Browsing by Author "Tolonen, Hanna"
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- Application of human biomonitoring data to support policy development, raise awareness and environmental public health protection among countries within the HBM4EU projectPublication . Ubong, Dorothy; Stewart, Lorraine; Sepai, Ovnair; Knudsen, Lisbeth E.; Berman, Tamar; Reynders, Hans; Van Campenhout, Karen; Katsonouri, Andromachi; Van Nieuwenhuyse, An; Ingelido, Anna Maria; Castaño, Argelia; Pedraza-Díaz, Susana; Eiríksdóttir, Ása Valgerður; Thomsen, Cathrine; Hartmann, Christina; Gjorgjev, Dragan; De Felip, Elena; Tolonen, Hanna; Santonen, Tiina; klanova, Jana; Norström, Karin; Kononenko, Lijana; Silva, Maria João; Uhl, Maria; Kolossa-Gehring, Marike; Apel, Petra; Jõemaa, Merli; Jajcaj, Michal; Estokova, Milada; Luijten, Mirjam; Lebret, Erik; von Goetz, Natalie; Holcer, Natasa Janev; Probst-Hensch, Nicole; Cavaleiro, Rita; Barouki, Robert; Tarroja, Elena; Balčienė, Rosita Marija; Strumylaite, Loreta; Latvala, Siiri; Namorado, Sónia; Szigeti, Tamás; Ingi Halldorsson, Thorhallur; Olafsdottir, Kristin; Wasowicz, Wojciech; Viegas, Susana; Alvito, PaulaMost countries have acknowledged the importance of assessing and quantifying their population’s internal exposure from chemicals in air, water, soil, food and other consumer products due to the potential health and economic impact. Human biomonitoring (HBM) is a valuable tool which can be used to quantify such exposures and effects. Results from HBM studies can also contribute to improving public health by providing evidence of individuals’ internal chemical exposure as well as data to understand the burden of disease and associated costs thereby stimulating the development and implementation of evidence-based policy. To have a holistic view on HBM data utilisation, a multi-case research approach was used to explore the use of HBM data to support national chemical regulations, protect public health and raise awareness among countries participating in the HBM4EU project. The Human Biomonitoring for Europe (HBM4EU) Initiative (https://www.hbm4eu.eu/) is a collaborative effort involving 30 countries, the European Environment Agency (EEA) and the European Commission (contracting authority) to harmonise procedures across Europe and advance research into the understanding of the health impacts of environmental chemical exposure. One of the aims of the project was to use HBM data to support evidence based chemical policy and make this information timely and directly available for policy makers and all partners. The main data source for this article was the narratives collected from 27 countries within the HBM4EU project. The countries (self-selection) were grouped into 3 categories in terms of HBM data usage either for public awareness, policy support or for the establishment HBM programme. Narratives were analysed/summarised using guidelines and templates that focused on ministries involved in or advocating for HBM; steps required to engage policy makers; barriers, drivers and opportunities in developing a HBM programme. The narratives reported the use of HBM data either for raising awareness or addressing environmental/public health issues and policy development. The ministries of Health and Environment were reported to be the most prominent entities advocating for HBM, the involvement of several authorities/institutions in the national hubs was also cited to create an avenue to interact, discuss and gain the attention of policy makers. Participating in European projects and the general population interest in HBM studies were seen as drivers and opportunities in developing HBM programmes. A key barrier that was cited by countries for establishing and sustaining national HBM programmes was funding which is mainly due to the high costs associated with the collection and chemical analysis of human samples. Although challenges and barriers still exist, most countries within Europe were already conversant with the benefits and opportunities of HBM. This article offers important insights into factors associated with the utilisation of HBM data for policy support and public awareness.
- Bias correction in self-reported high blood pressure prevalence based on objectively measured dataPublication . Kislaya, Irina; Leite, Andreia; Machado, Ausenda; Tolonen, Hanna; Torres, Ana Rita; Nunes, BaltazarIntroduction: Reliable and precise estimates of high blood pressure prevalence are essential to inform decision-making and policies evaluation. Self-reported high blood pressure prevalence may be underestimated by surveys due to misclassification of health status by participants. Ignoring misclassification may lead to inaccurate inference. We aimed to assess a feasibility of correcting misclassification bias in self-reported high blood pressure in the Portuguese component of the European Health Interview Survey (INS2014) using data on objective blood pressure measurements from a smaller health examination survey survey (INSEF2015).
- Collecting Valid and Reliable Data: Fieldwork Monitoring Strategies in a Health Examination SurveyPublication . Kislaya, Irina; Santos, Ana João; Lyshol, Heidi; Antunes, Liliana; Barreto, Marta; Gaio, Vânia; Gil, Ana Paula; Namorado, Sónia; Matias Dias, Carlos ; Tolonen, Hanna; Nunes, BaltazarIntroduction: Health surveys constitute a relevant information source to access the population’s health status. Given that survey errors can significantly influence estimates and invalidate study findings, it is crucial that the fieldwork progress is closely monitored to ensure data quality. The objective of this study was to describe the fieldwork monitoring conducted during the first Portuguese National Health Examination Survey (INSEF) regarding protocol deviations and key performance indicators (KPI). Methods: Data derived from interviewer observation and from the statistical quality control of selected KPI were used to monitor the four components of the INSEF survey (recruitment, physical examination, blood collection and health questionnaire). Survey KPI included response rate, average time distribution for procedures, distribution of the last digit in a specific measure, proportion of haemolysed blood samples and missing values. Results: Interviewer observation identified deviations from the established protocols, which were promptly corrected. During fieldwork monitoring through KPI, upon implementation of corrective measures, the participation rate increased 2.5-fold, and a 4.4-fold decrease in non-adherence to standardized survey procedures was observed in the average time distribution for blood pressure measurement. The proportion of measurements with the terminal digit of 0 or 5 decreased to 19.6 and 16.5%, respectively, after the pilot study. The proportion of haemolysed samples was at baseline level, below 2.5%. Missing data issues were minimized by promptly communicating them to the interviewer, who could recontact the participant and fill in the missing information. Discussion/Conclusion: Although the majority of the deviations from the established protocol occurred during the first weeks of the fieldwork, our results emphasize the importance of continuous monitoring of survey KPI to ensure data quality throughout the survey.
- Combining self-reported and objectively measured survey data to improve hypertension prevalence estimates: Portuguese experiencePublication . Kislaya, Irina; Leite, Andreia; Perelman, Julian; Machado, Ausenda; Torres, Ana Rita; Tolonen, Hanna; Nunes, BaltazarBackground: Accurate data on hypertension is essential to inform decision-making. Hypertension prevalence may be underestimated by population-based surveys due to misclassification of health status by participants. Therefore, adjustment for misclassification bias is required when relying on self-reports. This study aims to quantify misclassification bias in self-reported hypertension prevalence and prevalence ratios in the Portuguese component of the European Health Interview Survey (INS2014), and illustrate application of multiple imputation (MIME) for bias correction using measured high blood pressure data from the first Portuguese health examination survey (INSEF). Methods: We assumed that objectively measured hypertension status was missing for INS2014 participants (n = 13,937) and imputed it using INSEF (n = 4910) as auxiliary data. Self-reported, objectively measured and MIME-corrected hypertension prevalence and prevalence ratios (PR) by sex, age group and education were estimated. Bias in self-reported and MIME-corrected estimates were computed using objectively measured INSEF data as a gold-standard. Results: Self-reported INS2014 data underestimated hypertension prevalence in all population subgroups, with misclassification bias ranging from 5.2 to 18.6 percentage points (pp). After MIME-correction, prevalence estimates increased and became closer to objectively measured ones, with bias reduction to 0 pp - 5.7 pp. Compared to objectively measured INSEF, self-reported INS2014 data considerably underestimated prevalence ratio by sex (PR = 0.8, 95CI = [0.7, 0.9] vs. PR = 1.2, 95CI = [1.1, 1.4]). MIME successfully corrected direction of association with sex in bivariate (PR = 1.1, 95CI = [1.0, 1.3]) and multivariate analyses (PR = 1.2, 95CI = [1.0, 1.3]). Misclassification bias in hypertension prevalence ratios by education and age group were less pronounced and did not require correction in multivariate analyses. Conclusions: Our results highlight the importance of misclassification bias analysis in self-reported hypertension. Multiple imputation is a feasible approach to adjust for misclassification bias in prevalence estimates and exposure-outcomes associations in survey data.
- Differential self-report error by socioeconomic status in hypertension and hypercholesterolemia: INSEF 2015 studyPublication . Kislaya, Irina; Tolonen, Hanna; Rodrigues, Ana Paula; Barreto, Marta; Gil, Ana Paula; Gaio, Vânia; Namorado, Sónia; Santos, Ana João; Dias, Carlos Matias; Nunes, BaltazarBackground: This study aimed to compare self-reported and examination-based prevalence of hypertension and hypercholesterolemia in Portugal in 2015 and to identify factors associated with the measurement error in self-reports. Methods: We used data from the Portuguese National Health Examination Survey (n = 4911), that combines personal interview, blood collection and, physical examination. Sensitivity and specificity of self-reported hypertension and hypercholesterolemia were calculated. Poisson regression was used to estimate prevalence ratios (PRs) of underreport of hypertension and hypercholesterolemia according to sex, age, socioeconomic status (education and income) and general practitioner (GP) consultation in the past year. Results: Sensitivity of self-reports was 69.8% for hypertension and 38.2% for hypercholesterolemia. Underreport of hypertension was associated with male gender (PR = 1.54), lack of GP consultation (PR = 1.70) and being 25–44 years old (PR = 2.45) or 45–54 years old (PR = 2.37). Underreport of hypercholesterolemia was associated with lack of GP consultation (PR = 1.15), younger age (PR = 1.83 for 25–44 age group and PR = 1.52 for 45–54 age group), secondary (PR = 1.30) and higher (PR = 1.27) education. Conclusion: Self-reported data underestimate prevalence of hypertension and hypercholesterolemia. Magnitude of measurement error in self-reports varies by health conditions and population characteristics. Adding objective measurements to self-reported questionnaires improve data accuracy allowing better understanding of socioeconomic inequalities in health.
- Do self-reported data accurately measure health inequalities in risk factors for cardiovascular disease?Publication . Kislaya, Irina; Perelman, Julian; Tolonen, Hanna; Nunes, BaltazarObjectives: This study aimed to compare the magnitude of educational inequalities in self-reported and examination-based hypertension and hypercholesterolemia and to assess the impact of self-reported measurement error on health inequality indicators. Methods: We used the Portuguese National Health Examination Survey data (n = 4911). The slope index of inequality (SII) and the relative index of inequality (RII) were used to determine the magnitude of absolute and relative education-related inequalities. Results: Among the 25-49-year-old (yo) men, absolute and relative inequalities were smaller for self-reported than for examination-based hypertension (SIIeb = 0.18 vs. SIIsr = - 0.001, p < 0.001; RIIeb = 1.99 vs. RIIsr = 0.86, p = 0.031). For women, the relative inequalities were similar despite differences in self-reported and examination-based hypertension prevalence. For hypercholesterolemia, self-reported relative inequalities were larger than examination-based inequalities among the 50-74-yo men (RIIsr = 2.28 vs. RIIeb = 1.21, p = 0.004) and women (RIIsr = 1.22 vs. RIIeb= 0.87, p = 0.045), while no differences were observed among 25-49-yo. Conclusions: Self-reported data underestimated educational inequalities among 25-49-yo men and overestimated them in older individuals. Inequality indicators derived from self-report should be interpreted with caution, and examination-based values should be preferred, when available.
- Harmonization of Human Biomonitoring Studies in Europe: Characteristics of the HBM4EU-Aligned Studies ParticipantsPublication . Gilles, Liese; Govarts, Eva; Rodriguez Martin, Laura; Andersson, Anna-Maria; Appenzeller, Brice M.R.; Barbone, Fabio; Castano, Argelia; Coertjens, Dries; Den Hond, Elly; Dzhedzheia, Vazha; Eržen, Ivan; Esteban, Marta; Fábelová, Lucia; Fillol, Clémence; Franken, Carmen; Frederiksen, Hanne; Gabriel, Catherine; Haug, Line Småstuen; Horvat, Milena; Halldórsson, Thórhallur Ingi; Janasik, Beata; Holcer, Nataša Janev; Kakucs, Réka; Karakitsios, Spyros; Katsonouri, Andromachi; Klánová, Jana; Kold-Jensen, Tina; Kolossa-Gehring, Marike; Konstantinou, Corina; Koponen, Jani; Lignell, Sanna; Lindroos, Anna Karin; Makris, Konstantinos C.; Mazej, Darja; Morrens, Bert; Murínová, Ľubica Palkovičová; Namorado, Sónia; Pedraza-Diaz, Susana; Peisker, Jasmin; Probst-Hensch, Nicole; Rambaud, Loïc; Rosolen, Valentina; Rucic, Enrico; Rüther, Maria; Sarigiannis, Dimosthenis; Tratnik, Janja Snoj; Standaert, Arnout; Stewart, Lorraine; Szigeti, Tamás; Thomsen, Cathrine; Tolonen, Hanna; Eiríksdóttir, Ása; Van Nieuwenhuyse, An; Verheyen, Veerle J.; Vlaanderen, Jelle; Vogel, Nina; Wasowicz, Wojciech; Weber, Till; Zock, Jan-Paul; Sepai, Ovnair; Schoeters, GreetHuman biomonitoring has become a pivotal tool for supporting chemicals’ policies. It provides information on real-life human exposures and is increasingly used to prioritize chemicals of health concern and to evaluate the success of chemical policies. Europe has launched the ambitious REACH program in 2007 to improve the protection of human health and the environment. In October 2020 the EU commission published its new chemicals strategy for sustainability towards a toxic-free environment. The European Parliament called upon the commission to collect human biomonitoring data to support chemical’s risk assessment and risk management. This manuscript describes the organization of the first HBM4EU-aligned studies that obtain comparable human biomonitoring (HBM) data of European citizens to monitor their internal exposure to environmental chemicals. The HBM4EU-aligned studies build on existing HBM capacity in Europe by aligning national or regional HBM studies. The HBM4EU-aligned studies focus on three age groups: children, teenagers, and adults. The participants are recruited between 2014 and 2021 in 11 to 12 primary sampling units that are geographically distributed across Europe. Urine samples are collected in all age groups, and blood samples are collected in children and teenagers. Auxiliary information on sociodemographics, lifestyle, health status, environment, and diet is collected using questionnaires. In total, biological samples from 3137 children aged 6–12 years are collected for the analysis of biomarkers for phthalates, HEXAMOLL® DINCH, and flame retardants. Samples from 2950 teenagers aged 12–18 years are collected for the analysis of biomarkers for phthalates, Hexamoll® DINCH, and per and polyfluoroalkyl substances (PFASs), and samples from 3522 adults aged 20–39 years are collected for the analysis of cadmium, bisphenols, and metabolites of polyaromatic hydrocarbons (PAHs). The children’s group consists of 50.4% boys and 49.5% girls, of which 44.1% live in cities, 29.0% live in towns/suburbs, and 26.8% live in rural areas. The teenagers’ group includes 50.6% girls and 49.4% boys, with 37.7% of residents in cities, 31.2% in towns/suburbs, and 30.2% in rural areas. The adult group consists of 52.6% women and 47.4% men, 71.9% live in cities, 14.2% in towns/suburbs, and only 13.4% live in rural areas. The study population approaches the characteristics of the general European population based on age-matched EUROSTAT EU-28, 2017 data; however, individuals who obtained no to lower educational level (ISCED 0–2) are under represented. The data on internal human exposure to priority chemicals from this unique cohort will provide a baseline for Europe’s strategy towards a non-toxic environment and challenges and recommendations to improve the sampling frame for future EU-wide HBM surveys are discussed.
- Harmonized human biomonitoring in European children, teenagers and adults: EU-wide exposure data of 11 chemical substance groups from the HBM4EU Aligned Studies (2014-2021)Publication . Govarts, Eva; Gilles, Liese; Rodriguez Martin, Laura; Santonen, Tiina; Apel, Petra; Alvito, Paula; Anastasi, Elena; Andersen, Helle Raun; Andersson, Anna-Maria; Andryskova, Lenka; ANTIGNAC, Jean-Philippe; Rüther, Maria; Sarigiannis, Denis; Silva, Maria João; Šlejkovec, Zdenka; Snoj Tratnik, Janja; Stajnko, Anja; Szigeti, Tamas; Tarazona, Jose; Thomsen, Cathrine; Tkalec, Žiga; Trnovec, Tomas; Tolonen, Hanna; Uhl, Maria; Van Nieuwenhuyse, An; Vasco, Elsa; Verheyen, Veerle J.; Viegas, Susana; Vinggaard, Anne Marie; Vogel, Nina; Vorkamp, Katrin; Wasowicz, Wojciech; Wimmerova, Sona; Weber, Till; Woutersen, Marjolijn; Zimmermann, Philipp; Zvonar, Martin; Koch, Holger; Kolossa-Gehring, Marike; Esteban López, Marta; Castano, Argelia; Stewart, Lorraine; Sepai, Ovnair; Appenzeller, Brice; Schoeters, Greta; Barbone, Fabio; Barnett-Itzhaki, Zohar; Barouki, Robert; Berman, Tamar; Bil, Wieneke; Borges, Teresa; Buekers, Jurgen; Cañas-Portilla, Ana; Covaci, Adrian; Csako, Zsofia; Den Hond, Elly; Dvorakova, Darina; Fabelova, Lucia; Fletcher, Tony; Frederiksen, Hanne; Gabriel, Catherine; Ganzleben, Catherine; Göen, Thomas; Halldorsson, Thorhallur; Haug, Line Småstuen; Horvat, Milena; Huuskonen, Pasi; Imboden, Medea; Jagodic Hudobivnik, Marta; Janasik, Beata; Janev Holcer, Natasa; Karakitsios, Spyros; Katsonouri, Andromachi; Klanova, Jana; Kokaraki, Venetia; Kold Jensen, Tina; Koponen, Jani; Laeremans, Michelle; Laguzzi, Federica; Lange, Rosa; Lemke, Nora; Lignell, Sanna; Lindroos, Anna Karin; Lobo Vicente, Joana; Luijten, Mirjam; Makris, Konstantinos C.; Mazej, Darja; Melymuk, Lisa; Meslin, Matthieu; Mol, Hans; Montazeri, Parisa; Murawski, Aline; Namorado, Sónia; Niemann, Lars; Nübler, Stefanie; Nunes, Baltazar; Olafsdottir, Kristin; Palkovicova Murinova, Lubica; Papaioannou, Nafsika; Pedraza-Diaz, Susana; Piler, Pavel; Plichta, Veronika; Poteser, Michael; Probst-Hensch, Nicole; Rambaud, Loic; Rauscher-Gabernig, Elke; Rausova, Katarina; Remy, Sylvie; Riou, Margaux; Rosolen, Valentina; Rousselle, ChristopheAbstract: As one of the core elements of the European Human Biomonitoring Initiative (HBM4EU) a human biomonitoring (HBM) survey was conducted in 23 countries to generate EU-wide comparable HBM data. This survey has built on existing HBM capacity in Europe by aligning national or regional HBM studies, referred to as the HBM4EU Aligned Studies. The HBM4EU Aligned Studies included a total of 10,795 participants of three age groups: (i) 3,576 children aged 6–12 years, (ii) 3,117 teenagers aged 12–18 years and (iii) 4,102 young adults aged 20–39 years. The participants were recruited between 2014 and 2021 in 11–12 countries per age group, geographically distributed across Europe. Depending on the age group, internal exposure to phthalates and the substitute DINCH, halogenated and organophosphorus flame retardants, per- and polyfluoroalkyl substances (PFASs), cadmium, bisphenols, polycyclic aromatic hydrocarbons (PAHs), arsenic species, acrylamide, mycotoxins (deoxynivalenol (total DON)), benzophenones and selected pesticides was assessed by measuring substance specific biomarkers subjected to stringent quality control programs for chemical analysis. For substance groups analyzed in different age groups higher average exposure levels were observed in the youngest age group, i.e., phthalates/DINCH in children versus teenagers, acrylamide and pesticides in children versus adults, benzophenones in teenagers versus adults. Many biomarkers in teenagers and adults varied significantly according to educational attainment, with higher exposure levels of bisphenols, phthalates, benzophenones, PAHs and acrylamide in participants (from households) with lower educational attainment, while teenagers from households with higher educational attainment have higher exposure levels for PFASs and arsenic. In children, a social gradient was only observed for the non-specific pyrethroid metabolite 3-PBA and di-isodecyl phthalate (DiDP), with higher levels in children from households with higher educational attainment. Geographical variations were seen for all exposure biomarkers. For 15 biomarkers, the available health-based HBM guidance values were exceeded with highest exceedance rates for toxicologically relevant arsenic in teenagers (40%), 3-PBA in children (36%), and between 11 and 14% for total DON, Σ (PFOA + PFNA + PFHxS + PFOS), bisphenol S and cadmium. The infrastructure and harmonized approach succeeded in obtaining comparable European wide internal exposure data for a prioritized set of 11 chemical groups. These data serve as a reference for comparison at the global level, provide a baseline to compare the efficacy of the European Commission's chemical strategy for sustainability and will give leverage to national policy makers for the implementation of targeted measures.
- HBM4EU - Deliverable Report D 6.2. Revised set of key indicatorsPublication . Reynders, Hans; Van Campenhout, Karen; Mampaey, Maja; Gilles, Liese; Colles, Ann; Baken, Kirsten; Bessems, Jos; Schoeters, Greet; Ay, Derya; Lobo Vicente, Joana; Ganzleben, Catherine; Isidro, Glória; Louro, Henriqueta; Silva, Maria João; Uhl, Maria; Ubong, Dorothy; Sepai, Ovnair; Tarroja, Elena; Persoz, Charles; Barouki, Robert; Kobosil, Nicole; David, Madlen; Appel, Petra; Kolossa, Marike; Coertjens, Dries; Crabbé, Ann; Loots, Ilse; Covaci, Adrian; Antignac, Jean-Philippe; Debrauwer, Laurent; Fernandez, Mariana; Berglund, Marika; Blaha, Ludek; Esteban López, Marta; Scheepers, Paul; Tolonen, Hanna; Nørager., SofieThe current deliverable describes the process of revision of the first list of indicators (published in June 2017 as D6.1.) and presents the indicator leaflets ((see attachment 1) that link key results of HBM4EU to the objectives of the project as laid down in the description of action. These indicator leaflets already contain a lot of results on the revised list of indicators, and give very valuable information on the progress of HBM4EU in relation to the specific goals of the project. Combining the information from these leaflets in the frame of expected impacts will allow us to put forward conclusions towards impact and sustainability of HBM4EU. As such, this restructured list answers to the main comments on the first list of indicators from the task 6.5 partners, the Management Board, the Governing Board and the EU Policy Board, in concretu to: • Drastically reduce the number of indicators from 48 indicators (including 9 internal indicators) on the first list to 28 indicators on the revised list without losing essential information. Moreover by bundling related indicators we now have 22 indicator leaflets (and 1 overview leaflet); • Make the relationship between the indicators and the goals of HBM4EU more clear by structuring the list of indicators according to the overarching objectives and specific goals; • Use the indicators to say something about the impact of the HBM4EU project: the indicator leaflets were used to give input for the impact section of the periodic technical reporting 2018 to describe the progress made for the 5 expected impacts of HBM4EU. This exercise will be continued and ameliorated in the 2019 periodic technical reporting as more indicator leaflets will be available compared to 2018; • Link the indicators with the work on sustainability of HBM in Europe: the indicators were presented at the sustainability workshop in Paris. Participants indicated that they think the leaflets will be useful for institutional discussions, national hub meetings, meetings with policy makers and other meetings and that they would like to use them as soon as they are available. The added value of having indicators of success, is to monitor the implementation and achieved impact of HBM4EU. This will allow for a more efficient tracking of achieved goals. This deliverable will help to further optimize and revise the first set of indicators to monitor the implementation of the HBM4EU and the achieved impact. The indicators of success are written in a clear language, they are concise and capture the main achievements in the list of indicators that has been agreed amongst the partners. Therefore, they can be easily used by all partners across the consortium, the EU Policy Board and our HBM4EU ambassador Thomas Jackl.
- Health studies: opportunities for the development of Human Biomonitoring in EuropePublication . Namorado, Sónia; Andersson, Anna-Maria; Holmboe, Stine Agergaard; Nunes, Baltazar; Dias, Carlos Matias; Tolonen, HannaIntroduction: Human Biomonitoring (HBM) and health studies are very similar in terms of the infrastructure and procedures necessary for their implementation, as in either type of studies data is collected through fieldwork, which constitutes one of the largest expenditures for such studies. Thus, combined studies could result in more cost-effective ways to conduct health and environmental monitoring. As such, within the HBM4EU project an inventory of the health studies available which could include an HBM component was performed. Methods: An online questionnaire was developed to collect information on recently conducted, ongoing and planned health studies, which could be linked to an HBM study. The link to the questionnaire was distributed with the help of the National Hub Contact Points of the HBM4EU project. Results: From the 58 different studies included in this inventory, half were longitudinal and presented the possibility of introducing an HBM component in the future. Most of the studies for which data was reported had public funding, either from the government or from public grants (national or European). The vast majority of the studies included the collection of biological samples and the most frequently stored samples were blood, plasma, serum or DNA. More than 50% of the studies reported that the measurement of chemicals was already performed or was planned to be performed. The most frequently measured chemicals were phthalates, bisphenols and cadmium. Conclusions: In vast majority of the studies included in the inventory biological samples are collected and stored, posing the opportunity to use them in HBM studies for the analyses of chemicals of interest. About 50% of these studies already had ethical approval to measure chemicals from collected samples. Funding: HBM4EU has received funding from the European Union’s Horizon 2020 research and innovation programme (grant agreement 733032).