Over the last few decades, citizen awareness and perception of chemical products has been a topic of interest, particularly concerning national and international policy decision makers, expert/scientific platforms, and the European Union itself. To date, few qualitative studies on human biomonitoring have analysed communication materials, made recommendations in terms of biomonitoring surveillance, or asked for feedback in terms of specific biomonitoring methods. This paper provides in-depth insight on citizens’ perceptions of knowledge of biomonitoring, impact of chemical exposure on daily life, and claims on how results of research should be used. Four semi-structured focus groups were held in Austria, Portugal, Ireland, and the United Kingdom (UK). The cross-sectional observational qualitative design of this study allows for better understanding of public concern regarding chemicals, application, and use of human biomonitoring. The main findings of this study include citizens’ clear articulation on pathways of exposure, the demand on stakeholders for transparent decision-making, and sensitivity in communication of results to the public. Validated and trustful communication is perceived as key to empowering citizens to take action. The results can be used to facilitate decision-making and policy development, and feeds into the awareness needs of similar and future projects in human biomonitoring. Furthermore, it also brings to light ideas and concepts of citizens’ in shaping collaborative knowledge between citizens’, experts, scientists, and policy makers on equal terms.

Environmental health is at the intersection between health and the environment. However, it still has a recent (and narrow) history as a scientific area, mainly addressing human biomonitoring and toxicological issues. Only recently additional environmental ‘layers’, other than the traditional chemical, biological and physical environmental determinants, have been considered. This broader perspective of environmental health also encompasses digital, psychosocial, political, socioeconomic and cultural determinants, all of them relevant when considering human health from a planetary health paradigm. This reflects the progressive adoption of a systemic perspective regarding the impact of gains for human health and well-being towards a sustainable environment. It also implies a multi-method and participatory approach to understand the intertwined relationship between environmental changes and human health. In this paper, the broader approach to environmental health is discussed in order to ‘set the stage’ for introducing the Institute of Environmental Health (ISAMB) of the Lisbon School of Medicine, Portugal. Each of the research groups and labs that compose ISAMB are presented, as well as their main lines of research. Present and planned contributions of ISAMB to advance knowledge on environmental health and for promoting human health gains in an environmentally sustainable way are also discussed.

Evidence on the carcinogenic effects of municipal solid waste incinerators (MSWI) is inconsistent. This meta-analysis assessed associations between exposure to MSWI emissions and cancer risk. PubMed, Scopus, and Web of Science were searched for ecological, case-control, or cohort studies, evaluating cancer-related outcomes in populations exposed to MSWI. Study quality was evaluated. Random-effects meta-analyses were performed when at least three studies reported the same cancer outcome. Heterogeneity was assessed using I² and robustness with leave-one-out sensitivity analyses. Nineteen studies (11 ecological, 4 cohort, 4 case-control; 1996-January 2025) were included. Most ecological studies had poor quality, while cohort and case-control designs were fair-good. Meta-analyses showed modest excess risks for non-Hodgkin lymphoma incidence and lung cancer mortality, with a low certainty of evidence. For other cancers, no consistent and clear associations were found. Overall, current evidence is uncertain to establish causal links between MSWI exposure and cancer. The predominance of ecological designs, limitations in exposure assessment, and methodological heterogeneity contribute to this imprecision.