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[Biological monitoring of exposure to industrial toxic substances. Present-day situation and prospects for development].

Biological monitoring of exposure to an industrial chemical may be defined as the evaluation of the internal dose (internal exposure) by a biological method with the view of assessing the associated health risk. Depending on the biological parameter selected and on the time of sampling, internal dose may mean the amount of chemical recently absorbed, the amount stored in one or several compartments of the organism, or, under ideal conditions, the amount bound to the sites of action. The estimation of the internal dose has usually relied on two categories of tests: those based on the determination of the chemical and/or its metabolites in various biological media (eg, alveolar air, blood, urine) and those based on the quantification of a nonadverse biological effect, the intensity of which is related to the internal dose. Biological tests providing information on the amount of active chemical bound to the critical sites of action (target dose) and noninvasive analytical methods which measure the amount of cumulative toxins stored in certain body compartments (eg, bone, liver, kidney) are currently being developed. The main criteria to be considered in the selection of the most appropriate biological monitoring test of exposure are the specificity of the parameter and its sensitivity with respect to the exposure level, the analytical and biological applicability, the convenience for the workers, the possible risks associated with its application, and, of course, the accuracy of the exposure and/or health risk evaluation. Normally, the biological approach of exposure monitoring is reserved for chemicals which enter the organism and may exert systemic toxic effects. When a biological monitoring test of exposure is applicable, it offers several advantages over ambient air monitoring. A biological parameter reflecting the internal dose is necessarily more closely related to the systemic adverse effect(s) than any environmental measurement. Biological monitoring of exposure integrates the exposure by all routes (pulmonary, oral, and cutaneous) and sources. It may also take into account several factors which determine the uptake and the absorption of the chemical (individual variability, work load, hygiene habits, etc). However, contrary to ambient monitoring, biological monitoring is applicable only when sufficient information has been gathered on the metabolism of the chemical, its toxicity or that of its metabolites, and when some of the relationships between external exposure, internal dose and adverse effects have been assessed.(ABSTRACT TRUNCATED AT 400 WORDS)

Humans↗

Follow-up of biologic monitoring results in cadmium workers removed from exposure.

Biological monitoring and exposure monitoring data for employees at a nickel-cadmium battery production facility were made available to OSHA for review. Sixteen employees were medically removed from occupational exposures to cadmium due to elevated levels of biological parameters (CdB, Cdu, B2U). While the biological monitoring parameters for most workers significantly declined during the 18 months of medical removal, the biological parameters for only one employee's values returned to the normal range. Only one worker had frank renal dysfunction, based on beta-2-microglobulin levels at the time of removal; this dysfunction remained throughout the 17 months of observation after medical removal. Significant policy implications of medical removal protection beyond the current 18-month period provided by the cadmium standards exist and require physician discretion. Mitigating issues which may make it ethically appropriate to return an employee to work despite elevated biologic monitoring parameters are also discussed.

Cadmium↗

Current trends in the biological monitoring of exposure to carcinogens.

The biological monitoring of exposure to carcinogens and mutagens has gained a lot of research interest recently. Biological monitoring data, in conjunction with environmental monitoring data, will provide information for the needed exposure assessment for directing preventive actions. For the reviewed carcinogens aromatic amines, benzene, ethylene oxide, aflatoxins, N-nitroso compounds, polynuclear aromatic hydrocarbons, and alkylating anticancer drugs, there are methods which are already routine in practice, whereas some promising methods are still used only for research purposes.

Aflatoxins↗

Reference values and action levels of biological monitoring in occupational exposure.

The primary objectives of biological monitoring are (1) to prevent health impairment, (2) to assist in the assessment of risk, and (3) to evaluate the effectiveness of environmental controls. An efficient way to achieve these objectives would be to enforce the compliance of biological exposure standards at the workplace. However, biological monitoring should be viewed in the total context of control and prevention of work-related diseases, and not merely to comply with permissible standards. Biological monitoring depends very much on the conditions that the chemical is absorbed and how it is metabolised. Genetic diversity could therefore contribute to significant differences in this aspect. Furthermore, many of the reference values established have so far not been fully validated and therefore their usefulness is rather limited. This paper reviews and illustrates using some recent findings to show that biological reference values are influenced not just by the above mentioned issues, but also factors such as (1) health and nutritional status of the exposed population, (2) social and cultural factors, and (3) climatic conditions. Caution has to be taken when considering having an action level for some of the biological reference value. Biological reference values set without considering people, technology, and working conditions would be fraught with difficulties in implementation.

Benzene↗

Biological monitoring of nitroglycerin exposure by urine analysis.

Historically biological monitoring to assess exposure has been difficult due to the rapid half-life of NG. However, the recent development of a method to assess NG and its metabolites (glycerol dinitrates, GDNs) in urine has made biological monitoring more feasible. The data reported here result from samples taken from three sites using NG. Two of the sites are munitions manufacturing sites and the other site is a pharmaceutical manufacturing site. The range of urinary GDN concentrations found in the samples at the two munitions sites were 0.9-18, and 0-4.7 micromol/mol creatinine, and at the pharmaceutical site were 0-0.9 micromol/mol creatinine). The presence of nitroglycols in the urine of workers despite the use of personal protective equipment and local exhaust ventilation shows the usefulness of biological monitoring to assess the efficacy of any controls in place and the potential of dermal absorption of NG.

Drug Industry↗

External quality assurance program for biological monitoring in occupational and environmental medicine.

Biological monitoring of chemical exposure in the workplace and in the environment has become increasingly important in assessing health risk. The analysis must be carried out under a quality assurance scheme to guarantee that the results obtained in biological monitoring are comparable with the threshold limit values and results from other laboratories. Since 1982, the German Society for Occupational and Environmental Medicine has offered 28 intercomparison programs. These programs cover 96 analytes in urine, blood, and plasma for 47 substances and cover most parameters that are relevant in occupational and environmental medicine. The data obtained in these programs provide a good overview of the current quality of the determination of analytes that are assessed in occupational and environmental toxicological laboratories. For the analyses of inorganic substances in blood and urine, the tolerable variation ranges from 7.5% to 43.5%. For organic substances in urine, the tolerable variation ranges from 12% to 48%. For organic substances in urine, the tolerable variation ranges from 12% to 48%. The highest variations (36% to 60%) were found for the analysis of organochlorine compounds in plasma. The tolerable variations for determining solvents in blood by head space gas chromatography range from 26% to 57%. The overall average success rates for the participants of the external quality programs range from 65% to 75%.

Environmental Monitoring↗

Large-scale biological monitoring in Japan.

Data from the large-scale biological monitoring program in Japan were assembled and analyzed and the following results were obtained. All workers handling lead and eight kinds of major organic solvents received physical examinations and biological monitoring at the same time. Therefore, the number of workers handling industrial chemicals and that received physical examinations and the number of workers been examined by biological monitorings were similar to each other. The total number of cases examined from 1989 to 1994 was about 661,000 for lead in the blood and about 4,173,000 for the urinary metabolites of eight organic solvents. The results were classified into three categories and category 3 consists of workers having exposure concentrations above the 1988-1989 biological exposure indices of the ACGIH with the exception of lead concentration in the blood where the limit in Japan was set at 40 micrograms/100 ml. The percentage of exposed workers in category 3 was 1.4% for blood lead and 0.2-2.4% for the urinary metabolites of the eight organic solvents. The percentage of exposed workers in category 3 for blood lead, delta-aminolevulinic acid, urinary mandelic acid, N-methylformamide and 2,5-hexanedione in the urine has decreased with time. In ambient monitoring, the percentage of workplaces in classification 3 for lead and styrene also has decreased with time.

Aminolevulinic Acid↗

Biological monitoring values for occupational exposure: a United Kingdom perspective.

Policy developments in the United Kingdom have been aimed at facilitating the appropriate use of biological monitoring. Recent initiatives have established clear criteria for the interpretation of biological monitoring results, and new guidance that deals with the ethical and practical issues involved in operating an effective biological monitoring programme has been promulgated. The United Kingdom now has a system of non-statutory biological monitoring guidance values. There are two types, the health guidance value and the benchmark guidance value. Over a number of years, biological monitoring programmes have shown that they help in reducing exposure by regular monitoring and demonstrating adequate control.

Environmental Monitoring↗

[Influencing factors that affect the biological monitoring of workers exposed to N,N-dimethylformamide in textile coating factories].

OBJECTIVES: The objective of this study is to assess the factors influencing biological monitoring of textile coating factory workers exposed to N,N-dimethylformamide (DMF). METHODS: We studied 35 workers who were occupationally exposed to DMF from 9 textile coating factories. The study was carried out in two phases; summer and winter. While air concentration of DMF, temperature and humidity were assessed in order to monitor the atmospheric conditions, biological monitoring was done to determine the internal dose by analyzing the N-methylformamide (NMF) collected from urine at the beginning and end of the shift. Questionnaires and medical surveillance were also obtained during the two phases. RESULTS: Median air concentrations of DMF in winter and summer were 1.85 ppm and 2.78 ppm respectively. Also the difference between the urinary NMF concentration at the beginning and end of the shift (delta NMF) was always significant in each season (P < 0.001). The correlations between log DMF in air, log end-of-shift urinary NMF (r = 0.555, P < 0.001) and log delta NMF (r = 0.444, P < 0.001) was statistically significant in summer. The temperature, humidity, a shift system and different styles of clothing worn were significantly different during the two phases. In a multivariate analysis, temperature and the concentration of DMF in the air were the main factors influencing biological monitoring of textile coating factory workers. CONCLUSIONS: Concerning more comprehensive prevention measures to reduce exposure for those workers occupationally exposed to DMF, dermal exposure conditions such as temperature and humidity together with the air concentration of DMF should be assessed and biological monitoring is necessary to reduce adverse health effects, especially during the summer.

Adult↗

[Biological monitoring: concepts and applications in public health].

This study provides an overview of the theoretical discussion on potential uses for biological monitoring of exposure to chemical substances as related to human health, considering different concepts: definitions, uses, and limitations of internal dose and biological effect indicators and their availability for the substances to be quantified; knowledge of reference values, action levels, and limits based on health and negotiated patterns in biological monitoring interpretation and perspectives; and ethical and social problems in practice and within different preventive practices and their use in public health. Biological monitoring is the result of an exposure situation with conclusions based on scientific and consensus values, rules, and legislation. Biological monitoring as a continuous process and related to actually observed cases has helped establish technological exposure reference values and consensus levels as indicators for improving the environment and the workplace. As a step in the decision-making process in risk analysis, biological monitoring needs to be critically assessed as to its ethical aspects in light of the end use of results and values, which are references for application of this methodology.

Biomarkers↗

[Biological monitoring of chemical exposure].

The concept of biological monitoring (BM) has evoked a lot of interest among individual scientists and international organizations. Biological monitoring of exposure has thus far been applied to environmental and occupational toxicology or epidemiological studies. At present, BM plays no more than complementary role in industrial hygiene. Moreover, it is not clear whether BM belongs to occupational hygiene or to occupational medicine. Consequently, BM recommendations are not regarded as legal standards in most countries. Nowadays, when analytical problems have almost ceased to exist due to new laboratory techniques and quality assurance systems, the methods for interpreting the results have become a major issue. New, promising areas of BM application include determination of pesticides, antineoplastic drugs, hard metals, and unchanged volatile organic compounds in urine. The identification of new possible health-based biomarkers of exposure and the development of more sensitive methods due to decreasing occupational exposure limits seem to be one of the most important issues.

Environmental Monitoring↗

[The study of biological monitoring of inorganic arsenic exposure].

This review will describe method for biological monitoring of inorganic arsenic exposure, that delineates the chemical species of arsenic measured in urine. The studies established a method for exposure-level-dependent biological monitoring of inorganic arsenic exposure. Low-level exposure could be monitored only by determining the urinary inorganic arsenic concentration. High-level exposures clearly produced increased urinary inorganic arsenic, methylated arsenic (MA), dimethylated arsenic (DMA) and the sum of urinary inorganic arsenic and its metabolites (inorganic arsenic+MA+DMA) could be determined. Urinary arsenobetaine proved to be specifically seafood-derived arsenic, which could be distinguished from occupational arsenic exposure. There is increased use of gallium arsenide and indium arsenide in the semiconductor industry today. The determination of arsenic in ambient air is difficult to carry out in semiconductor factories. Monitoring arsenic exposure by determining the arsenic in the hair appeared to be of value only when used for environmental monitoring of arsenic rather than for biological monitoring.

Arsenic↗

Biological Monitoring of Pesticide Exposure: a review. Introduction.

Pesticides are used worldwide in agriculture, industry, public health and for domestic applications: as a consequence, a great part of the population may be exposed to these compounds. In spite of this extensive use, knowledge on the health risks associated with prolonged exposure is rather poor, and major uncertainties still exist. Epidemiological observations in man have so far produced little conclusive information, mainly because of weaknesses in exposure assessment. Therefore, information on the type and levels of exposure is fundamental in order to better understand and characterize risk to human health. Exposure assessment can be carried out via measurement of environmental concentrations, as well as via determination of the chemical or its metabolites in body tissues (biological monitoring). Besides indices of internal dose, biological monitoring also includes measurements of early effects attributable to interaction between the chemical agent and the human body. Biological monitoring has the advantage, over environmental monitoring, of determining the dose actually absorbed via any possible route: differences in absorption can be taken into account. whether they are due to biological variability or to use of protective equipment. When, in some cases, a combination of occupational and non-occupational exposure occurs, this also can be taken into consideration by biological monitoring. Few reference documents have been published on biological monitoring of pesticides. For this reason, the Office of Occupational Health of the World Health Organization gave ICPS a mandate to prepare a monograph specifically addressed to reviewing methods for biological monitoring of pesticide exposure. This review is based on more than 300 studies published over the period 1980-1999. For the most representative chemical classes, the available biological exposure indices are reported. Both indices of internal dose and. when available, of early effects are discussed. The reported tests were used to monitor exposure of pesticide applicators in agriculture and public health, manufacturing and formulating workers. subjects poisoned after accidental exposure or attempted suicide, volunteers involved in pharmacokinetic studies, as well as sub-groups of the general population exposed to environmentally persistent pesticides. Single chapters deal with organophosphorus insecticides, carbamate pesticides, dithiocarbamates, phenoxyacids, quaternary ammonium compounds. coumarin rodenticides, synthetic pyrethroids, organochlorine pesticides, chlorotriazines, and pentachlorophenol.

Animals↗

Biological monitoring for pesticide absorption.

This paper reviews the development of biological monitoring as a method of assessing absorption of pesticides during occupational exposure. An approach to human volunteer studies to estimate the relationship between exposure to pesticides and excretion of metabolites is described and practical aspects of applying biological monitoring to field studies are considered. Case studies are used to illustrate some of the pitfalls of extrapolating from animals to man and to demonstrate the importance of human volunteer studies in establishing a sound basis for biological monitoring for pesticides.

Absorption↗

[The biological monitoring of those exposed to 1,1,1-trichloroethane: a longitudinal study].

Data on long-term biological monitoring in two groups of workers engaged in cleaning operations in a wool factory and exposed to methylchloroform are presented. The longitudinal survey lasted one year and brought about 19 random systematic sampling (once or twice a month for everyone of the 13 subjects monitored). The biological marker adopted was the urinary concentration of the solvent as such, according to a previously studied method. The collected data allowed to measure: the annual average level of exposure (estimated by the long term geometric mean); the day to day variation of the true daily exposure averages (estimated by the geometric standard deviation); the probability of overexposure (daily exposures exceeding the biological exposure limit) and the yearly number of work shifts of overexposure. The usefulness of performing long-term surveys of occupational exposure to the chemical substances by mean of longitudinal biological monitoring is discussed.

Adult↗

Biological monitoring of hazardous waste workers: metals.

The author defines biological monitoring and discusses its role as a component of medical surveillance protocols, including traditional methods and new methods of monitoring of effect. Initiating a biological monitoring program, choosing a laboratory, and archiving specimens are detailed.

Environmental Monitoring↗

Biological monitoring of exposure to pesticides: current issues.

Biological monitoring is becoming an increasingly important element of field studies designed to assess the risk from occupational pesticide exposure for preventive purposes. Selection of suitable biomarkers of exposure to pesticides, development of detection methods, validation of measurement and interpretation of results are of utmost concern among current issues. This paper provides an overview on the research strategies and application of biological monitoring of pesticide exposure.

Acetylcholinesterase↗

[Creatinine and urine density as reference values in biological monitoring].

Creatinine and density of urine as reference parameters in biological monitoring Since in practice biological monitoring with 24-hour urine samples is not possible, a reference parameter is required. In two different experimental models - for 10 days in 24-hour portions and for 1 day with spontaneous individual fractions - creatinine excretion, mean daily urine volume and urine density were measured quantitatively in 5 healthy human subjects not exposed to chemistry. In the 10-day model, coefficients of variation were: 8.7% for creatinine, 24.9% for mean urine volume and 11.7% for urine density. In the 1-day model, coefficients of variation were: 15.8% for creatinine, 51.0% for mean urine volume and 28.0% for density. This indicates that the results of the second model are considerably more expressive than those of the first. It can be concluded that creatinine is the most suitable reference parameter. Density is less suitable and mean urine volume least suitable.

Adult↗