COLLEGIUM RAMAZZINI ANNUAL RAMAZZINI DAYS 2010 22-24 ... · Katanga, grouped according to proximity...

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(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 RAMAZZINI ANNUAL RAMAZZINI DAYS 2010 22-24 OCTOBER CARPI - ITALY

Transcript of COLLEGIUM RAMAZZINI ANNUAL RAMAZZINI DAYS 2010 22-24 ... · Katanga, grouped according to proximity...

Page 1: COLLEGIUM RAMAZZINI ANNUAL RAMAZZINI DAYS 2010 22-24 ... · Katanga, grouped according to proximity to mining or metal refining operations. Data are geometric means (25th–75th percentile).

(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

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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

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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.

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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

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WHO DECIDES?

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DECISION MAKINGPROCESSES

Concertation between MS and Commission regardingsubsidiarity sharing of responsibilities accountability towards citizens

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“ 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

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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.

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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