Interpreting biomarker data from the COPHES/DEMOCOPHES twin projects: Using external exposure data to understand biomarker differences among countries

R. Smolders*, E. Den Hond, G. Koppen, E. Govarts, H. Willems, L. Casteleyn, M. Kolossa-Gehring, U. Fiddicke, A. Castaño, H. M. Koch, J. Angerer, M. Esteban, Ovnair Sepai, K. Exley, L. Bloemen, M. Horvat, L. E. Knudsen, A. Joas, R. Joas, P. BiotD. Aerts, A. Katsonouri, A. Hadjipanayis, M. Cerna, A. Krskova, G. Schwedler, M. Seiwert, J. K.S. Nielsen, P. Rudnai, S. Közepesy, D. S. Evans, M. P. Ryan, A. C. Gutleb, M. E. Fischer, D. Ligocka, M. Jakubowski, M. F. Reis, S. Namorado, I. R. Lupsa, A. E. Gurzau, K. Halzlova, E. Fabianova, D. Mazej, J. Tratnik Snoj, S. Gomez, S. González, M. Berglund, K. Larsson, A. Lehmann, P. Crettaz, G. Schoeters

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)


In 2011 and 2012, the COPHES/DEMOCOPHES twin projects performed the first ever harmonized human biomonitoring survey in 17 European countries. In more than 1800 mother-child pairs, individual lifestyle data were collected and cadmium, cotinine and certain phthalate metabolites were measured in urine. Total mercury was determined in hair samples. While the main goal of the COPHES/DEMOCOPHES twin projects was to develop and test harmonized protocols and procedures, the goal of the current paper is to investigate whether the observed differences in biomarker values among the countries implementing DEMOCOPHES can be interpreted using information from external databases on environmental quality and lifestyle.In general, 13 countries having implemented DEMOCOPHES provided high-quality data from external sources that were relevant for interpretation purposes. However, some data were not available for reporting or were not in line with predefined specifications. Therefore, only part of the external information could be included in the statistical analyses. Nonetheless, there was a highly significant correlation between national levels of fish consumption and mercury in hair, the strength of antismoking legislation was significantly related to urinary cotinine levels, and we were able to show indications that also urinary cadmium levels were associated with environmental quality and food quality. These results again show the potential of biomonitoring data to provide added value for (the evaluation of) evidence-informed policy making.

Original languageEnglish
Pages (from-to)86-95
Number of pages10
JournalEnvironmental Research
Publication statusPublished - 1 Aug 2015

Bibliographical note

Funding Information:
We wish to thank the European Commission , Belgium, DG for Research and Innovation (RTD), who is funding COPHES in the 7th Framework Programme (No. 244237 ). DEMOCOPHES ( LIFE09 ENV/BE/000410 ) received 50% funding through the LIFE+ financial instrument of the European Union (DG ENV), as well as 50% through funding received from the DEMOCOPHES partners ( ). More information about the COPHES/DEMOCOPHES twin projects can be found at and the other papers in this Special Issue. Finally, we would particularly like to thank all the mothers and children who so generously participated in this study. All data were collected following the guidelines of national ethical committees.

Publisher Copyright:
© 2014 Elsevier Inc.


  • External exposure data
  • Human biomonitoring
  • Interpretation


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