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The aim of this work was to develop a comprehensive prioritization method to select the biomarkers to be monitored in the French national biomonitoring program. The first step consisted in building an exhaustive list of biomarkers. The next step involved prioritizing the initial list of biomarkers according to specific scientific questions about human exposure to chemicals in the environment, and meet logistical, feasibility and budgetary constraints. The Delphi consensus method was used to prioritize biomarkers and was developed in three phases: i) the definition of relevant criteria for selecting biomarkers; ii) the prioritization of the biomarker list based on these criteria and iii) the validation of the list by the stakeholders. Among the eight relevant criteria for selecting biomarkers, hazard identification and social perception were the highest-rated and lowestrated criteria, respectively. After scoring each criterion for each group of biomarkers, and discussing the relative ranking of each group during a round table meeting, the final prioritized list obtained contained both historic (e.g. dioxins or lead) and emerging substances (e.g. phthalates, bisphenol A). Combining rigor and flexibility, our method has clearly helped to build a prioritized list shared and supported by many international actors.
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