The added value of a surveillance human biomonitoring program: The case of FLEHS in Flanders (Belgium)

Abstract

In 2002 the Flemish Government decided to initiate the Flem-ish Environment and Health Survey (FLEHS), an extended humanbiomonitoring (HBM) program to assess and monitor human expo-sure of the Flemish population to environmental pollution and itsimpact on public health. Flanders is a densely populated area inthe North of Belgium with intense traffic and widespread indus-trial and agricultural activities, which have a measurable impacton environmental quality and human health. It has been estimated that 6.3% of the total burden of disease in Belgium, assessed usingDisability-adjusted life years (DALYs), is associated with a range ofwell characterized environmental stressors (i.e. particulate mat-ter (PM2.5), secondhand smoke, traffic noise, radon, lead, ozone,dioxins, benzene and formaldehyde) (Hänninen et al., 2014). DALYswere estimated using primarily World Health Organization dataon burden of disease, national environmental exposure data andepidemiological or toxicological risk estimates. However, for manyother chemicals, the exposure levels and associated health effectsare not well assessed or poorly understood.