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)

As one of the core elements of the European Human Biomonitoring Initiative (HBM4EU) a human biomonitoring (HBM) survey was conducted in 23 countries to generate EU-wide comparable HBM data. This survey has built on existing HBM capacity in Europe by aligning national or regional HBM studies, referre...

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Autores: Govarts, Eva, Gilles, Liese, Rodriguez Martin, Laura, Santonen, Tiina, Apel, Petra, Alvito, Paula, Anastasi, Elena, Andersen, Helle Raun, Andersson, Anna-Maria, Andryskova, Lenka, Antignac, Jean-Philippe, Appenzeller, Brice, Barbone, Fabio, Barnett-Itzhaki, Zohar, Barouki, Robert, Berman, Tamar, Bil, Wieneke, Borges, Teresa, Buekers, Jurgen, Cañas Portilla, Ana Isabel, Covaci, Adrian, Csákó, Zsófia, Den Hond, Elly, Dvorakova, Darina, Fábelová, Lucia, Fletcher, Tony, Frederiksen, Hanne, Gabriel, Catherine, Ganzleben, Catherine, Göen, Thomas, Halldórsson, Thórhallur Ingi, Haug, Line S, Horvat, Milena, Huuskonen, Pasi, Imboden, Medea, Jagodic Hudobivnik, Marta, Janasik, Beata, Janev Holcer, Natasa, Karakitsios, Spyros, Katsonouri, Andromachi, Klánová, Jana, Kokaraki, Venetia, Kold Jensen, Tina, Koponen, Jani, Laeremans, Michelle, Laguzzi, Federica, Lange, Rosa, Lemke, Nora, Lignell, Sanna, Lindroos, Anna Karin, Lobo Vicente, Joana, Luijten, Mirjam, Makris, Konstantinos C, Mazej, Darja, Melymuk, Lisa, Meslin, Matthieu, Mol, Hans, Montazeri, Parisa, Murawski, Aline, Namorado, Sónia, Niemann, Lars, Nübler, Stefanie, Nunes, Baltazar, Ólafsdóttir, Kristin, Palkovicova Murinova, Lubica, Papaioannou, Nafsika, Pedraza-Diaz, Susana, Piler, Pavel, Plichta, Veronika, Poteser, Michael, Probst-Hensch, Nicole, Rambaud, Loïc, Rauscher-Gabernig, Elke, Rausova, Katarina, Remy, Sylvie, Riou, Margaux, Rosolen, Valentina, Rousselle, Christophe, Rüther, Maria, Sarigiannis, Denis, Silva, Maria J, Šlejkovec, Zdenka, Snoj Tratnik, Janja, Stajnko, Anja, Szigeti, Tamás, Tarazona, Jose, Thomsen, Cathrine, Tkalec, Žiga, Tolonen, Hanna, Trnovec, Tomas, Uhl, Maria, Van Nieuwenhuyse, An, Vasco, Elsa, Verheyen, Veerle J, Viegas, Susana, Vinggaard, Anne Marie, Vogel, Nina, Vorkamp, Katrin, Wasowicz, Wojciech, Weber, Till, Wimmerova, Sona, Woutersen, Marjolijn, Zimmermann, Philipp, Zvonař, Martin, Koch, Holger M, Kolossa-Gehring, Marike, Esteban-Lopez, Marta, Castaño, Argelia, Stewart, Lorraine, Sepai, Ovnair, Schoeters, Greet
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/16310
Acceso en línea:http://hdl.handle.net/20.500.12105/16310
Access Level:acceso abierto
Palabra clave:Environmental Pollutants
Arsenic
Pesticides
Fluorocarbons
Young Adult
Humans
Child
Adolescent
Biological Monitoring
Cadmium
Biomarkers
Acrylamides
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oai_identifier_str oai:repisalud.isciii.es:20.500.12105/16310
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repository_id_str
dc.title.none.fl_str_mv 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)
title 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)
spellingShingle 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)
Govarts, Eva
Environmental Pollutants
Arsenic
Pesticides
Fluorocarbons
Young Adult
Humans
Child
Adolescent
Biological Monitoring
Cadmium
Biomarkers
Acrylamides
title_short 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)
title_full 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)
title_fullStr 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)
title_full_unstemmed 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)
title_sort 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)
dc.creator.none.fl_str_mv Govarts, Eva
Gilles, Liese
Rodriguez Martin, Laura
Santonen, Tiina
Apel, Petra
Alvito, Paula
Anastasi, Elena
Andersen, Helle Raun
Andersson, Anna-Maria
Andryskova, Lenka
Antignac, Jean-Philippe
Appenzeller, Brice
Barbone, Fabio
Barnett-Itzhaki, Zohar
Barouki, Robert
Berman, Tamar
Bil, Wieneke
Borges, Teresa
Buekers, Jurgen
Cañas Portilla, Ana Isabel
Covaci, Adrian
Csákó, Zsófia
Den Hond, Elly
Dvorakova, Darina
Fábelová, Lucia
Fletcher, Tony
Frederiksen, Hanne
Gabriel, Catherine
Ganzleben, Catherine
Göen, Thomas
Halldórsson, Thórhallur Ingi
Haug, Line S
Horvat, Milena
Huuskonen, Pasi
Imboden, Medea
Jagodic Hudobivnik, Marta
Janasik, Beata
Janev Holcer, Natasa
Karakitsios, Spyros
Katsonouri, Andromachi
Klánová, Jana
Kokaraki, Venetia
Kold Jensen, Tina
Koponen, Jani
Laeremans, Michelle
Laguzzi, Federica
Lange, Rosa
Lemke, Nora
Lignell, Sanna
Lindroos, Anna Karin
Lobo Vicente, Joana
Luijten, Mirjam
Makris, Konstantinos C
Mazej, Darja
Melymuk, Lisa
Meslin, Matthieu
Mol, Hans
Montazeri, Parisa
Murawski, Aline
Namorado, Sónia
Niemann, Lars
Nübler, Stefanie
Nunes, Baltazar
Ólafsdóttir, Kristin
Palkovicova Murinova, Lubica
Papaioannou, Nafsika
Pedraza-Diaz, Susana
Piler, Pavel
Plichta, Veronika
Poteser, Michael
Probst-Hensch, Nicole
Rambaud, Loïc
Rauscher-Gabernig, Elke
Rausova, Katarina
Remy, Sylvie
Riou, Margaux
Rosolen, Valentina
Rousselle, Christophe
Rüther, Maria
Sarigiannis, Denis
Silva, Maria J
Šlejkovec, Zdenka
Snoj Tratnik, Janja
Stajnko, Anja
Szigeti, Tamás
Tarazona, Jose
Thomsen, Cathrine
Tkalec, Žiga
Tolonen, Hanna
Trnovec, Tomas
Uhl, Maria
Van Nieuwenhuyse, An
Vasco, Elsa
Verheyen, Veerle J
Viegas, Susana
Vinggaard, Anne Marie
Vogel, Nina
Vorkamp, Katrin
Wasowicz, Wojciech
Weber, Till
Wimmerova, Sona
Woutersen, Marjolijn
Zimmermann, Philipp
Zvonař, Martin
Koch, Holger M
Kolossa-Gehring, Marike
Esteban-Lopez, Marta
Castaño, Argelia
Stewart, Lorraine
Sepai, Ovnair
Schoeters, Greet
author Govarts, Eva
author_facet Govarts, Eva
Gilles, Liese
Rodriguez Martin, Laura
Santonen, Tiina
Apel, Petra
Alvito, Paula
Anastasi, Elena
Andersen, Helle Raun
Andersson, Anna-Maria
Andryskova, Lenka
Antignac, Jean-Philippe
Appenzeller, Brice
Barbone, Fabio
Barnett-Itzhaki, Zohar
Barouki, Robert
Berman, Tamar
Bil, Wieneke
Borges, Teresa
Buekers, Jurgen
Cañas Portilla, Ana Isabel
Covaci, Adrian
Csákó, Zsófia
Den Hond, Elly
Dvorakova, Darina
Fábelová, Lucia
Fletcher, Tony
Frederiksen, Hanne
Gabriel, Catherine
Ganzleben, Catherine
Göen, Thomas
Halldórsson, Thórhallur Ingi
Haug, Line S
Horvat, Milena
Huuskonen, Pasi
Imboden, Medea
Jagodic Hudobivnik, Marta
Janasik, Beata
Janev Holcer, Natasa
Karakitsios, Spyros
Katsonouri, Andromachi
Klánová, Jana
Kokaraki, Venetia
Kold Jensen, Tina
Koponen, Jani
Laeremans, Michelle
Laguzzi, Federica
Lange, Rosa
Lemke, Nora
Lignell, Sanna
Lindroos, Anna Karin
Lobo Vicente, Joana
Luijten, Mirjam
Makris, Konstantinos C
Mazej, Darja
Melymuk, Lisa
Meslin, Matthieu
Mol, Hans
Montazeri, Parisa
Murawski, Aline
Namorado, Sónia
Niemann, Lars
Nübler, Stefanie
Nunes, Baltazar
Ólafsdóttir, Kristin
Palkovicova Murinova, Lubica
Papaioannou, Nafsika
Pedraza-Diaz, Susana
Piler, Pavel
Plichta, Veronika
Poteser, Michael
Probst-Hensch, Nicole
Rambaud, Loïc
Rauscher-Gabernig, Elke
Rausova, Katarina
Remy, Sylvie
Riou, Margaux
Rosolen, Valentina
Rousselle, Christophe
Rüther, Maria
Sarigiannis, Denis
Silva, Maria J
Šlejkovec, Zdenka
Snoj Tratnik, Janja
Stajnko, Anja
Szigeti, Tamás
Tarazona, Jose
Thomsen, Cathrine
Tkalec, Žiga
Tolonen, Hanna
Trnovec, Tomas
Uhl, Maria
Van Nieuwenhuyse, An
Vasco, Elsa
Verheyen, Veerle J
Viegas, Susana
Vinggaard, Anne Marie
Vogel, Nina
Vorkamp, Katrin
Wasowicz, Wojciech
Weber, Till
Wimmerova, Sona
Woutersen, Marjolijn
Zimmermann, Philipp
Zvonař, Martin
Koch, Holger M
Kolossa-Gehring, Marike
Esteban-Lopez, Marta
Castaño, Argelia
Stewart, Lorraine
Sepai, Ovnair
Schoeters, Greet
author_role author
author2 Gilles, Liese
Rodriguez Martin, Laura
Santonen, Tiina
Apel, Petra
Alvito, Paula
Anastasi, Elena
Andersen, Helle Raun
Andersson, Anna-Maria
Andryskova, Lenka
Antignac, Jean-Philippe
Appenzeller, Brice
Barbone, Fabio
Barnett-Itzhaki, Zohar
Barouki, Robert
Berman, Tamar
Bil, Wieneke
Borges, Teresa
Buekers, Jurgen
Cañas Portilla, Ana Isabel
Covaci, Adrian
Csákó, Zsófia
Den Hond, Elly
Dvorakova, Darina
Fábelová, Lucia
Fletcher, Tony
Frederiksen, Hanne
Gabriel, Catherine
Ganzleben, Catherine
Göen, Thomas
Halldórsson, Thórhallur Ingi
Haug, Line S
Horvat, Milena
Huuskonen, Pasi
Imboden, Medea
Jagodic Hudobivnik, Marta
Janasik, Beata
Janev Holcer, Natasa
Karakitsios, Spyros
Katsonouri, Andromachi
Klánová, Jana
Kokaraki, Venetia
Kold Jensen, Tina
Koponen, Jani
Laeremans, Michelle
Laguzzi, Federica
Lange, Rosa
Lemke, Nora
Lignell, Sanna
Lindroos, Anna Karin
Lobo Vicente, Joana
Luijten, Mirjam
Makris, Konstantinos C
Mazej, Darja
Melymuk, Lisa
Meslin, Matthieu
Mol, Hans
Montazeri, Parisa
Murawski, Aline
Namorado, Sónia
Niemann, Lars
Nübler, Stefanie
Nunes, Baltazar
Ólafsdóttir, Kristin
Palkovicova Murinova, Lubica
Papaioannou, Nafsika
Pedraza-Diaz, Susana
Piler, Pavel
Plichta, Veronika
Poteser, Michael
Probst-Hensch, Nicole
Rambaud, Loïc
Rauscher-Gabernig, Elke
Rausova, Katarina
Remy, Sylvie
Riou, Margaux
Rosolen, Valentina
Rousselle, Christophe
Rüther, Maria
Sarigiannis, Denis
Silva, Maria J
Šlejkovec, Zdenka
Snoj Tratnik, Janja
Stajnko, Anja
Szigeti, Tamás
Tarazona, Jose
Thomsen, Cathrine
Tkalec, Žiga
Tolonen, Hanna
Trnovec, Tomas
Uhl, Maria
Van Nieuwenhuyse, An
Vasco, Elsa
Verheyen, Veerle J
Viegas, Susana
Vinggaard, Anne Marie
Vogel, Nina
Vorkamp, Katrin
Wasowicz, Wojciech
Weber, Till
Wimmerova, Sona
Woutersen, Marjolijn
Zimmermann, Philipp
Zvonař, Martin
Koch, Holger M
Kolossa-Gehring, Marike
Esteban-Lopez, Marta
Castaño, Argelia
Stewart, Lorraine
Sepai, Ovnair
Schoeters, Greet
author2_role author
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dc.contributor.none.fl_str_mv Unión Europea. Comisión Europea. H2020

dc.subject.none.fl_str_mv Environmental Pollutants
Arsenic
Pesticides
Fluorocarbons
Young Adult
Humans
Child
Adolescent
Biological Monitoring
Cadmium
Biomarkers
Acrylamides
topic Environmental Pollutants
Arsenic
Pesticides
Fluorocarbons
Young Adult
Humans
Child
Adolescent
Biological Monitoring
Cadmium
Biomarkers
Acrylamides
description As one of the core elements of the European Human Biomonitoring Initiative (HBM4EU) a human biomonitoring (HBM) survey was conducted in 23 countries to generate EU-wide comparable HBM data. This survey has built on existing HBM capacity in Europe by aligning national or regional HBM studies, referred to as the HBM4EU Aligned Studies. The HBM4EU Aligned Studies included a total of 10,795 participants of three age groups: (i) 3,576 children aged 6-12 years, (ii) 3,117 teenagers aged 12-18 years and (iii) 4,102 young adults aged 20-39 years. The participants were recruited between 2014 and 2021 in 11-12 countries per age group, geographically distributed across Europe. Depending on the age group, internal exposure to phthalates and the substitute DINCH, halogenated and organophosphorus flame retardants, per- and polyfluoroalkyl substances (PFASs), cadmium, bisphenols, polycyclic aromatic hydrocarbons (PAHs), arsenic species, acrylamide, mycotoxins (deoxynivalenol (total DON)), benzophenones and selected pesticides was assessed by measuring substance specific biomarkers subjected to stringent quality control programs for chemical analysis. For substance groups analyzed in different age groups higher average exposure levels were observed in the youngest age group, i.e., phthalates/DINCH in children versus teenagers, acrylamide and pesticides in children versus adults, benzophenones in teenagers versus adults. Many biomarkers in teenagers and adults varied significantly according to educational attainment, with higher exposure levels of bisphenols, phthalates, benzophenones, PAHs and acrylamide in participants (from households) with lower educational attainment, while teenagers from households with higher educational attainment have higher exposure levels for PFASs and arsenic. In children, a social gradient was only observed for the non-specific pyrethroid metabolite 3-PBA and di-isodecyl phthalate (DiDP), with higher levels in children from households with higher educational attainment. Geographical variations were seen for all exposure biomarkers. For 15 biomarkers, the available health-based HBM guidance values were exceeded with highest exceedance rates for toxicologically relevant arsenic in teenagers (40%), 3-PBA in children (36%), and between 11 and 14% for total DON, Σ (PFOA + PFNA + PFHxS + PFOS), bisphenol S and cadmium. The infrastructure and harmonized approach succeeded in obtaining comparable European wide internal exposure data for a prioritized set of 11 chemical groups. These data serve as a reference for comparison at the global level, provide a baseline to compare the efficacy of the European Commission's chemical strategy for sustainability and will give leverage to national policy makers for the implementation of targeted measures.
publishDate 2023
dc.date.none.fl_str_mv 2023
2023-07-25
2023
2023-04-01
2023
2023-04-01
dc.type.none.fl_str_mv review article
http://purl.org/coar/resource_type/c_dcae04bc
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/20.500.12105/16310
url http://hdl.handle.net/20.500.12105/16310
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.relation.none.fl_str_mv European Commission http://dx.doi.org/10.13039/501100000780 Horizon 2020 Framework Programme 733032
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial-NoDerivatives 4.0 Internacional
http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repisalud
instname:Instituto de Salud Carlos III (ISCIII)
instname_str Instituto de Salud Carlos III (ISCIII)
reponame_str Repisalud
collection Repisalud
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869420593482301440
spelling 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)Govarts, EvaGilles, LieseRodriguez Martin, LauraSantonen, TiinaApel, PetraAlvito, PaulaAnastasi, ElenaAndersen, Helle RaunAndersson, Anna-MariaAndryskova, LenkaAntignac, Jean-PhilippeAppenzeller, BriceBarbone, FabioBarnett-Itzhaki, ZoharBarouki, RobertBerman, TamarBil, WienekeBorges, TeresaBuekers, JurgenCañas Portilla, Ana IsabelCovaci, AdrianCsákó, ZsófiaDen Hond, EllyDvorakova, DarinaFábelová, LuciaFletcher, TonyFrederiksen, HanneGabriel, CatherineGanzleben, CatherineGöen, ThomasHalldórsson, Thórhallur IngiHaug, Line SHorvat, MilenaHuuskonen, PasiImboden, MedeaJagodic Hudobivnik, MartaJanasik, BeataJanev Holcer, NatasaKarakitsios, SpyrosKatsonouri, AndromachiKlánová, JanaKokaraki, VenetiaKold Jensen, TinaKoponen, JaniLaeremans, MichelleLaguzzi, FedericaLange, RosaLemke, NoraLignell, SannaLindroos, Anna KarinLobo Vicente, JoanaLuijten, MirjamMakris, Konstantinos CMazej, DarjaMelymuk, LisaMeslin, MatthieuMol, HansMontazeri, ParisaMurawski, AlineNamorado, SóniaNiemann, LarsNübler, StefanieNunes, BaltazarÓlafsdóttir, KristinPalkovicova Murinova, LubicaPapaioannou, NafsikaPedraza-Diaz, SusanaPiler, PavelPlichta, VeronikaPoteser, MichaelProbst-Hensch, NicoleRambaud, LoïcRauscher-Gabernig, ElkeRausova, KatarinaRemy, SylvieRiou, MargauxRosolen, ValentinaRousselle, ChristopheRüther, MariaSarigiannis, DenisSilva, Maria JŠlejkovec, ZdenkaSnoj Tratnik, JanjaStajnko, AnjaSzigeti, TamásTarazona, JoseThomsen, CathrineTkalec, ŽigaTolonen, HannaTrnovec, TomasUhl, MariaVan Nieuwenhuyse, AnVasco, ElsaVerheyen, Veerle JViegas, SusanaVinggaard, Anne MarieVogel, NinaVorkamp, KatrinWasowicz, WojciechWeber, TillWimmerova, SonaWoutersen, MarjolijnZimmermann, PhilippZvonař, MartinKoch, Holger MKolossa-Gehring, MarikeEsteban-Lopez, MartaCastaño, ArgeliaStewart, LorraineSepai, OvnairSchoeters, GreetEnvironmental PollutantsArsenicPesticidesFluorocarbonsYoung AdultHumansChildAdolescentBiological MonitoringCadmiumBiomarkersAcrylamidesAs one of the core elements of the European Human Biomonitoring Initiative (HBM4EU) a human biomonitoring (HBM) survey was conducted in 23 countries to generate EU-wide comparable HBM data. This survey has built on existing HBM capacity in Europe by aligning national or regional HBM studies, referred to as the HBM4EU Aligned Studies. The HBM4EU Aligned Studies included a total of 10,795 participants of three age groups: (i) 3,576 children aged 6-12 years, (ii) 3,117 teenagers aged 12-18 years and (iii) 4,102 young adults aged 20-39 years. The participants were recruited between 2014 and 2021 in 11-12 countries per age group, geographically distributed across Europe. Depending on the age group, internal exposure to phthalates and the substitute DINCH, halogenated and organophosphorus flame retardants, per- and polyfluoroalkyl substances (PFASs), cadmium, bisphenols, polycyclic aromatic hydrocarbons (PAHs), arsenic species, acrylamide, mycotoxins (deoxynivalenol (total DON)), benzophenones and selected pesticides was assessed by measuring substance specific biomarkers subjected to stringent quality control programs for chemical analysis. For substance groups analyzed in different age groups higher average exposure levels were observed in the youngest age group, i.e., phthalates/DINCH in children versus teenagers, acrylamide and pesticides in children versus adults, benzophenones in teenagers versus adults. Many biomarkers in teenagers and adults varied significantly according to educational attainment, with higher exposure levels of bisphenols, phthalates, benzophenones, PAHs and acrylamide in participants (from households) with lower educational attainment, while teenagers from households with higher educational attainment have higher exposure levels for PFASs and arsenic. In children, a social gradient was only observed for the non-specific pyrethroid metabolite 3-PBA and di-isodecyl phthalate (DiDP), with higher levels in children from households with higher educational attainment. Geographical variations were seen for all exposure biomarkers. For 15 biomarkers, the available health-based HBM guidance values were exceeded with highest exceedance rates for toxicologically relevant arsenic in teenagers (40%), 3-PBA in children (36%), and between 11 and 14% for total DON, Σ (PFOA + PFNA + PFHxS + PFOS), bisphenol S and cadmium. The infrastructure and harmonized approach succeeded in obtaining comparable European wide internal exposure data for a prioritized set of 11 chemical groups. These data serve as a reference for comparison at the global level, provide a baseline to compare the efficacy of the European Commission's chemical strategy for sustainability and will give leverage to national policy makers for the implementation of targeted measures.ElsevierUnión Europea. Comisión Europea. H202020232023-07-2520232023-04-0120232023-04-01review articlehttp://purl.org/coar/resource_type/c_dcae04bcVoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfapplication/pdfhttp://hdl.handle.net/20.500.12105/16310reponame:Repisaludinstname:Instituto de Salud Carlos III (ISCIII)InglésengEuropean Commission http://dx.doi.org/10.13039/501100000780 Horizon 2020 Framework Programme 733032open accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial-NoDerivatives 4.0 Internacionalhttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:repisalud.isciii.es:20.500.12105/163102026-06-12T12:43:37Z
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