About the Center

Flemish Center of Expertise on Environment and Health

The Flemish Center of Expertise on Environment and Health is a scientific knowledge pool for environmental health in Flanders (Belgium). The consortium consists of researchers from the five Flemish universities (Antwerp, Brussels, Ghent, Hasselt, Leuven) and research institutes VITO and PIH.

Since 2002 a human biomonitoring network has been established by the Center as part of a program on environmental health surveillance (Flemish Envionment and Health Studies, FLEHS). Up to now, three FLEHS studies were implemented: FLEHS I (2002-2006), FLEHS II (2007-2011) and FLEHS III (2012-2015), and a fourth cycle is ongoing (2016-2020). This fourth cycle builds on strengths and experiences from the past and also addresses new upcoming challenges.

Human biomonitoring

Human biomonitoring investigates the very complex relation between environmental pollution and human health by measuring selected pollutants and certain health effects in humans, using biomarkers. Human biomonitoring is one of the most direct methods to measure the impact of pollutants in men. Both biomarkers of exposure and biomarkers of effect are monitored.

Flemish Environment and Health Studies (FLEHS)

The first FLEHS study (2002-2006; “monitoring for action”) included more than 4,400 participants recruited from 8 regions in Flanders with different environmental characteristics. The participants were recruited by a stratified clustered multi-stage design and belonged to 3 different age groups (newborns and their mothers, 14-15 yrs. old adolescents and 50-65 yrs. adults). The first cycle of the HBM evaluated exposure to traditional pollutants such as cadmium, lead, dioxin-like compounds, hexachlorobenzene (HCB), polychlorinated biphenyls (PCBs), para-,para-dichlorodiphenyldichloro-ethylene (p,p’-DDE), polyaromatic hydrocarbons (PAH’s) and benzene and showed that living in areas with different environmental pressure yields a different fingerprint of pollutants in the body indicating the importance of region based environmental policies and priorities [1,2].

The possibility to obtain geographically differentiated information on environmental health was exploited further in the second cycle of the human biomonitoring program (FLEHS II 2007-2011). A participatory process was used to propose and finally select 2 hotspots of interest for human biomonitoring [3]. The hypothesis was tested whether in the hot spot areas specific biomonitoring data (exposure and effects) are different from reference values that have been obtained over Flanders. As part of the second cycle of the biomonitoring program we obtained reference data for a much wider set of exposure biomarkers compared to the first cycle, this was emphasized by the slogan “What are you carrying with you?” Reference values for more than 50 biomarkers were generated [4].

The third cycle of the program has allowed to generate time trends of internal pollutant levels in humans of the general population of Flanders. The program has also allowed to evaluate the associations between exposure levels and different health outcomes in prospective cohorts of the first two cycles of the Flemish environmental health surveys (FLEHSI and FLEHSII) [5,6]. In addition we have used the HBM data to estimate the positive effects on health as we have seen decreases in biomarker levels of specific metals and persistent organic pollutants over time. However FLEHS III has also shown that for some chemicals no decreasing time trends can be observed yet. Many other chemicals that emerge from new lifestyles and habits have never been investigated. Besides, we demonstrated that levels of environmental exposures are related to differences in socio- economic status (SES) of the study participants emphasizing inequity of exposures and presumably also in health risks [7]. The need for targeted environmental protection guidance for subgroups in the population in relation to lifestyle and SES related is warranted.

fourth FLEHS cycle is ongoing (2016-2020). This fourth cycle builds on strengths and experiences from the past and also addresses new upcoming challenges.

This FLEHS program can only be realized by an interdisciplinary approach. A consortium of complementary teams carry out the program, coördinated by the executive committee and a field coordinators committee

The consortium includes researchers of the five Flemish universities (Antwerp, Brussels, Ghent, Hasselt, Leuven) and two Flemish research institutes (VITO and PIH).

The Center reports to the Flemish government via a steering committee.

An international scientific advisory board is installed for scientific advise on key aspects of the program.

References on this page

1. Schroijen, C.; Baeyens, W.; Schoeters, G.; Den Hond, E.; Koppen, G.; Bruckers, L.; Nelen, V.; Van De Mieroop, E.; Bilau, M.; Covaci, A.; Keune, H.; Loots, I.; Kleinjans, J.; Dhooge, W.; Van Larebeke, N. Internal exposure to pollutants measured in blood and urine of Flemish adolescents in function of area of residence. Chemosphere 2008, 71, 1317–25.

2. Koppen, G.; Den Hond, E.; Nelen, V.; Van De Mieroop, E.; Bruckers, L.; Bilau, M.; Keune, H.; Van Larebeke, N.; Covaci, A.; Van De Weghe, H.; Schroijen, C.; Desager, K.; Stalpaert, M.; Baeyens, W.; Schoeters, G. Organochlorine and heavy metals in newborns: results from the Flemish Environment and Health Survey (FLEHS 2002-2006). Environ. Int. 2009, 35, 1015–22.

3. Keune, H.; Morrens, B.; Croes, K.; Colles, A.; Koppen, G.; Springael, J.; Loots, I.; Van Campenhout, K.; Chovanova, H.; Schoeters, G.; Nelen, V.; Baeyens, W.; Van Larebeke, N. Opening the research agenda for selection of hot spots for human biomonitoring research in Belgium: a participatory research project. Environ. Health 2010, 9, 33.

4. Knudsen, L.; Merlo, D. F. Biomarkers and Human Biomonitoring Volume 1 : Ongoing Programs and Exposures. In; Thomas Graham House, Science Park, Milton Road, 2012; pp. 135–165.

5. Sioen, I.; Den Hond, E.; Nelen, V.; Van de Mieroop, E.; Croes, K.; Van Larebeke, N.; Nawrot, T. S.; Schoeters, G. Prenatal exposure to environmental contaminants and behavioural problems at age 7-8years. Environ. Int. 2013, 59, 225–31. 

6. Van Larebeke, N.; Sioen, I.; Hond, E. Den; Nelen, V.; Van de Mieroop, E.; Nawrot, T.; Bruckers, L.; Schoeters, G.; Baeyens, W. Internal exposure to organochlorine pollutants and cadmium and self-reported health status: a prospective study. Int. J. Hyg. Environ. Health 2015, 218, 232–45.

7. Morrens, B.; Bruckers, L.; Hond, E. Den; Nelen, V.; Schoeters, G.; Baeyens, W.; Van Larebeke, N.; Keune, H.; Bilau, M.; Loots, I. Social distribution of internal exposure to environmental pollution in Flemish adolescents. Int. J. Hyg. Environ. Health 2012, 215, 474–81.