Creation and Implementation of the National Biomonitoring Program (PNBS)

In France, the National Biomonitoring Program stems from Commitment No. 139 of the Grenelle Environment Forum. The Grenelle I Programming Act relating to the implementation of the Grenelle Environment Forum (Act No. 2009-967 of August 3, 2009) incorporated the PNBS into Action No. 43 of the Second National Health and Environment Plan (PNSE2, 2009–2013) and entrusted the ministries responsible for Health and the Environment with the administrative oversight of a “multi-year biomonitoring program for the French population coupled with a broader health survey and including the measurement of emerging pollutants.” The technical management of this work was entrusted to Santé publique France. The PNBS was re-included in the PNSE3 (2015–2019) through Action 28: “analysis of data generated under this program.”

Progress on the biomonitoring program is also tracked in the National Strategy on Endocrine Disruptors (SNPE 1 and 2).

Objectives

The objectives of the PNBS are to generate biomonitoring data in order to:

• Describe the levels of exposure of the population (general population, workers, children, pregnant women, etc.) to environmental pollutants based on biological samples (blood, urine, hair, umbilical cord blood, etc.).

• Compare current exposure levels with those from previous studies conducted in France and/or abroad to identify potential overexposure.

• Identify and quantify the determinants of exposure levels (exposure pathways such as diet, place of residence, leisure activities, lifestyle habits, type of occupational activity, etc.).

• Establish exposure reference values (ERVs) for the populations studied: pregnant women, children, adults, and possibly by age group and gender.

What is the purpose of the data collected?

The use of biomonitoring data should help guide public policy and define actions aimed at reducing exposures that are of concern for public health.

Conducting biomonitoring surveys over time helps identify new sources of exposure and track changes in body burden levels of known substances in order to assess the effectiveness of measures implemented to reduce exposure.

Implementation Guidelines for the National Biomonitoring Program

As part of PNSE 2 and 3

Between May 2009 and March 2010, a steering committee, led by Santé publique France, was established to prepare for the operational implementation of the PNBS, comprising two components:

• a component monitoring the exposure of mothers and their newborns through the perinatal biomonitoring component implemented within the ELFE cohort (French Longitudinal Study from Childhood) in 2011,

• a component monitoring exposure levels in the general population conducted through the national cross-sectional Esteban study (Study of Health, Environment, Biomonitoring, Physical Activity, and Nutrition) in 2014–2016.

As part of the PNSE3 (2015–2019), the PNBS focused on the challenges of understanding exposures, their health effects, and the levers for action to reduce them. A major part of the PNBS therefore aimed to establish links between environmental contamination, exposure biomarkers, and health data.

The implementation of the PNBS was overseen by the steering committee established in 2009, and its scientific direction by a scientific advisory board composed of experts in metrology, exposimetry, toxicology, epidemiology, and statistics.

Continuation of the National Biomonitoring Program

On October 23, 2018, Santé publique France was tasked by the ministries responsible for Health, the Environment, Labor, Research, and Agriculture with defining the terms for continuing the national biomonitoring program. This mandate affirmed the need to continue and renew the PNBS in order to incorporate new objectives.

In its response dated January 8, 2020, Santé publique France proposed several scenarios, the new terms of which should enable the production of future actionable biomonitoring data in order to:

• define exposure prevention measures for the general population and vulnerable population subgroups

• support etiological research in environmental health or occupational health

• inform expertise in health risk assessment, particularly in the development of health guideline values

• develop biomonitoring in the workplace

Discussions on the development of the new PNBS procedures will be organized throughout 2021, drawing on a number of external contributors to Santé publique France with expertise in the use of biomonitoring data: ANSES, LERES-EHESP, IRSET, INSERM, INRS, INERIS, INMA, and Health Canada. The goal is to begin operational implementation of the new components of the PNBS starting in January 2023.

Partnerships

As the lead agency for France’s biomonitoring program, Santé publique France has established the national network of expertise in the field of biomonitoring. In this context, we collaborate with numerous national and international partners to develop innovative initiatives and participate in several projects as France’s representative in this field.

Toward a national data analytics platform

In particular, in the field of biometrology, Santé publique France has been working for several years according to well-established quality criteria with numerous laboratories in France: Leres, Laberca, Labocea, Chemtox, LEA Vendée, Labeo… and internationally: INSPQ (Quebec). The aim of this work is to develop and support a national analytical platform and the development of innovative methods, such as non-targeted analyses, new exposure biomarkers, and effect biomarkers, in order to explore the link between exposure and health effects. Santé publique France has also advised and contributed to ANSES’s expertise in developing several health-based guideline values.

At the international level

• Member of the ESBIO project (Expert Support for Biomonitoring), funded under the “Life Sciences, Genomics, and Biotechnology for Health” priority of the Sixth Framework Program. This project brought together 22 experts from 18 EU member states, with the ultimate goal of improving the availability and comparability of human biomonitoring data within and between European countries.

• Organization of the European Conference on Human Biomonitoring (Paris, November 4–5, 2008) under the auspices of the French EU Presidency. This conference highlighted human biomonitoring programs and activities in the EU and beyond (the United States and Canada) and their added value in supporting public health policies, interventions, and research (see BEH in French and English).

• Member of the Consortium for Human Biomonitoring at the European Level (Cophes) and associate partner in the feasibility study (Democophes) 2009–2012.

• Participation in the second international conference on human biomonitoring in Berlin in 2016.

• Third party (linked to Inserm) in the European HBM4EU project (2015–2021). HBM4EU is a joint effort by 30 countries, the European Environment Agency, and the European Commission, co-funded under Horizon 2020. HBM4EU coordinates and advances human biomonitoring in Europe to provide better evidence of citizens’ actual exposure to chemicals.

• Interim co-leader of a work package on exposure monitoring in the future European project on chemical risk assessment (PARC). ANSES, the partnership coordinator, and its partners, including Santé publique France, are collaborating with more than thirty expert and research institutions across Europe to prepare the strategy and work program to be submitted to the European Commission in 2021 as part of the European Union’s next framework program for research and innovation, “Horizon Europe ” (2021–2027).

• Member of the International Biomonitoring Network, whose secretariat is provided by Health Canada.