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Human Biological Monitoring of I-Ndustrial Chemicals Series

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Human Biological Monitoring of I-Ndustrial Chemicals Series 1. ~ • ,.·.' 1 • ' ' 4. Commission of the European Communities Industrial health and safety Human biological monitoring of i-ndustrial chemicals series Benzene R. Lauwerys Cadmium L. Alessio, P. Odone, G. Bertelli, V. Foa Chlorinated Hydrocarbon Solvents A.C. Monster. R.L. Zielhuis Lead. L. Alessio, v. Foa. Manganese H.. Valentin, R. Schiele Titanium H. Valentin, K.H. Schaller Toluene R. Lauwerys Edited by L. Alessio, A. Berlin., R. Roi., M. Boni Joint Research Centre lspra Establishment. Directorate-General for Employment and Social Affairs Health and Safety Directorate Directorate-General for Science Res~arch and Development EUR 8476 EN 1983 Commission of the European Communities Industrial health and safety Human biological monitoring of industrial chemicals series Benzene R. Lauwerys Cadmium L. Alessio, P. Odone, G. Bertelli, V. Foa Chlorinated Hydrocarbon Solvents A.C. Monster. R.L. Zielhuis Lead L. Alessio, V. Foa Manganese H. Valentin, R. Schiele Titanium H. Valentin, K.H. Schaller Toluene R. Lauwerys Edited by L. Alessio, A. Berlin., R. Roi., M. Boni Joint Research Centre lspra Establishment Directorate-General for Employment and Social Affairs Health and Safety Directorate Directorate-General for Science Research and Development EUR 8476 EN 1983 c 1 J_ \ I ( L/ I Published by the COMMISSION OF THE EUROPEAN COMMUNITIES Directorate-General Information Market and Innovation Batiment Jean Monnet LUXEMBOURG LEGAL NOTICE Neither the Commission of the European Communities nor any person acting on behalf of the Commission is responsible for the use which might be made of the following information Cataloguing data can be found at the end of this publication .,. Luxembourg, Office for Official Publications of the European Communities, 1983 © ECSC- EEC- EAEC, Brussels Luxembourg, 1983 Printed in Italy Ill Contents Preface ................................................................................................................. V Benzene................................................................................................................ 1 Cadmium.............................................................................................................. 23 Chlorinated Hydrocarbon Solvents .. .. .... .... .... .. .. .. .. .. .. .... .... .... .. .. .. .. .. .... .... .... .. .. .. .. 45 Lead ...................................................................................................................... 105 Manganese ...................................................................................... ~. .. .. .. .. .. .. .. .. .. 133 Titanium ........................................................................... ;.................................. 147 Toluene................................................................................................................. 159 IV Editorial board Prof. Lorenzo Alessio Institute of Occupational Health Clinica del Lavoro L. Devoto University of Milan Dr. Alexander Berlin Commission of the European Communities Directorare General Employment and Social Affairs Health and Safety Directorate Luxembourg Dr. Renata Roi Dr. Mirto Boni Commission of the European Communities Joint Research Centre - ECDIN Group lspra (VA) Italy v Preface The evaluation of the exposure of workers to dangerous agents is one of the measures insuring a better health protection. This evaluation is called monitoring. Two approaches are available for the monitoring : - ambient monitoring already in use for many years and - biological monitoring of more recent development. The need for clear definitions and for establishing the respective roles of these two types of monitoring has become necessary recently. In 1980 in Luxembourg at an international seminar organized jointly by the CEC and the United States authorities (Occupational SafetY and Health Administration and the National Institute for Occupational Safety and Health) on the Assessment of Toxic Agents at the Workplace, the following definitions were agreed : - ambient monitoring is the measurement and assessment of agents at the workplace and evaluates ambient exposure and health risk compared to an appropriate reference; - biological monitoring is the measurement and assessment of workplace agents or their metabolites either in tissues, secreta, excreta, expired air or any combination of these to evaluate exposure and health risk compared to an appropriate reference. - In addition, the term "Health Surveillance" was also defined as the periodic medico­ physiological examinations of exposed workers with the objective of protecting health and preventing occupational related disease. The detection of established disease is outside the scope of this definition. The definitions of biological monitoring and health surveillance separate components of a continuum which can range from the measurements of agents in the body through measurements of metabolites, to signs of early disease. A problem left unresolved concerns the precise place within these definitions of certain biochemical tests such as zinc protoporphyrin (ZPP), delta aminolaevulinic acid dehydrase (ALA-D), delta aminolaevulinic acid (ALA) in the blood and urine, etc., which are, in fact, indicators of metabolic effects which have occurred as a consequence of exposure. Ambient monitoring is carried out for different reasons, for example : a. determining ambient concentrations in relation to an established legal standard or consensus guideline; b. determining the relationship, if any, between the concentrations of agents at the workplace and the health of the workers; c. ensuring the effectiveness of control measures; d. evaluating the need for controls in the vicinity of specific emission sources; e. indicating trends in relation to an improvement or determination at the workplace; f. providing an historical record. Biological monitoring measures ·or evaluates exposure from all routes. It sometimes allows a better evaluation of health risk than ambient monitoring especially in cases where exposure through different routes has to be considered. Biological monitoring takes into account individual variability, the impact of factors such as personal activity, biological characteristics and life styles of the individuctl. VI The two types of monitoring are complementary in increasing the protection of workers' health. If both are carried out simultaneously, information should be produced on the relationships existing between external exposure and concentration of the substance in biological samples, and between this concentration and early effects. Detailed knowledge of the metabolism of the toxic agent in the human organism and of the alterations that occur in the critical organ is essential in selecting the parameter to be used as indicator. Unfortunately, however, such knowledge is usually insufficient and thus limitations exist in most biological monitoring programmes. The conditions necessary for successful biological monitoring are : - existence of indicators, - existence of analytical methods that will guarantee technical reliability in the use of these indicators, - possibility of measuring the indicators on readily accessible biological specimens, - existence and knowledge of dose-effect and dose-response relationships. In carrying out a biological monitoring programme, it is indispensable to know exactly what the characteristics and behaviour of the indicators under study are in relationship to length of exposure, time elapsed since beginning and end of exposure, and all physiological and pathological factors other than exposure that could give a false interpretation of the results obtained. Conditions for biological monitoring application include adoption of analytical methods yielding values comparable throughout the different laboratories. This long time adopted approach has already permitted the CEC to standardize in 1972 a method for erythrocyte ALAD determination and develop programmes for inter­ laboratory comparisons for lead and cadmium determination in biological media. The Council of Ministers of the European Communities in adopting in 1978 the First Action Programme on Safety and Health at Work proposed by the Commission stressed the need to increase protection against dangerous substances; it emphasized the need to promote new monitoring and measuring methods for the assessment of individual exposure, in particular through the application of sensitive biological indicators. In August 1982 the Council adopted a directive on the protection of workers exposed to lead. The monitoring of blood lead levels as well as the determination of ALAU, ALAD and ZPP are among the tools to be used for monitoring worker exposure to lead. A comparison of the results with action levels and limit values allows appropriate action to be taken. Considerable data concerning the biological monitoring of a number of industrial chemicals has been published in the international literature. Nevertheless, the difference in approaches used in the research, the variety of analytical methods and the frequent discordances in the results, usually make it difficult to formulate a conclusive synthesis permitting the transfer of literature data into practice. The ai.m of this series dedicated to human biological monitoring of industrial chemicals in occupational health is based on the considerable experience acquired by the authors in the specific topics. For the draft of the monographs, the following outline, suggested by R.L. Zielhuis and R. Lauwerys, has been used : - a review of metabolism
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