COLLEGIUM RAMAZZINI ANNUAL RAMAZZINI DAYS 2010 22-24 ... · Katanga, grouped according to proximity...
Transcript of COLLEGIUM RAMAZZINI ANNUAL RAMAZZINI DAYS 2010 22-24 ... · Katanga, grouped according to proximity...
(FROM OLD AND) “NEW AGE”: MEASURING EXPOSURE OF CHILDREN AND THEIR MOTHERS IN A EUROPEAN HUMAN
BIOMONITOING FEASIBILITY STUDY
Ludwine Casteleyn, Katholieke Universiteit Leuven
COLLEGIUM RAMAZZINIANNUAL RAMAZZINI DAYS 2010
22-24 OCTOBER CARPI - ITALY
The Democratic Republic of Congo, part of the Katanga province. The Copperbelt stretches along both sides of the border between Zambia and the D.R. Congo.
High human exposure to cobalt and other metals in Katanga, a mining area of the Democratic Republic of Congo. Banza et al, 2009
Control area (Kamina) (n=40)
Residential areas 3–10 km from mining and refining (n=132)
Residential areas <3 km from mining and refining (n=179)
OverallpReference values according to NHANESa
Aluminum (Al) 3.96 (2.21–7.92) [25%] 15.8 (7.29–29.2)b [3%]
12.4 (6.05–20.7)b [2%] <0.0001
Antimony (Sb) 0.04 (0.02–0.09) [18%] 0.09 (0.04–0.14)b [2%]
0.07 (0.04–0.10)b [1%] 0.015 0.13 (0.17)d
Arsenicc (As) 3.15 (1.99–4.64) 10.8 (5.13–26.0)b 17.8 (10.9–29.0)b,e <0.0001 8.24 (14.1)f
Cadmium (Cd) 0.18 (0.14–0.27) 0.70 (0.40–0.11)b 0.75 (0.38–1.16)b <0.0001 0.20 (0.40)d
Chrome (Cr) 0.09 (0.06–0.12) [3%] 0.14 (0.09–0.21)b [7%]
0.17 (0.10–0.24)b,e [2%] <0.0001 0.12 (0.23)g
Cobalt (Co) 1.34 (0.74–2.19) 5.72 (3.25–9.14)b 15.7 (5.27–43.2)b,e <0.0001 0.36 (0.52)d
Copper (Cu) 5.89 (4.62–8.60) 12.8 (8.43–19.0)b 17.1 (8.44–28.2)b,e <0.0001Lead (Pb) 1.28 (0.93–2.01) 2.93 (1.64–4.95)b 3.17 (1.47–5.49)b <0.0001 0.64 (1.11)d
Manganese (Mn) 0.07 (0.02–0.19) [38%] 0.40 (0.11–1.09)b [4%]
0.32 (0.05–1.87)b [11%] <0.0001 0.48 (1.16)g
Molybdenum (Mo) 52.7 (36.8–75.6) 84.5 (54.0–143.6)b 75.2 (46.8–126.7)b 0.009 42.5 (62.0)d
Nickel (Ni) 3.11 (2.05–4.41) 3.06 (2.01–4.95) 3.27 (1.90–4.87) 0.79Selenium (Se) 7.86 (6.31–9.43) 13.5 (10.9–17.1)b 17.4 (13.3–20.6)b,e <0.0001
Tellurium (Te) 0.08 (0.07–0.09) [5%] 0.10 (0.09–0.11)b [2%] 0.09 (0.07–0.12)b 0.08
Tin (Sn) 0.05 (0.02–0.10) [25%] 0.06 (0.03–0.11)b [27%]
0.08 (0.04–0.16)b,e [15%] 0.004
Uranium (U) 0.003 (0.002–0.005) [83%]
0.018 (0.010–0.029)b [5%]
0.028 (0.013–0.065)b,e [6%] <0.0001 0.008 (0.014)d
Vanadium (V) 0.09 (0.06–0.13) [42%] 0.21 (0.13–0.33)b [7%]
0.22 (0.13–0.34)b [5%] <0.0001
Zinc (Zn) 224 (147–368) 312 (225–447)b 306 (199–473)b 0.049
Urinary metal concentrations (μg/g creatinine) in 351 residents of 11 areas in Katanga, grouped according to proximity to mining or metal refining operations.
Data are geometric means (25th–75th percentile). p-values adjusted by general linear models for sex, age (age and age squared), current smoking and occupational exposure. Values in square brackets [ ] indicate percentages of samples below the limit of detection.
Compared with background values from the US general population, subjects living very close to areas of mining or refining had urinary concentrations that were 4-fold(Cd), 43-fold(Co), 5-fold(Pb), 4-fold (U) higher
This first biomonitoring study of metal exposure in the African Copperbelt reveals a substantial exposure to several metals, especially in children.
The urinary Co concentrations found in this population are the highest ever reported for a general population.
Need for background values, importance of NHANES data
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Lack of clear processes for translation into policy
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EU data could be further exploited
Generated data are not comparable
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The European Commission‘s Environment and Health ActionPlan 2004 – 2010, Action 3
Development of a coherent approach to Human Biomonitoring (HBM) in Europe, in close cooperation with the Member States
more effective use of resources by shared development of tools and strategies
more meaningful results of national surveys as the number of study subjects involved becomes larger
• Need for translation into policy• Need for adapted communication strategies
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Reaction on policy demand:
35 partners coming from 27 European countries
COnsortium to Perform Human biomonitoring on a European Scale
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PILOT STUDY
“test the hypothesis that HBM can be performed in a coherent and harmonised approach throughout Europe by means of commonly developed protocols, strategies and scientific tools ensuring reliable and comparable data, whilst also leading to a more effective use of resources”.
cadmium, phthalates, cotinine in urinemercury in hairchildren (6-11) and their mothersat least 3600 study subjects
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What to expect?
a EU infrastructure and common approach tested in 16 MS
basic data on the distribution of specific biomarkers among defined/selected study population comparable at a EU scale
step toward European reference values
assessment of costs benefit of EU approach
LEARNING BY DOING
Re-sourc
eAdded value
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CHALLENGE 1: FUNDING
COPHES DEMOCOPHES
Two projects working together
cadmium, phthalates, cotinine in urinemercury in hairchildren and their mothersat least 3600 study subjects
provides frameworkprovides guidanceanalyses results on a EU levelrecommendations & conlusions
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CHALLENGE 2: DECISION MAKING
EU MS with differences in •culture•religion •language•environmental health concerns•ethical concerns•technical capacities•….
• Several disiciplines• Distinct techical language and
understanding
WHO DECIDES?
DECISION MAKINGPROCESSES
Concertation between MS and Commission regardingsubsidiarity sharing of responsibilities accountability towards citizens
“ Reduce, Reuse, Recycle”.
• Reduce, Reuse, Recycle” has shaped a generation of behaviors about environmental concerns..
• The same thinking can be used to shape our understanding about ways of reducing the costs and burdens of data collection, increasing the value of research, and maximizing the benefits for everyone involved in the research process.
Ethical concern: human samples are precious
Optimal (re)use of samplesto improve public healththrough translation of results into preventive actions
CHALLENGE 3: TRANSNATIONAL USE OF SAMPLES AND DATA
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CHALLENGE 4:PARTICIPATORY APPROACHES
Autonomy,BeneficenceNon-maleficenceJustice
the Georgetown Paradigm
Social justiceSolidarityDemocratic participation
PUBLIC HEALTH CONTEXT
CONSENSUS CONFERENCE December 11, 2006
“ Government by the people and for the people.’
Boston University School of Public Health
www.biomonitoring06.org
i. problem confirmation
ii. cause characterisation
iii. (environmental) source detection
iv. proposals for problem solving action
Every step is followed by a public communication moment.
Experts and stakeholders are involved
Need for environmental public health action identified in four steps
[email protected] [email protected]@lne. vlaanderen.be
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CHALLENGE 5: COMMUNICATION
• Clear messages• Timely• Adapted to target audience
• Uncertainty• Time delay due to analysis• Multiple targets
The mere fact of measuring and the results produced may enhance preventive actions to improve environmental health at individual and collective level if accompanied by a good communication strategy
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Tools to be developedASAP
• A decision making structure with mandated MS representatives and EU authorities.
• An advisory group of EU experts providing recommendations
• A transparent process to defineEU HBM reference and health based values
• A dedicated funding for long-lasting programmes
• Legal instruments or policies that integrate capacities, competences skills, and infrastructure
AFTER THE PILOT STUDY
• At short-term – To design the outline of a
more global EU programme• At mid-term
– To collaborate with otherexisting/in development surveys (EHES, INSPIRE)
• At long-term– To assure the continuity of a
EU HBM programme as a policy tool.
EH Process at EU level
Health programme
Environment7EnvAP
ResearchFP7‐FP8
JRC work programme
HUMAN BIOMONITORING
ECDC
EFSA
ECHA
EEA
CONSULTATIVE FORUM
Sc Com
EHES
INSPIRE
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Alexandra PolcherBiPRO GmbH, Munich, [email protected]
Pierre BiotFPS Health, Food Chain safety and Environment, Brussels, [email protected]
Reinhard JoasBiPRO GmbH, Munich, [email protected]
Ludwine CasteleynKatholieke Universiteit, Leuven, [email protected]
HBM
Thank you for your attention!
www.eu‐hbm.info