Human biological monitoring for exposure assessment in response to an incident involving hazardous materials.

Biological monitoring in humans (HBM) is widely used in the field of occupational and environmental health. In the situation of an unexpected release of hazardous materials HBM may contribute to the medical support and treatment of exposed individuals from the general population or of emergency responders. Such exposure information may also be used to respond to individual concerns such as questions about a possible relationship between the chemicals released during the incident and health effects. In The Netherlands a guideline was prepared to support early decision-making about the possible use of HBM for exposure assessment during or as soon as possible following a chemical incident. The application of HBM in such an emergency setting is not much different from situations where HBM is normally used but there are some issues that need extra attention such as the choice of the biomarker, the biological media to be sampled, the time point at which biological samples should be collected, the ethics approval and technical implementation of the study protocol and the interpretation and communication of the study results. These issues addressed in the new guideline will support the use of HBM in the management of chemical disasters.