Environmental exposure: key biomonitoring and exposure studies conducted by Santé publique France
Here you will find the main exposure and biomonitoring studies conducted, along with their results.
For more than 20 years, Santé publique France has been conducting biomonitoring studies. We have developed large-scale studies that combine exposure measurements with the collection of health data, as well as large-scale exposure studies targeting vulnerable populations or regions.
Studies from the National Biomonitoring Program
The National Nutrition and Health Survey (ENNS 2006–2007)
Objectives: to describe dietary intake, nutritional status, and physical activity among the general population in France (adults and children) and to study nutritional and environmental biomarkers.
ENNS measured exposure levels of various metals (including lead, cadmium, mercury, and arsenic) and pesticides (organophosphates, organochlorines, and pyrethroids) in the blood, urine, and hair of the French population. A total of 2,102 adults (aged 18 to 74) participated in the “biomonitoring” component of this study (participation rate ~40%).
Today, this program comprises two population-based components: pregnant women (the Elfe cohort) and the general adult and child population (the Esteban study).
Elfe Cohort (among pregnant women)
The perinatal component of the national biomonitoring program used data from the Elfe cohort (2011), which follows 18,000 children over 20 years to characterize the relationship between the environment and children’s development, health, and socialization. Exposure measurements were conducted on a sample of 4,145 pregnant women who gave birth in 2011 in metropolitan France. These measurements provided the first nationwide description of the exposure of French pregnant women to metals (lead, arsenic, cadmium, mercury, etc.) and organic pollutants (phthalates, bisphenol A, pesticides, perfluorinated compounds, dioxins, PCBs, brominated flame retardants).
The Esteban Study (among the general adult and child population)
Esteban (2014–2016) is a cross-sectional study on health, the environment, biomonitoring, physical activity, and nutrition. It is the second component of the national biomonitoring program. This study aims to monitor chemical exposures as well as chronic diseases and nutrition among the general population aged 6 to 74 years residing in mainland France during the 2014–2016 period.
A total of 2,503 adults (aged 18 to 74) and 1,104 children (aged 6 to 17) were included. The biomarkers analyzed include phthalates, bisphenols, brominated flame retardants, glycol ethers, parabens, PCBs, perfluorinated compounds, dioxins and furans, mycotoxins, metals and trace elements (As, Cu, Hg, Pb, Cd, Cr, Co, Mn, Ni, Zn, Se…), and certain pesticides. A biological sample bank (serum, plasma, urine, hair, and whole blood) for the long-term storage of samples at -80°C is available for transfer.
By the end of 2021, all results from the national biomonitoring program will be available. They will complement the results already published on the perinatal component and the initial results published on exposure to everyday products from the Esteban study. They will also enable a description of changes in exposure to certain metals and pesticides among the French population aged 18 to 74 between 2006–2007 and 2014–2016, based on the results of the ENNS study.
Learn more about the results of the PNBS studies
Perinatal component
Exposure to everyday products component of the Esteban study
Exposure of the French population to phthalates: National Biomonitoring Program, Esteban 2014-2016
Exposure of the French population to parabens: National Biomonitoring Program, Esteban 2014-2016
Metal exposure component of the Esteban study
Exposure of the French population to herbicides. National Biomonitoring Program, Esteban 2014-2016.
Exposure of the French population to pyrethroids. National Biomonitoring Program, Esteban 2014-2016.
Exposure of the French population to carbamates. National Biomonitoring Program, Esteban 2014-2016.
Exposure of the French population to copper. National Biomonitoring Program, Esteban 2014-2016.
Exposure of the French population to arsenic. National Biomonitoring Program, Esteban 2014-2016.
Cadmium exposure in the French population. National Biomonitoring Program, Esteban 2014-2016.
Mercury exposure in the French population. National Biomonitoring Program, Esteban 2014–2016.
Nickel exposure in the French population. National Biomonitoring Program, Esteban 2014-2016.
Metals and Chemical Exposure Component of the ENNS Study
| Biomarkers measured in the various studies of the national biomonitoring program | |||
|---|---|---|---|
| Study name | ENNS | Elfe | Esteban |
| Study period | 2006–2007 | 2011 | 2014–2016 |
| Type of population | General population (ages 18–74) | pregnant women | General population (ages 6–74) |
| Biomarker chemical group | |||
| Bisphenols | X | X | |
| BTEX-Styrene | X | ||
| Perfluorinated compounds (PFCs) | X | X | |
| Cotinine (nicotine metabolite) | X | ||
| Dioxins, furans | X | X | |
| Glycol ethers | X | ||
| Polycyclic Aromatic Hydrocarbons (PAHs) (metabolites) | X | ||
| Metals, metalloids, and trace elements | X | X | X |
| Mycotoxins | X | ||
| Organotin compounds | X | ||
| Parabens | X | ||
| Pesticides - Pyrethroids (metabolites) | X | X | X |
| Pesticides - Organochlorines - Chlorophenols | X | X | X |
| Pesticides - Organophosphates - Dialkyl phosphates | X | X | X |
| Pesticides - Herbicides | X | X | |
| Pesticides - Carbamates | X | X | |
| Pesticides - Miscellaneous | X | ||
| Phthalates | X | X | |
| Dioxin-like polychlorinated biphenyls (PCB-DL) | X | X | |
| Non-dioxin-like polychlorinated biphenyls (PCB-NDL) | X | X | X |
| Brominated flame retardants (BFRs) | X | X | |
Studies Focused on Vulnerable Populations
In addition to the national biomonitoring program, Santé publique France has also developed exposure studies to address specific or local issues:
Objectives:
To estimate the prevalence of lead poisoning (blood lead levels of 100 µg/L or higher) among children aged 6 months to 6 years in France in 2008–2009
to describe the levels of lead exposure among children in each region
to assess the contribution of risk factors to blood lead levels
This cross-sectional survey was conducted in a hospital setting. It included 3,831 children. Each child’s blood lead level was measured.
Objectives:
to determine whether populations living near municipal solid waste incineration plants (MSWIPs) were more exposed than those living farther away
to assess the contribution of locally produced food to this exposure
to study lead and cadmium exposure in these populations
Incinerators also release these metals into the environment. This multicenter study involved eight sites near MSWIs spread across several departments in France. It included 1,053 adults aged 30 to 65 in 2005.
Given the contamination of several waterways with PCBs and the fact that maximum permissible levels have been exceeded in certain areas for several species of freshwater fish, ANSES was tasked in 2008 with conducting, in collaboration with Santé publique France, a study on PCB exposure among consumers of freshwater fish.
Objectives: to identify the predominant determinants of serum PCB exposure and, in particular, to investigate the existence of a possible link between the consumption of highly bioaccumulative freshwater fish and exposure. This study was thus intended to help define acceptable frequencies of consumption of these fish, i.e., without long-term risk to humans.
A total of 606 recreational fishermen or members of their households and 16 commercial fishermen were included in the study. For each participant, dietary habits, as well as fishing practices and freshwater fish consumption patterns, were recorded. At the same time, a blood sample was collected to determine PCB exposure levels.
Learn more: https://www.anses.fr/
The aim of these studies, each of which involved several hundred people, was to investigate the exposure of communities living near former mining sites to soil contamination by heavy metals.
Learn more:
Agricultural activities in the Caribbean, particularly banana cultivation, are known for their heavy use of pesticides. The same is true of chlordecone, which was used between 1972 and 1993 to control the banana root weevil.
The Kannari study was launched in 2013–2014 to expand knowledge on population exposure to chlordecone and other organochlorine pollutants. The data collected included a description of dietary intake, biological sample data (blood samples), socioeconomic and demographic information, as well as specific additional data related to lifestyle habits.
A total of 742 individuals (292 in Guadeloupe and 450 in Martinique) were included in the study.
The PestiRiv study is the first initiative in mainland France to assess pesticide exposure among people living near vineyards and those living far from any agricultural land, taking into account all sources of exposure: air, food, occupational activities, and household uses.
The results of this study will reveal whether certain individuals are more exposed to these substances than others and identify the sources that contribute most to exposure, in order to make recommendations for reducing it. This study is funded under the Ecophyto II+ plan and will be launched in late 2021 in six regions: Auvergne-Rhône-Alpes, Bourgogne-Franche-Comté, Grand Est, Nouvelle-Aquitaine, Occitanie, and Provence-Alpes-Côte d’Azur.
European Projects
The European HBM4EU project (2017–2021)
HBM4EU – Human Biomonitoring for Europe is a joint effort involving 30 countries, the European Environment Agency, and the European Commission, co-funded under the Horizon 2020 research framework program (2014–2020). HBM4EU coordinates and advances human biomonitoring in Europe to provide better evidence of citizens’ actual exposure to chemicals. Santé publique France has contributed to six work packages within HBM4EU. Within these groups, we have:
led the definition of new selection criteria for the best biomarker/matrix pairs,
contributed, within the statistics working group (with UBA, VITO, and ISGlobal), to drafting the Statistical Analysis Plan (SAP) and developing the European strategy for deriving new reference values,
conducted two research protocols on bisphenol A and pyrethroids, comprising approximately 25 European biomonitoring studies,
provided data from the Esteban study and new biological samples across three different age groups to ensure consistent European data,
contributed to the development of new SOPs (Standard Operating Procedures) for health measurements in children and shared our expertise on the benefits of integrating health surveys with human biomonitoring studies,
supported ANSES in the prioritization process for the second cycle of chemical substances.
The PARC Project (2022–2030): Future European Project on Chemical Risk Assessment
The PARC partnership builds notably on the work undertaken and experience gained under the HBM4EU program. It aims to establish a European center of excellence for research and innovation and seeks to strengthen European capacity in the assessment of risks associated with chemicals. Impacts related to the specific objectives are expected at three levels through:
A sustainable, EU-wide interdisciplinary network to identify and agree on research and innovation needs, and to support the incorporation of conceptual, scientific, and technical advances from research into the regulatory risk assessment of chemicals.
Joint research and innovation activities addressing defined priorities to support current regulatory risk assessment processes for chemicals as well as new challenges.
Strengthening existing capacities and creating new transdisciplinary research and innovation platforms at the EU level to support chemical risk assessment.
Articles published in international journals
Dereumeaux C, Fillol C, Denys S, Quenel P. Pesticide exposures for residents living close to agricultural lands: a review. Environ Int., 2020 Jan; 134:105210.
Dereumeaux C, Saoudi A, Guldner L, Pecheux M, Chesneau J, Thomé JP, Ledrans M, Tertre AL, Denys S, Fillol C. Chlordecone and organochlorine compound levels in the French West Indies population in 2013–2014. Environ Sci Pollut Res Int. 2019 Dec 28.
Saoudi A, Dereumeaux C, Goria S, Berat B, Brunel S, Pecheux M, de Crouy-Chanel P, Zeghnoun A, Rambaud L, Wagner V, le Tertre A, Fillol C, Vandentorren S, Guldner L. Prenatal exposure to lead in France: Cord-blood levels and associated factors: Results from the perinatal component of the French Longitudinal Study since Childhood (Elfe). Int J Hyg Environ Health. 2018 Apr; 221(3):441-450.
Dereumeaux C, Saoudi A, Goria S, Wagner V, De Crouy-Chanel P, Pecheux M, Berat B, Zaros C, Guldner L. Urinary levels of pyrethroid pesticides and determinants in pregnant French women from the Elfe cohort. Environ Int. 2018 Oct;119:89-99.
Dereumeaux C, Saoudi A, Pecheux M, Berat B, de Crouy-Chanel P, Zaros C, Brunel S, Delamaire C, le Tertre A, Lefranc A, Vandentorren S, Guldner L. Biomarkers of exposure to environmental contaminants in French pregnant women from the Elfe cohort in 2011. Environ Int. 2016 Dec; 97: 56-67.
Etchevers A, Le Tertre A, Lucas JP, Bretin P, Oulhote Y, Le Bot B, Glorennec P. Environmental determinants of different blood lead levels in children: a quantile analysis from a nationwide survey. Environ Int, 2015 Jan;74:152-9.
Etchevers A, Glorennec P, Le Strat Y, Lecoffre C, Bretin P, Le Tertre A. Screening for Elevated Blood Lead Levels in Children: Assessment of Criteria and a Proposal for New Ones in France. Int J Environ Res Public Health, 2015 Dec 3;12(12):15366-78.
Etchevers A, Bretin P, Lecoffre C, Bidondo ML, Le Strat Y, Glorennec P, Le Tertre A. Blood lead levels and risk factors in young children in France, 2008-2009. Int J Hyg Environ Health, Apr-May 2014; 217(4-5): 528-37.
Denys S, Fraize-Frontier S, Moussa O, Le Bizec B, Veyrand B, Volatier JL. Is the consumption of freshwater fish a significant determinant of internal exposure to perfluoroalkylated substances (PFAS)? Toxicol Lett. 2014 Dec 1;231(2):233-8.
Saoudi A, Fréry N, Zeghnoun A, Bidondo ML, Deschamps V, Göen T, Garnier R, Guldner L. Serum levels of organochlorine pesticides in the French adult population: the French National Nutrition and Health Study (ENNS), 2006-2007. Sci Total Environ. 2014 Feb 15;472:1089-99.
Fillol C, Dor F, Denys S, Tack K, Labat L, Seta N. Urinary arsenic concentrations in children living in a naturally arsenic-contaminated area. J Expo Sci Environ Epidemiol. 2013 Mar; 23(2):145-50.
Saoudi A, Zeghnoun A, Bidondo ML, Garnier R, Cirimele V, Persoons R, Fréry N. Urinary arsenic levels in the French adult population: the French National Nutrition and Health Study, 2006-2007. Sci Total Environ. 2012 Sep 1; 433:206-15.
Falq G, Zeghnoun A, Pascal M, Vernay M, Le Strat Y, Garnier R, Olichon D, Bretin P, Castetbon K, Fréry N. Blood lead levels in the adult population living in France: the French Nutrition and Health Survey (ENNS 2006–2007). Environ Int. 2011 Apr; 37(3):565–71.
Oleko A, Betsou F, Sarter H, Gerdil C, Desbois I, Charles MA, Leridon H, Vandentorren S. A Pilot Study of the ELFE Longitudinal Cohort: Feasibility and Preliminary Evaluation of Biological Collection. Biopreserv Biobank. 2011 Sep;9(3):223-227.
