Towards a Swiss health study with human biomonitoring: Learnings from the pilot phase about participation and design.

BACKGROUND A large-scale national cohort aiming at investigating the health status and determinants in the general population is essential for high-quality public health research and regulatory decision-making. We present the protocol and first results of the pilot phase to a Swiss national cohort aiming at establishing the study procedures, evaluating feasibility, and assessing participation and willingness to participate. METHODS The pilot phase 2020/21 included 3 components recruited via different channels: a population-based cross-sectional study targeting the adult population (20-69 years) of the Vaud and Bern cantons via personal invitation, a sub-study on selenium in a convenience sample of vegans and vegetarians via non-personal invitation in vegan/vegetarian networks, and a self-selected sample via news promotion (restricted protocol). Along with a participatory approach and participation, we tested the study procedures including online questionnaires, onsite health examination, food intake, physical activity assessments and biosample collection following high-quality standards. RESULTS The population-based study and the selenium sub-study had 638 (participation rate: 14%) and 109 participants, respectively, both with an over-representation of women. Of altogether 1349 recruited participants over 90% expressed interest in participating to a national health study, over 75% to contribute to medicine progress and help improving others' health, whereas about one third expressed concerns over data protection and data misuse. CONCLUSIONS Publicly accessible high-quality public health data and human biomonitoring samples were collected. There is high interest of the general population in taking part in a national cohort on health. Challenges reside in achieving a higher participation rate and external validity. For project management clear governance is key

WP6 - Sustainability and Capacity building

This report aims to provide a revision on the national needs (T6.1), the funding mechanisms (T6.2) and the long-term sustainability of HBM4EU (T6.3). Therefore, this report is divided in the three above-mentioned sections, for which the different tasks within work package 6 (WP 6) provided input. Concerning national needs, a survey is conducted annually by the national hub (NH) coordinator to monitor and evaluate the progress and development of all National Hubs involved in HBM4EU. With 2020 being the fourth year of the HBM4EU project, the survey followed many of the questions of previous years. Most NHs are satisfied with their current HBM4EU involvement, but have expressed their concerns regarding the communication, funding and lack of direct involvement. The follow-up to HBM4EU, PARC, was mentioned and the necessary involvement of all countries as well as the importance of communication between NHs and National Hub Contact Points (NHCPs) was highlighted. Inclusivity of smaller countries seems to be a problem through both lack of funding and adequate tasks. Regarding funding mechanisms, the initial list of financing mechanisms in the HBM and environmental health area at national and international level was updated and is available on the HBM4EU website under the “Funding Opportunities” tab. This intends to be an inventory that can be used not only by the HBM4EU consortium but by the entire scientific community to provide an overview of existing funding sources. It comprises of a set of targeted strategies for identification and dissemination of funding which are explained in further detail in section 6 Funding mechanisms. A systematic literature review was also undertaken to understand what the primary funding source of projects in HBM was. The results are not available yet. As part of T6.3 on the long-term sustainability, a citizen survey was developed together with T4.1 – mapping of needs. This survey was initially used for focus groups to better understand their awareness and concerns of chemical exposure and Human Biomonitoring. It was updated to harvest more EU-wide results including chemical exposure during the COVID-19 pandemic. The survey took place between September 2020 and February 2021 and the results were organised to cover the same regions as the aligned studies to allow for the organisation of results in a similar way for coherence. In order to produce a short report summarising the outcome of the survey, the questions were grouped for quicker analysis. The majority of the respondents considers HBM a tool that produces important results on human exposure to chemicals and that it should be performed more often and in a more coordinated way. This was a non-representative survey and future work should focus on wider dissemination in other population groups and on understanding how perceptions change over time. The survey’s answers were also distributed to the NHs, so they can produce internal communication briefs on their own data for further dissemination.HORIZON2020 Programme Contract No. 733032 HBM4EU.info:eu-repo/semantics/publishedVersio

The value of Human Biomonitoring to assess chemical exposure and support policies: perceptions of the European population

Abstract publicado em: Environ Health Perspect. 2021;1. https://ehp.niehs.nih.gov/doi/abs/10.1289/isee.2021.P-481BACKGROUND AND AIM:The development of Human Biomonitoring (HBM) surveys is highly dependent on the cooperation and engagement of the individuals being sampled. As such, in the context of the European Human Biomonitoring Initiative (HBM4EU) an online citizen survey was conducted in Europe to gain insights into the perceptions of the population about HBM and exposure to chemicals. METHODS:The survey was undertaken between September 2020 and February 2021 and was available in the languages of all 30 HBM4EU-participating countries (EU, associated countries, Israel) through the HBM4EU website. Dissemination was done by the HBM4EU country representatives (National Hub Contact Points). RESULTS:Responses were received from 5391 participants. Around half were 35-54 years old and the majority were female, with higher education and employed. Concerning the perception of the respondents on HBM, the majority considers it should be done (81.7%), even if the chemicals are considered well managed. Most participants consider it a reliable method (84.0%) that should be performed more often (87.3%) and be more coordinated either at a European (86.2%) or at a national level (83.7%). The large majority of the respondents thinks that HBM results are important to evaluate the chemical exposure of the population (96.2%), to study the health impact of chemical exposure (96.3%) and to support the development of health policies (94.9%). The respondents also consider HBM results highly relevant to raise awareness and promote understanding of the impact of chemical exposure amongst the general population (94.3%), health professionals and policy makers. CONCLUSIONS:The use of HBM as a tool to assess human exposure to chemicals, allowing its management and health protection, was well perceived by respondents across Europe. Furthermore, the need for more studies conducted in a coordinated way was indicated. Future work should comprise population groups less represented here and should also attempt to understand how perceptions change over time.HBM4EU is funded by the European Union’s Horizon 2020 research and innovation programme under grant agreement Nº 733032info:eu-repo/semantics/publishedVersio

AD6.2 WP6 - Sustainability and capacity building. Results of the interaction and surveys with the Environment Protection Agency network and the National Reference Centre on Environment & Health

The aim of this additional deliverable is to analyse the result of the interaction and surveys with the Environment Protection Agency network and the National Reference Centre on Environment & Health. The consultation to both the EPA network and the NRCs was done through a similar targeted survey, with the aim of understanding their perception of the current HBM4EU and their ideas for a future Human Biomonitoring initiative. The online survey also explored if and how their institution would use HBM4EU results in their work and it also explored the focus that their institution considered a future initiative might take. This could be in terms of exploring exposure to new emerging risks or understanding exposure to known chemical risks, such as heavy metals. In addition, it explored interest in participating in a new initiative and openness towards sharing of best practice. This included questions regarding the possible role that the EPAs and NRCs might play in such an initiative. The invitation was sent out to 29 EPA countries and 15 NRCs, from which 19 answers were obtained in total with 4 EPAs answered and 13 NRCs. One of the EPAs is also a HBM4EU partner, whereas from the 15 NRCs, 13 of those provided their countries/institution from which 7 are HBM4EU partners. The survey produced quite interesting results, where it was pointed out that HBM is the only instrument that can assess human exposure in an integrated and reliable way. From the institutions that are not part of HBM4EU, most of them were aware of the project. The ones that were already part of it would like to carry on as such if a future initiative is to take place. Despite the fact that a slightly higher percentage of institutions do not use HBM at the moment in their work (53 % vs 47 %), all of the institutions recognised the value of HBM and plan on using it in the future. All the NRCs and 75 % of the EPAs are interested in being part of a future initiative with a possible role in: positioning Human Biomonitoring in the strategic agenda of implementation of environmental policy and state of the environment in Europe, supporting the activities of the HBM initiative through an existing interest group under the NRC Network, creating joint working initiatives with other relevant networks. It was clear from the answers given that HBM has triggered an interest and there is a willingness to be part of the future initiative.HORIZON2020 Programme - Contract No. 733032 HBM4EUinfo:eu-repo/semantics/publishedVersio