Health-related environmental monitoring

Humans are at the heart of health-related environmental monitoring. Currently, the German Environment Agency mainly uses two instruments: the German Environmental Survey on Health (GerES; formerly the German Environmental Survey) and human samples from the German Environmental Specimen Bank.

Since the 1980s, the German Environment Agency has been conducting the German Environmental Surveys on Health (GerES) for the Federal Government at intervals of several years. The surveys compile and update representative data on the internal exposure of the population to pollutants and pollutant exposure in the home. To this end, blood and urine samples are collected and samples of tap water, indoor air and house dust are taken from homes for analysis. In addition, participants fill out structured questionnaires about their living conditions and exposure-relevant behaviours. This enables potential sources of pollution to be identified.

The GerES findings are representative of the population, enabling the study results to be used as a basis for statements about the whole population in the age group being studied.

The fifth cycle of the GerES (GerES V) focussed on exposure in children and adolescents aged 3 to 17 years. As the GerES V was carried out in close cooperation with a health study by the Robert Koch Institute, the specific data it obtained on exposure to chemicals, noise and indoor air pollutants could also be assessed in the context of general health data 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), focussing on exposure in adults, was carried out from 2023 to 2024. The detailed assessment of this study and the report on the findings are currently being prepared.

The German Environmental Specimen Bank archives frozen human samples (blood and urine). Samples are collected every year from young adults (mostly students) in Münster (since 1984), Halle/Saale (since 1995), Greifswald (since 1996) and Ulm (since 1997). Participants also fill out a questionnaire to provide socio-demographic information and information on exposure-relevant behaviour and living conditions.

 The regular annual storage of new samples since the 1980s enable statements to be made about changes over time in the population’s exposure to pollutants. Moreover, the stored samples can be tested retroactively for pollutants or their metabolites that at the time of storage were unknown or could not be analysed.

Human biomonitoring (HBM) is a key analytic method in the GerES and the German Environmental Specimen Bank. HBM involves the examination of blood and urine for pollutants or their metabolites. Occasionally, breast milk and other body fluids or tissue are also examined. 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 draw conclusions about the sources of the chemicals.

Chemicals can be absorbed by humans from a variety of sources, such as air, water, food, textiles or personal care products. Some chemicals can accumulate in different organs over time with continued exposure, other substances are quickly excreted. Where people are directly exposed to chemicals, absorption may be limited to individual sources, even if they occur in other media, depending on the extent of exposure and types of chemicals involved.

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 adversely impacts 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 urgently need to be further reduced, as they can compromise human health.

The Human Biomonitoring Commission (HBM Commission) at the German Environment Agency is responsible for the health assessment of chemical concentrations in blood and urine. The Commission has derived numerous reference values and human biomonitoring values (HBM values) for chemicals. Reference values are statistically derived and give the average concentrations of a chemical in the population or a specific population group at a particular point in time. Reference levels do not make any statements on the risks to human health. The HBM values are based on toxicological results and include a health assessment. HBM values are divided into HBM-I and HBM-II values. If the concentration is below the HBM-I value of a chemical, there is no cause for concern according to current knowledge of its properties. If the concentration is above the HBM-II value, adverse health effects are possible. In these cases, action is needed to reduce exposure; biomedical support may be necessary, depending on the concentrations in question. If the concentration lies between the two 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 monitoring tool for initiating and adjusting 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.

Not all chemicals can be reliably examined in the context of human biomonitoring. That is why 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 ways of testing for chemicals that were not previously measurable. Due to the complexity of the tasks involved, the initiative has been extended until the agreed methods have been completed. The goal is to develop the first methods for detecting up to 50 chemicals that are relevant for the general public which have potential health implications. Substances for which such methods have been successfully developed to date include 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 the scientific community, public authorities and industry. The panel of experts proposes substances and supports the method developing process. The VCI is responsible for the development of detection methods. All methods are validated and published in scientific journals so that they are available worldwide.

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

Germany’s human biomonitoring activities make it a pioneer in Europe in the field. In view of that, the German Environment Agency took on coordination of a major EU research project for the 2016-2022 period: The European Commission supported the European Human Biomonitoring Initiative (HBM4EU) with over 74 million euros. The project coordinated HBM activities in the 30 participating countries, established common standards and developed approaches to make results usable for EU substance policy. The project concluded mid-2022. The work is being continued and expanded on in the framework of a new EU research partnership on chemical safety — 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 promoted 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 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 experience exchange, mutual support in the practical implementation of studies, capacity building, joint development of strategies for anchoring HBM more firmly in legislation, mobilisation of resources and risk communication. Unlike research-oriented EU cooperation, which is always for a limited time period, the Partnership under the umbrella of WHO aims to facilitate the creation of more permanent networks. As of July 2025, the Partnership had 22 member states.

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, the 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.