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Humans worldwide are exposed to a wide range of chemicals through their diets, consumer products and the environment, often changing in concentrations, combinations and over time. Health impact assessment (HIA) for exposure to chemicals is poorly defined and its contribution to the global burden of disease is difficult to quantify and certainly underestimated. The importance of taking actions for reducing deaths and illness associated to hazardous chemicals is reflected in the UN Sustainable Development Goals target 3.9, as well as in the 7th European Environment Action Programme or in the European Green Deal (Communication of the European Commission, COM (2019) 640 final). Recent discussions suggest that current EU Legislation, while contributing to reducing the overall risks of chemicals in the environment, is protecting mainly against highly toxic chemicals in the workplace. However, the assessment of potential health impacts over the general population is limited by uncertainties related to data collection, health indicators and confounding factors. Concerns have also been reported regarding the increased introduction in the market and the environment of new substances with unknown properties as well as referring to the chronic, low-level exposure to chemical mixtures, which are considered to be poorly characterised and yet to be systematically addressed. Notably, in recent years the European Commission (EC), acknowledging that the assessment and management of mixtures is only partly covered by current legislation, has identified several gaps and areas for action. With regard to carcinogens, the proportion of non-genotoxic carcinogens in the environment is expected to increase, since industrial chemists are designing compounds without overly reactive moieties. In addition, the manufacture and use of novel types of substances including nanomaterials, new generation pesticides and pharmaceuticals (e.g. biologicals, cell and gene therapies) are expected to increase. This raises new challenges for the assessment and risk management of the carcinogenicity impacts of chemicals. The present workshop intends to provide an overview of the different initiatives conducted in Europe at different scales (European, national and regional), to address such defies related to the HIA of chemicals. Specifically, we will debate about existing data sets for characterising both human exposure and health effects related to chemicals, new approaches and guidance for the assessment of exposure to mixtures, and the carcinogenicity impacts as well as how all that is being translated to policy actions. Key messages Increasing global trend of human exposure to chemicals demands holistic approach for action. Several research/policy initiatives for improving HIA-chemicals are ongoing, with expected strong impacts.

4.D. Workshop: Health Impact assessment of chemical exposure: state of the art and challenges