Manno M, Sito F, Licciardi L
Department of Public Health, Section of Occupational Medicine and Toxicology, University of Naples Federico II, Via S. Pansini, 5, 80131, Naples, Italy.
Department of Public Health, Section of Occupational Medicine and Toxicology, University of Naples Federico II, Via S. Pansini, 5, 80131, Naples, Italy.
Toxicol Lett. 2014 Dec 1;231(2):111-21. doi: 10.1016/j.toxlet.2014.10.004. Epub 2014 Oct 18.
Biological monitoring, i.e., the use of biomarkers for the measurement of systemic human exposure, effects and susceptibility to chemicals has increased considerably in recent years. Biomonitoring techniques, originally limited to a few metals and other chemicals in the workplace, are currently applied to a large number of exposure situations and have become a useful tool for occupational and environmental health risk assessment. Almost any biomonitoring program, however, entails a number of relevant ethical issues, which concern all the phases of the entire process, from the selection of the biomarker to the study design, from the collection, storage and analysis of the biological sample to the interpretation, communication and management of the results, from the (truly?) informed consent of the worker to the independence and autonomy of the occupational health professional. These issues require a balanced assessment of the interests and responsibilities of all the parties, the worker primarily, but also the employer, the occupational health professional, the health authorities and, for research studies on new biomarkers, also the scientists involved. Ideally, decisions of ethical relevance concerning biomarkers should be based on, and respectful of the best scientific, legal and ethical evidence available. When, however, a conflict should arise, before any decision is taken a thorough risk-benefit analysis should be done, at the beginning of the process and after listening to the workers and the management involved, by the occupational physician or scientist, based on his/her professional experience, independent judgement and individual responsibility.
生物监测，即使用生物标志物来测量人体对化学物质的全身暴露、影响和易感性，近年来有了显著增加。生物监测技术最初仅限于工作场所中的少数金属和其他化学物质，目前已应用于大量暴露情况，并已成为职业和环境健康风险评估的有用工具。然而，几乎任何生物监测计划都涉及一些相关的伦理问题，这些问题涉及整个过程的所有阶段，从生物标志物的选择到研究设计，从生物样本的采集、储存和分析到结果的解释、传达和管理，从工人的（真正的？）知情同意到职业健康专业人员的独立性和自主性。这些问题需要对所有各方的利益和责任进行平衡评估，主要是工人，但也包括雇主、职业健康专业人员、卫生当局，对于新生物标志物的研究，还包括相关科学家。理想情况下，关于生物标志物的伦理相关决策应基于并尊重现有的最佳科学、法律和伦理证据。然而，当出现冲突时，在做出任何决定之前，职业医生或科学家应根据其专业经验、独立判断和个人责任，在过程开始时并听取相关工人和管理层的意见后，进行全面的风险效益分析。
