Health-related environmental monitoring

Health-related environmental monitoring revolves around people. Currently, the German Environment Agency mainly uses two instruments: the German Environmental Surveys on Health (GerES) and human samples from the German Environmental Specimen Bank.

The German Environment Agency has been conducting the German Environmental Surveys on Health (GerES) for the Federal Government since the 1980s at intervals of several years. The surveys compile and update representative data on people’s internal and domestic exposure to pollutants. To this end, blood and urine samples are collected and samples of tap water, indoor air and house dust are taken from people's homes and analysed in the lab. In addition, survey participants fill out structured questionnaires about their living conditions and exposure-relevant behaviours.

The findings from the surveys are representative of the population. This means that the study results can be used as the basis for claims about the whole population in the age group being studied.

The fifth cycle of GerES (GerES V) focused on exposure in children and adolescents aged three to 17 years. GerES V was carried out in close cooperation with a health study by the Robert Koch Institute. This meant the specific data obtained on exposure to chemicals, noise and indoor air pollutants could also be assessed in the context of more general data on the health of the participating individuals. In addition to familiar chemicals such as cadmium, lead and mercury, newer substances like phthalates, triclosan, UV filters, bisphenol A and per- and polyfluoroalkyl substances (PFAS) were also investigated.

Field work for the next German Environmental Survey on Health (GerES VI), focusing on exposure in adults, ran from 2023 to 2024 as an additional health-related environmental study. The results of the study are currently being evaluated and synthesised in a report.

The German Environmental Specimen Bank is an archive of frozen human biological samples (blood and urine). Samples are collected every year from young adults (mostly students) in Münster (since 1984), Halle (since 1995), Greifswald (since 1996) and Ulm (since 1997). In addition, participants fill out a questionnaire that collects socio demographic data and information on exposure-relevant behaviour and living conditions. The continuous storage of new samples since the 1980s provides a basis for evidence-based claims about changes over time in public exposure to pollutants. Using the stored samples, it is also possible to retroactively identify environmental pollutants or their metabolites that were unknown or could not be analysed as environmental pollutants at the time of storage.

The analytical method human biomonitoring (HBM) plays a key role in GerES and the German Environmental Specimen Bank. HBM involves testing blood and urine samples for pollutants or their metabolites. Occasionally, breast milk and other body fluids or tissue are also tested. Human biomonitoring provides information on whether chemicals have entered the human body from the environment, and if so which chemicals and in what quantities. This data alone is not sufficient to enable conclusions about the sources of the chemicals.

People can absorb chemicals from a variety of sources, including via air, water, food, textiles or personal care products. With continued exposure, some chemicals can accumulate in different organs over time, whereas other substances are quickly excreted. Depending on whether, how, and to what extent people are directly exposed to chemicals, intake may be limited to individual sources, even if they are present in other media.

For that reason, more comprehensive investigations are often needed to identify intake pathways and chemical sources and, if necessary, initiate targeted measures to minimise them.

Not every chemical absorbed has adverse impacts on human health. Modern analytical methods enable the detection of many chemicals in the human body that do not pose a risk to human health. There are, however, numerous chemicals which we know for certain need to be urgently (further) reduced as they can compromise human health.

The Human Biomonitoring Commission (HBM Commission) of the German Environment Agency evaluates the health impacts of chemical concentration levels detected in blood and urine samples. The Commission has set reference values and human biomonitoring values (HBM values) for a range of chemicals. Reference values are determined using statistics and represent the average concentrations of a chemical in the population or a specific population group at a particular point in time. These values are per se of no health relevance. By contrast, HBM values are based on toxicological findings and have a health dimension. Two levels of values are defined: HBM-I and HBM-II. If the concentration of a chemical is below its HBM-I value, there is no cause for concern based on current knowledge of the chemicals’ properties. If the concentration is above the HBM-II value, adverse health effects are possible. In these cases, action needs to be taken to reduce exposure and, depending on the concentrations in question, biomedical support may be needed. If the concentration lies between the HBM-I and HBM-II values, an attempt should be made to identify the exposure source in order to reduce substance absorption into the body and prevent adverse health impacts.

Human biomonitoring is an indispensable tool for initiating and adapting environmental policy measures and determining whether protection goals are being met. It is the only way to reliably assess whether a ban or restriction of harmful chemicals has reduced public exposure to these chemicals. That is why there is close cooperation with REACH, the European regulatory framework for chemicals policy.

Human biomonitoring also makes it possible to determine whether chemicals have been absorbed by the human body to an unexpectedly high extent and therefore require regulation.

Some chemicals are challenging to detect or measure in the context of human biomonitoring. For this reason, the Federal Environment Ministry and the German Chemical Industry Association (VCI) launched a cooperative initiative in 2010 to further develop human biomonitoring. The aim of this initiative, originally intended for a period of ten years, is to develop methods for testing chemicals that were not previously measurable. Due to the complexity of this work, the initiative has been extended until the agreed methods are completed. The goal is to develop pioneering methods to detect up to 50 chemicals of relevance to the general population which have potential health implications. Tests have been successfully developed to date for substances including new plasticisers, flame retardants, technical solvents, UV filters and preservatives, all of which are used in consumer products.

The main partners in this project are the German Environment Agency and a panel of experts from science, public authorities and industry. The panel proposes substances and supports the development of methods. The VCI is responsible for developing detection methods. All methods are validated and published in scientific journals so that they are available worldwide.

The Federal Government is responsible for the application of the new methods (e.g. using samples from the Environmental Specimen Bank or within the framework of the German Environmental Surveys on Health). Once the Human Biomonitoring Commission of the German Environment Agency has established corresponding HBM values, exposure levels can finally be assessed from a health standpoint. This will provide valuable information for chemicals policy.

Germany plays a pioneering role in Europe with its human biomonitoring activities. For this reason, the German Environment Agency took on coordination of a major EU research project for the 2016-2022 period: the European Human Biomonitoring Initiative (HBM4EU), which the European Commission funded with over 74 million euros. The initiative coordinated HBM activities in the 30 participating countries, established common standards and developed approaches to make results usable for EU chemicals policy. The project concluded in mid-2022. The work is being continued and expanded on in the framework of a new EU research initiative PARC, Partnership for the Assessment of Risks from Chemicals, which began in May 2022 and will run for seven years.

The Federal Environment Ministry and the German Environment Agency jointly organised international human biomonitoring conferences in Berlin in 2010, 2016 and 2020 to promote the international exchange of experience and knowledge in the field of health-related environmental monitoring.

Important health-related environmental monitoring activities also take place at international level. For instance, since 2010 the Federal Environment Ministry has been promoting the activities of the Environment and Child Health International Group (ECHIG), which comprises experts from Japan, China, France, Denmark, Norway and Germany, including experts from the German Environment Agency. The goal of this collaboration is to exchange methods and experiences and harmonise approaches to ensure that the data obtained is as comparable as possible. This will enable findings which would not be possible using isolated data from individual investigations. The World Health Organization (WHO) is part of this initiative through the International Agency for Research on Cancer (IARC).

The Federal Environment Ministry also works together with WHO in the context of the Environment and Health Process (EHP). This WHO Europe process was initiated in 1989 in Frankfurt am Main. At intervals of several years, conferences of the region’s environment and health ministers set goals for further improvements in the field of environment and health. Data from health-related environmental monitoring supports this process and helps to set priorities. The seventh Ministerial Conference on Environment and Health took place in Budapest from 5 to 7 July 2023. EHP Partnerships were launched as a new tool to implement decisions. The Federal Environment Ministry took over lead responsibility for a new EHP Partnership on Human Biomonitoring, which is open to all interested member states of the WHO European region. The focus of the Partnership is the exchange of experience, mutual support in the practical implementation of studies, capacity building, joint development of strategies to anchor HBM more firmly in legislation, resource mobilisation and risk communication. Unlike research-oriented EU cooperation, which is always for a limited time period, the Partnership under the umbrella of WHO will enable networking on a more permanent basis. As of July 2025, 22 member states have joined the partnership.

WHO Europe is one of the regional organisations of the World Health Organization (WHO). The WHO European region comprises 53 countries, including all EU member states, all countries of the former Soviet Union, Israel and Turkey. A central pillar of this process is the WHO European Centre for Environment and Health (ECEH) in Bonn, which receives significant financial support from the Federal Environment Ministry.