The CELSPAC - FIREexpo biomonitoring study investigates the long-term effects of chemical exposure on firefighters' wellness and fitness. It aims to provide science-based measures to minimize the health risks of the firefighting occupation. Here, we present the study design, cohort profile, and first results with respect to internal per- and polyfluoroalkyl substances (PFAS) and polycyclic aromatic hydrocarbons (PAH) levels in study participants. Participants (n = 166) were divided into three subcohorts: i) newly recruited firefighters, ii) professional firefighters with several years' experience, and iii) the control group. Participants underwent physical performance tests, provided information on their lifestyle and diet, and urine and blood samples 1-4 times within an 11-week period. 12 serum PFAS and 10 urinary hydroxylated PAH (OH-PAH) levels were determined using HPLC-MS/MS and compared between subcohorts and samplings. The association of internal exposure with reported lifestyles and occupational factors was investigated using Spearman's correlation, principal component analysis, and multivariate regression analysis. ΣPFAS levels in firefighters were significantly higher than in the control group and were mostly associated with the length of firefighting career, age, blood donation, and population size. 10.9 % and 7.6 % of measurements exceeded the HBM-I or HBM-II value for PFOS and PFOA, respectively. Urinary ΣPAH levels increased significantly after training with burning wooden pallets, but none of them exceeded the no observed genotoxic effect level. Firefighters' occupational exposure, its sources, and pathways, need to be systematically monitored and investigated on a long-term and individual basis. The CELSPAC - FIREexpo study helps to clarify the degree of occupational exposure to the given compounds and the subsequent risks to firefighters.

• Klíčová slova
• Cohort profile, Firefighters, HBM value, Human biomonitoring, Perfluoroalkyl substances, Polycyclic aromatic hydrocarbons,
• MeSH
• biologický monitoring MeSH
• fluorokarbony * analýza   MeSH
• hasiči * MeSH
• látky znečišťující vzduch v pracovním prostředí * analýza   MeSH
• lidé MeSH
• monitorování životního prostředí MeSH
• polycyklické aromatické uhlovodíky * analýza   MeSH
• pracovní expozice * analýza   MeSH
• studie případů a kontrol MeSH
• tandemová hmotnostní spektrometrie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Česká republika MeSH
• Názvy látek
• fluorokarbony * MeSH
• látky znečišťující vzduch v pracovním prostředí * MeSH
• polycyklické aromatické uhlovodíky * MeSH

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.

• Klíčová slova
• HBM4EU, exposure, human biomonitoring, phthalates, pollutants,
• Publikační typ
• časopisecké články MeSH

Current approaches for the assessment of environmental and human health risks due to exposure to chemical substances have served their purpose reasonably well. Nevertheless, the systems in place for different uses of chemicals are faced with various challenges, ranging from a growing number of chemicals to changes in the types of chemicals and materials produced. This has triggered global awareness of the need for a paradigm shift, which in turn has led to the publication of new concepts for chemical risk assessment and explorations of how to translate these concepts into pragmatic approaches. As a result, next-generation risk assessment (NGRA) is generally seen as the way forward. However, incorporating new scientific insights and innovative approaches into hazard and exposure assessments in such a way that regulatory needs are adequately met has appeared to be challenging. The European Partnership for the Assessment of Risks from Chemicals (PARC) has been designed to address various challenges associated with innovating chemical risk assessment. Its overall goal is to consolidate and strengthen the European research and innovation capacity for chemical risk assessment to protect human health and the environment. With around 200 participating organisations from all over Europe, including three European agencies, and a total budget of over 400 million euro, PARC is one of the largest projects of its kind. It has a duration of seven years and is coordinated by ANSES, the French Agency for Food, Environmental and Occupational Health & Safety.

• Klíčová slova
• Chemicals, Exposure assessment, Hazard characterisation, Human biomonitoring (HBM), New approach methods (NAM), Next-generation risk assessment (NGRA), Safety assessment,
• MeSH
• hodnocení rizik * MeSH
• lidé MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• dopisy MeSH
• Geografické názvy
• Evropa MeSH

Within the European Human Biomonitoring (HBM) Initiative HBM4EU we derived HBM indicators that were designed to help answering key policy questions and support chemical policies. The result indicators convey information on chemicals exposure of different age groups, sexes, geographical regions and time points by comparing median exposure values. If differences are observed for one group or the other, policy measures or risk management options can be implemented. Impact indicators support health risk assessment by comparing exposure values with health-based guidance values, such as human biomonitoring guidance values (HBM-GVs). In general, the indicators should be designed to translate complex scientific information into short and clear messages and make it accessible to policy makers but also to a broader audience such as stakeholders (e.g. NGO's), other scientists and the general public. Based on harmonized data from the HBM4EU Aligned Studies (2014-2021), the usefulness of our indicators was demonstrated for the age group children (6-11 years), using two case examples: one phthalate (Diisobutyl phthalate: DiBP) and one non-phthalate substitute (Di-isononyl cyclohexane-1,2- dicarboxylate: DINCH). For the comparison of age groups, these were compared to data for teenagers (12-18 years), and time periods were compared using data from the DEMOCOPHES project (2011-2012). Our result indicators proved to be suitable for demonstrating the effectiveness of policy measures for DiBP and the need of continuous monitoring for DINCH. They showed similar exposure for boys and girls, indicating that there is no need for gender focused interventions and/or no indication of sex-specific exposure patterns. They created a basis for a targeted approach by highlighting relevant geographical differences in internal exposure. An adequate data basis is essential for revealing differences for all indicators. This was particularly evident in our studies on the indicators on age differences. The impact indicator revealed that health risks based on exposure to DiBP cannot be excluded. This is an indication or flag for risk managers and policy makers that exposure to DiBP still is a relevant health issue. HBM indicators derived within HBM4EU are a valuable and important complement to existing indicator lists in the context of environment and health. Their applicability, current shortcomings and solution strategies are outlined.

• Klíčová slova
• DINCH, HBM4EU, Human biomonitoring (HBM), Phthalates, Science-policy uptake, indicator,
• MeSH
• biologický monitoring MeSH
• dítě MeSH
• kyseliny ftalové * MeSH
• kyseliny karboxylové MeSH
• lidé MeSH
• mladiství MeSH
• postup MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Názvy látek
• kyseliny ftalové * MeSH
• kyseliny karboxylové MeSH
• phthalic acid MeSH Prohlížeč

Many legacy and emerging flame retardants (FRs) have adverse human and environmental health effects. This study reports legacy and emerging FRs in children from nine European countries from the HBM4EU aligned studies. Studies from Belgium, Czech Republic, Germany, Denmark, France, Greece, Slovenia, Slovakia, and Norway conducted between 2014 and 2021 provided data on FRs in blood and urine from 2136 children. All samples were collected and analyzed in alignment with the HBM4EU protocols. Ten halogenated FRs were quantified in blood, and four organophosphate flame retardants (OPFR) metabolites quantified in urine. Hexabromocyclododecane (HBCDD) and decabromodiphenyl ethane (DBDPE) were infrequently detected (<16% of samples). BDE-47 was quantified in blood from Greece, France, and Norway, with France (0.36 ng/g lipid) having the highest concentrations. BDE-153 and -209 were detected in <40% of samples. Dechlorane Plus (DP) was quantified in blood from four countries, with notably high median concentrations of 16 ng/g lipid in Slovenian children. OPFR metabolites had a higher detection frequency than other halogenated FRs. Diphenyl phosphate (DPHP) was quantified in 99% of samples across 8 countries at levels ∼5 times higher than other OPFR metabolites (highest median in Slovenia of 2.43 ng/g lipid). FR concentrations were associated with lifestyle factors such as cleaning frequency, employment status of the father of the household, and renovation status of the house, among others. The concentrations of BDE-47 in children from this study were similar to or lower than FRs found in adult matrices in previous studies, suggesting lower recent exposure and effectiveness of PBDE restrictions.

• Klíčová slova
• Children, Europe, HBM4EU, Human biomonitoring, Organophosphate flame retardants, Polybrominated diphenyl ethers,
• MeSH
• dítě MeSH
• dospělí MeSH
• halogenované difenylethery MeSH
• lidé MeSH
• lipidy MeSH
• retardanty hoření * MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Geografické názvy
• Evropa MeSH
• Názvy látek
• 2,2',4,4'-tetrabromodiphenyl ether MeSH Prohlížeč
• halogenované difenylethery MeSH
• lipidy MeSH
• retardanty hoření * MeSH

Mycotoxins are natural metabolites produced by fungi that contaminate food and feed worldwide. They can pose a threat to human and animal health, mainly causing chronic effects, e.g., immunotoxic and carcinogenic. Due to climate change, an increase in European population exposure to mycotoxins is expected to occur, raising public health concerns. This urges us to assess the current human exposure to mycotoxins in Europe to allow monitoring exposure and prevent future health impacts. The mycotoxins deoxynivalenol (DON) and fumonisin B1 (FB1) were considered as priority substances to be studied within the European Human Biomonitoring Initiative (HBM4EU) to generate knowledge on internal exposure and their potential health impacts. Several policy questions were addressed concerning hazard characterization, exposure and risk assessment. The present article presents the current advances attained under the HBM4EU, research needs and gaps. Overall, the knowledge on the European population risk from exposure to DON was improved by using new harmonised data and a newly derived reference value. In addition, mechanistic information on FB1 was, for the first time, organized into an adverse outcome pathway for a congenital anomaly. It is expected that this knowledge will support policy making and contribute to driving new Human Biomonitoring (HBM) studies on mycotoxin exposure in Europe.

• Klíčová slova
• HBM4EU, deoxynivalenol (DON), fumonisin B1 (FB1), human biomonitoring, human health, mycotoxins exposure, risk assessment,
• MeSH
• biologický monitoring MeSH
• hodnocení rizik MeSH
• houby MeSH
• lidé MeSH
• mykotoxiny * toxicita   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH
• Geografické názvy
• Evropa MeSH
• Názvy látek
• mykotoxiny * MeSH

Human biomonitoring has become a pivotal tool for supporting chemicals' policies. It provides information on real-life human exposures and is increasingly used to prioritize chemicals of health concern and to evaluate the success of chemical policies. Europe has launched the ambitious REACH program in 2007 to improve the protection of human health and the environment. In October 2020 the EU commission published its new chemicals strategy for sustainability towards a toxic-free environment. The European Parliament called upon the commission to collect human biomonitoring data to support chemical's risk assessment and risk management. This manuscript describes the organization of the first HBM4EU-aligned studies that obtain comparable human biomonitoring (HBM) data of European citizens to monitor their internal exposure to environmental chemicals. The HBM4EU-aligned studies build on existing HBM capacity in Europe by aligning national or regional HBM studies. The HBM4EU-aligned studies focus on three age groups: children, teenagers, and adults. The participants are recruited between 2014 and 2021 in 11 to 12 primary sampling units that are geographically distributed across Europe. Urine samples are collected in all age groups, and blood samples are collected in children and teenagers. Auxiliary information on socio-demographics, lifestyle, health status, environment, and diet is collected using questionnaires. In total, biological samples from 3137 children aged 6-12 years are collected for the analysis of biomarkers for phthalates, HEXAMOLL® DINCH, and flame retardants. Samples from 2950 teenagers aged 12-18 years are collected for the analysis of biomarkers for phthalates, Hexamoll® DINCH, and per- and polyfluoroalkyl substances (PFASs), and samples from 3522 adults aged 20-39 years are collected for the analysis of cadmium, bisphenols, and metabolites of polyaromatic hydrocarbons (PAHs). The children's group consists of 50.4% boys and 49.5% girls, of which 44.1% live in cities, 29.0% live in towns/suburbs, and 26.8% live in rural areas. The teenagers' group includes 50.6% girls and 49.4% boys, with 37.7% of residents in cities, 31.2% in towns/suburbs, and 30.2% in rural areas. The adult group consists of 52.6% women and 47.4% men, 71.9% live in cities, 14.2% in towns/suburbs, and only 13.4% live in rural areas. The study population approaches the characteristics of the general European population based on age-matched EUROSTAT EU-28, 2017 data; however, individuals who obtained no to lower educational level (ISCED 0-2) are underrepresented. The data on internal human exposure to priority chemicals from this unique cohort will provide a baseline for Europe's strategy towards a non-toxic environment and challenges and recommendations to improve the sampling frame for future EU-wide HBM surveys are discussed.

• Klíčová slova
• adults, children, human biomonitoring, joint HBM4EU survey, teenagers,
• MeSH
• biologický monitoring * MeSH
• dítě MeSH
• dospělí MeSH
• hodnocení rizik MeSH
• kadmium analýza   MeSH
• látky znečišťující životní prostředí * analýza   MeSH
• lidé MeSH
• mladiství MeSH
• monitorování životního prostředí MeSH
• vystavení vlivu životního prostředí analýza   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH
• Názvy látek
• kadmium MeSH
• látky znečišťující životní prostředí * MeSH

Record linkage of human biomonitoring (HBM) survey data with administrative register data can be used to enhance available datasets and complement the possible shortcomings of both data sources. Through record linkage, valuable information on medical history (diagnosed diseases, medication use, etc.) and follow-up information on health and vital status for established cohorts can be obtained. In this study, we investigated the availability of health registers in different EU Member States and EEA countries and assessed whether they could be linked to HBM studies. We found that the availability of administrative health registers varied substantially between European countries as well as the availability of unique personal identifiers that would facilitate record linkage. General protocols for record linkage were similar in all countries with ethical and data protections approval, informed consent, approval by administrative register owner, and linkage conducted by the register owner. Record linkage enabled cross-sectional survey data to be used as cohort study data with available follow-up and health endpoints. This can be used for extensive exposure-health effect association analysis. Our study showed that this is possible for many, but not all European countries.

• Klíčová slova
• HBM4EU, administrative registers, biomonitoring, chemicals, health, health registers,
• MeSH
• biologický monitoring * MeSH
• chorobopisy - spojování MeSH
• kohortové studie MeSH
• lidé MeSH
• monitorování životního prostředí * metody   MeSH
• průřezové studie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

The role of environmental chemicals in the etiology of attention deficit hyperactivity disorder (ADHD) has been of interest in recent research. This scoping review aims to summarize known or possible associations between ADHD and environmental exposures to substances selected as priority chemicals of the European Human Biomonitoring Initiative (HBM4EU). Literature searches were performed in PubMed to identify relevant publications. Only meta-analyses and review articles were included, as they provide more extensive evidence compared to individual studies. The collected evidence indicated that lead (Pb), phthalates and bisphenol A (BPA) are moderately to highly associated with ADHD. Limited evidence exists for an association between ADHD and polycyclic aromatic hydrocarbons (PAHs), flame retardants, mercury (Hg), and pesticides. The evidence of association between ADHD and cadmium (Cd) and per- and polyfluoroalkyl substances (PFASs) based on the identified reviews was low but justified further research. The methods of the individual studies included in the reviews and meta-analyses covered in the current paper varied considerably. Making precise conclusions in terms of the strength of evidence on association between certain chemicals and ADHD was not straightforward. More research is needed for stronger evidence of associations or the lack of an association between specific chemical exposures and ADHD.

• Klíčová slova
• ADHD, HBM4EU, bisphenol A, chemical exposure, health effect, lead, mercury, pesticides, phthalates, polycyclic aromatic hydrocarbons,
• MeSH
• biologický monitoring MeSH
• hyperkinetická porucha * chemicky indukované   epidemiologie   MeSH
• lidé MeSH
• pesticidy * analýza   MeSH
• retardanty hoření * analýza   MeSH
• rtuť * analýza   MeSH
• vystavení vlivu životního prostředí škodlivé účinky   analýza   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Scoping Review MeSH
• Názvy látek
• pesticidy * MeSH
• retardanty hoření * MeSH
• rtuť * MeSH

A quality assurance/quality control program was implemented in the framework of the EU project HBM4EU to assess and improve the comparability of biomarker analysis and to build a network of competent laboratories. Four rounds of proficiency tests were organized for 15 phthalate and two DINCH urinary biomarkers (0.2-138 ng/mL) over a period of 18 months, with the involvement of 28 laboratories. A substantial improvement in performance was observed after the first round in particular, and by the end of the program, an average satisfactory performance rate of 90% was achieved. The interlaboratory reproducibility as derived from the participants' results varied for the various biomarkers and rounds, with an average of 24% for the biomarkers of eight single-isomer phthalates (e.g., DnBP and DEHP) and 43% for the more challenging biomarkers of the mixed-isomer phthalates (DiNP, DiDP) and DINCH. When the reproducibility was based only on the laboratories that consistently achieved a satisfactory performance, this improved to 17% and 26%, respectively, clearly demonstrating the success of the QA/QC efforts. The program thus aided in building capacity and the establishment of a network of competent laboratories able to generate comparable and accurate HBM data for phthalate and DINCH biomarkers in 14 EU countries. In addition, global comparability was ensured by including external expert laboratories.

• Klíčová slova
• HBM4EU, QA/QC, external quality assurance scheme (EQUAS), human biomonitoring (HBM), interlaboratory comparison investigation (ICI), proficiency testing,
• Publikační typ
• časopisecké články MeSH