Environmental Health
What biomonitoring studies reveal
The chemical body burden of the general population — measured in people who have never worked in a chemical plant.
Contamination is not the exception — it is the baseline
For most of the twentieth century, toxicology asked what happens to workers in factories. Human biomonitoring asks a different and far more uncomfortable question: what is circulating in the blood and urine of ordinary people who have never worked in a chemical plant? Over the past two decades, large, government-funded, population-representative surveys across Europe and beyond have answered it. The answer is remarkably consistent from one country to the next: contamination is not the exception, it is the baseline.
Twenty-three countries, one result
The most comprehensive dataset comes from HBM4EU, a human biomonitoring survey conducted across 23 countries with over ten thousand participants, designed to generate EU-wide representative data (Govarts et al. 2023). Its results are difficult to read as anything other than a portrait of universal exposure.
Phthalates were detected in the urine of all (100%) participants; of the twelve phthalate compounds assessed, all twelve were found in 95–100% of subjects, and 10% of children and 6% of teenagers reached potentially toxic levels of total phthalates, leading the authors to conclude that adverse health risks from co-exposure to different phthalates cannot be excluded (Govarts et al. 2023). The newer substitute plasticiser DINCH — one of the so-called “regrettable replacements” — was itself detected in 99% of subjects (Govarts et al. 2023).
Roughly one in seven teenagers above the guidance value
PFAS told a similar story. Across 100 different PFAS compounds tested, PFAS in total were detected in all (100%) participants, with 40% exceeding potentially toxic levels; up to 13% of teenagers exceeded the guidance value for the sum of PFOS, PFOA, PFNA and PFHxS, meaning roughly one in seven European teenagers is at risk from these four compounds alone — a figure the authors note could be an underestimate, since two countries measured only the linear form of PFOS (Govarts et al. 2023).
PFAS across the HBM4EU cohort
100 PFAS compounds tested · the teenage figure may be an underestimate
The same pattern, group after group
The remaining substance groups follow the same pattern: bisphenols in the urine of at least 92% of participants (BPA 92%, BPS 67%, BPF 62%), with more than 11% exceeding health-based guidance values (Govarts et al. 2023); pesticides in more than 99% of participants, five of eight tested compounds in over 90%, with children more exposed and one compound reaching toxicologically relevant levels in 36% of cases (Govarts et al. 2023); flame retardants in more than 99% (Govarts et al. 2023); benzophenones in at least 96% (Govarts et al. 2023); acrylamide in more than 99.8%, with at least 7% at or above potentially toxic levels (Govarts et al. 2023); and the mycotoxin marker tDON in 96.5%, of whom 14% reached or exceeded potentially toxic levels (Govarts et al. 2023; HBM4EU, 2022a).
Arsenic and cadmium in virtually everyone
Arsenic was detected in all (100%) samples from Germany, France, Belgium, Sweden, Spain and Slovenia, with 40% of teenagers exceeding toxicologically relevant levels (Govarts et al. 2023; Buekers et al. 2023). The HBM4EU cadmium study of 2,500 adults across nine countries found cadmium in virtually all (99.9%) samples, 16% at levels of concern — 42% in France and 36% in Germany (Tratnik et al. 2022; Govarts et al. 2023). Taken as a whole, health-based guidance values were exceeded for at least 15 of the substances tested (Govarts et al. 2023).
Share above health-based guidance values
Guidance values were exceeded for at least 15 of the substances tested
GerES V: 31 substances in almost every participant
The German nationwide representative biomonitoring study GerES V tested for 107 substances in the urine and blood of over 2,000 subjects. Lead, arsenic, PFAS, phthalates, PAHs, acrylamide, DDE, NMP and lysmeral were each detected in all (100%) participants; mercury in 95%, BPA in 96%, ethylparaben in 97%, benzene in 98%, PCBs in 90%, cadmium in 76%, and glyphosate in about 50% (Umweltbundesamt, 2023). Multiple exposure to at least three PFAS was observed in two-thirds of participants, and PFOS and PFOA were present at concentrations harmful to health in a significant proportion of children and adolescents (Umweltbundesamt, 2023). For cadmium, the authors concluded that health impairments cannot be ruled out for roughly 67,740 German children and adolescents (Umweltbundesamt, 2023). Perhaps the single most striking figure: 31 substances were found in [almost] all participants (Umweltbundesamt, 2023).
107 substances tested · GerES V
Earlier German data point the same way — BPA in more than 99% of 599 randomly selected children’s urine samples (Becker et al. 2009), parabens in more than 99% of 660 samples (Moos et al. 2015), and pesticides and PCBs in the blood of all 105 subjects tested across age groups (Schettgen et al. 2011).
Every compound family, in every teenager
The fourth Flemish Environment and Health Study (FLEHS IV), which collected blood and urine from more than 400 teenagers, detected virtually every compound family tested in every participant: arsenic, cadmium, lead, PAHs, phthalates, pesticides, PCBs, flame retardants and PFAS in all (100%) subjects, and bisphenols in at least 96.6% — with BPF (96.6%) actually more frequent than BPA (85.7%) (Schoeters et al. 2022). Guidance values were exceeded for arsenic in 25%, cadmium in 39.5%, one pesticide in 22%, lead in 12% and PFAS in 10% of participants (Schoeters et al. 2022).
In Switzerland, the 2023 national biomonitoring study (n = 789) found lead in 99% of blood samples, cadmium in 97%, mercury in 85%, arsenic in 76%, and four PFAS in essentially 100% (BAG, 2023). A further Swiss study of over 900 participants quantified cadmium, mercury, arsenic, lead and aluminium across plasma and urine at comparably high rates (Perrais et al. 2024); PFAS were detected in all 630 serum samples in another (Jaus et al. 2025); and dioxins, furans and PCBs exceeded the limit of quantification in all serum samples in a Lausanne study, whose authors stressed that even in a country with stringent food-safety regulation these contaminants represent a significant public health concern (Oltramare et al. 2025). Cadmium was likewise found in all urine samples of 1,400 Swiss participants (Jenny-Burri et al. 2015).
The map keeps returning the same answer
French data from 2,000 participants show arsenic in 98–99.5%, mercury in 88–96.5%, aluminium in 84%, and cadmium and lead in 99–100% of blood and urine samples (Nisse et al. 2016). In Belgium, at least one pesticide or PCB was found in 96% of 252 adults, with over half contaminated by four or more organochlorines (Pirard et al. 2017). Greek children showed phthalates in 100%, BPA in 99%, organophosphate pesticides in over 98% and parabens in 38% of urine samples (Myridakis et al. 2015), with a separate cohort of 387 children carrying PCBs and the pesticides HCB, DDT and DDE in all subjects (Mouatsou et al. 2025).
In fat, in organs, after death
Blood and urine capture only part of the picture. Spanish studies of adipose tissue found cadmium in all 226 volunteers (Echeverría et al. 2019), lead in all 228 (Freire, 2020), parabens in all 144 and BPA in 87% (Artacho-Cordón et al. 2018), and organochlorine pesticides in all 458 women examined (Fernández et al. 2004). In France, all 78 persistent organic pollutants tested — dioxins, PCBs, flame retardants, pesticides, furans — were found in the adipose tissue of all 100 women, with blood detection rates somewhat lower (Ploteau et al. 2016). Autopsy work confirms systemic distribution: PFAS in all human tissues examined in 99 Spanish samples (Pérez et al. 2013) and in the blood, liver, kidney, brain and lung of all 19 deceased Danish individuals studied (Nielsen et al. 2024).
Where the compounds have been found
- Blood and serum
- Urine
- Adipose tissue
- Liver
- Kidney
- Brain
- Lung
- Bone
- Placenta
- Umbilical cord blood
— a body burden, not a passing trace in one fluid
It starts before birth, and distance is no protection
Exposure begins before birth. The Pollution in Newborns study identified 287 different chemicals in umbilical cord blood, at least 180 known carcinogens, 217 toxic to the brain and 208 capable of causing birth defects or abnormal development in animal tests (Environmental Working Group, 2005). All five PFAS tested were found in every mother and every foetal organ examined in a Danish study, indicating systemic foetal exposure (Mamsen et al. 2017). Nor is remoteness protective: PFAS were detected in over 99% of 85 residents of St. Lawrence, Alaska (Byrne et al. 2018), and chlorinated pesticides in high concentrations in the liver, brain and fat of Greenland Inuit (Dewailly et al. 1999).
Identified in umbilical cord blood
Detectable in nearly everyone, simultaneously
The consistent finding across these surveys is not merely that pollutants are detectable, but that they are detectable in nearly everyone, simultaneously, and in a meaningful minority of people at levels that regulators themselves define as unsafe.
As the German investigators put it, almost without exception these substances have toxicologically harmful properties, and simultaneous exposure is particularly critical because effects of substances with similar modes of action can add up — so that a critical total burden may be reached even where each individual exposure is considered non-critical (Umweltbundesamt, 2023).
A summary of findings from the referenced scientific literature. Not medical advice.
Sources
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BAG, 2023 — Bundesamt für Gesundheit (Swiss Federal Office of Public Health), Bern: human biomonitoring / population exposure data, Switzerland, 2023.
Becker et al., 2009 — Kerstin Becker, Thomas Göen, Margarete Seiwert, André Conrad, Helga Pick-Fuß, Johannes Müller, Matthias Wittassek, Christine Schulz, Marike Kolossa-Gehring: GerES IV: Phthalate metabolites and bisphenol A in urine of German children, International Journal of Hygiene and Environmental Health, 212(6), 2009; DOI: 10.1016/j.ijheh.2009.08.002.
Buekers et al., 2023 — Jurgen Buekers, Kirsten Baken, Eva Govarts, Laura Rodriguez Martin, Nina Vogel, Marike Kolossa-Gehring, Zdenka Šlejkovec, Ingrid Falnoga, Milena Horvat, Sanna Lignell, Anna Karin Lindroos, Loïc Rambaud, Margaux Riou, Susana Pedraza-Diaz, Marta Esteban-Lopez, Argelia Castaño, Elly Den Hond, Willy Baeyens, Tiina Santonen, Greet Schoeters: Human urinary arsenic species, associated exposure determinants and potential health risks assessed in the HBM4EU Aligned Studies, International Journal of Hygiene and Environmental Health, 248, 2023; DOI: 10.1016/j.ijheh.2023.114115.
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Fernández et al., 2004 — Mariana F. Fernández, Ana Rivas, Fatima Olea-Serrano, Isabel Cerrillo, José M. Molina-Molina, Pilar Araque, José L. Martínez-Vidal, Nicolás Olea: Assessment of total effective xenoestrogen burden in adipose tissue and identification of chemicals responsible for the combined estrogenic effect, Analytical and Bioanalytical Chemistry, 379(1), 2004; DOI: 10.1007/s00216-004-2558-5.
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Govarts et al., 2023 — Eva Govarts, Liese Gilles, Laura Rodriguez Martin, Tiina Santonen, Petra Apel, … Greet Schoeters: Harmonized human biomonitoring in European children, teenagers and adults: EU-wide exposure data of 11 chemical substance groups from the HBM4EU Aligned Studies (2014–2021), International Journal of Hygiene and Environmental Health, 249, 2023; DOI: 10.1016/j.ijheh.2023.114119. Author list abbreviated; the source lists all contributors in full.
HBM4EU, 2022a — HBM4EU: Substance Report: Mycotoxins (deoxynivalenol), 2022.
Jaus et al., 2025 — Alexandra Jaus, Céline Fragnière Rime, Julien Riou, Beat J. Brüschweiler, Murielle Bochud, Natalie von Goetz: Serum biomonitoring of per- and polyfluoroalkyl substances (PFASs) in the adult population of Switzerland: Results from the pilot phase of the Swiss Health Study, Environment International, 198, 2025; DOI: 10.1016/j.envint.2025.109382.
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Moos et al., 2015 — Rebecca K. Moos, Holger M. Koch, Jürgen Angerer, Petra Apel, Christa Schröter-Kermani, Thomas Brüning, Marike Kolossa-Gehring: Parabens in 24 h urine samples of the German Environmental Specimen Bank from 1995 to 2012, International Journal of Hygiene and Environmental Health, 218(7), 2015; DOI: 10.1016/j.ijheh.2015.07.005.
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Ploteau et al., 2016 — Stéphane Ploteau, Jean-Philippe Antignac, Christelle Volteau, Philippe Marchand, Anaïs Vénisseau, Vincent Vacher, Bruno Le Bizec: Distribution of persistent organic pollutants in serum, omental, and parietal adipose tissue of French women with deep infiltrating endometriosis and circulating versus stored ratio as new marker of exposure, Environment International, 97, 2016; DOI: 10.1016/j.envint.2016.08.011.
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Schoeters et al., 2022 — Greet Schoeters, et al.: Fourth Flemish Environment and Health Study (FLEHS IV) — human biomonitoring in Flemish teenagers, 2022.
Tratnik et al., 2022 — Janja Snoj Tratnik, David Kocman, Milena Horvat, Anna-Maria Andersson, Anders Juul, Eva Jacobsen, Kristín Ólafsdóttir, Jana Klanova, Lenka Andryskova, Beata Janasik, Wojciech Wasowicz, Nataša Janev Holcer, Sónia Namorado, Inês Coelho, Loïc Rambaud, Margaux Riou, An Van Nieuwenhuyse, Brice Appenzeller, Marike Kolossa-Gehring, Till Weber, Marta Esteban-López, Argelia Castaño, Liese Gilles, Laura Rodriguez Martin, Greet Schoeters, Ovnair Sepai, Eva Govarts: Cadmium exposure in adults across Europe: Results from the HBM4EU Aligned Studies survey 2014–2020, International Journal of Hygiene and Environmental Health, 246, 2022; DOI: 10.1016/j.ijheh.2022.114050.
Umweltbundesamt, 2023 — Umweltbundesamt: Deutsche Umweltstudie zur Gesundheit von Kindern und Jugendlichen 2014–2017 (GerES V), Dessau-Roßlau, 2023.