From science to policy: translation of human biomonitoring results into policy measures in Flanders (Belgium): phased action plan

By order of the  Government of Flanders the first generation 'Flemish Centre of Expertise on Environment and Health' implemented the Flemish human biomonitoring program 2002 - 2006.

The aim of the Flemish biomonitoring program is not only to provide better insights in the impact of the environment on human health, it also aims at providing a profound base for a more effective environment and health policy.

A complex and vast amount of scientific data became available for the Flemish policy makers, although translating human biomarker results into concrete policy measures is not as easy and straight forward as it might seem.

The phased action-plan

In order to guarantee that the results of the human biomonitoring campaign are translated into a policy response, a phased action-plan was developed.
The phased action-plan should make it possible to evaluate the gravity of the biomarker signals found, to trace the causes and to develop a policy consisting of targeted actions.
The action-plan implies 3 phases in which

  1. the seriousness of biomarker anomalies is evaluated and priorities are set
  2. the sources of pollution that are causing the anomalies are traced
  3. concrete policy measures are proposed when appropriate

These phases are run through with an expert panel of multi-disciplinary experts (epidemiology, public health, clinical medicine and environmental toxicology) and a jury including local stakeholders and representatives of the Flemish administrations.

The purpose of phase I is to arrive at a preliminary assessment of the seriousness of the deviating biomarkers, followed by their classification for further actions in the framework of the phased action-plan. To this end, the biomonitoring data will be thoroughly analyzed with reference to international scientific studies and biomonitoring and epidemiological data. Several aspects will be covered such as known health risks, the size and age of the population group concerned, possible solutions to the problem and social factors (ethical, social and economic).

In phase II will be studied if the deviations are due to local environmental pollution or other factors that may possibly differ from one sampling area to another. This includes a more detailed study of lifestyle factors (diet, work, hobbies and smoking habits, ...) and the environmental status of the sampling area(s) concerned (emission and immission data, modeling results, ...). If the deviations appear to be due to a local environmental problem, a possible local source is identified. This will be done by means of e.g. inventorying and identification of possible sources, detecting sources via environmental distribution models, exposure assessment by means of e.g. pharmacokinetic modeling.

In phase III, this coordinated approach will eventually lead to the description of possible specific and well coordinated policy decisions.

The phased plan pays particular attention to transparency, expansion of knowledge, level of support for the working method and policy choice.

The action-plan was piloted in practice on the basis of the DDE-results of the human biomonitoring campaign.
The proposed policy actions were classified on the basis of e.g. following policy criteria: costs (financial and manpower), effectiveness in terms of reduction in exposure to DDT, added value of the action for different age groups and other pollutants of the human biomonitoring programme.

Since some of the listed actions already were dealt with in ongoing policy actions, the main focus of the advice was on two actions.

  1. A specific research study on routes of exposure to DDE/DDT by means of a case-control study amongst high and low exposed participants of the biomonitoring in order to get an idea of e.g. (historical) use and gardening practices.
  2. A special campaign of awareness raising and collection of DDT and other pesticides for waste disposal.

Currently the action-plan is being carried for two different cases: increased levels of persistent organic pollutants in the rural areas in Flanders and the increased asthma and allergy incidences in Flemish city areas.