Phthalates are mainly used as plasticizers and are associated inter alia with adverse effects on reproductive functions. While more and more national programs in Europe have started monitoring internal exposure to phthalates and its substitute 1,2-Cyclohexanedicarboxylic acid (DINCH), the comparability of results from such existing human biomonitoring (HBM) studies across Europe is challenging. They differ widely in time periods, study samples, degree of geographical coverage, design, analytical methodology, biomarker selection, and analytical quality assurance level. The HBM4EU initiative has gathered existing HBM data of 29 studies from participating countries, covering all European regions and Israel. The data were prepared and aggregated by a harmonized procedure with the aim to describe-as comparably as possible-the EU-wide general population's internal exposure to phthalates from the years 2005 to 2019. Most data were available from Northern (up to 6 studies and up to 13 time points), Western (11; 19), and Eastern Europe (9; 12), e.g., allowing for the investigation of time patterns. While the bandwidth of exposure was generally similar, we still observed regional differences for Butyl benzyl phthalate (BBzP), Di(2-ethylhexyl) phthalate (DEHP), Di-isononyl phthalate (DiNP), and Di-isobutyl phthalate (DiBP) with pronounced decreases over time in Northern and Western Europe, and to a lesser degree in Eastern Europe. Differences between age groups were visible for Di-n-butyl phthalate (DnBP), where children (3 to 5-year olds and 6 to 11-year olds) had lower urinary concentrations than adolescents (12 to 19-year-olds), who in turn had lower urinary concentrations than adults (20 to 39-year-olds). This study is a step towards making internal exposures to phthalates comparable across countries, although standardized data were not available, targeting European data sets harmonized with respect to data formatting and calculation of aggregated data (such as developed within HBM4EU), and highlights further suggestions for improved harmonization in future studies.

Department of Clinical Medicine University of Copenhagen 2200 Copenhagen Denmark

Department of Environment and Health Provincial Institute of Hygiene 2000 Antwerp Belgium

Department of Environmental Health Ministry of Health Jerusalem 9446724 Israel

Department of Environmental Medicine Faculty of Public Health Slovak Medical University 83303 Bratislava Slovakia

Department of Environmental Sciences Jožef Stefan Institute Jamova Cesta 39 1000 Ljubljana Slovenia

Department of Food Safety Norwegian Institute of Public Health 0456 Oslo Norway

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

Department of Pediatrics Turku University Hospital 20521 Turku Finland

Department of Public Health University of Copenhagen 1165 Copenhagen Denmark

Department of Zoology and Anthropology Faculty of Natural Sciences and Informatics Constantine the Philosopher University in Nitra 94901 Nitra Slovakia

Environment Agency Austria 1090 Vienna Austria

Environmental Research and Innovation Department Luxembourg Institute of Science and Technology L 4422 Belvaux Luxembourg

Federal Public Service Health Food Chain Safety and Environment 1060 Brussels Belgium

Flemish Institute for Technological Research 2400 Mol Belgium

German Environment Agency Department of Toxicology Health Related Environmental Monitoring 14195 Berlin Germany

Hainaut Analyse 7000 Mons Belgium

Institute for Prevention and Occupational Medicine of the German Social Accident Insurance Institute of the Ruhr University Bochum 44789 Bochum Germany

Institute of Environmental Medicine Karolinska Institutet 171 77 Stockholm Sweden

Instituto de Salud Carlos 3 28220 Majadahonda Spain

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

National Institute of Public Health Centre for Health and Environment 10000 Prague Czech Republic

National Public Health Center Environmental Health Unit of the Department of Public Health Laboratory 1097 Budapest Hungary

Nofer Institute of Occupational Medicine 91 348 Lodz Poland

Public Health Authority Department of Environment and Health 83105 Bratislava Slovakia

Research Centre for Integrative Physiology and Pharmacology Institute of Biomedicine University of Turku 20520 Turku Finland

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