From Environmental Evidence to Biomarker Selection: A Structured Decision-Support Process for Human Biomonitoring...

Area of Science:

• Environmental Health Sciences
• Toxicology
• Biomarker Research

Background:

• Human Biomonitoring (HBM) assesses exposure to environmental contaminants and early biological changes.
• Complex contaminated sites require structured processes for exposure assessment and risk evaluation.

Purpose of the Study:

• To describe the methodological process for designing the INSINERGIA_RT HBM study in Tuscany, Italy.
• To present a structured approach for designing HBM studies in complex environmental settings.
• To integrate environmental, toxicological, epidemiological, and public health data for biomarker selection.

Main Methods:

• The study design integrated environmental evidence, toxicological knowledge, and epidemiological priorities.
• A hierarchical model organizes biomarkers reflecting biological response stages.
• A multi-level approach includes oxidative stress, inflammation, organ damage markers, and integrative indicators like telomere length and metabolomics.

Main Results:

• The manuscript presents a methodological framework, not biomonitoring results.
• The approach is illustrated by an ongoing HBM study in Livorno and Piombino.
• Biomarkers are categorized by biological response levels: upstream pathways, early effects, and cumulative responses.

Conclusions:

• The described structured approach can guide the design of HBM studies in complex contaminated areas.
• A multi-level, mechanistic biomarker strategy is proposed for comprehensive exposure and health risk assessment.
• The INSINERGIA_RT study design provides a practical example of applying this framework.