HBM4EU feasibility studies: Lessons learned in combining health and human biomonitoring studies

Hanna Maria Elonheimo; Karoliina Uusitalo; Sonja Moore; Anna Maria Andersson; Ronny Baber; Kerstin Wirkner; Madlen David; Marike Kolossa-Gehring; Lorraine Stewart; Ovnair Sepai; Dominik Lermen; Martina Bartel-Steinbach; Panu Rantakokko; Jani Koponen; Hanna Tolonen

doi:10.1016/j.ijheh.2022.114100

HBM4EU feasibility studies: Lessons learned in combining health and human biomonitoring studies

Hanna Maria Elonheimo^*, Karoliina Uusitalo, Sonja Moore, Anna Maria Andersson, Ronny Baber, Kerstin Wirkner, Madlen David, Marike Kolossa-Gehring, Lorraine Stewart, Ovnair Sepai, Dominik Lermen, Martina Bartel-Steinbach, Panu Rantakokko, Jani Koponen, Hanna Tolonen

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

31 Downloads (Pure)

Abstract

Background: The European Human Biomonitoring Initiative (HBM4EU) is a joint program evaluating humans’ exposure to several environmental substances and their potential health effects. One of the main objectives of HBM4EU is to make use of human biomonitoring (HBM) to assess human exposure to chemicals in Europe to better understand the associated health impacts and to improve chemical risk assessment. In parallel to HBM studies, health examination surveys (HESs), nutrition/dietary surveys, and disease specific health surveys are conducted in many European countries. In HESs, information collected by questionnaire(s) is supplemented with physical examinations and analysis of clinical and biological biomarkers in biological samples. HBM and health examination survey (HES) use similar data collection methods and infrastructures hence the feasibility of combining these two is explored in this paper.

Methods: Within HBM4EU, three feasibility studies (in Finland, Germany, and UK/England) were conducted to evaluate opportunities and obstacles of combining HBM and health studies. In this paper we report lessons learned from these feasibility studies.

Results: The Finnish feasibility study called KouBio-KUOPIO study was a new initiative without links to existing studies. The German feasibility study added a HBM module to the first follow-up examination of the LIFE-Adult-Study, a population-based cohort study. The UK feasibility integrates a sustainable HBM module into the Health Survey for England (HSfE), an annual health examination survey. Benefits of combining HBM and HESs include the use of shared infrastructures. Furthermore, participants can receive additional health information from HES, and participation rates tend to be higher due to the potential to obtain personal health information. Preparatory phases including obtaining ethical approval can be time-consuming and complicated. Recruitment of participants and low participation rates are common concerns in survey research and therefore designing user-friendly questionnaires with low participant burden is important. Unexpected events such as the COVID-19 pandemic can cause substantial challenges and delays for such studies. Furthermore, experiences from several countries demonstrated that long-term funding for combined studies can be difficult to obtain.

Conclusions: In the future, incorporating HBM modules into existing HESs can provide a feasible and cost-effective method to conduct HBM studies and obtain a wide range of relevant data to support public health policies and research.

Original language	English
Article number	114100
Journal	International Journal of Hygiene and Environmental Health
Volume	248
Early online date	9 Dec 2022
DOIs	https://doi.org/10.1016/j.ijheh.2022.114100
Publication status	Published - Mar 2023

Bibliographical note

Funding Information: HBM4EU has received funding from EU/Horizon 2020 Programme Contract No. 733032 HBM4EU.
The LIFE-Adult-Study was supported by Leipzig Research Centre for Civilization Diseases ( LIFE ), an organizational unit affiliated with the Medical Faculty of the University of Leipzig, Germany. LIFE is funded by means of the European Union , by the European Regional Development Fund ( ERDF ) and by funds of the Free State of Saxony within the framework of the excellence initiative (project numbers 713–241202 , 713–241202 , 14505/2470 , 14575/2470 ). We wish to thank the residents of the City of Leipzig for their willingness to participate in the study. We also thank the team of the LIFE-Adult-Study centre for their skilful technical assistance.
HSfE is commissioned by NHS Digital and carried out by the Joint Health Surveys Unit of National Centre for Social Research (NatCen) in collaboration with the Research Department of Epidemiology and Public Health at University College London (UCL). The study is supported by colleagues from NatCen and NHS Digital. The HBM module is funded by the National Institute for Health Research (NIHR) Health Protection Research Unit in Environmental Exposures and Health, a partnership between UKHSA and Imperial College London . The views expressed are those of the authors and not necessarily those of the NIHR, UKHSA or the Department of Health and Social Care.

Open Access: This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

Publisher Copyright: © 2022 The Authors. Published by Elsevier GmbH.

Citation: Hanna Maria Elonheimo, Karoliina Uusitalo, Sonja Moore, Anna-Maria Andersson, Ronny Baber, Kerstin Wirkner, Madlen David, Marike Kolossa-Gehring, Lorraine Stewart, Ovnair Sepai, Dominik Lermen, Martina Bartel-Steinbach, Panu Rantakokko, Jani Koponen, Hanna Tolonen, HBM4EU feasibility studies: Lessons learned in combining health and human biomonitoring studies, International Journal of Hygiene and Environmental Health, Volume 248, 2023, 114100, ISSN 1438-4639,

DOI: https://doi.org/10.1016/j.ijheh.2022.114100.

Keywords

Environmental chemicals
Environmental health
Feasibility studies
HBM4EU
Health examination surveys (HESs)
Human biomonitoring (HBM)

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.ijheh.2022.114100Licence: CC BY

Elonheimo2023HBM4EUFeasibilityStudiesLessonsLearnedInCombiningHealthAndHumanBiomonitoringStudiesIntJHygEnvironHealthFinal published version, 448 KBLicence: CC BY

Cite this

Elonheimo, H. M., Uusitalo, K., Moore, S., Andersson, A. M., Baber, R., Wirkner, K., David, M., Kolossa-Gehring, M., Stewart, L., Sepai, O., Lermen, D., Bartel-Steinbach, M., Rantakokko, P., Koponen, J., & Tolonen, H. (2023). HBM4EU feasibility studies: Lessons learned in combining health and human biomonitoring studies. International Journal of Hygiene and Environmental Health, 248, Article 114100. https://doi.org/10.1016/j.ijheh.2022.114100

@article{79504ba5d2a942b98050d8dce7e46ab8,

title = "HBM4EU feasibility studies: Lessons learned in combining health and human biomonitoring studies",

abstract = "Background: The European Human Biomonitoring Initiative (HBM4EU) is a joint program evaluating humans{\textquoteright} exposure to several environmental substances and their potential health effects. One of the main objectives of HBM4EU is to make use of human biomonitoring (HBM) to assess human exposure to chemicals in Europe to better understand the associated health impacts and to improve chemical risk assessment. In parallel to HBM studies, health examination surveys (HESs), nutrition/dietary surveys, and disease specific health surveys are conducted in many European countries. In HESs, information collected by questionnaire(s) is supplemented with physical examinations and analysis of clinical and biological biomarkers in biological samples. HBM and health examination survey (HES) use similar data collection methods and infrastructures hence the feasibility of combining these two is explored in this paper. Methods: Within HBM4EU, three feasibility studies (in Finland, Germany, and UK/England) were conducted to evaluate opportunities and obstacles of combining HBM and health studies. In this paper we report lessons learned from these feasibility studies. Results: The Finnish feasibility study called KouBio-KUOPIO study was a new initiative without links to existing studies. The German feasibility study added a HBM module to the first follow-up examination of the LIFE-Adult-Study, a population-based cohort study. The UK feasibility integrates a sustainable HBM module into the Health Survey for England (HSfE), an annual health examination survey. Benefits of combining HBM and HESs include the use of shared infrastructures. Furthermore, participants can receive additional health information from HES, and participation rates tend to be higher due to the potential to obtain personal health information. Preparatory phases including obtaining ethical approval can be time-consuming and complicated. Recruitment of participants and low participation rates are common concerns in survey research and therefore designing user-friendly questionnaires with low participant burden is important. Unexpected events such as the COVID-19 pandemic can cause substantial challenges and delays for such studies. Furthermore, experiences from several countries demonstrated that long-term funding for combined studies can be difficult to obtain. Conclusions: In the future, incorporating HBM modules into existing HESs can provide a feasible and cost-effective method to conduct HBM studies and obtain a wide range of relevant data to support public health policies and research.",

keywords = "Environmental chemicals, Environmental health, Feasibility studies, HBM4EU, Health examination surveys (HESs), Human biomonitoring (HBM)",

author = "Elonheimo, {Hanna Maria} and Karoliina Uusitalo and Sonja Moore and Andersson, {Anna Maria} and Ronny Baber and Kerstin Wirkner and Madlen David and Marike Kolossa-Gehring and Lorraine Stewart and Ovnair Sepai and Dominik Lermen and Martina Bartel-Steinbach and Panu Rantakokko and Jani Koponen and Hanna Tolonen",

note = "Funding Information: HBM4EU has received funding from EU/Horizon 2020 Programme Contract No. 733032 HBM4EU. The LIFE-Adult-Study was supported by Leipzig Research Centre for Civilization Diseases ( LIFE ), an organizational unit affiliated with the Medical Faculty of the University of Leipzig, Germany. LIFE is funded by means of the European Union , by the European Regional Development Fund ( ERDF ) and by funds of the Free State of Saxony within the framework of the excellence initiative (project numbers 713–241202 , 713–241202 , 14505/2470 , 14575/2470 ). We wish to thank the residents of the City of Leipzig for their willingness to participate in the study. We also thank the team of the LIFE-Adult-Study centre for their skilful technical assistance. HSfE is commissioned by NHS Digital and carried out by the Joint Health Surveys Unit of National Centre for Social Research (NatCen) in collaboration with the Research Department of Epidemiology and Public Health at University College London (UCL). The study is supported by colleagues from NatCen and NHS Digital. The HBM module is funded by the National Institute for Health Research (NIHR) Health Protection Research Unit in Environmental Exposures and Health, a partnership between UKHSA and Imperial College London . The views expressed are those of the authors and not necessarily those of the NIHR, UKHSA or the Department of Health and Social Care. Open Access: This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Publisher Copyright: {\textcopyright} 2022 The Authors. Published by Elsevier GmbH. Citation: Hanna Maria Elonheimo, Karoliina Uusitalo, Sonja Moore, Anna-Maria Andersson, Ronny Baber, Kerstin Wirkner, Madlen David, Marike Kolossa-Gehring, Lorraine Stewart, Ovnair Sepai, Dominik Lermen, Martina Bartel-Steinbach, Panu Rantakokko, Jani Koponen, Hanna Tolonen, HBM4EU feasibility studies: Lessons learned in combining health and human biomonitoring studies, International Journal of Hygiene and Environmental Health, Volume 248, 2023, 114100, ISSN 1438-4639, DOI: https://doi.org/10.1016/j.ijheh.2022.114100.",

year = "2023",

month = mar,

doi = "10.1016/j.ijheh.2022.114100",

language = "English",

volume = "248",

journal = "International Journal of Hygiene and Environmental Health",

issn = "1438-4639",

publisher = "Elsevier GmbH",

}

Elonheimo, HM, Uusitalo, K, Moore, S, Andersson, AM, Baber, R, Wirkner, K, David, M, Kolossa-Gehring, M, Stewart, L, Sepai, O, Lermen, D, Bartel-Steinbach, M, Rantakokko, P, Koponen, J & Tolonen, H 2023, 'HBM4EU feasibility studies: Lessons learned in combining health and human biomonitoring studies', International Journal of Hygiene and Environmental Health, vol. 248, 114100. https://doi.org/10.1016/j.ijheh.2022.114100

TY - JOUR

T1 - HBM4EU feasibility studies

T2 - Lessons learned in combining health and human biomonitoring studies

AU - Elonheimo, Hanna Maria

AU - Uusitalo, Karoliina

AU - Moore, Sonja

AU - Andersson, Anna Maria

AU - Baber, Ronny

AU - Wirkner, Kerstin

AU - David, Madlen

AU - Kolossa-Gehring, Marike

AU - Stewart, Lorraine

AU - Sepai, Ovnair

AU - Lermen, Dominik

AU - Bartel-Steinbach, Martina

AU - Rantakokko, Panu

AU - Koponen, Jani

AU - Tolonen, Hanna

N1 - Funding Information: HBM4EU has received funding from EU/Horizon 2020 Programme Contract No. 733032 HBM4EU. The LIFE-Adult-Study was supported by Leipzig Research Centre for Civilization Diseases ( LIFE ), an organizational unit affiliated with the Medical Faculty of the University of Leipzig, Germany. LIFE is funded by means of the European Union , by the European Regional Development Fund ( ERDF ) and by funds of the Free State of Saxony within the framework of the excellence initiative (project numbers 713–241202 , 713–241202 , 14505/2470 , 14575/2470 ). We wish to thank the residents of the City of Leipzig for their willingness to participate in the study. We also thank the team of the LIFE-Adult-Study centre for their skilful technical assistance. HSfE is commissioned by NHS Digital and carried out by the Joint Health Surveys Unit of National Centre for Social Research (NatCen) in collaboration with the Research Department of Epidemiology and Public Health at University College London (UCL). The study is supported by colleagues from NatCen and NHS Digital. The HBM module is funded by the National Institute for Health Research (NIHR) Health Protection Research Unit in Environmental Exposures and Health, a partnership between UKHSA and Imperial College London . The views expressed are those of the authors and not necessarily those of the NIHR, UKHSA or the Department of Health and Social Care. Open Access: This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Publisher Copyright: © 2022 The Authors. Published by Elsevier GmbH. Citation: Hanna Maria Elonheimo, Karoliina Uusitalo, Sonja Moore, Anna-Maria Andersson, Ronny Baber, Kerstin Wirkner, Madlen David, Marike Kolossa-Gehring, Lorraine Stewart, Ovnair Sepai, Dominik Lermen, Martina Bartel-Steinbach, Panu Rantakokko, Jani Koponen, Hanna Tolonen, HBM4EU feasibility studies: Lessons learned in combining health and human biomonitoring studies, International Journal of Hygiene and Environmental Health, Volume 248, 2023, 114100, ISSN 1438-4639, DOI: https://doi.org/10.1016/j.ijheh.2022.114100.

PY - 2023/3

Y1 - 2023/3

N2 - Background: The European Human Biomonitoring Initiative (HBM4EU) is a joint program evaluating humans’ exposure to several environmental substances and their potential health effects. One of the main objectives of HBM4EU is to make use of human biomonitoring (HBM) to assess human exposure to chemicals in Europe to better understand the associated health impacts and to improve chemical risk assessment. In parallel to HBM studies, health examination surveys (HESs), nutrition/dietary surveys, and disease specific health surveys are conducted in many European countries. In HESs, information collected by questionnaire(s) is supplemented with physical examinations and analysis of clinical and biological biomarkers in biological samples. HBM and health examination survey (HES) use similar data collection methods and infrastructures hence the feasibility of combining these two is explored in this paper. Methods: Within HBM4EU, three feasibility studies (in Finland, Germany, and UK/England) were conducted to evaluate opportunities and obstacles of combining HBM and health studies. In this paper we report lessons learned from these feasibility studies. Results: The Finnish feasibility study called KouBio-KUOPIO study was a new initiative without links to existing studies. The German feasibility study added a HBM module to the first follow-up examination of the LIFE-Adult-Study, a population-based cohort study. The UK feasibility integrates a sustainable HBM module into the Health Survey for England (HSfE), an annual health examination survey. Benefits of combining HBM and HESs include the use of shared infrastructures. Furthermore, participants can receive additional health information from HES, and participation rates tend to be higher due to the potential to obtain personal health information. Preparatory phases including obtaining ethical approval can be time-consuming and complicated. Recruitment of participants and low participation rates are common concerns in survey research and therefore designing user-friendly questionnaires with low participant burden is important. Unexpected events such as the COVID-19 pandemic can cause substantial challenges and delays for such studies. Furthermore, experiences from several countries demonstrated that long-term funding for combined studies can be difficult to obtain. Conclusions: In the future, incorporating HBM modules into existing HESs can provide a feasible and cost-effective method to conduct HBM studies and obtain a wide range of relevant data to support public health policies and research.

AB - Background: The European Human Biomonitoring Initiative (HBM4EU) is a joint program evaluating humans’ exposure to several environmental substances and their potential health effects. One of the main objectives of HBM4EU is to make use of human biomonitoring (HBM) to assess human exposure to chemicals in Europe to better understand the associated health impacts and to improve chemical risk assessment. In parallel to HBM studies, health examination surveys (HESs), nutrition/dietary surveys, and disease specific health surveys are conducted in many European countries. In HESs, information collected by questionnaire(s) is supplemented with physical examinations and analysis of clinical and biological biomarkers in biological samples. HBM and health examination survey (HES) use similar data collection methods and infrastructures hence the feasibility of combining these two is explored in this paper. Methods: Within HBM4EU, three feasibility studies (in Finland, Germany, and UK/England) were conducted to evaluate opportunities and obstacles of combining HBM and health studies. In this paper we report lessons learned from these feasibility studies. Results: The Finnish feasibility study called KouBio-KUOPIO study was a new initiative without links to existing studies. The German feasibility study added a HBM module to the first follow-up examination of the LIFE-Adult-Study, a population-based cohort study. The UK feasibility integrates a sustainable HBM module into the Health Survey for England (HSfE), an annual health examination survey. Benefits of combining HBM and HESs include the use of shared infrastructures. Furthermore, participants can receive additional health information from HES, and participation rates tend to be higher due to the potential to obtain personal health information. Preparatory phases including obtaining ethical approval can be time-consuming and complicated. Recruitment of participants and low participation rates are common concerns in survey research and therefore designing user-friendly questionnaires with low participant burden is important. Unexpected events such as the COVID-19 pandemic can cause substantial challenges and delays for such studies. Furthermore, experiences from several countries demonstrated that long-term funding for combined studies can be difficult to obtain. Conclusions: In the future, incorporating HBM modules into existing HESs can provide a feasible and cost-effective method to conduct HBM studies and obtain a wide range of relevant data to support public health policies and research.

KW - Environmental chemicals

KW - Environmental health

KW - Feasibility studies

KW - HBM4EU

KW - Health examination surveys (HESs)

KW - Human biomonitoring (HBM)

UR - http://www.scopus.com/inward/record.url?scp=85143980386&partnerID=8YFLogxK

U2 - 10.1016/j.ijheh.2022.114100

DO - 10.1016/j.ijheh.2022.114100

M3 - Article

AN - SCOPUS:85143980386

SN - 1438-4639

VL - 248

JO - International Journal of Hygiene and Environmental Health

JF - International Journal of Hygiene and Environmental Health

M1 - 114100

ER -

HBM4EU feasibility studies: Lessons learned in combining health and human biomonitoring studies

Abstract

Bibliographical note

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this