Human Biomonitoring Data Enables Evidence-Informed Policy to Reduce Internal Exposure to Persistent Organic Compounds: A Case Study.

Human biomonitoring (HBM) monitors levels of environmental pollutants in human samples, which often is a topic of concern for residents near industrially contaminated sites (ICSs). Around an ICS area in Menen (Belgium), including a (former) municipal waste incinerator and a metal recovery plant, increasing environmental concentrations of dioxins and polychlorinated biphenyls (PCBs) were observed, causing growing concern among residents and authorities. The local community succeeded in convincing the responsible authorities to investigate the problem and offer research funding. Persistent organic pollutants (POPs) were measured in two consecutive HBM studies (2002-2006 and 2010-2011), in the context of the Flemish Environment and Health Study (FLEHS), as well as in soil and locally produced food. Meanwhile, local authorities discouraged consumption of locally produced food in a delineated area of higher exposure risk. Ultimately, HBM and environmental data enabled tailored dietary recommendations. This article demonstrates the usefulness of HBM in documenting the body burdens of residents near the ICS, identifying exposure routes, evaluating remediating actions and providing information for tailored policy strategies aiding to further exposure reduction. It also highlights the role of the local stakeholders as an example of community-based participatory research and how such an approach can create societal support for research and policy.

The added value of a surveillance human biomonitoring program: The case of FLEHS in Flanders (Belgium).

Since 2002, the Flemish Government decided to carry out the Flemish Environment and Health Survey (FLEHS), an extended human biomonitoring (HBM) program, which is integrated in the environmental health policy. Through the FLEHS studies, a vast amount of data such as biomarkers of exposure and effect, exposure-effect associations, time trends and geographical differences, became available to the Flemish policy makers. In order to facilitate the policy interpretation, a phased action-plan was developed collaboratively by FLEHS researchers and policy makers. In this article we look back on more than 15 years of investments of the Flemish government in HBM and reflect on how this large scaled and challenging HBM-initiative contributed to shaping the environmental health policy in Flanders. We used the FLEHS I (2002-2006) and II (2007-2011) results on persistent organic pollutants (POPs) and the resulting policy actions as an example to illustrate the added value of HBM for policy making. Policy measures for POPs, including source-related regulation (e.g. further optimization and tightening of existing Flemish legislation on open fires), investment in monitoring networks and communication and awareness campaigns, are presented and the added value for environmental health policy is discussed. We also reflect on how HBM can support science and innovation in the environmental monitoring context. Finally, we describe what society can gain from HBM in terms of opportunities for (1) feeding the political and societal debate, (2) stimulating community involvement and (3) empowering participants and citizens. All together, the gained insights and phased action plan showed that next to compliance with high scientific standards, results of the Flemish human biomonitoring campaign could be translated in targeted policy actions even for chemicals that have since long been regulated.

Identification of PM10 characteristics involved in cellular responses in human bronchial epithelial cells (Beas-2B).

Notwithstanding evidence is present that physicochemical characteristics of ambient particles attribute to adverse health effects, there is still some lack of understanding in this complex relationship. At this moment it is not clear which properties (such as particle size, chemical composition) or sources of the particles are most relevant for health effects. This study investigates the in vitro toxicity of PM10 in relation to PM chemical composition, black carbon (BC), endotoxin content and oxidative potential (OP). In 2013-2014 PM10 was sampled (24h sampling, 108 sampling days) in ambient air at three sites in Flanders (Belgium) with different pollution characteristics: an urban traffic site (Borgerhout), an industrial area (Zelzate) and a rural background location (Houtem). To characterize the toxic potential of PM10, airway epithelial cells (Beas-2B cells) have been exposed to particles in vitro. Different endpoints were studied including cell damage and death (cell viability) using the Neutral red Uptake assay, the production of pro-inflammatory molecules by interleukin 8 (IL-8) induction and DNA-damaging activity using the FPG-modified Comet assay. The endotoxin levels in the collected samples were analysed and the capacity of PM10 particles to produce reactive oxygen species (OP) was evaluated by electron paramagnetic resonance (EPR) spectroscopy. Chemical characteristics of PM10 (BC, As, Cd, Cr, Cu, Mn, Ni, Pb, Zn) and meteorological conditions were recorded on the sampling days. PM10 particles exhibited dose-dependent cytotoxicity in Beas-2B cells and were found to significantly induce the release of IL-8 in samples from the three locations. Oxidatively damaged DNA was observed in exposed Beas-2B cells. Endotoxin levels above the detection limit were detected in half of the samples. OP was measurable in all samples. Associations between PM10 characteristics and biological effects of PM10 were assessed by single and multiple regression analyses. The reduction in cell viability was significantly correlated with BC, Cd and Pb. The induction of IL-8 in Beas-2B cells was significantly associated with Cu, Ni and Zn and endotoxin. Endotoxin levels explained 33% of the variance in IL-8 induction. A significant interaction between ambient temperature and endotoxin on the pro-inflammatory activity was seen. No association was found between OP and the cellular responses. This study supports the hypothesis that, on an equal mass basis, PM10 induced biological effects differ due to differences in PM10 characteristics. Metals (Cd, Cu, Ni and Zn), BC, and endotoxin were among the main determinants for the observed biological responses.

Key aspects of a Flemish system to safeguard public health interests in case of chemical release incidents.

Although well-established protocols are available for emergency services and first-responders in case of chemical release incidents, a well-developed system to monitor and safeguard public health was, until recently, lacking in Flanders. We therefore developed a decision support system (DSS) to aid public health officials in identifying the appropriate actions in case of incidents. Although the DSS includes human biomonitoring as one of its key instruments, it also goes well beyond this instrument alone. Also other, complementary, approaches that focus more on effect assessment using in vitro toxicity testing, indirect exposures through the food chain, and parallel means of data collection (e.g. through ecosurveillance or public consultation), are integrated in the Flemish approach. Even though the DSS is set up to provide a flexible and structured decision tree, the value of expert opinion is deemed essential to account for the many uncertainties associated with the early phases of technological incidents. When the DSS and the associated instruments will be fully operational, it will provide a valuable addition to the already available protocols, and will specifically safeguard public health interests.