Monitoring Goals. Air monitoring (or workplace environmental monitoring) and biological monitoring have complementary goals and frequently are applied simultaneously in industrial hygiene investigations.
1. Air monitoring. Air monitoring provides an estimate of the potential for exposure to an agent. The presence of a health hazard is estimated by reference to environmental exposure limits, such as the NIOSH recommended exposure levels, the Occupational Safety and Health Administration (OSHA) permissible exposure levels, or the threshold limit values (TLVsTM) of the American Conference of Governmental Industrial Hygienists (ACGIH). Compared with biological monitoring, air monitoring offers advantages in certain situations. If the agent has acute toxic effects on the respiratory tract or the eyes, air monitoring is the logical tool for controlling the exposure. Air monitoring can be conducted continuously and, thus, can detect peak exposures to dangerous chemicals.
2. Biological monitoring of exposure. A biomarker of exposure represents uptake of the agent through all routes of exposure. Thus, compared to air monitoring, biological monitoring offers a better estimate of the health risk in situations where routes of exposure other than inhalation are significant.
a. The rate of disappearance of a biomarker determines the period of time after exposure during which the level of the biomarker is still affected by the exposure [7]. The levels of rapidly disappearing biomarkers primarily reflect exposures during the previous several hours. On the other hand, biomarkers which disappear over the course of several weeks reflect one, several, or numerous exposure incidents occurring anytime during a period of several weeks previous to the measurement.
b. Some toxicants accumulate in one or several parts of the body and are in dynamic equilibrium with the sites of toxicity. In the case of polychlorinated biphenyl (PCB), which accumulates in fatty tissue, the blood level of PCB reflects the amount stored in the body.
c. When the site of critical action for a toxicant is known, the concentration of the biomarker at that site can be used as a measure of the biologically effective dose. Carboxyhemoglobin is such a biomarker for carbon monoxide poisoning. In this case, the biomarker level is correlated with the health effect.
3. Biological monitoring of effect. This term is defined as monitoring reversible biochemical changes resulting from exposures. The degree of change is less than that which leads to injury and is not associated with a known irreversible pathological effect [23]. Biological monitoring of effect is not health surveillance through which individuals with early signs of adverse health effects are identified. Some examples of biomarkers of effect are:
a. Zinc protoporphyrin in blood, levels of which increase with lead exposure, because lead inhibits the biosynthesis of heme [24].
b. Protein and DNA adducts of aromatic amines in blood. These adducts can both reflect the intensity of exposure and be correlated with the biologically effective dose.
c. Antibodies produced against low-molecular-weight molecules [25]. Some chemicals, while not immunogenic in their own right because of small size and other limitations, may bind to constitutive polymers (such as host proteins) and become immunogenic, causing the production of specific antibodies. Alternatively, such exposures may lead to production of new antigenic determinants, through nonadduct-forming reactions of the agent with selected protein-carrier molecules. Antibodies can be made to these modified proteins or to the parent hapten-conjugate [26]. In both cases, the antibodies
Manual of Analytical Methods
