The identifcation of human co-exposure to industrial chemicals or environmental substances is of high interest in human health risk assessment. Due to their ubiquity and persistence in the environment, heavy metals such as cadmium (Cd) and lead (Pb) are of particular concern. Approaches to adequately investigating combinations of these and other often highly correlated variables are lacking. This study proposes a modeling approach to investigate the co-exposure to Cd and Pb, and better understanding the variations of blood Cd and Pb (CdB and PbB, respectively) together with potentially determinant factors. A copula-based regression model was built, using Bayesian inference and Markov Chain Monte Carlo simulation, to relate CdB and PbB of 3- to 14-year-old children participating in the German Environmental Survey for Children (GerES IV) with socio-demographic and ancillary exposure-relevant information. A minor to negligible dependence between CdB and PbB was observed, suggesting that Cd and Pb are subject to difering exposure sources/pathways or kinetics within human body. Despite the resulting low association between CdB and PbB, the developed approach provides methodological bases for enhancing the assessment of the cumulative exposure to multiple substances and for deepening the understanding of the determinants of these exposures. © The Author(s) 2023
HBM reference values, in contrast to toxicologically derived values, are statistically derived values that provide information on the exposure of the population. The exceedance frequency (if applicable for individual population groups) is often a first assessment standard for the local exposure situation for municipalities. More than 25 years have passed since the German Human Biomonitoring Commission (HBMC) formulated the first recommendations for the derivation of population-based reference values (HBM reference values, RV95) for substance concentrations based on HBM studies. A fundamental revision is timely, for several reasons. There have been considerable advances in relevant statistical methods, which meant that previously time-consuming and inaccessible procedures and calculations are now widely available. Furthermore, not all steps for the derivation of HBM reference values were clearly elaborated in the first recommendations. With this revision we intended to achieve a rigorous standardization of the entire process of deriving HBM reference values, also to realise a higher degree of transparency. In accordance with established international practice, it is recommended to use the 95th percentile of the reference distribution as the HBM reference value. To this end, the empirical 95th percentile of a suitable sample should be rounded, ensuring that the rounded value is within the two-sided 95% confidence interval of the percentile. All estimates should be based on distribution-free methods, and the confidence interval should be estimated using a bootstrap approach, if possible, according to the BCa ("bias-corrected and accelerated bootstrap"). A minimum sample size of 80 observations is considered necessary. The entire procedure ensures that the derived HBM reference value is robust against at least two extreme values and can also be used for underlying mixed distributions. If it is known in advance that certain subgroups (different age groups, smokers, etc.) show differing internal exposures, it is recommended that group-specific HBM reference values should be derived. Especially when the sample sizes for individual subgroups are too small, individual datasets with potential outliers can be excluded in advance to homogenize the reference value population. In the second part, new HBM reference values based on data of the German Environmental Survey for Children and Adolescents (GerES V, 2014-2017) were derived in accordance with the revised recommendations. The GerES V is the most recent population-representative monitoring of human exposure to pollutants in Germany on children and adolescents aged 3-17 years (N = 2294). RV95 for GerES V are reported for four subgroups (males/females and 3-11/12-17 years) for 108 different substances including phthalates and alternative plasticisers, metals, organochlorine pesticides, polychlorinated biphenyls (PCB), per- and polyfluoroalkyl substances (PFAS), parabens, aprotic solvents, chlorophenols, polycyclic aromatic hydrocarbons (PAH) and UV filter, in total 135 biomarkers. Algorithms implemented in R were used for the statistics and the determination of the HBM reference values. To facilitate a quality control of the study data, the corresponding R source code is given, together with graphical representations of results. The HBM reference values listed in this article replace earlier RV95 values derived by the HBMC for children and adolescents from data of precedent GerES studies (e.g. published in Apel et al., 2017). © 2023 The Authors
Indoor air concentrations of formaldehyde, furfural, benzaldehyde, and 11 aliphatic aldehydes (C2-C11) were measured in residences of 639 participants in the German Environmental Survey for Children and Adolescents 2014-2017 (GerES V). Sampling was conducted using passive samplers over periods of approximately seven days for each participant. The most abundant compounds were formaldehyde and hexanal with median concentrations of 24.9 (micro)g m-3 and 10.9 (micro)g m-3, respectively. Formaldehyde concentrations exceeded the Guide Value I recommended by the German Committee on Indoor Guide Values (Ausschuss für Innenraumrichtwerte - AIR) (0.10 mg m-3) for 0.3% of the participating residences. The sum of aliphatic n-aldehydes between C4 (butanal) and C11 (undecanal) exceeded their Guide Value (0.10 mg m-3) for 2.0% of the residences. The geometric mean concentrations of most aldehydes were lower than in the earlier GerES IV (2003-2006) study. Formaldehyde and hexanal concentrations, however, were comparable in both studies and showed no significant difference. Indoor aldehyde concentrations did not exhibit significant correlations with factors collected in questionnaires, such as the age of the participants, their socio-economic status, the location of the residence (former East/West Germany), migration background, tobacco exposure, and the type of furniture used. The validity of the passive sampler measurements was verified against active sampling techniques in a test chamber experiment. © 2021 The Authors
Public green spaces have a high potential for a positive impact on people's health and wellbeing, especially in urban areas. Studies on environmental justice indicate socially unequal access possibilities to urban green spaces. This article presents results on associations between individual socioeconomic position (SEP) and walking time from home to public green spaces in young people living in urban areas with more than 20,000 inhabitants in Germany. Data were derived from the German Environmental Survey for Children and Adolescents 2014-2017 (GerES V), the environmental module of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2). The sample comprises 1149 participants aged 3 to 17 years. A total of 51.5% of the participants reach a public green space on foot within five and 72.8% within ten minutes from home. The lower the participant's SEP, the longer the walking time. Logistic regression models controlling for age group, sex, migration background, and region of residence show that participants with a low SEP have a significantly higher risk (odds ratio = 1.98; 95% confidence interval: 1.31-2.99) of needing more than ten minutes to walk from home to a public green space than participants with a high SEP. GerES V data indicate that young people living in urban areas in Germany do not equally benefit from the health-promoting potential of green spaces, which is an important aspect of environmental health inequalities. © 2021 by the authors.
Exposure to environmental phenols such as bisphenol A, benzophenones, 2-phenylphenol, triclosan, and triclocarban is of concern, because of their endocrine disrupting properties and broad application in consumer products. The current body burden of the 3-17-year-old population in Germany to these substances was assessed in first-morning void urine samples (N = 515-516) collected within the population-representative German Environmental Survey for Children and Adolescents 2014-2017 (GerES V). Bisphenol A was the most prominent phenol analysed here, ubiquitously found in almost all samples with a geometric mean (GM) concentration of 1.905 (my)g/L (1.669 (my)g/gcreatinine) and a maximum (MAX) urinary concentration of 399 (my)g/L. Benzophenone-3 and benzophenone-1 were quantified in 35% and 41% of the samples. GM was below the limit of quantification (LOQ) for benzophenone-3 and 0.559 (my)g/L (0.489 (my)g/gcrea) for benzophenone-1, MAX concentrations were 845 (my)g/L and 202 (my)g/L, respectively. In 16% of the samples triclosan was found in quantifiable amounts resulting in a GM below LOQ and a MAX concentration of 801 (my)g/L. Benzophenone-8, 2-phenylphenol and triclocarban were quantified in none or only 1% of the samples. Benzophenone-1 and -3 concentrations were found to be associated with frequent application of personal care products. A comparison with the previous cycle of the survey, GerES IV (2003-2006), showed a decrease of urinary bisphenol A concentrations, mainly in young children. Despite this decrease, the concentration of bisphenol A exceeded the human biomonitoring (HBM) value HBM-I of 0.1 mg/L in 0.11% of the samples. For triclosan, all urinary concentrations were well below the HBM-I value of 2 mg/L. To minimise environmental health risks, it is therefore necessary to maintain a further declining trend for bisphenol A and continue monitoring the exposure to environmental phenols, as well as to monitor substitutes such as bisphenol F and S. © 2020 Published by Elsevier B.V.
Since the 1970s, glyphosate has become the most used herbicide of the world. The general population is ubiquitously exposed to glyphosate. Its long-term toxicity, carcinogenic potential and other health effects are controversially discussed. Even though the possible health impacts of glyphosate are of global concern, no population-wide monitoring of glyphosate was done yet. This study presents the worldwide first population-representative data on glyphosate and its metabolite aminomethylphosphonic acid (AMPA) for children and adolescents. 2144 first-morning void urine samples of 3-17-year-old children and adolescents living in Germany were analysed for concentrations of glyphosate and AMPA in the German Environmental Survey for Children and Adolescents 2014-2017 (GerES V). In 52 % of the samples (46 % for AMPA) the urinary glyphosate concentrations were above the limit of quantification of 0.1 (microgramm)/L. The geometric mean concentrations were 0.107 (microgramm)/L (0.090 (microgramm)/gcreatinine) for glyphosate and 0.100 (microgramm)/L (0.085 (microgramm)/gcreatinine) for AMPA. No clear association between exposure to glyphosate or AMPA and vegetarian diet or consumption of cereals, pulses, or vegetables could be identified. The low quantification rate and the 95th percentiles for glyphosate and AMPA of around 0.5 (microgramm)/L demonstrate an overall low exposure of the young population in Germany. Quelle: © Elsevier 2021
The German Environmental Survey (GerES) is a population-representative, cross-sectional study on environ-mental exposures of the general population of Germany. GerES has repeatedly been conducted since 1985 by the German Environment Agency (UBA) in close collaboration with the Health Interview and Examination Surveys of the Robert Koch Institute (RKI). In the German Environmental Survey for Children and adolescents 2014-2017 (GerES V) pollutants and other environmental stressors were measured in human samples as well as in the homes of 3- to 17-year-old children and adolescents. Interviews were conducted about health-related behaviors and living conditions. The GerES V basic program encompassed examinations of whole blood, blood plasma, morning urine and drinking water samples, measurements of ultrafine particles and noise levels, comprehensive stan-dardized interviews, and self-administrated questionnaires. Additional modules on volatile organic compounds and aldehydes, particulate matter (PM2.5) in indoor air, organic compounds in drinking water and pollutants in house dust were conducted in subsamples. Potential GerES V participants were identified and attained by the RKI from those participants who were examined and interviewed for the cross-sectional component of the second follow-up to the German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2). The gross sample of GerES V comprised 3031 children and adolescents of which 2294 finally took part in the survey. This equals a total response rate of 75.7 %. Response rates varied, depending on region, type of mu-nicipality, age and sex, from 66.0 % to 78.3 %. By calculating individual case weights, discrepancies due to sample design and non-response between the GerES V sample and the whole population could be considered in statistical analysis. Therefore, the representativeness of the GerES V results with regard to age, sex, community size and region was assured. © 2021 Elsevier GmbH.
N-methyl-2-pyrrolidone (NMP) and its substitute N-ethyl-2-pyrrolidone (NEP) are aprotic solvents used in many technical applications, but also in carpets, and consumer products such as cleaning agents, and cosmetics. NMP and NEP are classified as reproductive toxicants. As a substance of very high concern (SVHC), NMP is included in the European REACH (Registration, Evaluation, Authorisation of Chemicals) candidate list for authorisation. NMP and NEP metabolites were measured in more than 2100 urine samples of 3- to 17-year-old children and adolescents, participating in the population-representative German Environmental Survey for Children and Adolescents 2014-2017 (GerES V). The two NMP metabolites 5-hydroxy-N-methyl-2-pyrrolidone (5-HNMP) and 2-hydroxy-N-methylsuccinimide (2-HMSI) could be detected and quantified in all urine samples, and the two NEP metabolites 5-hydroxy-N-ethylpyrrolidone (5-HNEP) and 2-hydroxy-N-ethylsuccinimide (2-HESI) in 32% and 87% of the urine samples. Geometric mean concentrations were 103.1 (my)g/L (88.21 (my)g/gcreatinine) for the sum of NMP metabolites and 11.86 Ìg/L (10.15 (my)g/gcreatinine) for the sum of NEP metabolites, thus remaining below the current health-based human biomonitoring values. For NMP, highest exposure was found in young children, but exposure pathways could not be revealed. Exposure to NEP was highest in adolescents and participants with low socio-economic status or migration background. Associations to usage of personal care products suggested the choice of products to have a distinct impact on NEP exposure. The presented data can be used by the German Human Biomonitoring Commission to derive new reference values (RV95) for NMP and NEP for children and adolescents in Germany. This will facilitate to recognise changing exposure levels in this population group in Germany. © 2020 The Author(s).
Perfluoroalkyl substances (PFAS) such as perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS) are ubiquitously found in humans across all age groups. The German Environmental Survey for Children and Adolescents carried out from 2014 to 2017 (GerES V) revealed detectable blood plasma levels of PFAS in all participants. Two third of the participants had blood plasma levels above the limit of quantification (0.25-0.50 (micro)g/L) simultaneously for PFOA, PFOS, and perfluorohexane-1-sulphonic acid (PFHxS). The health-based guidance values I (HBM-I) derived by the German Human Biomonitoring Commission of 2 (micro)g/L for PFOA and 5 (micro)g/L for PFOS were exceeded by 21% and 7% of the participants. For these participants adverse health effects cannot be ruled out with sufficient certainty. Another 0.2% even exceeded the HBM-II value for PFOS of 20 (micro)g/L for the general population and 10 (micro)g/L for women of child-bearing age, respectively, which is regarded as intervention or action level. PFAS are found to substantial extent even in the youngest children born after the ban of PFOS in 2006, underlining the problematic and long-lasting effects of persistent chemicals. PFAS contamination is evident globally in various environmental compartments, food as well as breast milk. The aim of this study is to quantify the effect of relevant sources of PFAS exposure on children and adolescents in Germany, including various sociodemographic characteristics, living environment, dietary preferences, breast-feeding history, and tap water contamination. Breast-feeding duration and maternal age are significantly correlated with log-transformed plasma concentrations of PFOA, PFOS, and PFHxS (pearson correlation coefficients 0.12-0.24, p < 0.001) - i.e. higher maternal age and longer breast-feeding duration are associated with higher PFAS levels in the offspring. Multivariate analyses are used to quantify the contribution of exposure sources to internal PFAS exposure. The results suggest that, while breast-feeding is generally encouraged due to its various positive health effects, recommendations regarding breast-feeding duration should consider the PFAS burden of mothers especially when they have their first child only at relatively high age. © The Authors 2021
The 5th cycle of the German Environmental Survey (GerES V) investigated the internal human exposure of children and adolescents aged 3-17 years in Germany to per- and polyfluoroalkyl substances (PFAS). The fieldwork of the population-representative GerES V was performed from 2014 to 2017. In total, 1109 blood plasma samples were analysed for 12 PFAS including perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and perfluorohexane sulfonic acid (PFHxS). PFOS was quantified in all and PFOA in almost all samples, demonstrating ubiquitous exposure. The highest geometric mean concentrations measured were 2.49 ng/mL for PFOS, followed by PFOA (1.12 ng/mL) and PFHxS (0.36 ng/mL), while concentrations of other PFAS were found in much lower concentrations. The 95th percentile levels of PFOS and PFOA were 6.00 and 3.24 ng/mL, respectively. The results document a still considerable exposure of the young generation to the phased out chemicals PFOS and PFOA. The observed exposure levels vary substantially between individuals and might be due to different multiple sources. The relative contribution of various exposure parameters such as diet or the specific use of consumer products need to be further explored. Although additional investigations on the time trend of human exposure are warranted, GerES V underlines the need for an effective and sustainable regulation of PFAS as a whole. Source: © 2020 Elsevier GmbH
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