Guidelines for biomarkers of exposure for Health and Environment-wide Associations based on Large population Surveys (HEALS)

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Abstract

Introduction: HEALS (online access: www.heals-eu.eu) aims to refine an integrated approach to perform environment-wide association studies (EWAS) to explain the exposome for an improved understanding of the links between the genome, and disease. HEALS is at present the largest EU project on this issue. Guidelines for biomarkers of exposure (BoE) were developed to characterize internal exposures in EWAS. Methods: Fact sheets about the human biomonitoring (HBM) of selected environmental stressors were provided using >800 references in an expert-driven, distributed, narrative review process. Information regarding chemistry, effects on biological systems, exposure routes, absorption, elimination, reference values and specimens for analysis were collected. Chemical, physical, biological, social and psychological stressors were included to fulfil the requirements of EWAS. Results: Fact sheets for 56 stressors were created. While BoE are available for stressor groups like chemicals (metals, organic contaminants, mixtures, etc.), others, including electromagnetic fields, noise or UV light, do not leave any measurable substance in accessible body specimens. Some stressors cannot be measured directly but their metabolites can be analysed. The relative importance of the considered stressors was determined by a list of priorities based on science based evidence. Conclusions: In an extensive review considering various kinds of environmental stressors, strength and limitations regarding the identification of internal exposures using HBM were identified. Identifying research gaps about BoE and summarizing evidence about the importance of these stressors improves the basis for policy-making to safe human health. This work has received funding from the European Union?s Seventh Programme for research, technological development and demonstration under grant agreement No 603946 (Health and Environment-wide Associations based on Large population Surveys, HEALS).

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