In e na ional Jou nal o
En i onmen al Resea ch
and Public Heal h
A icle
Chemical Exposu e: Eu opean Ci izens’ Pe spec i es, T us ,
and Conce ns on Human Biomoni o ing Ini ia i es,
In o ma ion Needs, and Scien i ic Resul s
Ma ia Uhl 1,*, Rica do R. San os 2, Joana Cos a 2, Os aldo San os 2,3, Ana Vi golino 2, Da id S. E ans 4,
Co a Mu ay 5, Mau ice Mulcahy 5, Do o hy Ubong 6, O nai Sepai 6, Joana Lobo Vicen e 7, Michaela Lei ne 1,
Sil ia Benda-Kah i 1and Daniela Zanini-F ei ag 1,*


Ci a ion: Uhl, M.; San os, R.R.; Cos a,
J.; San os, O.; Vi golino, A.; E ans,
D.S.; Mu ay, C.; Mulcahy, M.; Ubong,
D.; Sepai, O.; e al. Chemical
Exposu e: Eu opean Ci izens’
Pe spec i es, T us , and Conce ns on
Human Biomoni o ing Ini ia i es,
In o ma ion Needs, and Scien i ic
Resul s. In . J. En i on. Res. Public
Heal h 2021,18, 1532. h ps://
doi.o g/10.3390/ije ph18041532
Academic Edi o : Juan
Ped o A ebola
Recei ed: 22 Decembe 2020
Accep ed: 27 Janua y 2021
Published: 5 Feb ua y 2021
Publishe ’s No e: MDPI s ays neu al
wi h ega d o ju isdic ional claims in
published maps and ins i u ional a il-
ia ions.
Copy igh : © 2021 by he au ho s.
Licensee MDPI, Basel, Swi ze land.
This a icle is an open access a icle
dis ibu ed unde he e ms and
condi ions o he C ea i e Commons
A ibu ion (CC BY) license (h ps://
c ea i ecommons.o g/licenses/by/
4.0/).
1En i onmen Agency Aus ia, 1090 Vienna, Aus ia; [email p o ec ed] (M.L.);
[email p o ec ed] (S.B.-K.)
2En i onmen al Heal h Beha iou Lab, Ins i u o de Saúde Ambien al, Faculdade de Medicina,
Uni e sidade de Lisboa, 1649-028 Lisboa, Po ugal; ica do [email p o ec ed] (R.R.S.);
[email p o ec ed] (J.C.); [email p o ec ed] (O.S.); [email p o ec ed] (A.V.)
3Unb eakable Idea Resea ch, 2550-426 Painho, Po ugal
4Heal h Se ice Execu i e, Depa men o Public Heal h, Me lin Pa k Regional Hospi al, H91N973 Galway,
I eland; [email p o ec ed]
5Heal h Se ice Execu i e, En i onmen al Heal h Se ice, H91EW40 Galway, I eland;
[email p o ec ed] (C.M.); [email p o ec ed] (M.M.)
6Public Heal h England, London SE1 8UG, UK; do o hy[email p o ec ed].uk (D.U.);
o nai [email p o ec ed].uk (O.S.)
7Eu opean En i onmen Agency, 1050 Copenhagen, Denma k; [email p o ec ed]
*
Co espondence: ma ia.uhl@umwel bundesam .a (M.U.); daniela.zanini- ei ag@umwel bundesam .a (D.Z.-F.);
Tel.: +43-1-313043605 (M.U.); +43-1-313043468 (D.Z.-F.)
Abs ac :
O e he las ew decades, ci izen awa eness and pe cep ion o chemical p oduc s has
been a opic o in e es , pa icula ly conce ning na ional and in e na ional policy decision make s,
expe /scien i ic pla o ms, and he Eu opean Union i sel . To da e, ew quali a i e s udies on
human biomoni o ing ha e analysed communica ion ma e ials, made ecommenda ions in e ms
o biomoni o ing su eillance, o asked o eedback in e ms o speci ic biomoni o ing me hods.
This pape p o ides in-dep h insigh on ci izens’ pe cep ions o knowledge o biomoni o ing, impac
o chemical exposu e on daily li e, and claims on how esul s o esea ch should be used. Fou
semi-s uc u ed ocus g oups we e held in Aus ia, Po ugal, I eland, and he Uni ed Kingdom (UK).
The c oss-sec ional obse a ional quali a i e design o his s udy allows o be e unde s anding
o public conce n ega ding chemicals, applica ion, and use o human biomoni o ing. The main
indings o his s udy include ci izens’ clea a icula ion on pa hways o exposu e, he demand on
s akeholde s o anspa en decision-making, and sensi i i y in communica ion o esul s o he
public. Valida ed and us ul communica ion is pe cei ed as key o empowe ing ci izens o ake
ac ion. The esul s can be used o acili a e decision-making and policy de elopmen , and eeds in o
he awa eness needs o simila and u u e p ojec s in human biomoni o ing. Fu he mo e, i also
b ings o ligh ideas and concep s o ci izens’ in shaping collabo a i e knowledge be ween ci izens’,
expe s, scien is s, and policy make s on equal e ms.
Keywo ds:
human biomoni o ing; ocus g oup; ci izen e lec ions; chemical exposu e; policy deci-
sion making
1. In oduc ion
Ci izens a e exposed o a wide ange o en i onmen al chemicals in hei daily li es,
in di e en con ex s and ia mul iple ou es, including indoo s and ou doo s (e.g., ai ,
soil, and wa e con amina ion [
1
,
2
]; consume p oduc s (e.g., cosme ics, cleaning agen s,
ex iles) [
3
–
5
]; ood, as chemicals a e widely used in ood p oduc ion (e.g., an imic obial
In . J. En i on. Res. Public Heal h 2021,18, 1532. h ps://doi.o g/10.3390/ije ph18041532 h ps://www.mdpi.com/jou nal/ije ph
In . J. En i on. Res. Public Heal h 2021,18, 1532 2 o 17
d ugs in ood-p oducing animals [
6
], including pes icides o con ol pes s ha a ec c op
p oduc ion [
7
], ood packaging [
8
], and pollina o s which a e di ec ly in ol ed in a ound
one- hi d o global ood p oduc ion [
9
]); d inking wa e [
10
]; and a wo k [
11
,
12
]. Inc eased
ulne abili y o chemical exposu e occu s du ing childhood [
13
] and p egnancy [
14
,
15
],
which may impai li e ime heal h [16].
Acco ding o he Special Eu oba ome e 456: Chemical Sa e y (wi h conside able
a ia ion by membe s a es), 65% o ci izens om 28 Eu opean Union (EU) membe s a es
a e “a li le” o “ e y much” conce ned abou being exposed o chemicals in hei daily
li es, while 45% o he esponden s el well in o med abou he po en ial dange s o
chemicals included in consume p oduc s. Pe cep ions ega ding he sa e y o consume
p oduc s con aining chemicals a e di ided, wi h 46% o EU ci izens answe ing “no eally”
o “no a all”, and 49% end o ag ee o some ex en wi h he sa e y o hese p oduc s [
17
].
Public pe cep ion o a chemical isk is linked o indi idual and place a ibu es; i is no
limi ed o he ype and s eng h o he exposu e o a haza dous chemical. P e ious s udies
ha e shown ha chemical cues, o ins ance, may esul in mo e a ibu ions o symp oms
o a chemical cause, e en i no exposu e occu ed in eali y [
18
]. This sugges s ha people
assess isks by di e en means, acco ding o he p obabilis ic isk assessmen s conduc ed by
expe s [
19
]. Di e en componen s (delibe a i e, a ec i e, o expe ien ial [
20
]), and many
ac o s a e in ol ed in he o ma ion o isk pe cep ions, including li e acy and nume acy
le els [
21
], disposi ional si ua ions [
22
], pe sonal expe iences, in o ma ion a ailabili y and
p esen a ion [
23
], and physical and psychological well-being o he exposed indi idual [
24
].
Heal h isk pe cep ion o chemical exposu e has been assessed in nume ous se ings and
a ge ed popula ions (e.g., d inking wa e quali y [
25
], chemical household p oduc s [
24
,
26
],
ood addi i es and con aminan s [
27
], esea ch labo a o y wo ke s [
28
], o ec ea ional
beach use by child en [
29
]), as a s a ing poin , o build-up e ec i e isk communica ion
s a egies and public heal h in e en ions, which ul ima ely may lead o isk pe cep ion
and heal h beha iou changes [20].
The inclusion o ci izen pe spec i es and pe cep ions is pa o a sys ema ic, anspa -
en , and pa icipa o y s a egy wi hin he Human Biomoni o ing Ini ia i e o Eu ope [
30
]
(HBM4EU). The HBM4EU is a p og amme in ol ing 30 Eu opean coun ies aimed a
coo dina ing and ad ancing human biomoni o ing in Eu ope while p o iding e idence
ha suppo s policymaking. A wide ange o s akeholde s, including go e nmen al bodies,
EU agencies, non-go e nmen al o ganiza ions, and indus y and ade unions pa icipa e
in he ini ia i e.
One main conce n wi hin he HBM4EU conso ium is o in ol e all ac o s in chemical
sa e y, including he ci izens, o (i) iden i y socie al challenges and needs; (ii) se esea ch
p io i ies ha add ess hose needs; (iii) ensu e ha HBM4EU ac i i ies a e legi ima e and
c edible; (i ) implemen p ocedu es ha a e anspa en and accoun able; ( ) gene a e
bene i s o he socie y; and ( i) dissemina e HBM4EU esul s. S a egies engaging hose
ac o s p o e o enable a mo e e ec i e isk go e nance, a g ea e accep ance by he public
owa ds human biomoni o ing, and, a he same ime, b ing ci izen pe spec i es in o
public heal h policy de elopmen s [
31
,
32
]. This encou ages con inuous (heal h) li e acy
ac ions (p o iding ac shee s, ailo made in o ma ion) a ge ed o ci izens wi h di e en
backg ounds in an inclusi e, easily accessible app oach.
In line wi h e o s o engage ci izens in he ini ia i e, su eys o Eu opean ci izens
we e conduc ed wi hin he HBM4EU, o in o m he p io i iza ion p ocess (i.e., iden i ica ion
o ele an subs ances and hei heal h e ec s ollowing chemical exposu e should be
add essed), which se es as a basis o he wo k unde aken unde he p ojec . Despi e his
ini ial e o o ga he some inpu om non-specialis s in chemical exposu e, nume ous
ques ions ega ding Eu opean ci izens’ pe cep ions, conce ns and belie s on chemical
exposu e and sa e y, as well as on HBM (i.e., HBM li e acy) emain unexplo ed. E idence
om ela ed ields demons a e ha ci izens’ engagemen in sensi i e ques ions ha di ec ly
o indi ec ly a ec hem is c ucial o suppo decision making and o a oid dis us in he
au ho i ies [
33
,
34
]. Conside ing his, his pape desc ibes he esul s o ou ocus g oups
In . J. En i on. Res. Public Heal h 2021,18, 1532 3 o 17
o ganized wi hin he HBM4EU amewo k in ou Eu opean coun ies, Aus ia, Po ugal,
I eland, and he Uni ed Kingdom (UK). The objec i es o his s udy we e o ga he u he
unde s anding on (i) ci izens’ pe cep ion o chemical exposu e in hei daily li es and HBM;
(ii) hei conce ns ega ding exposu e o chemical subs ances; (iii) belie s owa ds chemical
exposu e and sa e y, as well as ega ding HBM. Al oge he , he esul s om each o he
ou g oup discussions a e aluable con ibu ions o suppo he design, implemen a ion,
and communica ion o u u e HBM ac ions, as well as o b idge he gap be ween science
and ci izens.
2. Ma e ials and Me hods
This is a c oss-sec ional obse a ional quali a i e s udy, wi h da a collec ed h ough
semi-s uc u ed ocus g oups conduc ed in ou Eu opean coun ies: Aus ia, Po ugal,
I eland, and he UK. In each coun y, one ocus g oup composed o ci izens was mode a ed
by HBM4EU pa ne s. Da a collec ion ook place in Aus ia (Feb ua y 2018), Po ugal (May
2019), I eland (Sep embe 2019), and he UK (Oc obe 2019).
A quali a i e app oach using ocus g oups was employed o p o ide an in-dep h
unde s anding o ci izen’s knowledge, belie s, and a i udes in e ms o chemical expo-
su e [
35
]. I was el ha a quan i a i e app oach would lose dep h and meaning, and may
omi key issues o ele ance o policy make s. This is also pa icula ly app op ia e, as he e
ha e been ew quali a i e s udies o human biomoni o ing. Focus g oups can p o ide
iche in o ma ion abou he knowledge, a i udes, and expe iences o he pa icipan s.
They ob ain in o ma ion om he in e ac ions wi h and be ween he pa icipan s. Thei
in en is
“no o in e bu o unde s and, no o gene alize bu de e mine he ange, and
no o make s a emen s abou he popula ion bu o p o ide insigh s abou how
people in he g oups pe cei e a si ua ion” [36], (p. 66).
Theo e ical sa u a ion is unde discussion wi h ou ocus g oups unde aken; simila
hough s om di e en ocus g oups do e lec ha some common conce ns a e c oss-
sec ional o di e en coun ies. Apa om he opic(s) unde discussion, in ensi e phases
o in e ac ion indica e ha he opics a e key and ele an o he pa icipan s in he g oup
discussion [37].
2.1. Pa icipan s: Sampling and Inclusion/Exclusion C i e ia
Pa icipan ec ui men ollowed a pu posi e sampling (non- andom, concep ually
d i en) in each o he ou coun ies. Eligible pa icipan s we e adul ci izens (18+ yea s
old), bo h sexes. An e o was made o ensu e he e ogenei y ega ding age, educa ional
le el, u ban/ u al esidence, and p o essional backg ound, in o de o ga he di e en
pe spec i es abou he opics unde discussion. Ci izens we e excluded om pa icipa ing
in ocus g oups i hey could no mas e he language ha he ocus g oup was conduc ed
in (Ge man, English, o Po uguese, acco ding o he coun y). This was also he case i
pa icipan s we e no able o p o ide w i en consen o pa icipa e in he ocus g oup.
Pa icipan s we e in i ed o ake pa in he ocus g oups h ough di e en ways, acco ding
o he coun y. Selec ion om a panel o ci izens om p e ious quali a i e s udies ollowed
by in i a ion ia email (Po ugal), in i a ion ia email and h ough online pos s on ins i-
u ional homepages o social media accoun s o he HBM4EU ins i u ions (I eland and
Aus ia), in i a ion ia ci izen pool om occasional ci izen dialogues and h ough snowball
p inciple (Aus ia), in i a ion om a long s anding people panel (UK) acili a ed by Public
Heal h England (PHE), and in i a ion om ad e isemen s pos ed in public/communi y
buildings wi hin he adjacen geog aphical a ea o he ocus g oup enue (I eland). Sample
size anged be ween se en (UK) and ou een (Aus ia) pa icipan s. A o al o ou ocus
g oups we e unde aken. This p o ided su icien da a o analyse hemes. A e iew o 40
ocus g oup s udies [
38
] ound ha 80% o all hemes could be iden i ied wi hin 2–3 ocus
g oups and 90% by 3–6 ocus g oups.
In . J. En i on. Res. Public Heal h 2021,18, 1532 4 o 17
2.2. Se ing, P ocedu es and Ins umen s o Da a Collec ion
Focus g oups ook place wi hin he acili ies o he esea ch uni s o local ins i u ions.
A mode a o and a co-mode a o , bo h expe ienced in hese ypes o g oup discussions,
conduc ed he ocus g oups. The co-mode a o assumed a less ac i e ole in he discussion
and was mainly esponsible o in oducing opics no co e ed by he mode a o and o
aking ield no es. The session s a ed wi h he mode a o seeking consen o audio eco d
he discussion, ollowed by an o e iew o he main sec ions o be discussed
(Table 1)
and
a i e-minu e in oduc ion o he HBM4U p ojec . Pa o he ocus g oup opic guide
in ol ed pa icipan s ha ing o imagine ha hey we e in he yea 2023. This was used
o encou age discussion on po en ial changes and impac s ha he HBM4U p ojec may
ha e had, and he bes way o dissemina e in o ma ion. The mode a o s assumed a non-
di ec i e semi-s uc u ed app oach, p oposing he opics o discussion and p omo ing
g oup in e ac ion. The opic guide ques ions we e lexible in e ms o o de and dep h o
discussion, so na ional eams could eo ganize he discussion o e lec local needs. The
du a ion o he ocus g oups was a iable and anged om one o h ee hou s ( ull session).
Pa icipan s we e gi en ligh e eshmen s du ing he sessions, which also con ibu ed o
“b eak he ice” and p omo e g oup in e ac ion.
Table 1. Guidelines o conduc ing he ocus g oup: ele an opics o be co e ed.
1
In oduc ion on human
biomoni o ing
- P e-knowledge on human biomoni o ing
- Rela ion o he opic
- Special in e es on human biomoni o ing
s udies/p e ious pa icipa ion
2
Human biomoni o ing now:
exposu e o chemical
subs ances in ou daily li es
- Subs ances o conce n
- Assessmen o chemical exposu e
- Heal h p oblems ela ed o chemical exposu e
- Rele ance o Human biomoni o ing esul s and he
Human biomoni o ing (HBM) ini ia i e o e e yday
li e
- I applicable, a eas and easons o ele ance
3
Though expe imen : human
biomoni o ing p ojec — he
u u e
- Expec a ion ega ding he esul s: con en
- Expec a ions ega ding he esul s: impac (e.g., policy
making)
4
P ospec i e u u e: esul s o
he human biomoni o ing
p ojec
- Pe cep ion o achie ed esul s and applicabili y o he
esul s
- Who ecei es in o ma ion abou he p ojec ’s esul s
and how (i.e., communica ion channels)
- P e e ed communica ion channel o ob ain
in o ma ion abou he p ojec
The ull sessions we e audio aped and ully ansc ibed. The ansc ip and ex
ma e ial we e echecked p io and du ing he coding p ocess by a leas wo expe ienced
esea che s ( ansc ip s o FG and code lis can be ound in Supplemen a y Ma e ial).
2.3. Da a Analysis
Con en analysis was independen ly unde aken by wo esea che s o he s udy
eam, pe coun y, ollowing g ounded heo y p inciples [
39
,
40
]. Each esea che inde-
penden ly ead he ansc ip s, no ing key wo ds o ph ases (open coding). These we e
used o cons uc a coding amewo k o simila ca ego ies. The coding amewo k was
iangula ed o in e p e a i e alidi y [
41
] by he mode a o s and co-mode a o s o he
ocus g oups. Concep ual iangula ion was enhanced by a e iew o he li e a u e. The
coding amewo k was hen used o iden i y key hemes eme ging om he da a ga he ed
in he g oup discussions. Fu he in e p e a i e and signi icance alidi y was assu ed by
In . J. En i on. Res. Public Heal h 2021,18, 1532 5 o 17
p o iding open access o he anonymized co pus (enclosed aw ex da a o ansc ip s is
p o ided as Supplemen a y Ma e ial).
2.4. E hical Issues
P io o aking pa in he ocus g oups, all pa icipan s signed an in o med consen
o m. Wi hin ha , i was explained ha pa icipa ion was olun a y, ha hey could
wi hd aw a any ime and ha all da a collec ed we e anonymous and con iden ial. The
ocus g oup mode a o also sough consen o audio eco d he discussion and asked o
pa icipan s’ pe mission o ake pho og aphs du ing he g oup discussion. The conduc o
he ocus g oups in HBM4EU was app o ed by he p ojec managemen boa d. Adhe ence
o ules o he GDPR (Gene al Da a P o ec ion Regula ion) was assu ed by he p ojec
eams ca ying ou he ocus g oups in acco dance wi h na ional policy. In all ocus g oups,
ci izens ga e in o med consen h ough a decla a ion o consen on da a p o ec ion o
he a ec ed pe sons (acco ding o A 6 Pa a 1 li a GDPR) Ci izen Wo kshop on Human-
Biomoni o ing in he EU. Addi ionally, in Po ugal, posi i e app o al o conduc ion o he
ocus g oup was ob ained by he E hics Commi ee o he Cen o Académico de Medicina
de Lisboa (Re e ence 306/19). E hics commi ee app o al was no equi ed in he o he
h ee coun ies.
3. Resul s
Sample cha ac e isa ion, by coun y, in e ms o sociodemog aphic a iables, is p o-
ided in Table 2.
Table 2. Sample cha ac e isa ion by coun y.
Po ugal I eland Uni ed Kingdom Aus ia
Gende
Male 5 (50.0%) 5 (45.5%) 3 (43%) 7 (50%
Female 5 (50.0%) 6 (54.5%) 4 (57%) 7 (50%)
Age
Age ange (24–63) (18–74) (52–72) (20–72)
Mean age ±SD 46.6 ±14.6 Age coho s we e
eco ded 64.0 ±6.9 41.3 ±4.6
Educa ion
Uni e si y deg ee (8),
Seconda y educa ion
(1), p ima y
educa ion (1)
Thi d educa ion le el
(9), seconda y
educa ion (2)
P o essional
backg ound was
eco ded
Uni e si y deg ee (9),
seconda y educa ion (5)
P e ious knowledge
abou HBM
Pa icipan s claimed
lack o in o ma ion
on he opic
Few pa icipan s we e
p e iously exposed o
he opic, ei he
h ough he media o a
wo k
Knowledge mainly
claimed on media
consump ion (TV
documen a ies,
mo ies)
Almos hal o ci izens
wi h p o essional o
educa ional backg ound
on he opic, all claimed
in e es on his
3.1. Ci izens’ Pe cep ions and Conce ns abou Chemical Risks and Thei Impac on Human Heal h
In he ollowing sec ion, speci ic s a emen s o pa icipan s a e ci ed and discussed
in ela ion o cu en challenges in isk assessmen and managemen . Pa icipan s we e
conce ned abou he heal h isks associa ed o he exposu e o a a ie y o chemicals,
namely h ough a ious sou ces o exposu e hey a e exposed o in hei daily li es and
ia consume p oduc s and ood. Few pa icipan s named speci ic chemical subs ances;
asbes os and ph hala es we e men ioned in he Po uguese ocus g oup, whe eas diesel
umes we e e e ed o in he I ish ocus g oup. Some pa icipan s exp essed hei gene al
conce n abou pollu ed wa e and indus y- ela ed ai pollu ion ( isible s eam).
“I ’s hose hings ha he plas ics we use in ou daily li e ha e
. . .
he leaching
in o he be e ages we d ink, he ood we ea , he ood we hea in he mic owa e,

In . J. En i on. Res. Public Heal h 2021,18, 1532 6 o 17
inside o plas ic boxes, all hose con ac s we made, as s a ed be o e, also h ough
he clo hes we wea , wha we ouch, and he e ec s e en o ou o sp ing”
(Po ugal, male, lines 108–114).
“
. . .
we o en walk Sandymoun S and wi h ou dog and he e is a non-ending
plume o wha is supposed o be s eam coming om i ; bu wha ’s in s eam? Bu
I p esume ha EPA a e moni o ing ha .” (I eland, male, lines 31–33).
In one ocus g oup, pa icipan s iden i ied main exposu e pa hways o chemicals (e.g.,
ou doo ai , ood, d inking wa e , and clo hes) and es ablished a link be ween exposu e
pa hways and di e en sou ces o pollu ion. Fo example, ca exhaus emissions and ca
b ake dus we e linked o chemical exposu e h ough ou doo ai . Pes icides used in c ops
and la ou ings, p ese a i es, and colou addi i es used in so d inks p oduc ion we e
linked o chemical exposu e h ough ood; en i onmen al ese oi s o an ibio ic esis an
mic oo ganisms and indus ial was ewa e discha ges we e linked o chemical exposu e
h ough d inking wa e .
Two g oups men ioned mix u es o chemical subs ances and in e ac ions be ween
hese subs ances:
“
. . .
you know I used shampoo his mo ning, and I ha e a oo hpas e which I
belie e is be e han he luo ide ones, bu how do I know is he e some hing
s ill in ha oo hpas e ha is no good, and I ied o ha e as li le as possible in
e ms o makeup, and you know, I am using eally good pu e baby- ype c eams
and hings like ha , bu wha abou all he s u I do no know abou .” (I eland,
emale, lines 17–22).
“
. . .
was men ioning abou hings in combina ion as well. Me cu y wi h o he
exposu es seems o ha e mo e o an e ec . How can his be moni o ed? Wha do
we do abou mix u es.” (UK, male, pa 2, lines 255–256).
Some pa icipan s in ano he ocus g oup iden i ied he “chain o e ec s” o he
human in luence on he whole ecosys em:
“One o he one o he hings ha I hink goes on in esea ch ha you do is you
look a single chemicals. And one o he hings ha I hink pe haps isn’ looked
a enough is he cock ail o chemicals ha we’ e abso bing. Because we seem o
ha e a lo mo e s u ha ’s going on. And he, i ’s ac ually how, how, wha , wha
can be done abou ha , o example . . . ” (UK, emale, pa 1, lines 577–581).
“
. . .
when you ge in hings ha a e coming in
. . .
ou side he EU, o example,
om Sou h Ame ica, aking he example o g apes. Wha ? How do we know
hey’ e no illed wi h pes icides?” (UK, emale, pa 1, lines 610–611).
Indi ec exposu e om using p oduc s ha we e in con ac wi h po en ially haza dous
subs ances a any s age o he p oduc ion chain was also an exp essed conce n. Fo example,
I ish and UK ci izens we e conce ned abou he use o pes icides o p o ec c ops om
pes s, especially in he case o ui p oduc ion:
“bu i you cu an apple om he shop in hal , i s ays pe ec , so wha is making
ha s ay pe ec , he e some hing, you know, whe eas when hey jus pick i o
he ee wi h no pes icides o any hing, i would s a , he minu e you cu i , i
would s a o go b own, bu when you buy hem, hey don’ , hey s ay like ha .”
(I eland, emale, lines 57–61).
A UK ci izen men ioned a m animals and he use o an ibio ics and an ibio ic
esis ance:
“
. . .
ac o y a med animals a e ou inely ed an ibio ics as a p ophylac ic, a he
han ac ually o ea condi ion and hose an ibio ics, p esumably and I’m saying
p esumably because o , I don’ know, go access o esea ch, bu hey’ e in he
mea and he e o e when we ea ha mea we’ e aking in an ibio ic.” (UK, emale,
pa 1, lines 584–587).
In . J. En i on. Res. Public Heal h 2021,18, 1532 7 o 17
A Po uguese pa icipan men ioned he i iga ion o ag icul u al ields using
po en ially con amina ed wa e om he i e s ha is cap u ed h ough a isanal bo eholes:
“My main conce n is no so much abou di ec consump ion, which I belie e is
well egula ed and well con olled, bu i is much mo e abou indi ec consump-
ion, ha is, wa e ha is used o i iga e he c ops we la e ea and ha is no
so sc u inised, i is o en aken di ec ly om he i e o ano he wa e cou se
( . . . ah . . . )
and also in Po ugal, he pe cen age o people who s ill only use
wa e pumped om a isanal bo eholes is highe han expec ed.” (Po ugal, male,
lines 270–276).
Al hough pa icipan s gene ally exp essed some conce n in e ms o exposu e o
en i onmen al pollu ion, some pa icipan s poin ed ou ha i is impo an o a oid
ala mism, as his can be equally ha m ul o heal h. Acco ding o hem, i is impo an o
es ablish us in he go e ning au ho i ies ins ead:
“Because i makes us wo ied and when we a e wo ied, we li e less. I guess.”
(Po ugal, male, line 139).
“I always guide mysel by he way I us o no in he au ho i ies ha egula e
i .” (Po ugal, male, lines 231–232).
3.2. Communica ing In o ma ion abou Chemical Exposu e
Pa icipan s in he ou ocus g oups acknowledged he key ole o communica ion
in empowe ing ci izens o ake ac ion. I empowe s u u e consume s’ decision-making
and opens possibili ies o hem o pu p essu e on egula o y au ho i ies. The dep h
o he discussion on communica ion o in o ma ion on chemical exposu e and HBM
a ied ac oss g oups, wi h some pa icipan s e e ing o gene ic ypes o communica ion
(such as websi es, a icles in newspape s) whe eas o he s men ioned speci ic ypes o
communica ion.
“We would need a da abase a ailable o he public, one we can ga he mo e
in o ma ion om. Wha is happening? Wha is i abou a ce ain subs ance?
Wha does i do [
. . .
] wi h a ce ain chemical? Empowe men !” (Aus ia, emale,
lines 282–284).
Anecdo al e idence o ci izen empowe men a e anspa ency in in o ma ion com-
munica ion was p o ided by a Po uguese pa icipan :
“We had phenomena like he his o y o mad cow’s disease, e c., i i we en’
o public p essu e, maybe we s ill a e con amina ed bee oday, wouldn’ we?”
(Po ugal, male, lines 785–787).
A model o he communica ion p ocess in HBM in ol ing science, decision make s,
and ci izens eme ged om he Po uguese ocus g oup. Pa icipan s men ioned ha science
p oduces in o ma ion ha is used o suppo decisions by policy make s, ul ima ely leading
o ac ion. In e es ingly, na ional au ho i ies, such as he Po uguese En i onmen Agency,
we e no iden i ied as being pa o his communica ion p ocess. The ole o lobbying
in he p io i isa ion p ocess o poli ical ac ion o e ed some conce n o he Po uguese
pa icipan s in he g oup discussion, as well as he ole o ci izens, who we e conside ed
as passi e ecep o s o poli ical decisions ha , acco ding o hem, ollows a op-down
app oach. O e all, Po uguese pa icipan s in he ocus g oup el ha communica ing
scien i ic esul s was a e y impo an componen o he “communica ion iangle o
science” (Figu e 1). Dissemina ing in o ma ion o he public may con ibu e o inc eased
ci izen engagemen , which in u n may empowe hem o pu p essu e on poli icians o ake
e ec i e ac ions ha shall be o ien ed o mee ci izens’ needs. Ul ima ely, his con ibu es
o educe mis us in poli icians.
“Fi s , each he public and hen he public pu p essu e on he poli icians.”
(Po ugal, male, lines 1025–1026).
In . J. En i on. Res. Public Heal h 2021,18, 1532 8 o 17
Figu e 1.
Model o in o ma ion low and communica ion o HBM knowledge (communica ion om
media and science, in o ma ion om o he sou ces, and educa ion om he con ex , all oge he
seems o a ec , a di e en le els, ci izen pe cep ions on he heal h impac o chemical exposu e.
The as e isks indica e c i ical poin s ela ed o he way in o ma ion is emi ed o ecei ed by he
s akeholde s. Con inuous lines ep esen ha in o ma ion o ac ions lows in closed ci cui s, i.e.,
no aken in o conside a ion ci izens pe cep ions o needs. Do ed lines indica e an open low o
in o ma ion o which ci izens a e exposed o. The hickness o hese lines is ela ed o he le el o
in luence on ci izens’ pe cep ions and a i udes. The e o e, he con ex (subjec i ely unde s ood he e
as he combina ion o indi idual, social, and place a ibu es) seems o ha e mo e in luence han
o he sou ces o in o ma ion (e.g., social media), media, and science communica ion) (empi ical da a
d i en model: ci izen pe spec i e).
Th ea s o anspa en and c edible scien i ic da a communica ion we e also discussed.
Pa icipan s in one o he g oup discussions s essed ha scien i ic in o ma ion should be
communica ed using c edible sou ces, such as science expe s. This was an impo an s ep
o p o ide “ce ain y” and o p o ec ci izens and public opinion om “ ake news”. The
en i onmen al campaign led by G e a Thunbe g was gi en as an example o an app oach
emphasising he impo ance o science and he need o “lis en o he scien is s”.
Pa icipan s in he UK ocus g oup iden i ied he need o execu i e and go e nmen
agencies o p oduce de ailed, ocused, and ailo ed in o ma ion o be deli e ed o he
ci izens. Some pa icipan s exp essed hei opinion ha ci izens should ha e “a igh ”
o ecei e in o ma ion when ad e se human heal h e ec s a e de ec ed om chemicals
o which hey a e di ec ly o indi ec ly exposed o. A lis compiled by medically ained
indi iduals, p o iding in o ma ion abou haza dous and less ha m ul chemicals (e.g.,
p oduc s whe e he chemicals can be ound, isks o pa icula g oups), should be p oduced
and deli e ed o he gene al popula ion.
“Public Heal h, I hink has a high p io i y o mos people. No jus hei own
pe sonal heal h, bu he heal h o he popula ion a la ge. Fo all so s o easons,
I hink i ’s a good hing ha people a e mo e awa e han was he case in my
In . J. En i on. Res. Public Heal h 2021,18, 1532 9 o 17
pa en s’ gene a ion, o e en my g andpa en s’ gene a ion, hey simply we en’
awa e o hese issues. (UK, male, pa 2, lines 722–725).
“
. . .
he public, I hink, a e becoming mo e and mo e awa e o pollu ion, and
hea y chemicals in wa e and ood and plas ic in he ocean, and all o hese kinds
o hings. And wha we need, I belie e, is a guide om go e nmen o om
execu i e agencies, o maybe bo h abou a b oad ballpa k a ea whe e we can look
o mo e in o ma ion on hese opics, and pe haps speci ic websi es, and whe e
we can ind answe s o ques ions. So I hink he objec i e communica ion in his
ealm is o make he public mo e awa e. And mo e awa e in a mo e ocused,
a ge ed way han go e nmen is gene ally e y good a so ha we can begin
o ask he igh ques ions o people like you (PHE scien is s).” (UK; male, pa 1,
lines 481–491).
“I belie e we need o lead om medical p ac i ione s, people wi h medically
ained who can say he e’s a whole load o chemicals in he ai in he soil, we ea
hem, b ea h hem, d ink hem, many o hem a e no dange ous, bu some a e
and he e’s a lis o hem.” (UK, male, pa 1, lines 705–707).
One pe son s essed ha he e was a need o build-up us and con idence in go -
e nmen o ganisa ions. Se e al o he s el ha in o ma ion should be p o ided by non-
go e nmen al o ganisa ions. One ocus g oup highligh ed he impo ance o an indepen-
den “wa chdog” o ganisa ion ha had au ho i y:
“So, i we ha e go e nmen s looking o independen bodies like an independen
wa e au ho i y, you know, ha is moni o ing wa e s, wa e pollu ion le els.”
(I eland, male, lines 362–364).
The need o he HBM4EU p ojec o p o ide in o ma ion, namely e idence on heal h
e ec s om chemical exposu e, in a use - iendly o ma , easily unde s andable by he
gene al ci izen, was s essed by he pa icipan s in he I ish ocus g oup. One pa icipan ,
holding a Mas e ’s deg ee in biochemis y, commen ed ha some in o ma ion p o ided,
e.g., on a chemical sa e y da a shee he had seen, was “ o ally unin elligible.” A di e en
pa icipan s essed ha i would be impo an o his p ojec o u n “scien i ic knowledge
in o unde s anding”.
“
. . .
we a e going o ha e i in language a i e-yea -old can unde s and.” (I eland,
male, lines 289–290).
3.3. Ba ie s o Reduce Pollu ion Le els
Pollu ion was iden i ied by he pa icipan s in he ocus g oups as one impo an
pa hway o exposu e o chemicals. As such, he discussion no only ocused upon con-
ce ns abou heal h e ec s a e exposu e o sou ces o pollu ion (see Sec ion 3.1 Ci izens’
pe cep ions and conce ns abou en i onmen al isks and hei impac on human heal h),
bu also se e al ba ie s ha p e en ac i e ac ion o educe pollu ion le els. Di e en
expec a ions om di e en s akeholde s we e emphasised ac oss ocus g oups as a main
po en ial ba ie o educe pollu ion le els ha could be su passed i he s akeholde s
engage in a collabo a i e e o a many di e en le els. The go e nmen was poin ed ou
by some pa icipan s as a ba ie , because hey would p o ec he indus y o e ci izens’
in e es s. The a ionale was ha he indus y sec o c ea es jobs and con ibu es o he
economical weal h o he coun y. As such, measu es aimed a educing pollu ion le els
mainly a ge he consume and less is equi ed in his ealm om p i a e companies.
The ole o “lobbyism” and he indus y sec o ’s own agenda and in e es s in shap-
ing poli ical decisions was e e ed in wo ou o he ou ocus g oups by some o he
pa icipan s. Addi ional indus y- ela ed ba ie s we e iden i ied by he pa icipan s: Ag-
g essi e ma ke ing s a egies we e men ioned as con ibu ing o an o e load o messages
ha makes i ha de o dis inguish ele an and c edible in o ma ion abou haza dous
subs ances. Cons an p oduc inno a ion by indus y in highly indus ialised a eas o he
In . J. En i on. Res. Public Heal h 2021,18, 1532 16 o 17
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