Towards a Swiss health study with human biomonitoring: Learnings from the pilot phase about participation and design

PLOS ONE RESEARCH ARTICLE Towards a Swiss health study with human biomonitoring: Learnings from the pilot phase about participation and design Réjane Morand Bourqui1☯, Semira Gonseth Nusslé2☯, Natalie von Goetz ID1,3*, Caroline Veys-Takeuchi2, Claire Zuppinger2, Yoanne Boulez2, Nolwenn Bühler ID4, Laurence Chapatte5, Christine Currat5, Aline Dousse5, Vincent Faivre2, Oscar H. Franco6, Julien Virzi5, Martine Bourqui-Pittet1, Murielle Bochud2* a1111111111 a1111111111 a1111111111 a1111111111 a1111111111 1 Health Protection Directorate, Federal Office of Public Health, Bern, Switzerland, 2 General Direction, Center for Primary Care and Public Health, Unisanté, Lausanne, Switzerland, 3 Federal Institute of Technology (ETH Zurich), Zurich, Switzerland, 4 Institute of Social Sciences, University of Lausanne, Lausanne, Switzerland, 5 Swiss Biobanking Platform, Epalinges, Switzerland, 6 Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland ☯ These authors contributed equally to this work. * (MB); (NG) OPEN ACCESS Citation: Morand Bourqui R, Nusslé SG, von Goetz N, Veys-Takeuchi C, Zuppinger C, Boulez Y, et al. (2023) Towards a Swiss health study with human biomonitoring: Learnings from the pilot phase about participation and design. PLoS ONE 18(7): e0289181. https://doi.org/10.1371/journal. pone.0289181 Editor: Claus Kadelka, Iowa State University, UNITED STATES Abstract Background A large-scale national cohort aiming at investigating the health status and determinants in the general population is essential for high-quality public health research and regulatory decision-making. We present the protocol and first results of the pilot phase to a Swiss national cohort aiming at establishing the study procedures, evaluating feasibility, and assessing participation and willingness to participate. Received: April 6, 2023 Accepted: July 12, 2023 Published: July 31, 2023 Copyright: © 2023 Morand Bourqui et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Funding: The study has been funded by the Swiss government through its agencies (FOPH, Federal Office of Food Security and Veterinary Affairs (FSVO) and Federal Office for the Environment (FOEN)), and from the involved institutions: the Center for Primary care and Public Health, Unisanté in Lausanne, the Swiss Trop-ical and Public Health Methods The pilot phase 2020/21 included 3 components recruited via different channels: a population-based cross-sectional study targeting the adult population (20–69 years) of the Vaud and Bern cantons via personal invitation, a sub-study on selenium in a convenience sample of vegans and vegetarians via non-personal invitation in vegan/vegetarian networks, and a self-selected sample via news promotion (restricted protocol). Along with a participatory approach and participation, we tested the study procedures including online questionnaires, onsite health examination, food intake, physical activity assessments and biosample collection following high-quality standards. Results The population-based study and the selenium sub-study had 638 (participation rate: 14%) and 109 participants, respectively, both with an over-representation of women. Of altogether 1349 recruited participants over 90% expressed interest in participating to a national health study, over 75% to contribute to medicine progress and help improving others’ health, whereas about one third expressed concerns over data protection and data misuse. PLOS ONE | https://doi.org/10.1371/journal.pone.0289181 July 31, 2023 1 / 20 PLOS ONE Institute in Basel, and the Institute of Social and Preventive Medicine, ISPM, Bern. FSVO and FOEN had no role in study design, data collection and analysis, decision to publish or prepara-tion of the manuscript. FOPH and the involved institutions cited above were involved in developing the study design. Unisanté and ISPM were involved in data collection, Unisanté and FOPH in data analysis. FOPH, Unisanté and ISPM were involved in the decision to publish. FOPH and Unisanté were involved in the preparation of the manuscript. Competing interests: The authors have declared that no competing interests exist. Towards a Swiss Health Study with human biomonitoring Conclusions Publicly accessible high-quality public health data and human biomonitoring samples were collected. There is high interest of the general population in taking part in a national cohort on health. Challenges reside in achieving a higher participation rate and external validity. For project management clear governance is key. Introduction Health data are not only essential for research purposes, but also for evidence-based public health policy–they form the basis for public health decisions and interventions. In Switzerland, health data on the general population are mostly fragmented, local and heterogeneous. Already in 2011, the OECD pointed out in its review of the Swiss health system a poor health information system, needing appropriate effort into collecting the information necessary to generate evidence [1]. Switzerland’s demographics and life expectancy–one of the highest in the World [2]–are such that some scientists predict a grey tsunami [3]: the proportion of the elderly in the population will drastically increase in the coming decades from 18% currently [4] to up to 30% in 2050 [5]. Although Switzerland’s global health status is fairly good compared to the neighboring countries [6], socioeconomic inequalities in health are substantial [7, 8]. Another future challenge lies in the health impacts of climate change. For Switzerland, as a middleEuropean country, experts announce for instance a rise in communicable diseases, and in the lethality and morbidity of heat stress and weather-related disasters, together with a worsening of health inequalities consecutive to migrations and economic crisis [9–11]. These challenges ahead underline the need for good quality health data for both public health monitoring and research. We need studies that can take into account the broad and interconnected cumulative health effects of life-course exposures, be they environmental, related to lifestyle, due to toxic compounds, or “social exposures” such as social inequities [12]. The exposome–a concept encompassing all exposures on an individual, from conception and onward–can be studied at different scales, from external general exposures down to specific molecular alterations. Population-based cohort studies investigating the exposome constitute a method of choice for epidemiology and public health: they enable a better understanding of the determinants of health and disease and a monitoring of the impact of pub (...truncated)