He Ministry of Healthin collaboration with three other ministries and several scientific entities, plans to start the first major state study in December to see how they affect us the chemicals we are exposed to on a daily basis. The initiative is part of the new national human biomonitoring structure and aims to measure the levels of contaminants in thousands of volunteers as a first step to then take public health measures based on science. Other surrounding countries, such as France or Germany, already have this type of structures, while In the US, similar work helped ban lead in gasoline.. Until now, only partial studies had been carried out (on adolescents, mothers and workers).
Every day, we are in contact with chemical substances present in all types of objects, from packaging to cosmetics, from textiles to food packaging and even food (which may contain traces of pesticides and herbicides). Although they are generally safe, some of them function as endocrine disruptorsThat is, they affect hormones and, over the years, can cause reproductive problems, breast cancer, diabetes, obesity… These types of studies serve to identify sources of exposure to different pollutants, study their relationship with the disease, identify vulnerable groups, setting research priorities or determining the effectiveness of public health policies.
A spokesperson for Mónica García’s department points out that, first of all, it is planned to send 14,000 letters to as many families, based on a sampling carried out by the National Institute of Statistics (INE). If the deadlines are met, shipping will begin in December. “An adult over 18 years of age from that family is asked to participate. We sent many letters so that the final sample is around 25%, that is, about 3,000 people,” he points out.
Afterwards, those who wish to participate must go to a health center – although this could be different in some communities – to have blood, hair and urine samples taken. If everything goes as planned, this phase will begin at the beginning of 2025. These samples will be sent to laboratories of scientific entities throughout Spain to analyze the remains of around 40 contaminating substances.
Argelia Castaño is the president of the Permanent Commission of the Interministerial Commission on Human Biomonitoring (CIBMH), which is coordinated by the Carlos III Health Institute (ISCIII): “We have been fighting for 15 years to establish a national surveillance program in Spain like many countries around us have. Until now, very good work had been done by researchers, but institutional support was lacking. Now, finally, a stable human biomonitoring structure is being put in place.”
The work began in 2022, with the agreement between Health and Ecological Transition, which were later joined by Agriculture and Consumer Affairs, as well as different public and scientific entities. The following year the plenary session and the permanent commission were formed, and the first major project began to see the light. “We are now in the phase of starting this first study, and as soon as filming begins it can be expanded to the regional level,” says Castaño. Health confirms that it has allocated five million euros to the program, and another million and a half for communities that wish to expand the data in their territories.
What is it for? “These types of studies are essential to know the environmental exposure to which the population is exposed,” says Marta Esteban, head of the Environmental Toxicology Area of the National Center for Environmental Health (CNSA) —of which Castaño has been director for seven years— from the ISCIII and technical coordinator of the project. “The idea is that the work is periodic, carried out over the years and covers a representative population of the entire country. This provides fundamental data when establishing temporal and geographical differences, and possible associations with health effects,” he continues.
One of the laboratories that chooses to evaluate the samples is that of the University of Murcia, where toxicologist Miguel Motas works (who has already participated in similar work with adolescents): “Substances such as lead, mercury or cadmium will be monitored, in addition to pesticides and emerging substances from plastics, such as bisphenols, phthalates and perfluorinated substances. The important thing is to know what reaches human beings, in what quantity, and what effects it can cause in the long term, to then take measures.”
The results can help take public health measures. “In the United States it was seen that lead generated a problem in the population, but it was not known to what extent it had to do with leaded gasoline,” says Motas. “They managed to ban lead in gasoline and in their biomonitoring study they discovered that a spectacular drop in lead in the population had been achieved, around 80%. So these works serve to demonstrate that an epidemiological measure is efficient,” he adds. In Spain, different papers on the effect of mercury on babies and pregnant women led to in the recommendation that this population reduce tuna consumption to a minimumsince this fish contains high levels of that metal.
Epidemiological survey
Each sample will be accompanied by an epidemiological survey with all types of data, from place of residence or eating habits to type of clothing worn or sport practiced. “We are selecting the indicators and from our center we will manage the databases that are created, we will analyze them, code them and store them so that scientists can consult them,” comments José Luis Peñalvo, director of the National Center for Epidemiology (CNE), which highlights that the study “is pioneering and very ambitious.”
In his opinion, when there are samples “general environmental exposures can be measured and areas where the levels of exposure to certain substances are higher can be mapped, to then investigate where they come from or know if they affect vulnerable populations.” Thus, “it will be a solid and objective scientific basis to generate preventive policies for health levels,” in a complementary way to the National Health Surveys.
Both the samples and the surveys will be anonymized, although if in any case an unusually high level of dangerous substance is detected, the citizen will be advised (provided they give permission) to go to their doctor. “I directed a biomonitoring program for adolescents with the ISCIII and in Cádiz we found high levels of mercury due to the consumption of tuna,” says Motas. “However, there was also a case in Albacete that did not come from fish. With the family’s permission, we went to interview them and eventually entered the boy’s room, which had a mineral collection that included cinnabarwhich has mercury. We told them to take him out of the room and in a short time his levels of that metal went down,” he continued.
The results will take at least two years. From there, public administrations will have scientific data to take measures. “Bisphenol A has been banned in certain foods and plastic containers, but we are already looking for bisphenol F and Z, which are the substitutes that the industry is using,” says Motas. And he adds: “We can also give recommendations. For example, I would advise removing all black plastic materials (spatulas, cutlery) from the kitchen, because they are made with recycled elements but the perfluorinated materials, which are endocrine disruptors, have not been removed.”
Argelia Castaño summarizes: “We hope that this pioneering work offers us a snapshot of how Spaniards are exposed to pollutants. There will be some that affect us more than others, maybe surprises will come out. In any case, it is about helping administrations to be able to better adjust chemical product control policies.”
