German Environmental Survey, GerES 2014-2017

Six children on a lawn sich in einer Kette bei den Händen gefasst und hüpfen lachend in die LuftClick to enlarge
UBA is tracking exposure to pollutants of children and adolescents from 167 German communities
Source: yanlev / Fotolia.com

From 2014 to 2017, the German Environment Agency is investigating the degree of child and adolescent exposure to environmental influences in Germany. Families are selected to participate in the survey according to certain statistical criteria. They are providing important insights into the health of today’s young generation – including a health check of the environmental impact on their children.

Table of Contents

 

Spotlight on the young generation

The 2014-2017 German Environmental Survey for Children (GerES V) by the German Environment Agency (UBA) is the 5th large-scale survey of the population’s exposure to pollutants in the environment. The survey focuses mainly on the young generation. UBA invited children and adolescents between the ages of 3 and 17 who had previously been part of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS, wave 2) of the Robert Koch Institute (RKI).

 

Survey objectives

GerES V is investigating the exposure of the young generation in Germany to potentially harmful chemicals and environmental influences. The findings will make it possible to draw inferences about which pollutants and other environmental factors can impact the development and health of children and adolescents.
In addition to determining current exposure and its effect on health, the other aims of GerES V include identifying or determining

  • the source of individual pollutants,
  • the exposure pathways from the environment into the human body,
  • whether there are groups which are especially vulnerable, and
  •  how human exposure to the environment has changed in recent years.

The outcome will also provide information on what everyone can do to promote good health and how to avoid exposure to environmental pollutants. The data will serve as a basis for decision-making concerning regulations to protect man and the environment.

 

Survey benefits

The main benefits of GerES V include:

  • delivery of population-based data about the exposure of children and adolescents in Germany to environmental pollutants.
  • derivation of reference values which can provide the basis for standardized assessment which can also be applied as a European benchmark in other EU surveys.
  • Its results can provide early warning about the environment impact on health.
  • Trends of environmental impacts and their changes can be identified.
  • The effectiveness of common measures to reduce pollution can be reviewed.
  • Vulnerable groups can be identified and pollution sources and exposure pathways can be traced.
  • GerES V data can also help to identify correlations between the environment and certain health problems and reveal any associations between socioeconomic factors and environmental exposure.
 

Survey test methods

A core element of the survey is human biomonitoring (HBM) – examination of the body’s own fluids and tissues. The survey involves testing blood and urine samples taken from the participating children and adolescents. The environmental influences in the participants’ living environment will also be examined. This includes testing drinking water, house dust and indoor as well as the noise level in the surroundings.
A standardized interview is conducted with all participants and their parents to identify the major factors which determine the extent of their individual exposure. This might include home décor and furnishings, dietary habits, the use of different products and other behaviour which is relevant to the environment.
Some of the blood and samples will be frozen and stored (subject to participant consent), so that they can be tested for new environmental pollutants at a later point in time since the necessary methods of analysis are currently still under development.
All the test methods and procedures were trialled prior to GerES V in a preliminary study involving families living in Berlin.

 

Selection of survey participants

The children and adolescents aged 3-17 who are participating in GerES V come from 167 cities and municipalities which are considered representative of the whole of Germany. All the invited participants have already participated in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS, wave 2) of the Robert Koch Institute (RKI). They were selected randomly from the local population registers as representative of their age and sex. This is to ensure that the results of the study are representative, that is, that one can generalise about all children and adolescents in the given age group in Germany.
The greater the number of people to participate in GerES V, the more meaningful the results will be. As a small bonus the families, if they desire they can receive an environmental health evaluation of the measured pollutants.
GerES V, just as its predecessor GerES IV, is an UBA investigation of the exposure of children and adolescents. There are many reasons the young generation is considered vulnerable to health disorders:

  • Toddlers like to put things in their mouths, crawl and play on the floor or dig in sandpits. In this way they ingest certain pollutants more intensely than adults.
  • Young people’s bodies are in a state of constant development. They are particularly sensitive to certain influences at various stages of growth.
  • The child or adolescent organism usually processes pollutants and other environmental influences differently than an adult.
  •  Children and adolescents absorb more pollutants relative to their body weight than adults.
 

Participant surveillance scheme

UBA has assigned the Kantar Health GmbH to conduct the surveys, sampling and the measurements which are taken during a home visit to the participating families. The average time for sampling and the survey is about 90 minutes. The procedure involves:

  • sampling household drinking water,
  • collecting a morning urine sample from the child/adolescent,
  • measuring the sound level,
  • measuring the amount of ultrafine particles in the indoor air,
  • completing a questionnaire with parent/guardians and children ages 11 and older about potential exposure to pollutants,
  • answering questions about the general health of the child/adolescent.

A few randomly selected households will also:

  • provide a full hoover bag for testing
  • have a small collector hung indoors which takes a seven-day measurement of volatile organic compounds, or
  • have a small filter collection device installed to take a seven-day measurement of particulates in both the indoor and outdoor air.
 

Analysis of samples in current survey

The GerES V survey is testing samples of urine, blood, drinking water, house dust, and indoor air for traces of pollutants. UBA is focusing on substances and environmental impacts which are known or presumed to be harmful to health under certain circumstances.

Analysis of samples in current survey

What urine, noise measurement and other investigations can tell us.

  • Overview

    UBA’s researchers will examine morning urine and blood samples to determine the degree of child and adolescent exposure to certain environmental pollutants. The pollutants may have had various different sources or uptake pathways. What is crucial in these human biomonitoring tests is that there is a specific method of analysis to trace pollutants or their metabolites in both urine and blood.
    GerES V is testing urine and blood for plasticisers, parabens (used as preservatives), cotinine (tobacco degradation product), polycyclic aromatic hydrocarbons, or PAHs (a product of combustion processes), various metals, perfluorinated compounds, or PFCs (used in many products), and long-lived polychlorinated biphenyls (PCB).
    Some of the substances tested have an effect similar to hormones and can encourage the development of cancer or trigger allergies.

  • Plasticisers in urine

    Plasticisers are substances which are added to brittle materials to make them soft, flexible and elastic. Phthalates are a common group of plastics. They are used in soft PVC, for instance in toys, food packaging wrap, floor coverings, hoses, seals or floor coverings. Some phthalates have hormone-like properties and are classified as reprotoxic.
    Because of their health risks the use of some phthalates has been greatly restricted since early 2015 and may only be used with special authorisation. Many phthalates and their substitutes are nevertheless still in use.
    Phthalates are degraded relatively quickly in the body. Their metabolites are traceable in urine. GerES V is tracking the concentrations of metabolites from more than different phthalates (e.g. DEP, BBzP, DnBP, DiBP, DEHP) in the urine of children and adolescents. A few phthalate substitutes such as DINCH and DPHP will also be tracked since their use is becoming more and more common.

  • Parabens in urine

    Parabens are used primarily as preservatives in foods, medicines and cosmetic products. Parabens in cosmetics are taken up through the skin whereas oral absorption is the common path for food and medicines. Animal tests have shown that several parabens act similarly to hormones.
    Short and long-chained and branched parabens are being tracked in the urine of children and adolescents.

  • Cotinine in urine

    Tobacco smoking is still widespread in Germany. Second-hand smoke contains more than 70 pollutants and is inhaled involuntarily by non-smokers. Passive smoking in childhood is associated with a wide range of health problems and increases the risk of various diseases such as bronchitis and asthma.
    Because nicotine can no longer be detected in urine after just a few hours, exposure to smoke or second-hand smoke is determined by the presence of the nicotine degradation product cotinine. Cotinine can be tracked in urine for one to two days after exposure, and even longer in non-smokers and children.

  • PAH in urine

    Polycyclic aromatic hydrocarbons (PAH) are produced when the combustion of organic material such as wood, coal, or oil is incomplete. They also occur in used motor oils, tar and soot. Many PAH are carcinogenic, may cause harm to the unborn child or impair fertility. There is evidence that children react more sensitively to PAH than adults.

  • Pyrrolidones in urine

    Pyrrolidones are used as solvents in many technical applications. Child and adolescent exposure can occur through contact with paint and graffiti removers and indoors through the use of varnishes or from floor coverings.
    The pyrrolidone NMP has been classified as mutagenic or reprotoxic in humans and is therefore increasingly being replaced by the pyrrolidone NEP. The latter, however, has toxicological properties very similar to NMP.
    Various NMP and NEP metabolites can be tracked in urine and indicate exposure.

  • Metals in urine and blood

    Some metals – iron, zinc, copper – are vital to the human organism, whereas others can cause damage in even small amounts: cadmium and mercury, for example. The body absorbs metals from food, drinking water, tobacco smoke, and from soil and dust particles.

  • Mercury in urine

    Mercury occurs naturally in the environment but is also a by-product of industrial processes. Thermometers used to be made using mercury; nowadays it is used in energy-saving lamps. Mercury vapour escapes if they burst. Exposure to mercury can also occur by eating fish or from amalgam tooth fillings.
    Chronic mercury exposure can cause damage to the central nervous system, kidneys and stomach.
    GerES V is screening the urine of children and adolescents for mercury concentrations, which would mainly reflect the absorption of inorganic mercury.

  • Cadmium in urine and blood

    Just like mercury, cadmium occurs naturally in the environment. Soil and bodies of water contain high levels of cadmium if they are near industrial metals mines or battery and paint manufacturing plants.
    The major source of exposure to cadmium, however, is tobacco smoke and second-hand smoke. Foods which contain cadmium can also be a factor of exposure.
    Chronic exposure to cadmium can cause kidney damage and is also thought to be carcinogenic.
    GerES V is tracking cadmium in both urine and blood. Whereas cadmium remains in the blood for a short time only, its presence in urine reflects accumulated, lifelong exposure.

  • Perfluorinated compounds in blood

    GerES V is tracking twelve perfluorinated compounds (PFC) in blood. PFC are persistent synthetic substances which accumulate in the environment, the food chain and in the human body. The most well known among them are perfluorooctanesulfonic acid (PFOS) and perfluorooctanoic acid (PFOA). PFOS is used in oil, water and stain-repellent coatings in textiles, food packaging materials, and kitchen utensils. PFOA is also used in the textiles industry as well as the electronics, semiconductor, and aerospace industries.
    In long-term animal tests PFOA and PFOS favour the development of tumours. Some PFC are also presumed to impair fertility.

  • Polychlorinated biphenyls in blood

    Although the production and use of polychlorinated biphenyls (PCB) has been banned for decades in Germany, their persistence and accumulation in the environment can mean they are absorbed through contaminated food. PCB are neuro- and immunotoxic and may cause cancer in higher concentrations. GerES V is tracking seven different PCB compounds in blood.

  • Overview

    Drinking water is among the most effectively monitored foodstuffs in Germany and must meet the same safety criteria as bottled drinking water. And yet, undesirable substances are released from pipes into the water. The longer water remains in the pipe - experts speak of stagnant water - the greater in general terms is the contamination. In GerES V, UBA is investigating the household drinking water for traces of metals and organic substances.

  • Metals in drinking water

    In GerES IV (2003-2006) the scientists traced mainly copper, nickel and lead in stagnant water. In GerES V the content of these metals is determined in both stagnant and fresh tap water.

  • Organic substances in drinking water

    Organic substances enter drinking water, for example, from plastic pipes, rubber seals and coatings. Gas chromatography-mass spectrometry screening is carried out in accordance with the DIN EN 15768 norm to determine the quantities involved and what types of organic pollutant are common in drinking water.

  • Overview

    The analysis of the hoover bag reveals the content of plasticisers (e.g. phthalates) and flame retardants in household dust. The pollutants can be absorbed via the lungs or the digestive tract. Children usually have a higher risk of exposure than adults because they are prone to putting things in their mouth and also breathe at a more rapid rate. Children may also crawl on the ground and their direct contact with dust results in more uptake than an adult.

  • Plasticisers and flame retardants in the hoover bag

    The phthalate DEHP is in the group of plasticisers which pose a risk to health. It acts like a hormone and can impair fertility, which is why it may no longer be used in children's toys.
    UBA does lab tests on the house dust to determine the content of various phthalates and their substitutes. Another test determines the extent of dust contamination with flame retardants which may come from electronic devices, upholstered furniture and floor coverings.

  • Overview

    Walls, floors, cupboards and pieces of clothing continuously emit chemicals into the indoor air. This wave of the GerES survey traces volatile organic compounds (VOC) and carbonyls in indoor air. High concentrations of VOC can cause health problems because they irritate the mucous membranes of the respiratory tract and eyes. Excessively high concentrations of VOC can also lead to headaches, allergies and sleep disorders. Carbonyls can irritate the mucous membranes and in some cases are carcinogenic.

  • Volatile organic compounds (VOCs) in indoor air

    In GerES V VOC are collected for seven days in a passive collector inside and outside the child’s room. Researchers make use of thermo-desorption procedures and gas chromatography-mass spectrometry to determine the concentrations of alkanes, aromatic hydrocarbons, cyclic siloxanes, and different aromatic substances.

  • Formaldehyde and other carbonyls in indoor air

    The content of indoor air is analysed for 15 carbonyls, including formaldehyde and longer-chain aldehydes and ketones. They offgas from particle board, cork flooring, linoleum and some paints.
    Passive samplers are installed for seven days inside the child’s room. They collect all pollutants containing carbonyl groups. The concentration of the individual substances is determined using high-pressure liquid chromatography followed by mass spectroscopy.

  • Overview

    Particulate matter refers to small airborne particles with a diameter of less than 10 microns (µm) (a micron is one millionth of a metre). The smaller the particles are, the deeper they penetrate into the lung, making it difficult or impossible to expel them by coughing. Ultrafine particles even enter the bloodstream via the alveoli.
    Air measurements inside and outside the homes indicate the exposure of the residents to particulate matter, polycyclic aromatic hydrocarbons (PAH) and ultrafine particles.

  • Particulate matter in indoor and outdoor air

    UBA places small filter devices (mini volume samplers) in the participating families' living room for seven days to collect particles which measure no more than 2.5 microns (µm) in diameter from the air. At the same time the participating families keep a journal in which they document when they hoover or air the apartment or clean pets' cages. The particulate concentration outside the home is measured for comparison.

  • PAH analysis of particulate matter indoors

    Heavy metals or sometimes carcinogenic polycyclic aromatic hydrocarbons (PAHs) can accumulate on the surface of dust particles. GerES V also tests the dust collected for the particulate matter analysis for its PAH content.

  • Ultrafine particles in the indoor environment

    Airborne particles smaller than 1 micron in diameter can penetrate into the bloodstream via the alveoli. This may cause inflammation of the lungs or damage the cardiovascular system.
    A condensation particle counting device is installed in the child’s room for an hour to determine the content of ultrafine particles (which are less than 0.1 µm in diameter). It counts all particles which measure between 1 and 0.01 µm. The concentration ranges from 0 up to 100,000 particles per cubic centimetre of air. Measurements are taken with windows and doors closed.

  • Overview

    A level of background noise that is persistently too high or recurrent is detrimental to well-being and health. Children and adolescents are also affected. Increased blood pressure is associated with high exposure to noise. Listening to loud music with headphones or at concerts and discos is known to cause damage to the ear. However, the exact conditions in which noise becomes harmful to health have not yet been conclusively determined.

  • Noise measurement

    Average sound exposure is measured for a 15-to-20-minute period from the window ledge of an open window or on the balcony. The interviewers document the position of the child’s or adolescent’s room in relation to the road, identify the type of road and ask questions to establish how the residents rate the noise level in the home.
    Generally speaking, an average outdoor sound level of no more than 40 dB(A) at night and 50 dB(A) during the day is recommended. Higher sound levels diminish the sense of well-being. The risk of damage to health increases proportionally with sound level.