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- Associations of ambient exposure to benzene, toluene, ethylbenzene, and xylene with daily mortality: a multicountry time-series study in 757 global locationsPublication . Zhou, Lu; Xiong, Ying; Sera, Francesco; Vicedo-Cabrera, Ana Maria; Abrutzky, Rosana; Guo, Yuming; Tong, Shilu; Coelho, Micheline de Sousa Zanotti Stagliorio; Saldiva, Paulo Hilario Nascimento; Lavigne, Eric; Correa, Patricia Matus; Ortega, Nicolás Valdés; Osorio, Samuel; Roye, Dominic; Kyselý, Jan; Orru, Hans; Maasikmets, Marek; Jaakkola, Jouni J.K.; Ryti, Niilo; Pascal, Mathilde; Huber, Veronika; Breitner-Busch, Susanne; Schneider, Alexandra; Katsouyanni, Klea; Samoli, Evangelia; Entezari, Alireza; Mayvaneh, Fatemeh; Goodman, Patrick; Zeka, Ariana; Raz, Raanan; Scortichini, Matteo; Stafoggia, Massimo; Honda, Yasushi; Hashizume, Masahiro; Ng, Chris Fook Sheng; Alahmad, Barrak; Diaz, Magali Hurtado; Félix Arellano, Eunice Elizabeth; Overcenco, Ala; Klompmaker, Jochem; Rao, Shilpa; Carrasco, Gabriel; Seposo, Xerxes; Chua, Paul Lester Carlos; das Neves Pereira da Silva, Susana; Madureira, Joana; Holobaca, Iulian-Horia; Scovronick, Noah; Garland, Rebecca M.; Kim, Ho; Lee, Whanhee; Tobias, Aurelio; Íñiguez, Carmen; Forsberg, Bertil; Ragettli, Martina S.; Guo, Yue Leon; Pan, Shih-Chun; Li, Shanshan; Masselot, Pierre; Colistro, Valentina; Bell, Michelle; Zanobetti, Antonella; Schwartz, Joel; Dang, Tran Ngoc; Van Dung, Do; Gasparrini, Antonio; Huang, Yaoxian; Kan, HaidongBackground: The presence of benzene, toluene, ethylbenzene, and xylene isomers (BTEX) in the environment is of increasing concern due to their toxicity and ubiquity. Although the adverse health effects of BTEX exposure have been documented, robust epidemiological evidence from large-scale, multicountry studies using advanced exposure assessment methodologies remains scarce. We aimed to assess the association of short-term ambient exposure to individual BTEX components and their mixture with daily total, cardiovascular, and respiratory mortality on a global scale. Methods: Daily data on mortality, meteorological factors, and air pollution were collected from 757 locations across 46 countries or regions. Data on individual chemicals (ie, benzene, toluene, xylenes [summation of ethylbenzene, m-xylene, p-xylene, and o-xylene]) and the aggregate mixture (ie, BTEX) were estimated using a chemistry–climate model. We examined the short-term associations of each individual chemical as well as the BTEX mixture with daily total, cardiovascular, and respiratory mortality in a multicountry framework. Using a two-stage time-series design, we first applied generalised additive models with a quasi-Poisson distribution to obtain location-specific associations, which were subsequently pooled using random-effects meta-analysis. Two-pollutant models were used to assess the independent effects of BTEX after adjusting for co-pollutants (PM2·5, PM10, nitrogen dioxide, sulphur dioxide, ozone, and carbon monoxide). Additionally, we assessed the overall exposure–response curves with spline terms. Findings: An IQR increment of BTEX concentration on lag 0–2 days (3-day moving average of the present day and the previous 2 days) was associated with increases of 0·57% (95% CI 0·49–0·65), 0·42% (0·30–0·54), and 0·68% (0·50–0·86) in total, cardiovascular, and respiratory mortality, respectively. The corresponding effect estimates for an IQR increment in individual chemicals (benzene, toluene, and xylenes) were 0·38–0·61%, 0·44–0·70%, and 0·41–0·65%, respectively. The associations remained significant after adjusting for co-pollutants, with a general decline in magnitude, except for a slight increase after adjustment for ozone. The shape of the exposure–response curves for all pollutants and causes of death was almost linear, with steeper slopes at low concentrations and no discernible thresholds. Interpretation: This global study provides novel evidence linking short-term exposure to ambient BTEX, both individually and as a mixture, with increased daily total, cardiovascular, and respiratory mortality. Our findings underscore the need for comprehensive air pollution mitigation policies, including stringent controls on BTEX emissions, to protect public health.
- FAIREHR: a novel online research registry platform to advance global environmental and occupational health researchPublication . Galea, Karen S.; Brooker, Finlay; Rashid, Shahzad; Bader, Michael; Ait Bamai, Yu; Bessems, Jos; Beyene, Embialle Mengistie; Connolly, Alison; Costa, Carla; Deligannu, Pravina; Duca, Radu-Corneliu; Chbihi, Kaoutar; Eba, Kasahun; Ghosh, Manosij; Gonzales, Melissa; Harrad, Stuart; Haynes, Erin N.; Hopf, Nancy B.; Huang, Po-Chin; Jones, Kate; Kasiotis, Konstantinos M.; Chung, Ming Kei; Kil, Jihyon; Koch, Holger; Kwon, Jung-Hwan; Lin, Elizabeth Ziying; Louro, Henriqueta; Machera, Kyriaki; Magagna, Barbara; Menouni, Aziza; Mizuno, Yuki; Van Nieuwenhuyse, An; Nakayama, Shoji F.; Robert Pasanen-Kase; Pollock, Tyler; Quirós-Alcalá, Lesliam; Santonen, Tiina; Scheepers, Paul J.; Sepai, Ovnair; Bird, Emily; Serrano Ramòn, Blanca; Silva, Maria Joao; Souza, Gustavo; Stingone, Jeanette A.; Teitelbaum, L. Susan; Teixeira, João Paulo; Tranfo, Giovanna; Vekic, Ana Maria; Viegas, Susana; Xia, Yankai; Yunesian, Masud; Zare Jeddi, MaryamThe FAIREHR (Findable, Accessible, Interoperable, Reusable Environmental and Health Registry) platform is a state-of-the-art online registry for prospective harmonization of human biomonitoring (HBM). It was developed by the HBM working group of the Europe Regional Chapter of the International Society of Exposure Science (ISES Europe) and is supported by the HBM Global Network. FAIREHR is designed to harmonize HBM metadata and support the implementation of the FAIR (Findable, Accessible, Interoperable and Reusable) Guiding Principles throughout HBM studies or programs. The registry enables preregistration of HBM by capturing key metadata on study design, metadata management, and planned methods before participant recruitment. This process enhances transparency and reproducibility in environmental and occupational health research. FAIREHR includes both study-level and program-level metadata. Its harmonized metadata template facilitates the storage of results (measurement data) in repositories such as IPCHEM and PEH. Here we outline the unique features of the FAIREHR platform, emphasizing its role in increasing research visibility, improving metadata comparability and harmonization, and strengthening the exchange of information. By supporting the effective use of HBM data, FAIREHR is expected to yield significant benefits for researchers, policymakers, and the broader fields of environmental and occupational health.
- Hazard characterization of the mycotoxins enniatins and beauvericin to identify data gaps and improve risk assessment for human healthPublication . Behr, Anne-Cathrin; Fæste, Christiane Kruse; Azqueta, Amaya; Tavares, Ana M.; Spyropoulou, Anastasia; Solhaug, Anita; Olsen, Ann-Karin; Vettorazzi, Ariane; Mertens, Birgit; Zegura, Bojana; Streel, Camille; Ndiaye, Dieynaba; Spilioti, Eliana; Dubreil, Estelle; Buratti, Franca Maria; Crudo, Francesco; Eriksen, Gunnar Sundstøl; Snapkow, Igor; Teixeira, João Paulo; Rasinger, Josef D.; Sanders, Julie; Machera, Kyriaki; Ivanova, Lada; Gaté, Laurent; Le Hegarat, Ludovic; Novak, Matjaz; Smith, Nicola M.; Tait, Sabrina; Fraga, Sónia; Hager, Sonja; Marko, Doris; Braeuning, Albert; Louro, Henriqueta; Silva, Maria João; Dirven, Hubert; Dietrich, JessicaEnniatins (ENNs) and beauvericin (BEA) are cyclic hexadepsipeptide fungal metabolites which have demonstrated antibiotic, antimycotic, and insecticidal activities. The substantial toxic potentials of these mycotoxins are associated with their ionophoric molecular properties and relatively high lipophilicities. ENNs occur extensively in grain and grain-derived products and are considered a food safety issue by the European Food Safety Authority (EFSA). The tolerable daily intake and maximum levels for ENNs in humans and animals remain unestablished due to key toxicological and toxicokinetic data gaps, preventing full risk assessment. Aiming to find critical data gaps impeding hazard characterization and risk evaluation, this review presents a comprehensive summary of the existing information from in vitro and in vivo studies on toxicokinetic characteristics and cytotoxic, genotoxic, immunotoxic, endocrine, reproductive and developmental effects of the most prevalent ENN analogues (ENN A, A1, B, B1) and BEA. The missing information identified showed that additional studies on ENNs and BEA have to be performed before sufficient data for an in-depth hazard characterisation of these mycotoxins become available.
- HBM4EU E-waste study – An untargeted metabolomics approach to characterize metabolic changes during E-waste recyclingPublication . Kozlowska, Lucyna; Viegas, Susana; Scheepers, Paul T.J.; Duca, Radu C.; Godderis, Lode; Martins, Carla; Krzesimir, Ciura; Jagiello, Karolina; Silva, Maria João; Mahiout, Selma; Mārtiņsone, Inese; Matisāne, Linda; van Nieuwenhuyse, An; Puzyn, Tomasz; Sijko-Szpanska, Monika; Verdonck, Jelle; Santonen, Tiina; HBM4EU E-waste Study TeamE-waste contains hazardous chemicals that may be a direct health risk for workers involved in recycling. We conducted an untargeted metabolomics analysis of urine samples collected from male e-waste processing workers to explore metabolic changes associated with chemical exposures in e-waste recycling in Belgium, Finland, Latvia, Luxembourg, the Netherlands, Poland, and Portugal. Questionnaire data and urine samples were obtained from workers involved in the processing of e-waste (sorting, dismantling, shredding, pre-processing, metal, and non-metal processing), as well as from controls with no known occupational exposure. Pre- and post-shift urine samples were collected and analysed using ultrahigh-performance liquid chromatography-mass spectrometry (UPLC-MS). A total of 32 endogenous urinary metabolites were annotated with a Variable Importance in Projection (VIP) above 2, indicating that e-waste recycling is mainly associated with changes in steroid hormone and neurotransmitter metabolism, energy metabolism, bile acid biosynthesis, and inflammation. The highest VIP was observed for dopamine-o-quinone, which is linked to Parkinson’s disease. These and other changes in metabolism in workers employed in the processing of e-waste need further verification in targeted studies.
- HBM4EU e-waste study – Occupational exposure assessment to chromium, cadmium, mercury and lead during e-waste recyclingPublication . Leese, Elizabeth; Verdonck, Jelle; Porras, Simo P.; Airaksinen, Jaakko; Duca, Radu C.; Galea, Karen S.; Godderis, Lode; Janasik, Beata; Mahiout, Selma; Martins, Carla; Mārtiņsone, Inese; Ani, Maria Mirela; van Nieuwenhuyse, An; Scheepers, Paul T.J.; Silva, Maria João; Viegas, Susana; Santonen, Tiina; HBM4EU E-waste Study TeamProcessing of electronic waste (e-waste) causes the release of toxic substances which may lead to occupational exposure. The study aimed to gather information on potential occupational exposure during e-waste recycling, with a focus on biomonitoring of chromium, cadmium, mercury and lead. In eight European countries, 195 workers involved in the recycling of lead batteries, white goods, brown goods and metals and plastics were studied. These workers were compared to 73 controls with no direct involvement of e-waste recycling or other metal processing activities. The samples collected consisted of urine, blood and hair samples, along with personal air samples, hand wipes, settled dust samples and contextual information. Chromium, cadmium, mercury and lead was measured in urine, hair, air samples, hand wipes and settled dust; cadmium and lead in whole blood and chromium in red blood cells. Results showed that lead exposure is of concern, with workers from all five types of e-waste showing exposure, with elevated measurements in all matrices. Internal exposure markers were positively correlated with markers of external exposure, indicating workers are not adequately protected. Exposure to mercury and cadmium was also observed but to a much lesser extent with raised cadmium concentrations in urine and blood of all workers when compared to controls and raised mercury concentrations were found in brown goods workers when compared to controls. This study has highlighted exposure concerns when processing e-waste, particularly for lead across all waste categories studied, indicating a need for improved control measures in this sector.
- Guidance on minimum information requirements (MIR) from designing to reporting human biomonitoring (HBM)Publication . Jeddi, Maryam Zare; Galea, Karen S.; Ashley-Martin, Jillian; Nassif, Julianne; Pollock, Tyler; Poddalgoda, Devika; Kasiotis, Konstantinos M.; Esteban-López, Marta; Chung, Ming Kei; Kil, Jihyon; Jones, Kate; Covaci, Adrian; Ait Bamai, Yu; Fernandez, Mariana F.; Pasanen Kase, Robert; Louro, Henriqueta; Silva, Maria J.; Santonen, Tiina; Katsonouri, Andromachi; Castaño, Argelia; Quirós-Alcalá, Lesliam; Argelia Castaño; Lesliam Quirós-Alcalá; Lin, Elizabeth Ziying; Pollitt, Krystal; Ana Virgolino; Virgolino, Ana; Scheepers, Paul T.J; Mustieles, Vicente; Cañas-Portilla, Ana Isabel; Viegas, Susana; von Goetz, Natalie; Sepai, Ovnair; Bird, Emily; Gӧen, Thomas; Fustinoni, Silvia; Ghosh, Manosij; Dirven, Hubert; Kwon, Jung-Hwan; Carignan, Courtney; Mizuno, Yuki; Ito, Yuki; Xia, Yankai; Shoji F. Nakayama; Nakayama, Shoji F.; Makris, Konstantinos C.; Parsons, Patrick J.; Gonzales, Melissa; Bader, Michael; Dusinska, Maria; Menouni, Aziza; Duca, Radu Corneliu; Chbihi, Kaoutar; El Jaafari, Samir; Godderis, Lode; van Nieuwenhuyse, An; Qureshi, Asif; Ali, Imran; Costa Trindade, Carla; Teixeira, Joao Paulo; Bartonova, Alena; Tranfo, Giovanna; Audouze, Karine; Verpaele, Steven; LaKind, Judy; Mol, Hans; Bessems, Jos; Magagna, Barbara; Nasution Waras, Maisarah; Connolly, Alison; Nascarella, Marc; Yang, Wonho; Huang, Po-Chin; Heussen, Henri; Goksel, Ozlem; Yunesian, Masud; Yeung, Leo W.Y.; Souza, Gustavo; Vekic, Ana Maria; Haynes, Erin N.; Hopf, Nancy B.Human biomonitoring (HBM) provides an integrated chemical exposures assessment considering all routes and sources of exposure. The accurate interpretation and comparability of biomarkers of exposure and effect depend on harmonized, quality-assured sampling, processing, and analysis. Currently, the lack of broadly accepted guidance on minimum information required for collecting and reporting HBM data, hinders comparability between studies. Furthermore, it prevents HBM from reaching its full potential as a reliable approach for assessing and managing the risks of human exposure to chemicals. The European Chapter of the International Society of Exposure Science HBM Working Group (ISES Europe HBM working group) has established a global human biomonitoring community network (HBM Global Network) to develop a guidance to define the minimum information to be collected and reported in HBM, called the “Minimum Information Requirements for Human Biomonitoring (MIR-HBM)”. This work builds on previous efforts to harmonize HBM worldwide. The MIR-HBM guidance covers all phases of HBM from the design phase to the effective communication of results. By carefully defining MIR for all phases, researchers and health professionals can make their HBM studies and programs are robust, reproducible, and meaningful. Acceptance and implementation of MIR-HBM Guidelines in both the general population and occupational fields would improve the interpretability and regulatory utility of HBM data. While implementation challenges remain—such as varying local capacities, and ethical and legal differences at the national levels, this initiative represents an important step toward harmonizing HBM practice and supports an ongoing dialogue among policymakers, legal experts, and scientists to effectively address these challenges. Leveraging the data and insights from HBM, policymakers can develop more effective strategies to protect public health and ensure safer working environments.
- Occupational exposure to wildland firefighting and its effects on systemic DNA damagePublication . Esteves, Filipa; Madureira, Joana; Costa, Carla; Pires, Joana; Barros, Bela; Alves, Sara; Vaz, Josiana; Oliveira, Marta; Slezakova, Klara; Fernandes, Adília; Pereira, Maria do Carmo; Morais, Simone; Valdiglesias, Vanessa; Bonassi, Stefano; Teixeira, João Paulo; Costa, SolangeBackground: Portugal is among the European Union countries more devastated by forest fires. Wildland firefighters are at the forefront of this battle, facing exposure to a wide range of harmful pollutants. Epidemiological studies have highlighted a potential link between occupational firefighting exposure and several diseases, including cancer. To date, very few studies have explored the biological mechanisms associated with such exposure. The present longitudinal study aims to assess changes in early effect biomarkers following wildland firefighters’ occupational exposure to a real wildfire event. Methods: Paired blood samples from 59 healthy Portuguese wildland firefighters were collected at two different time points: before wildfire season and after a fire event during wildfire season. Sociodemographic variables (e.g., age, sex) and work-related factors (e.g., years of service) were assessed via a self-reported questionnaire. Levels of early effect biomarkers, such as primary DNA damage and oxidative DNA damage (oxidised purines) were assessed via comet assay. DNA double-strand breaks (DSBs) were evaluated by phosphorylated H2AX (γH2AX). Moreover, hydroxylated polycyclic aromatic hydrocarbon metabolites (OHPAHs) and metal(loid)s were quantified in urine samples. The influence of urinary OHPAHs, urinary metal(loid)s, and other exposure-related factors (e.g., firefighting duration) on changes (Δ) in early effect biomarkers (post-vs. baseline levels) was investigated. Results: Firefighting activities led to a significant increase in both primary DNA damage and oxidative DNA damage by 22 % (95 % CI: 1.11–1.35; p < 0.05) and 23 % (95 % CI: 1.04–1.45; p < 0.05), respectively. Results from linear regression revealed that per each unit increase of urinary 2-hydroxyfluorene (2-OHFlu) (μmol/mol creatinine), the risk of ⧍ oxidative DNA damage increased by 20 % [FR: 1.20 (1.09–1.32); p < 0.01]. Additionally, each unit increase in urinary cesium (Cs) (μg/L) resulted in a significant 4 % increase in Δ primary DNA damage [FR: 1.04 (1.01–1.06); p < 0.05] and a 3 % increase in Δ oxidative DNA damage [FR: 1.03 (1.01–1.05); p < 0.05]. Post-exposure levels of γH2AX were significantly correlated with urinary 2-OHFlu levels assessed after firefighting (r = 0.30; p < 0.05). Furthermore, exposure duration and reported breathing difficulties during firefighting were significantly associated with increased levels of primary DNA damage. Conclusion: Results obtained provide insights into the potential human health effects of wildland firefighting occupational exposure at the genetic and molecular levels, offering new and important mechanistic data. These findings are crucial for implementing health and safety measures, recommendations, and best practices to mitigate occupational risks and protect the health of wildland firefighters.
- Seasonality of mortality under climate change: a multicountry projection studyPublication . Madaniyazi, Lina; Armstrong, Ben; Tobias, Aurelio; Mistry, Malcolm N.; Bell, Michelle L.; Urban, Aleš; Kyselý, Jan; Ryti, Niilo; Cvijanovic, Ivana; Ng, Chris Fook Sheng; Roye, Dominic; Vicedo-Cabrera, Ana Maria; Tong, Shilu; Lavigne, Eric; Íñiguez, Carmen; das Neves Pereira da Silva, Susana; Madureira, Joana; Jaakkola, Jouni J.K.; Sera, Francesco; Honda, Yasushi; Gasparrini, Antonio; Hashizume, Masahiro; Multi-Country Multi-City Collaborative Research NetworkBackground: Climate change can directly impact temperature-related excess deaths and might subsequently change the seasonal variation in mortality. In this study, we aimed to provide a systematic and comprehensive assessment of potential future changes in the seasonal variation, or seasonality, of mortality across different climate zones. Methods: In this modelling study, we collected daily time series of mean temperature and mortality (all causes or non-external causes only) via the Multi-Country Multi-City Collaborative (MCC) Research Network. These data were collected during overlapping periods, spanning from Jan 1, 1969 to Dec 31, 2020. We projected daily mortality from Jan 1, 2000 to Dec 31, 2099, under four climate change scenarios corresponding to increasing emissions (Shared Socioeconomic Pathways [SSP] scenarios SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5). We compared the seasonality in projected mortality between decades by its shape, timings (the day-of-year) of minimum (trough) and maximum (peak) mortality, and sizes (peak-to-trough ratio and attributable fraction). Attributable fraction was used to measure the burden of seasonality of mortality. The results were summarised by climate zones. Findings: The MCC dataset included 126 809 537 deaths from 707 locations within 43 countries or areas. After excluding the only two polar locations (both high-altitude locations in Peru) from climatic zone assessments, we analysed 126 766 164 deaths in 705 locations aggregated in four climate zones (tropical, arid, temperate, and continental). From the 2000s to the 2090s, our projections showed an increase in mortality during the warm seasons and a decrease in mortality during the cold seasons, albeit with mortality remaining high during the cold seasons, under all four SSP scenarios in the arid, temperate, and continental zones. The magnitude of this changing pattern was more pronounced under the high-emission scenarios (SSP3-7.0 and SSP5-8.5), substantially altering the shape of seasonality of mortality and, under the highest emission scenario (SSP5-8.5), shifting the mortality peak from cold seasons to warm seasons in arid, temperate, and continental zones, and increasing the size of seasonality in all zones except the arid zone by the end of the century. In the 2090s compared with the 2000s, the change in peak-to-trough ratio (relative scale) ranged from 0·96 to 1·11, and the change in attributable fraction ranged from 0·002% to 0·06% under the SSP5-8.5 (highest emission) scenario. Interpretation: A warming climate can substantially change the seasonality of mortality in the future. Our projections suggest that health-care systems should consider preparing for a potentially increased demand during warm seasons and sustained high demand during cold seasons, particularly in regions characterised by arid, temperate, and continental climates.
- Air pollution mixture complexity and its effect on PM2.5-related mortality: A multicountry time-series study in 264 citiesPublication . Masselot, Pierre; Kan, Haidong; Kharol, Shailesh K; Bell, Michelle L.; Sera, Francesco; Lavigne, Eric; Breitner, Susanne; das Neves Pereira da Silva, Susana; Burnett, Richard T.; Gasparrini, Antonio; Brook, Jeffrey R.; MCC Collaborative Research NetworkBackground: Fine particulate matter (PM2.5) occurs within a mixture of other pollutant gases that interact and impact its composition and toxicity. To characterize the local toxicity of PM2.5, it is useful to have an index that accounts for the whole pollutant mix, including gaseous pollutants. We consider a recently proposed pollutant mixture complexity index (PMCI) to evaluate to which extent it relates to PM2.5 toxicity. Methods: The PMCI is constructed as an index spanning seven different pollutants, relative to the PM2.5 levels. We consider a standard two-stage analysis using data from 264 cities in the Northern Hemisphere. The first stage estimates the city-specific relative risks between daily PM2.5 and all-cause mortality, which are then pooled into a second-stage meta-regression model with which we estimate the effect modification from the PMCI. Results: We estimate a relative excess risk of 1.0042 (95% confidence interval: 1.0023, 1.0061) for an interquartile range increase (from 1.09 to 1.95) of the PMCI. The PMCI predicts a substantial part of within-country relative risk heterogeneity with much less between-country heterogeneity explained. The Akaike information criterion and Bayesian information criterion of the main model are lower than those of alternative meta-regression models considering the oxidative capacity of PM2.5 or its composition. Conclusions: The PMCI represents an efficient and simple predictor of local PM2.5-related mortality, providing evidence that PM2.5 toxicity depends on the surrounding gaseous pollutant mix. With the advent of remote sensing for pollutants, the PMCI can provide a useful index to track air quality.
- Baseline data and associations between urinary biomarkers of polycyclic aromatic hydrocarbons, blood pressure, hemogram, and lifestyle among wildland firefightersPublication . Barros, Bela; Paiva, Ana Margarida; Oliveira, Marta; Alves, Sara; Esteves, Filipa; Fernandes, Adília; Vaz, Josiana; Slezakova, Klara; Costa, Solange; Teixeira, João Paulo; Morais, SimoneIntroduction: Available literature has found an association between firefighting and pathologic pathways leading to cardiorespiratory diseases, which have been linked with exposure to polycyclic aromatic hydrocarbons (PAHs). PAHs are highlighted as priority pollutants by the European Human Biomonitoring Initiative in occupational and non-occupational contexts. Methods: This cross-sectional study is the first to simultaneously characterize six creatinine-adjusted PAHs metabolites (OHPAHs) in urine, blood pressure, cardiac frequency, and hemogram parameters among wildland firefighters without occupational exposure to fire emissions (> 7 days), while exploring several variables retrieved via questionnaires. Results: Overall, baseline levels for total OHPAHs levels were 2 to 23-times superior to the general population, whereas individual metabolites remained below the general population median range (except for 1-hydroxynaphthalene+1-hydroxyacenaphtene). Exposure to gaseous pollutants and/or particulate matter during work-shift was associated with a 3.5-fold increase in total OHPAHs levels. Firefighters who smoke presented 3-times higher total concentration of OHPAHs than non-smokers (p < 0.001); non-smoker females presented 2-fold lower total OHPAHs (p = 0.049) than males. 1-hydroxypyrene was below the recommended occupational biological exposure value (2.5 μg/L), and the metabolite of carcinogenic PAH (benzo(a)pyrene) was not detected. Blood pressure was above 120/80 mmHg in 71% of subjects. Firefighters from the permanent intervention team presented significantly increased systolic pressure than those who performed other functions (p = 0.034). Tobacco consumption was significantly associated with higher basophils (p = 0.01–0.02) and hematocrit (p = 0.03). No association between OHPAHs and blood pressure was found. OHPAHs concentrations were positively correlated with monocyte, basophils, large immune cells, atypical lymphocytes, and mean corpuscular volume, which were stronger among smokers. Nevertheless, inverse associations were observed between fluorene and pyrene metabolites with neutrophils and eosinophils, respectively, in non-smokers. Hemogram was negatively affected by overworking and lower physical activity. Conclusion: This study suggests possible associations between urinary PAHs metabolites and health parameters in firefighters, that should be further assessed in larger groups.