Human Biomonitoring

Environmental exposures, from air, soil, water, and diet, can enter the human body and be measured as exposure biomarkers. These exposures may induce oxidative stress, causing damage reflected in effect biomarkers, which can indicate increased disease susceptibility.

Human biomonitoring based on blood donations to the National Blood Services

Together with Magen David Adom Blood Services and the National Public Health Laboratory, we measured blood concentrations of heavy metals (exposure biomarkers) in 900 donors across Israel and examined their association with environmental pollution near the donors’ residences. The study methodology is described in (Hassan et al, 2020.

National blood bank services as a platform for national human biomonitoring: a proof-of-concept study

This study (Hassan et al, 2023a)demonstrates the feasibility of using a national blood bank as a platform for human biomonitoring (HBM). We analyzed whole blood samples from 911 donors across Israel, measuring heavy metals (As, Cd, Cr, Pb) and linking them to residential and donation locations. Comparing donors from the industrialized Haifa Bay region with those from the rest of the country revealed region-specific differences in exposure levels. The findings support blood banking systems as an efficient infrastructure for large-scale environmental health surveillance.

Ambient Pollution and Blood Metal Concentrations: A Nationwide Blood Bank Study

In this study (Hassan et al, 2023b) we assessed associations between ambient air pollution in Israel and internal metal exposure using a national blood donor cohort linked to nearby air quality monitoring data. After adjustment for age, gender, and smoking (inferred from cadmium levels), NO₂ was associated with higher arsenic levels in blood, while PM₁₀ and SO₂ were associated with increased lead concentrations. SO₂ was also linked to higher cadmium levels, and proximity to quarries was associated with elevated lead. These findings support a clear link between air pollution and internal metal burden.

Prenatal Environmental Metal Exposure, Urinary Biomarkers, and Early-Life Health Outcomes

This line of research among Bedouin-Arab women and their offspring examines how prenatal exposure to environmental metals is reflected in urinary biomarkers and how these exposures relate to maternal and neonatal health outcomes. We first showed that prenatal metal exposure is associated with increased neonatal morbidity, indicating early-life health effects (Karakis et al., 2014). We then demonstrated links between maternal metal exposure and congenital anomalies in a biomonitoring study of pregnant Bedouin-Arab women, highlighting developmental risks during pregnancy (Karakis et al., 2015). More recently, we showed that household and outdoor air pollution exposures are associated with urinary metal concentrations in pregnant women, connecting environmental exposure pathways to internal dose (Karakis et al, 2020).

Ambient Air Pollution, Umbilical Cord Biomarkers, and Early-Life Biological Effects

This line of research investigates how ambient air pollution is reflected in biological processes in newborns, using umbilical cord blood as a sensitive indicator of early-life exposure. We first showed that environmental exposures are associated with altered cell proliferation in umbilical cord blood cells, suggesting early biological responses to environmental stressors (Novack et al, 2015). We then demonstrated that ambient air pollution levels are associated with changes in cord blood cell proliferation, linking specific pollutants such as ozone, carbon monoxide, and particulate matter to measurable biological effects at birth (Novack et al, 2016). Together, these studies highlight how prenatal environmental exposures may already influence cellular processes at the earliest stages of life.