Phthalates and the substitute plasticizer DINCH belong to the first group of priority substances investigated by the European Human Biomonitoring Initiative (HBM4EU) to answer policy-relevant questions and safeguard an efficient science-to-policy transfer of results. Human internal exposure levels were assessed using two data sets from all European regions and Israel. The first collated existing human biomonitoring (HBM) data (2005-2019). The second consisted of new data generated in the harmonized "HBM4EU Aligned Studies" (2014-2021) on children and teenagers for the ten most relevant phthalates and DINCH, accompanied by a quality assurance/quality control (QA/QC) program for 17 urinary exposure biomarkers. Exposures differed between countries, European regions, age groups and educational levels. Toxicologically derived Human biomonitoring guidance values (HBM-GVs) were exceeded in up to 5% of the participants of the HBM4EU Aligned Studies. A mixture risk assessment (MRA) including five reprotoxic phthalates (DEHP, DnBP, DiBP, BBzP, DiNP) revealed that for about 17% of the children and teenagers, health risks cannot be excluded. Concern about male reproductive health emphasized the need to include other anti-androgenic substances for MRA. Contaminated food and the use of personal care products were identified as relevant exposure determinants paving the way for new regulatory measures. Time trend analyses verified the efficacy of regulations: especially for the highly regulated phthalates exposure dropped significantly, while levels of the substitutes DINCH and DEHTP increased. The HBM4EU e-waste study, however, suggests that workers involved in e-waste management may be exposed to higher levels of restricted phthalates. Exposure-effect association studies indicated the relevance of a range of endpoints. A set of HBM indicators was derived to facilitate and accelerate science-to-policy transfer. Result indicators allow different groups and regions to be easily compared. Impact indicators allow health risks to be directly interpreted. The presented results enable successful science-to-policy transfer and support timely and targeted policy measures.

Brabant Advies Brabantlaan 3 5216 TV 's Hertogenbosch the Netherlands

Department of Biomedical Sciences University of Antwerp Universiteitsplein 1 2610 Wilrijk Belgium

Department of Growth and Reproduction Copenhagen University Hospital Rigshospitalet 2100 Copenhagen Denmark

Environmental Toxicology Unit National Centre for Environmental Health Instituto de Salud Carlos 3 28220 Majadahonda Spain

Finnish Institute of Occupational Health P O Box 40 FI 00032 Tyoterveyslaitos Finland

German Environment Agency Corrensplatz 1 14195 Berlin Germany

Institute for Prevention and Occupational Medicine of the German Social Accident Insurance Institute of the Ruhr University Bochum Bürkle de la Camp Platz 1 44789 Bochum Germany

Institute of Occupational Safety and Environmental Health Rīga Stradiņš University Dzirciema 16 LV 1007 Riga Latvia

International Centre for Research and Research Training in Endocrine Disruption of Male Reproduction and Child Health Copenhagen University Hospital Rigshospitalet 2100 Copenhagen Denmark

RECETOX Faculty of Science Masaryk University Kotlarska 2 Brno 611 37 Czech Republic

University of Antwerp Toxicological Center Universiteitsplein 1 2610 Wilrijk Belgium

VITO Health Flemish Institute for Technological Research 2400 Mol Belgium

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