Key messages

• The study identifies occupational exposure pathways and their health impacts, providing a foundation for evidence-based regulations to protect workers and reduce occupational health risks.
• Sentinel surveillance delivers early warnings on emerging health threats, enabling timely preventive actions and enhancing EU health resilience.
• The findings support targeted strategies to prevent work-related diseases, reducing the economic burden on healthcare systems and industries.
• Research fosters EU-wide collaboration and harmonisation, enhancing regulatory frameworks for occupational health and safety across Member States.
• Insights promote sustainable practices, aligning with EU Green Deal ↗ goals by enabling the substitution of hazardous substances with safer alternatives. 

Overview

A Sentinel Surveillance System in occupational settings is a strategic and cost-effective tool for monitoring health issues linked to environmental and occupational exposures, using the expertise of trained occupational health and safety professionals. This system involves selecting specific locations to gather comprehensive data on occupational and environmental health conditions alongside exposure data for substances of high concern. Sentinel surveillance generates vital data for advancing exposome research, improving innovative approaches in exposure studies, and offering cost-efficient methods for biomonitoring exposure data. 

Establishing national sentinel surveillance platforms enhances data collection in workplace settings, enabling continuous monitoring of exposure levels and related health outcomes. Additionally, the system serves as an early warning system for identifying and addressing emerging threats in workplaces.

This project aims to establish a European sentinel surveillance system to support human biomonitoring surveys in the general adult population, using occupational physicians and nurses. Sentinel networks, made up of motivated physicians, provide and efficient way to collect data and samples, a method that has proven successful in occupational health studies. The primary objective of this project is to assess the feasibility of using a sentinel system to enhance human biomonitoring surveys, covering a broad range of chemical exposures, including PFAS ↗ (also known as "forever chemicals"), pesticides ↗, bisphenols ↗, metals, and mercury ↗.

By involving occupational physicians and nurses, the project aims to improve recruitment for the Partnership for the Assessment of Risks from Chemicals (PARC) general population human biomonitoring survey, providing critical data on the environmental and occupational exposure for a representative sample of European working adults. This initiative supports regulatory frameworks related to the general population human biomonitoring survey and aligns with the EU’s Health & Safety at Work – Strategic Framework (2021-2027) ↗, which focuses on guidelines and standards for protecting workers’ health and safety.  

In addition, this project contributes to the EU's objectives of zero pollution ↗, one-substance-one-assessment ↗ approach, and exposome initiatives ↗ by generating aggregated exposure data from various sources. Ultimately, the project functions as a strategic tool to address current and emerging health risks, while promoting a safer working environment in line with EU regulations and standards.

From an international perspective, establishing and implementing a sentinel surveillance approach across EU countries, combined with training occupational health and safety professionals in assessing occupational and environmental exposures, is seen as a promising strategy. This approach has the potential to generate more reliable data and enable meaningful comparisons of large-scale exposure information across nations. 

Achievements & Results

In Belgium, a significant milestone has been achieved with the development and launch of the Human Sentinel Surveillance Platform (HSSP ↗), a web-based sentinel surveillance tool. The platform is currently undergoing testing to evaluate its feasibility for national-level surveillance of occupational chemical exposures. 

Policy relevance

• This project aims to explore, design, and test the feasibility of, and implement a European sentinel surveillance system to support human biomonitoring and assess the exposure of a representative sample of European working population exposed to substances of high concern. This will be achieved through the involvement of motivated and specifically trained occupational physicians and nurses, familiarised with the sentinel approach and human biomonitoring.
• The project hold significant potential to support regulatory processes under the Registration, Evaluation, Authorisation, and Restriction of Chemicals (REACH ↗) and the Occupational Safety and Health (OSH) field. REACH regulations play a critical role in assessing chemical risks and proposing risk management measures, ensuring the protection of both the environment and the health of workers exposed to these substances in the workplace.  
• Meanwhile, the concept of a Sentinel Surveillance System has emerged as a dynamic tool for advancing occupational health within OSH regulations. By systematically monitoring workplace environments and the health of workers exposed to substances of high concerns, this system provides a robust framework for the early detection of hazards, proactive interventions, and data-driven decision-making.