Biomonitoring of occupational exposure

Biomonitoring of occupational exposure: an important tool for protecting workers’ health and a means of improving chemical risk prevention in the workplace.

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Biomonitoring in the general population and among workers: two approaches to better understanding chemical risks to the population

Human biomonitoring provides useful information on exposure from the general environment or the workplace. This tool, which has established itself over the past 20 years in France as one of the methods contributing to the understanding and prevention of chemical risks, presents similarities and differences in approach depending on whether the focus is on the general population or on workers; it also has limitations.

Among the similarities, biomonitoring allows for the integration of all routes of absorption and sources of exposure, regardless of the population concerned.

The differences between biomonitoring in the general population and occupational biomonitoring concern the regulatory framework, the stakeholders involved in the activity, the timing of sampling, the reference standards used for interpreting results, and the manner in which these results are reported.

Limitations specific to biomonitoring can be identified, regardless of the population of interest: lack of biomarkers for all chemical substances, difficulty in linking a test result to a health effect, etc. Ultimately, both approaches to biomonitoring contribute to a better understanding of chemical risks in the population.

Current Status of Occupational Exposure Biomonitoring in France

One of the objectives of the 3rd Occupational Health Plan 2016–2020 (PST-3) was to promote biomonitoring of occupational exposures (also known as biological monitoring) as a means of improving chemical risk prevention. Centralizing data collected by occupational health services at the national level could provide a tool for monitoring the population of exposed workers from a prevention perspective. A prerequisite for this is to conduct an assessment of current occupational exposure biomonitoring activities in order to understand how they are organized and to evaluate their validity, constraints, and feasibility.

In this context, Santé publique France conducted a survey in 2019 among approximately forty individuals from occupational health services, laboratories, and experts in toxicology and biomonitoring of occupational exposures. The results of this survey were submitted to the PST-3 working group to propose potential recommendations for the biomonitoring of occupational exposures. These results show that chemical risks in the workplace are still often underestimated, particularly in small businesses. Biomonitoring of occupational exposures remains a marginal practice among occupational physicians regarding workers’ chemical exposures in France. The role of each stakeholder varies significantly depending on the occupational health service.

A project to centralize biometrology data is under consideration to provide a comprehensive, even national, overview of exposure to certain chemical risks (with an analysis of the results) and to raise awareness of chemical risks in the workplace that are currently still underestimated.

Recommendations for best practices in occupational exposure biomonitoring (SBEP) were issued in 2016 by the French Society of Occupational Medicine in partnership with the French Society of Analytical Toxicology and the Society of Clinical Toxicology, with support from the French Agency for Food, Environmental and Occupational Health & Safety (ANSES), Santé publique France, and the National Research and Safety Institute (INRS).

The list of biomarker analysis laboratories is available in the INRS Biotox database (www.inrs.fr/biotox).

Occupational biomonitoring in European projects

As the lead agency for the national biomonitoring program, Santé publique France is deeply involved in the European HBM4EU project, contributes to the development of common methods, and benefits from a wide range of European experiences. The pooling of efforts in biomonitoring aims to generate results for scientific research and public health, as well as to develop regulations that protect the public from chemical substances.

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Activities of the European Occupational Biomonitoring Group

Santé publique France collaborates with the INRS within the European Occupational Biomonitoring Group, whose objective is to contribute to a better understanding of occupational exposures in Europe. Several types of initiatives are carried out within this group, such as:

  • prioritizing chemicals to be monitored,

  • developing scientific reviews of occupational biomonitoring studies for prioritized chemicals,

  • implementing coordinated occupational biomonitoring studies using the same protocol,

  • analyzing data from general population studies to identify groups of workers exposed in the workplace.

The literature reviews conducted help identify available biomonitoring studies regarding worker exposure. They examine available evidence from occupational biomonitoring, highlight relevant regulations, and identify knowledge gaps. This enables the proposal of biomonitoring and research activities to be conducted among workers. These reviews have focused on certain carcinogenic and/or endocrine-disrupting chemicals such as phthalates, bisphenols, polycyclic aromatic hydrocarbons, and diisocyanates (allergenic substances).

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Launch of the first European occupational biomonitoring study

The European HBM4EU project enabled the launch in 2020 of the first coordinated European occupational biomonitoring study focusing on exposure to chromium, particularly chromium VI, which is classified as a Group 1 carcinogen by the IARC. The aim of this study is to provide information on chromium body burden levels among workers and on the effectiveness of protective measures implemented to reduce exposure. It was conducted among various categories of workers (metalworkers and painters) in eight European countries: Belgium, Finland, France, Italy, the Netherlands/Austria, Portugal, Poland, and the United Kingdom, for which a harmonized protocol was developed. In France, the fieldwork for the study is being carried out by the INRS. The results are expected to provide useful information to the European Commission, as there is currently no European biological limit value adopted under the Carcinogens and Mutagens Directive.

Additional biomonitoring studies are planned for workers exposed to diisocyanates (an allergen found notably in polyurethane foams) or those working in electronic waste recycling. This work, conducted in close cooperation with other countries, will help develop occupational biomonitoring to protect the health of workers in Europe.

The work will continue with the European PARC project, which will take over from HBM4EU in 2022.