7.3 Smolders
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Transcript of 7.3 Smolders
16/10/2013
Interpreting biomarker data from the COPHES‐DEMOCOPHES twin projects:
Using lifestyle and environmental data to understand biomarker differences among countries
HUMAN BIOMONITORING FOR EUROPEa harmonised approach
16/10/2013 2© 2013, VITO NV
HUMAN BIOMONITORING FOR EUROPEa harmonised approach
16/10/2013 3© 2013, VITO NV
HUMAN BIOMONITORING FOR EUROPEa harmonised approach
16/10/2013 4© 2013, VITO NV
» In short:» COPHES: FP7‐project, coordinated by BiPRO GmbH (Germany)» DEMOCOPHES: LIFE+ cofunding together with participating countries,
coordinated by FPS (Belgium)» Primary aims:
» 1. Feasibility study
» 2. Capacity building
HUMAN BIOMONITORING FOR EUROPEa harmonised approach
‘To perform HBM in a coherent and harmonised approach throughout Europe by means of commonly developed protocols, strategies and scientific tools ensuring reliable and
comparable data.’
‘With great efforts and success, (DEMO)COPHES established an analytical quality assurance scheme (Interlaboratory comparison & External Quality Assessment Schemes) that:
a) enabled identification, training and selection of analytically competent laboratories for the HBM measurements throughout Europe and,
b) guaranteed the reliability and comparability of data throughout Europe and the world
16/10/2013 5© 2013, VITO NV
» In short:» Study details:
» Selected biomarkers: Cd, cotinine, certain phthalates (urine), Hg (hair)
» Study population: 120 mother‐ child pairs per country (CY & LU: n = 60)
» In total, 1844 urine and hair samples were collected» Convenience samples from a rural and urban area» Additionally, BPA was measured in 6 countries
HUMAN BIOMONITORING FOR EUROPEa harmonised approach
16/10/2013 6© 2013, VITO NV
» Data collection for interpretation purposes:
HUMAN BIOMONITORING FOR EUROPEa harmonised approach
16/10/2013 7© 2013, VITO NV
Hypotheses tested using aggregate datasetsTested for…
Cd Hg CotinineAre differences in environmental concentrations able to explain differences inbiomarker values (national level)
Air X XFood (for Hg specifically aquatic food products) X XSoil X X
Is anti‐smoking legislation and banning of smoking in public places related tobiomarker values of non‐smokers? X X
Are regional emission data useful to improve the interpretation of biomarkervalues? X X
» Interpreting biomarker data:
» No specific hypotheses were tested for phthalates
HUMAN BIOMONITORING FOR EUROPEa harmonised approach
Research question: are differences in environmental concentrations or lifestyle variables able to explain differences in biomarker values among the
17 countries participating in the DEMOCOPHES field study?
Hypotheses tested using aggregate datasetsTested for…
Cd Hg CotinineAre differences in environmental concentrations able to explain differences inbiomarker values (national level)
Air X XFood (for Hg specifically aquatic food products) X XSoil X X
Is anti‐smoking legislation and banning of smoking in public places related tobiomarker values of non‐smokers? X X
Are regional emission data useful to improve the interpretation of biomarkervalues? X X
16/10/2013 8© 2013, VITO NV
» Cadmium» Hypothesis: Are differences in environmental concentrations able to
explain differences in urinary Cd (national level) – Air emissions» Data source: Centre on Emission Inventories and Projections (CEIP)
HUMAN BIOMONITORING FOR EUROPEa harmonised approach
16/10/2013 9© 2013, VITO NV
» Cadmium» Hypothesis: Are differences in environmental concentrations able to
explain differences in urinary Cd (national level) – Air emissions» Data source: Centre on Emission Inventories and Projections database» Biomarker data: Geometric mean (GM) urinary Cd in Mothers
HUMAN BIOMONITORING FOR EUROPEa harmonised approach
16/10/2013 10© 2013, VITO NV
HUMAN BIOMONITORING FOR EUROPEa harmonised approach
» Cadmium» Hypothesis: Are differences in dietary lifestyle factors able to explain
differences in urinary Cd – Uptake through food» Data source: European Food Safety Authority (EFSA)
16/10/2013 11© 2013, VITO NV
HUMAN BIOMONITORING FOR EUROPEa harmonised approach
» Cadmium» Hypothesis: Are differences in dietary lifestyle factors able to explain
differences in urinary Cd – Uptake through food» Data source: European Food Safety Authority (EFSA)
16/10/2013 12© 2013, VITO NV
HUMAN BIOMONITORING FOR EUROPEa harmonised approach
» Cadmium» Hypothesis: Are differences in dietary lifestyle factors able to explain
differences in urinary Cd – Uptake through food» Data source: European Food Safety Authority (EFSA)» Biomarker data: Mothers (high exposure scenario*) * Sum of P95 for cereals and vegetables +
mean exposure for whole population
Spearman’s r=0.71 n=8; p=0.058
16/10/2013 13© 2013, VITO NV
HUMAN BIOMONITORING FOR EUROPEa harmonised approach
» Mercury» Hypothesis: Are differences in dietary lifestyle factors able to explain
differences in Hg in hair – Uptake through fish consumption» Data source: Food and Agriculture Organization (FAO)
16/10/2013 14© 2013, VITO NV
HUMAN BIOMONITORING FOR EUROPEa harmonised approach
» Mercury» Hypothesis: Are differences in dietary lifestyle factors able to explain
differences in Hg in hair – Uptake through fish consumption» Data source: FAO data – Consumption of marine organisms» Biomarker data: Children and mothers
Spearman’s r=0.75 n=17; p<0.001
Spearman’s r=0.80 n=17; p<0.001
16/10/2013 15© 2013, VITO NV
HUMAN BIOMONITORING FOR EUROPEa harmonised approach
» Cotinine» Hypothesis: Is anti‐smoking legislation and banning of smoking in
public places related to biomarker values of non‐smokers?» Data source: Smokefree Partnership database and DG Sanco
The countries in green follow both the letterand spirit of the Article 8 guidelines of the WHOFramework Convention on Tobacco Control1. The smoke-free law is strong;2. The smoke-free law is strongly enforced.There is negligible smoking in workplaces, barsand restaurants.
The countries in orange only offer limitedprotection. Many places are smoke free butdoes not give 100% protection against theharmful effects of second-hand smoke due tothe exemptions allowed. In some countries, thelaw is strong, but it is poorly enforced.
The countries in red have weak or unenforcedlaws. Workers are not protected
16/10/2013 16© 2013, VITO NV
HUMAN BIOMONITORING FOR EUROPEa harmonised approach
» Cotinine» Hypothesis: Is anti‐smoking legislation and banning of smoking in
public places related to biomarker values of non‐smokers?» Data source: Smokefree Partnership database and DG Sanco» Biomarker data: Children and mothers
K-W p=0.039K-W p=0.033*
*
16/10/2013 17© 2013, VITO NV
» CONCLUSIONS» The COPHES/DEMOCOPHES twin projects were succesful in collecting
comparable biomarker data across 17 countries in Europe!
» Although interpretation was not the key goal of the projects, someinteresting findings:
» Cd: marginal significance with air emissions and food quality (onlymothers, reflecting long‐term integration of urinary Cd)
» Hg: clear relationship between both qualitative and quantitativefish consumption
» Cotinine: Countries with a strict anti smoking legislation show lower levels of ETS‐related biomarkers
HUMAN BIOMONITORING FOR EUROPEa harmonised approach
16/10/2013 18© 2013, VITO NV
» CONCLUSIONS (continued)» (Sub)National datasets: difficult to find representative and comparable
regional data» No data for all DEMOCOPHES countries» Differences in data quality/quantity» Result: limited power of analyses
» Some limitations to use aggregate data:» Problem of spatial scale: How relevant are national emission data?» Study populations not country‐representative (convenience sample)» Harmonized food quality/quantity data difficult to find» Future: more harmonised datasets (EU‐Menu, INSPIRE,…)
HUMAN BIOMONITORING FOR EUROPEa harmonised approach
16/10/2013 19© 2013, VITO NV
» Take home message…
HUMAN BIOMONITORING FOR EUROPEa harmonised approach
Harmonised HBM across Europe…
YES WE CAN !!!
Interpretation of biomarker data…
YES WE COULD !!!
Need for continued harmonisation…
YES WE SHOULD !!!
16/10/2013 20© 2013, VITO NV
United Kingdom:Health Protection Agency
(HPA)
Ireland:Health Service Executive
(HSE) The Netherlands:Environmental Health Sciences International
(EHSI)
The Netherlands:National Institute of Public Health and the Environment
(RIVM)
Spain:Instituto de Salud Carlos III
(ISCIII)
Italy:Istituto Superiore di Sanità
(ISS)
Germany:BiPRO GmbH
Coordinator COPHES
Denmark:University of Copenhagen
(UCHP)
Estonia:National Institute for Health Development
(NIHD)
Belgium:Flemish Institute for technological Research
(VITO)
Belgium:Joint Research Centre
(JRC)
Belgium:CEFIC
Belgium:Health and Environment Alliance
(HEAL)
Switzerland:Federal Office of Public Health
Germany:Umweltbundesamt
(UBA)
Germany:Deutsche Gesetzliche Unfallversicherung
(DGUV)Austria:
Umweltbundesamt GmbH
Czech Republic:National Institute of Public Health
(NIPH)Hungary:National Institute of Environmental Health
(NIEH)
France:Institut de Veille Sanitaire
(InVS) Croatia:Institute for Medical Research and Occupational Health
(IMROH)
Lithuania:Nvytautas Magnus University
(VDU)
Luxembourg:Centre de Recherche Public – Gabriel Lippmann
(CRP-GL)
Finland:National Institute for Health and Welfare
(THL)Sweden:Karolinska Institutet
(KI-IMM)
Norway:National Institute of Public Health Norway
(NIPH-NO)
Poland:Nofer Institute of Occupational Medicine
(NIOM)
Romania:Environmental Health Center
(EHC)
Slovenia:Jozef Stefan Institute
(JSI)
Slovakia:Public Health Authority of the Slovak Republic
(UVZ SR)
Greece:National Hellenic Research Foundation
(NHRF)Cyprus:
Ministry of Health - State General Laboratory(SGL)
HUMAN BIOMONITORING FOR EUROPEa harmonised approach
AustriaUmweltbundesamt GmbH
BelgiumVITO
SwitzerlandFederal Office of Public
Health
CyprusSGL
Larnaca Hospital
Czech RepublicNIPH
GermanyUBA
HungaryNIEH
DenmarkUCHP
United KingdomHPA
EstoniaNIHD
SpainISCIII
FinlandTHL
FranceInVS
GreeceNHRF
CroatiaIMROH
IrelandHSEItalyISS
LithuaniaVDU
LuxembourgCRP-GL
Laboratoire National de Santé
the NetherlandsEHSIRIVM
NorwayNIPH-NOPolandNIOM
PortugalAIDFL / IMP
RomaniaEHC
SloveniaJSI
SlovakiaUVZ SR
KUL
SwedenKI-IMM
JRCCEFICHEAL
FPSCoordinator
DEMOCOPHES
DGUVBiPRO
Coordinator COPHES
Luxembourg:Laboratoire Nationale de Santé
(THL)
Cyprus:Larnaca Hospital
Portugal:Institute of Preventive Medicine, Lisbon Faculty of Medicine
(AIDFM / IMP)
Belgium:FPS Health, Food chain safety and environment
Coordinator DEMOCOPHES
Belgium:Katholieke Universiteit Leuven
(KUL)