[Bases and perspectives of biological monitoring: from the analysis of individual compounds in blood and urine to exposome characterization in exhaled air].

PURPOSE

The present paper summarizes recent data concerning the use of exhaled breath condensate to characterize complex mixtures of both volatile (VOCs) and non-volatile substances giving rise to a human "exposome".

RECENT FINDINGS

Data published over the last 10 years show that not only VOCs, but also toxic metallic elements are detectable in EBC, raising the possibility of using this medium to quantify the lung tissue dose of metals resulting from occupational exposures. Exhaled air is therefore a complement of the traditional approaches to biological monitoring aimed at assessing systemic doses. Different biomarkers of effect, such as biomarkers of oxidative stress and inflammation have also been applied in the investigation of occupational asthma and pneumoconiosis, suggesting that the collection of exhaled air and EBC may contribute to studying the pathological state of the airways of workers with acute and chronic exposure to pneumotoxic pollutants. The same noninvasive approach may open new frontiers in the study of workers currently or previously exposed to pulmonary carcinogenic agents characterizing their respiratory "exposome", as well as their lung pathobiology or "breathomics".

SUMMARY

Currently, research on biomonitoring is focusing on the characterization of complex patterns of exposures relying on noninvasive methods, particularly suitable to be applied infield studies and for longitudinal assessments of pulmonary biology frequently affected in occupational settings.