Integrating human biomonitoring exposure data into a primary care morbidity database: a feasibility study

In collaboration with the Department of Health of the Flemish government, VITO (Flemish Institute for Technological Research), and PIH (Provincial Institute for Hygiene), Intego is investigating the health effects of environmental pollutants. For example, there is currently a study on PFAS. Residents of Zwijndrecht who participated in the "human biomonitoring" study in the region in 2021 were given the option to send their PFAS blood results to their general practitioner. If you participated in this study and gave permission to send the data to your general practitioner, and your general practice is connected to our Intego network, we can use your PFAS results to investigate whether high PFAS concentrations are linked to certain conditions (such as elevated liver values, cardiovascular problems, cholesterol, etc.). We do not have access to your personal medical records: the data we use cannot be traced back to a specific person. Therefore, there is no risk that your personal PFAS results or medical data will be disclosed. You can obtain information about this project by sending an email to Pieter Jansen at this address: pieter.jansen@kuleuven.be. As always, you can choose not to have your data used for Intego. You can contact your general practitioner for this.

The detection of a local per- and polyfluoroalkyl substances (PFAS) pollution hotspot in Zwijndrecht (Belgium) necessitated immediate action to address health concerns of the local community. Several human biomonitoring (HBM) studies were initiated, gathering cross-sectional exposure data from more than 10,000 participants. The linkage of these HBM data with primary care health registries might be a useful new tool in environmental health analysis. We assessed the feasibility of linking exposure data from HBM programs to health outcomes from the Intego registry, which collects data from general practitioners’ electronic health records. This feasibility study uses exposure data from one of the completed PFAS HBM studies, which included 796 individuals. We describe the separate datasets, the process of integrating the HBM data into Intego, the analysis plan and the advantages and challenges of using this method. We established the integration of HBM data into the Intego primary care morbidity database, adhering to stringent privacy regulations and quality standards to ensure result integrity. Because of the modest sample size used in this feasibility study, no conclusions about the impact of PFAS on health endpoints can be drawn. However, with PFAS data from more than 10,000 residents available soon, more robust studies will be possible with this new method. We introduce a novel approach for assessing the impact of environmental health hazards within primary care settings. The methods outlined here not only pave the way for larger-scale projects but also offer a promising avenue for long-term environmental health monitoring.

Geen (haalbaarheidsstudie)

Human biomonitoring data (PFAS concentrations). These data are part of Intego and therefore, in principle, not a separate linked dataset.