEHM programme that would enable monitoring and measuring the impact of environmental changes on human health. We define IEHM as 'a systemic process to measure, analyse and interpret the state and changes of natural-eco-anthropogenic systems and its related health impact over time at the same location with causative explanations across the various compartments of the cause-effect chain'. We develop a structural work process to integrate information that is based on existing environmental health monitoring programmes. Such a framework allows the development of combined monitoring systems that exhibit a large degree of compatibility between countries and regions.

Framework for the development and application of environmental biological monitoring guidance values.

Human biomonitoring (HBM) is widely recognised as a useful tool to aid assessment of exposure to chemical substances, but our ability to detect hazardous substances (or their metabolites and health effects) often exceeds our understanding of their biological relevance. There are only a few established frameworks for developing and using occupational and environmental biological guidance values (BGVs), mostly for data-rich substances that have been in use for some time. BGVs for new substances and those with unknown dose-response relationships are difficult to derive. An accepted framework based on current scientific knowledge and best practice is therefore urgently needed to help scientists, regulators, and stakeholders to design appropriate HBM studies, interpret HBM data (both for groups and individuals) understand the limitations and to take appropriate action when required. The development and application of such a tool is described here. We derived a conceptual framework that was refined by consultation with an advisory group and workshop. The resulting framework comprised four levels defined by increasing data, with increasing confidence for human health risk assessment. Available data were used for 12 chemicals with expert judgement to illustrate the utility of the framework.

A review on the practical application of human biomonitoring in integrated environmental health impact assessment.

Environmental health sciences focus on the link between the presence of contaminants in the environment and their relation with possible adverse health effects. Within this context, human biomonitoring (HBM) data have proven to be a valuable addition to, or have even surpassed, estimates of exposure based on environmental measures. Probably the main achievement of HBM data is that it provides an integrated overview of the pollutant dose any constituent is exposed to and incorporates bioaccumulation, excretion, half-life, and other potentially critical toxicokinetic parameters. In an integrated environmental health impact assessment framework, HBM serves as a pivotal point between environment and health, on the one hand leaning on environmental data to provide information on sources and pathways of exposure, and on the other hand clarifying hypotheses on the relationship between internal dose and prevalence of disease clusters. This study reflects the work performed in the INTARESE project (Integrated Assessment of Health Risk of Environmental Stressors in Europe). Because it was perceived that there was an overall lack of knowledge on the general methodology and potential application of HBM data in integrated environmental health impact assessment, an extensive review of literature was performed on past and current developments, potential, and applicability of HBM within the context of integrated environmental health impact assessment. This study covers three main topics that provide guidance for improved interpretation and application of HBM data: (1) sample collection and storage, (2) sample measurement, and (3) data interpretation. These main issues were discussed for 15 of the most common or relevant (classes of) chemicals. For more detailed information, the reader is pointed to the unabridged review (INTARESE, 2007), and consultation is available through the INTARESE web site (www.intarese.org).

Applicability of non-invasively collected matrices for human biomonitoring.

With its inclusion under Action 3 in the Environment and Health Action Plan 2004-2010 of the European Commission, human biomonitoring is currently receiving an increasing amount of attention from the scientific community as a tool to better quantify human exposure to, and health effects of, environmental stressors. Despite the policy support, however, there are still several issues that restrict the routine application of human biomonitoring data in environmental health impact assessment. One of the main issues is the obvious need to routinely collect human samples for large-scale surveys. Particularly the collection of invasive samples from susceptible populations may suffer from ethical and practical limitations. Children, pregnant women, elderly, or chronically-ill people are among those that would benefit the most from non-invasive, repeated or routine sampling. Therefore, the use of non-invasively collected matrices for human biomonitoring should be promoted as an ethically appropriate, cost-efficient and toxicologically relevant alternative for many biomarkers that are currently determined in invasively collected matrices. This review illustrates that several non-invasively collected matrices are widely used that can be an valuable addition to, or alternative for, invasively collected matrices such as peripheral blood sampling. Moreover, a well-informed choice of matrix can provide an added value for human biomonitoring, as different non-invasively collected matrices can offer opportunities to study additional aspects of exposure to and effects from environmental contaminants, such as repeated sampling, historical overview of exposure, mother-child transfer of substances, or monitoring of substances with short biological half-lives.

Cellular energy allocation in Hediste diversicolor exposed to sediment contaminants.

Environmental contaminants released into water tend to accumulate in sediment, leading to exposure for sediment-dwelling organisms. This study aimed to clarify whether chronic (56 d) exposure to a mixture of environmentally relevant concentrations of contaminants (tributyltin [TBT] and perfluorononanoic acid [PFNA]) spiked in clean sediment would affect the sediment-dwelling polychaete Hediste diversicolor. Endpoints were burial time, biomass change, and cellular energy allocation (CEA). Sediments were spiked with these two contaminants to produce different levels of contamination. Chemical analyses of the sediment following the exposure indicated that the spiking procedure was only partially successful and treatments were grouped into four categories according to contaminant concentrations: "background," "low," "moderate," and "high." No significant differences were found between treatments with respect to burial time, biomass change, or energy storage fractions (proteins, lipids, carbohydrates) in the polychaetes. A significant increase in cellular respiration was found for polychaetes in "moderate" and "high" treatment groups compared to the "background" treatment group. This resulted in significantly lower cellular energy allocation values for "moderate" and "high" treatment groups compared to "background." Although the effects were not marked, the results show that sediment-dwelling organisms may be affected following chronic exposure to environmental contaminants. There is a need to clarify whether chronic exposures exert a negative effect on sediment-dwelling organisms.

Mode of action clustering of chemicals and environmental samples on the bases of bacterial stress gene inductions.

Over the years, environment and the human population have seen an increasing exposure to both existing and newly developed chemicals. It is generally accepted that at least some of those are toxic, albeit as pure compound or in combination with others. In response to a growing public awareness and scientific data, the new European chemicals legislation (Registration, Evaluation and Authorization of Chemicals) is under implementation at the moment. As a consequence, during the coming years about 30,000 chemicals have to be assessed on their potential hazard for man and biota. Part of this assessment will be done using existing and new in vitro tests offering insight into the toxicity of chemicals and into their toxicological mode of action. This study presents data on a battery of 14 bacterial reporter gene assay allowing mode of action determination and statistical grouping of chemicals based on their induction profile. Gene induction results are used to group reference chemicals in a statistical cascade employing hierarchical tree and k-means clustering for initial grouping. Both complementary, yet mathematically different, algorithms are consequently confirmed by principal component analysis (PCA). The gene induction profiles of an environmental extract with documented in vivo effects and a chemical with limited toxicological are data available and projected in the PCA vector space. The projection allows correct mode of action grouping and indicates that effect predictions based on the known toxicological effects of the reference compounds can be made.

Human biomonitoring and the INSPIRE directive: spatial data as link for environment and health research.

Recently, there has been a rapid gain of interest in the availability, applicability, and integration of different types of spatial data for environment and health issues. The INSPIRE Directive (Directive 2007/2/EC) aims at providing better and easily accessible spatial information in Europe for the formulation and implementation of community policy on the environment by triggering the creation of a European spatial information infrastructure that delivers integrated spatial information services to potential users. Human biomonitoring (HBM) significantly contributes to the already existing data on environment and health because of its specific nature of providing information on the internal dose of chemicals rather than their mere presence in different environmental compartments. However, due to the intrinsic nature of HBM data, a number of issues need to be dealt with if HBM data are to be used to its full capacity in a geographic information systems (GIS) environment and within the INSPIRE directive. The current article highlights some of these issues, and discusses a number of options to improve the geographical relevance of HBM data for their optimal use within the INSPIRE Directive framework. The main aim of this publication is to illustrate that HBM has a significant contribution to make to the INSPIRE Directive, although some kind of data aggregation will be necessary to protect individual privacy. If HBM data wants to have a significant contribution to spatial information used to assist policymaking and on the surveillance or tracking of the direct or indirect impact of such policies, the HBM data need to be compatible with other data collected within the other themes of the INSPIRE Directive.

Alterations in the energy budget of Arctic benthic species exposed to oil-related compounds.

We studied cellular energy allocation (CEA) in three Arctic benthic species (Gammarus setosus (Amphipoda), Onisimus litoralis (Amphipoda), and Liocyma fluctuosa (Bivalvia)) exposed to oil-related compounds. The CEA biomarker measures the energy budget of organisms by biochemically assessing changes in energy available (carbohydrates, protein and lipid content) and the integrated energy consumption (electron transport system activity (ETS) as the cellular aspect of respiration). Energy budget was measured in organisms subjected to water-accommodated fraction (WAF) of crude oil and drill cuttings (DC) to evaluate whether these compounds affect the energy metabolism of the test species. We observed significantly lower CEA values and higher ETS activity in G. setosus subjected to WAF treatment compared to controls (por=0.19). Different responses to oil-related compounds between the three test species are likely the result of differences in feeding and burrowing behavior and species-specific sensitivity to petroleum-related compounds.

Effluent impact assessment using microarray-based analysis in common carp: a systems toxicology approach.

Effluents are a main source of direct and continuous input of pollutants to the aquatic environment, and can cause ecotoxicological effects at different levels of biological organization. Since gene expression responses represent the primary interaction site between environmental contaminants and biota, they provide essential clues to understand how chemical exposure can affect organismal health. The aim of the present study was to investigate the applicability of a microarray approach for unraveling modes of action of whole effluent toxicity and impact assessment. A chronic toxicity test with common carp (Cyprinus carpio) was conducted where fish were exposed to a control and 100% effluent for 21 days under flow-through conditions. Microarray analysis revealed that effluent treatment mainly affected molecular pathways associated with the energy balance of the fish, including changes in carbohydrate and lipid metabolism, as well as digestive enzyme activity. These gene expression responses were in clear agreement with, and provided additional mechanistic information on various cellular and higher level effects observed for the same effluent. Our results demonstrate the benefit of toxicogenomic tools in a "systems toxicology" approach, involving the integration of adverse effects of chemicals and stressors across multiple levels of biological complexity.

Relationship between the energy status of Daphnia magna and its sensitivity to environmental stress.

This work tested the hypothesis that animals with a high energy status are more successful in dealing with stress than animals with a low energy status. Daphnids (Daphnia magna) were reared for 2 weeks in four different concentrations of food. Survival was not affected by food supply, and growth and reproduction increased with increasing food ration. This increase correlated well with the energy status, as was measured by scope for growth on day 15. After 2 weeks, the daphnids in the four different food ration groups were exposed for another 2 weeks to a range of increased salinities or cadmium concentrations, while remaining in their respective food concentrations. In the salinity groups, survival, growth, or reproduction were not influenced at low salinities. Exposure to higher salinity significantly decreased survival and reproduction, but this decrease was more pronounced in the highest food concentrations. In the cadmium exposed daphnids, cadmium content increased with increasing exposure concentrations, but accumulation was independent of food rations. Cadmium exposure significantly decreased survival, growth, and reproduction and this decrease again was more pronounced with increasing food concentration. Thus, the high energy status of the daphnids from the high food concentrations at the start of the exposure did not provide an increased capacity to cope with additional stress. Instead, the sensitivity of the daphnids to stress increased with increasing food ration. This increased sensitivity is likely to be the result of a change in life history from emphasizing survival at low food supply to stressing reproduction at high food supply.

First steps toward harmonized human biomonitoring in Europe: demonstration project to perform human biomonitoring on a European scale.

BACKGROUND: For Europe as a whole, data on internal exposure to environmental chemicals do not yet exist. Characterization of the internal individual chemical environment is expected to enhance understanding of the environmental threats to health. OBJECTIVES: We developed and applied a harmonized protocol to collect comparable human biomonitoring data all over Europe. METHODS: In 17 European countries, we measured mercury in hair and cotinine, phthalate metabolites, and cadmium in urine of 1,844 children (5-11 years of age) and their mothers. Specimens were collected over a 5-month period in 2011-2012. We obtained information on personal characteristics, environment, and lifestyle. We used the resulting database to compare concentrations of exposure biomarkers within Europe, to identify determinants of exposure, and to compare exposure biomarkers with health-based guidelines. RESULTS: Biomarker concentrations showed a wide variability in the European population. However, levels in children and mothers were highly correlated. Most biomarker concentrations were below the health-based guidance values. CONCLUSIONS: We have taken the first steps to assess personal chemical exposures in Europe as a whole. Key success factors were the harmonized protocol development, intensive training and capacity building for field work, chemical analysis and communication, as well as stringent quality control programs for chemical and data analysis. Our project demonstrates the feasibility of a Europe-wide human biomonitoring framework to support the decision-making process of environmental measures to protect public health.

Transplanted zebra mussels (Dreissena polymorpha) as active biomonitors in an effluent-dominated river.

For over 20 years, mussels have been recommended as one of the most suitable biomonitoring organisms for aquatic ecosystems. Though the common mussel (Mytilus edulis) is frequently used for biomonitoring estuarine and marine ecosystems, no freshwater species is promoted for similar monitoring networks. Recently, however, the zebra mussel (Dreissena polymorpha) has been proposed as a suitable monitoring organism in freshwater ecosystems. The aim of this study was to explore the usefulness of transplanted zebra mussels as active biomonitors in an effluent-dominated stream. Results showed that for these purposes, an exposure period of at least a few weeks is required to detect any significant changes in condition status or scope for growth. Wet-tissue-weight:dry-tissue-weight ratio was the most sensitive measure to quantify effects of field exposure on physiological fitness. In case of scope for growth (SfG), energy intake was the factor determining the overall energy budget of the mussels. Based on the dilution rates of the two different effluents present, effluent 2 had the most important effect on the condition status of the exposed organisms. Overall, we conclude that the use of transplanted mussels is a sensitive and easily applicable active biomonitor that can be used to assess water quality, pollution, and subsequent recovery through self-purification in field situations.

Changes in cellular energy budget as a measure of whole effluent toxicity in zebrafish (Danio rerio).

Organisms exposed to suboptimal conditions face an a priori cost of combating stress in terms of metabolic resources. The energy available for maintenance, growth, and reproduction, based on the biochemical analysis of the energy budget rather than on the direct measurement of those endpoints, may therefore provide a sensitive measure of stress in an organism. The aim of this study was to validate changes in energy budget as an ecologically relevant sublethal parameter by comparing these responses with physiological, growth, and reproductive endpoints. A toxicity test with zebrafish (Danio rerio) was conducted where fish were exposed to a control and 50, 75, and 100% effluent for 28 d under flow-through conditions. Effects of effluent exposure were measured as changes in glycogen, lipid, and protein budgets. Furthermore, the observed effects were linked to different processes like growth, condition, respiration, and reproduction within the same populations. Our results indicate that changes in lipid budgets in exposed fish were the most sensitive endpoint. Excellent relations were found between cellular energy budgets, relative condition factor, and respiration (r2 = 0.795, p < 0.001; and r2 = 0.735, p < 0.001, respectively), but relations were poorer for reproductive output (r2 = 0.410, p < 0.034). As a whole, especially changes in lipid energy budgets provide a sensitive and fast indicator of altered condition in zebrafish under the given exposure regime and allow linking cellular effects to other endpoints within the same exposed populations.

Integrated condition indices as a measure of whole effluent toxicity in zebrafish (Danio rerio).

Toxic exposure of organisms interferes with organismal integrity at the biochemical level and ultimately gives rise to effects at the individual level. These effects may result in reductions in ecologically relevant characteristics such as growth, reproduction, and survival. A chronic toxicity test with zebrafish (Danio rerio) was conducted where fish were exposed to 50, 75, and 100% effluent for 28 d under flow-through conditions. Effects of effluent exposure were determined using endpoints of physiological (respiration during swimming), growth (condition, length, and weight), and reproductive (spawning and hatching) processes within the same population. Results clearly indicate that the condition and growth of zebrafish is depressed by exposure to the effluent. Also, increased oxygen consumption was found after 14, 21, and 28 d of exposure. Reproduction proved to correlate well with the condition of the motherfish in the control, and spawning and hatching were significantly depressed by effluent exposure. These results indicate that the evaluation of endpoints describing different ecologically relevant processes provides a rational assessment of the cause-effect relationships of effluent toxicity. This approach can quantify effects on different biological processes and can determine the interactions that occur between these different processes.

Identifying a role for human biomonitoring in incidents involving hazardous materials.

Human biological monitoring (HBM) is an established method for chemical exposure characterization. Over the past few years HBM complemented environmental modelling and measurement strategies in several large scale chemical incidents in Belgium and Germany. These applications showed biomarkers to persist in body fluids, allowing sample collection to start in the aftermath of the incident. In addition, integration of exposure over time and from different routes and sources of exposure were reflected in HBM results. Especially adducts to hemoglobin were used to study exposures of workers and of the general population in retrospect. HBM results confirmed the exposure, sometimes pointing to a-typical sources and routes of exposure, not foreseen in incident scenarios. As a next step in Belgium, Germany and The Netherlands guidelines were prepared to support a role for HBM in the response to chemical incidents. Current practices indicate that the interpretation of HBM outcome can still be improved, using refined sample collection strategies and reverse dose calculations to facilitate the use of available exposure standards in the interpretation of HBM results. Exchange of knowledge and experience as well as sharing technical resources will further strengthen the role of HBM in the response to public health incidents and disasters.

Perspectives for environment and health research in Horizon 2020: dark ages or golden era?

The European Commission recently published the first calls for proposals for the Horizon 2020 (H2020) work programme for research and innovation. When browsing through the Health programme, it became apparent that the work programme made little reference to environmental health research. In this commentary we describe major milestones of environmental health research in previous European Framework Programmes and the policy shift that took place when preparing H2020. We introduce mobile health technologies as a niche innovation to reconcile the environmental health research arena with the H2020 programme that has a clear focus on ICT. The recent economic crises urged strong policy action to reinforce Europe's economic and innovation leadership. Market-driven and job-creating ambitions became primary goals of H2020. Environmental health-related keywords referring to, e.g. human biomonitoring, exposure assessment or exposome are absent in the current H2020-calls and this may suggest a lack of opportunities for environmental health researchers. Technologies related to mobile healthcare (mhealth) are rapidly maturing and offer new research and market opportunities. In a typically technology-pushed market, these sensor technologies however require validation by a third-party and implementation in large-scale public health monitoring studies. Also, issues related to data protection need further development to warrant user rights and privacy. If the European environmental health research arena succeeds in embracing these new mhealth sensor technologies, it may not only create an opportunity to play a role as a key innovation partner in health transition technologies, but it may also support authorities to realize a transition in our healthcare with a much bigger emphasis on a preventive and sustainable system.