Evidências globais em biomonitoramento humano: revisão sistemática das principais exposições e desfechos em saúde correlacionados

Abstract

Introduction: Human biomonitoring (HBM) represents an essential tool for assessing exposure to environmental chemicals and their health impacts, given the challenges posed by the diversity and complexity of modern chemical pollutants. Objective: To synthesize the current scientific evidence available on human biomonitoring studies, considering aspects related to the type of exposure, technique, biomarkers, and associated outcomes in populations investigated across different continents. Methodology: This study adopted the PRISMA guidelines for systematic reviews and meta-analyses, using the PICO method to define research questions and study inclusion criteria. We prioritized research employing biomonitoring techniques to assess human exposures and health impacts, conducting searches in the LILACS, PubMed, and Web of Science databases without language or geographical restrictions. Study selection, conducted by two independent reviewers, focused on works published between 2019 and 2023, applying exclusion criteria to ensure relevance. Geospatial mapping using QGIS software provided a global analysis of research distributed across five continents. Results: Initially, 3,038 articles were identified. Rigorous application of screening and eligibility criteria resulted in the exclusion of 2,795 works, primarily due to temporality (2019-2023), thematic irrelevance, classification as grey literature, duplication, and failure to meet PICO methodology criteria. Subsequent analysis focused on 96 selected articles, demonstrating significant geographic heterogeneity, with most studies located in Asia (36.5%), followed by Europe (30.2%), the Americas (17.7%), Africa (8.3%), and Oceania (7.3%). The demographic composition of study participants revealed a predominance of females (59.6%) and a concentration in the 15-64 age group (75.6%). The investigation categorized exposures into five main domains: Environmental (38.5%), Nutritional (20.8%), Residential (20.8%), Occupational (13.5%), and Pharmacological (6.3%). Among the substances analyzed, Atmospheric Pollutants (19.8%), Persistent Organic Pollutants (15.6%), and Metals (13.5%) were the most frequent, providing crucial data for understanding the distribution and impact of these exposures in the global context. Conclusion: The analysis underscores the complexity of challenges in protecting public health from environmental exposure. There is a significant gap in knowledge regarding the specific mechanisms of action of these contaminants and the effectiveness of current mitigation strategies, highlighting the need for more sensitive biomonitoring methods and their integration with regulatory policies.