title: Human biological monitoring for exposure assessment in response to an incident involving hazardous materials.
abstract: 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.
authors.affiliation: Department for Health Evidence, Radboud university medical center, PO Box 9101, 6500 HB Nijmegen, The Netherlands. Electronic address: paul.scheepers@radboudumc.nl.
authors.forename: Paul T J
authors.initials: PT
authors.lastname: Scheepers
authors.affiliation: National Institute of Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: nelly.van.brederode@rivm.nl.
authors.forename: Nelly E
authors.initials: NE
authors.lastname: van Brederode
authors.affiliation: National Institute of Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands. Electronic address: peter.bos@rivm.nl.
authors.forename: Peter M J
authors.initials: PM
authors.lastname: Bos
authors.affiliation: Department of Environmental Health, Public Health Service Amsterdam, PO Box 2200, 1000 CE Amsterdam, The Netherlands. Electronic address: nnijhuis@ggd.amsterdam.nl.
authors.forename: Nicole J
authors.initials: NJ
authors.lastname: Nijhuis
authors.affiliation: Public Health Services Gelderland-Midden, Postbus 5364, 6802 EJ Arnhem, The Netherlands. Electronic address: rik.van.de.weerdt@vggm.nl.
authors.forename: Rik H J
authors.initials: RH
authors.lastname: van de Weerdt
authors.affiliation: Medical Emergency Preparedness and Planning Office, PO Box 9154, 3007 AD Rotterdam, The Netherlands. Electronic address: i.vanderwoude@veiligheidsregio-rr.nl.
authors.forename: Irene
authors.initials: I
authors.lastname: van der Woude
authors.affiliation: Public Health Service Groningen, Municipal Health Department, PO Box 584, 9700 AN Groningen, The Netherlands. Electronic address: martin.eggens@ggd.groningen.nl.
authors.forename: Martin L
authors.initials: ML
authors.lastname: Eggens
mesh_terms: D015415:Biomarkers / Q000032:analysis*; D055884:Chemical Hazard Release; D003657:Decision Making; D004781:Environmental Exposure / Q000009:adverse effects* / Q000032:analysis; D004784:Environmental Monitoring / Q000379:methods*; D017408:Guidelines as Topic; D015386:Hazardous Substances / Q000032:analysis / Q000633:toxicity*; D006801:Humans; D009426:Netherlands
chemical_list: D015415:Biomarkers; D015386:Hazardous Substances
keywords: Acute toxicity; Disaster management; Emergency response; Exposure assessment; Hazardous materials; Health surveillance