Biological Exposure Indices

1.
BIOLOGICAL EXPOSURE INDICES
1.1 Introduction
Biological monitoring – the measurement of a substance or its metabolites
in body fluids such as urine or blood – provides a complementary approach
to air monitoring for estimating exposure to workplace contaminants.
A Biological Exposure Index (BEI) is considered by the ACGIH

(American Conference of Governmental Industrial Hygienists).. as a value often
corresponding to the WES (Workplace Exposures Standard). If a worker’s
inhalation exposure is equal to the WES, and he/she is engaged in
moderate work, then the BEI represents the expected level of the
biological determinant.
This applies where (as in most cases), the BEI has been derived from the
observed relationship between the measured air levels and measured
biological (e.g. blood or urine) levels as this knowledge enables
extrapolation from a WES to a BEI level. However, in some cases (such as
with lead), the relationship between the biological level and the potential
health effects has been approached more directly (e.g. by identifying
adverse effects as a function of blood lead levels).
1.2 Exposure Periods

Depending on the pharmacokinetics of the substance, the results from the
biological determination may reflect very recent exposure, the average
exposure over the last day(s), or long-term cumulative exposure. The BEIs
listed in this publication assume that exposure has been reasonably steady
and that an eight-hour day, five-day week has been worked. Extrapolation
to other exposures can be made, but only with a clear understanding of the
relationship between absorption, metabolism, and elimination.
1.3 Effectiveness
Biological monitoring has been widely used to monitor the uptake of
cumulative toxins (e.g. lead, mercury, organophosphate insecticides). It
also may be employed effectively where there is a significant potential for
increased uptake as a result of skin absorption, increased respiratory rate,
or exposure outside the workplace (even if there is no change in workplace
air levels).
The effectiveness of hazard control measures taken to limit uptake may

also in some cases be assessed with follow-up biological monitoring tests.
As with air monitoring, the design of the monitoring protocol and
interpretation of results should only be done by a person with the
appropriate qualifications and experience.
The fact that a BEI has been listed for a particular substance does not
imply that biological monitoring is necessary. An appraisal of the exposure
should be made before considering monitoring requirements.
1.4 Biological Assays
Several conditions must be satisfied for a biological assay to be a reliable
indicator of exposure to a substance. The fate of the substance in the
human body must have been adequately researched, and a
time/concentration relationship must exist. It is not essential for the
concentration of the determinant to be zero in cases where there is no
occupational exposure, as long as the increase is measurably observable
above the background level.
The biological assay must be as sensitive and specific as possible. While

the concentration of the major metabolite may be high, and therefore
easily detected, if it is a metabolite that is common to several substances,
the determination of the unaltered substance, or minor metabolite, may be
preferable.
The biological assay is often performed at a remote laboratory, therefore

the determinant must be stable in the biological fluid.
1.5 Legal Requirements

Section 10 of the HSE Act requires employers to take “all practicable steps”
to minimise hazards that cannot be eliminated or isolated. In workplaces
where health monitoring can be used to identify workers’ health effects at
an early stage for effective treatment, section 10(2)(d)-(e) requires
employers to take all practicable steps to obtain the employees’ consent to
the monitoring of their health in relation to the hazard, and only conduct
monitoring with that consent.
This means an employer needs to be proactive in seeking approval, and

take responsibility for informing and encouraging employees about health
monitoring where appropriate. However, consent must be granted
voluntarily and without any form of coercion or duress on the part of the
employer seeking consent.
Section 11 of the HSE Act requires the employer to give the results of
monitoring to affected employees. Where the monitoring results relate to
biological monitoring, the employer shall ensure that the results of each
worker’s monitoring is kept private and only made known to the worker,
the employer, and health professionals if necessary.
1.6 Issues with Biological Monitoring

Generally a BEI as assessed by only one specific assay method is given for
each substance, even though there may be several ways of estimating
exposure. Preference has been given to urinary assays over more invasive
blood tests, but factors such as the stability of the sample and the
possibility of sample interference should be considered. Cultural sensitivity
of the worker towards submitting a particular type of sample may also
influence the selection of the biological monitoring procedure. Alternative
methods may be available, especially for monitoring exposure to
(2,11)
solvents .
th
Workplace Exposure Standards and Biological Exposure Indices 7 edition
For the routine surveillance of exposure to some substances, biological
monitoring may be preferred over air sampling. For example, if the substance
has a long half-time in the body, the biological monitoring assay will give a
result that reflects an integrated exposure, with little variation no matter when
the sample is taken. In other cases, the corresponding air sampling procedure
may, because of the typical work practices or sampling difficulties encountered,
give less reliable results than biological monitoring.
Quantitative interpretation of biological monitoring results is often difficult.

The overall value of the information may be improved if measurements
are obtained from several workers with similar exposure, and/or serial
determinations on an individual worker are conducted.
1.7 Information prior to Monitoring

Before undertaking a biological monitoring exercise, it is essential that
background information be obtained, including data on the
pharmacokinetics of the substances, interferences, and “background” levels
of the determinant arising from non-workplace exposures. The following
two references are recommended as a source of the relevant background
material:
a) ACGIH Documentation of the Threshold Limit Values

(2)
and Biological Exposure Indices
b) Industrial Chemical Exposure, Guidelines for
(11)
Biological Monitoring .
1.8 Sample Collection

It is important to observe the timing of the sample collection for each
determination. The level of a substance, or its metabolic products, will
vary with the time elapsed since the last exposure, and the biological
index for some chemicals is only applicable if the recommended timing of
sample collection is closely adhered to.
Assuming that there has been continual exposure over the working day,
the following potential sample periods (causing minimal disturbance of
working routines) have received most attention. The most appropriate
sample period for any given substance depends on how quickly it (or its
measured metabolite) is eliminated from the body:
Prior to (next) Shift: Following a period of 16 hours with no exposure.

(Appropriate for substances “promptly” but not rapidly eliminated).
End of Shift: The last two hours immediately following the end of the
working day. (Appropriate for substances “rapidly” eliminated, whose
measured levels could have fallen substantially if sampling was delayed
until just prior to the next shift).
th
End of Work Week: After at least four days with exposure. (Appropriate
for substances eliminated more slowly and thus incompletely over 24
hours, causing some accumulation, with the highest levels observed on the
last day).
However, if the exposure has been confined to a portion of the working

day, it may be necessary to adjust the timing, but it must be recognised
that the estimation of exposure may be compromised.
Other factors may also compromise test results. Contamination of the

sample could take place during collection as a result of inadequate cleaning
of the skin prior to taking a blood sample, or on other inadvertent
contamination of a specimen. Loss of sample integrity on storage and
transport may occur through the use of an inappropriate container or
storage conditions. Further details of the procedure to be followed for
sample collection should be obtained from the laboratory carrying out the
analysis.
1.9 Interpretation of Results

Biological monitoring data must be interpreted with some caution.
Especially useful is to compare any individual’s result with their previous
results (if any).
There are several reasons why the levels of the determinant may vary
between individuals, even under seemingly identical exposure situations.
Workers may differ in size, physical fitness and work practices, resulting in
differing uptakes, such as through variations in respiration rate/volume and
skin contact (and absorption). Further, there may be inter-individual
differences in metabolism and elimination rates of the absorbed substance
or contaminant.
Further advice on the application of biological monitoring can be obtained

from the Ministry of Business, Innovation and Employment.
th
2. LEAD BIOLOGICAL EXPOSURE INDICES
This section should be read in conjunction with the Ministry of Business, Innovation and
Employment publication Guidelines for the Medical Surveillance of Lead Workers. The
overall objective of the surveillance outlined in the guidelines is to maintain the blood lead
levels of all workers below 1.5µmol/litre whole blood. Medical surveillance, including blood
lead monitoring, is extended to all those working with lead in a process that may result in
blood lead levels above 1.5µmol/litre whole blood.
2.1 Female Employees

While it is preferable for all employees’ blood lead levels to stay at or below
1.5µmol/litre whole blood, this value must be more stringent for pregnant women or
women planning to become pregnant, because they should be exposed to as little lead as
possible. Ideally, these women should have no exposure to lead at all, because the
developing foetus is extremely susceptible to this substance. Additionally, accumulated
lead can be released from the mothers’ bones during times of calcium stress such as
pregnancy and lactation.
2.2 Recommended Blood Lead Levels

(This subsection does not include employees who are pregnant, breastfeeding
or women of child-bearing age).
An employee will normally be suspended by a Departmental Medical Practitioner where a

(2010)
single blood lead result is 2.4µmol/litre whole blood or greater .
An employee can return to work if their blood levels achieve 1.93 µmol/litre whole blood or
(2010)
below .

Biological Exposure Indices

Uploaded by

Copyright:

Available Formats

Biological Exposure Indices

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Biological Exposure Indices

Uploaded by

Copyright:

Available Formats

1.

BIOLOGICAL EXPOSURE INDICES

A Biological Exposure Index (BEI) is considered by the ACGIH

1.2 Exposure Periods

The effectiveness of hazard control measures taken to limit uptake may

The biological assay must be as sensitive and specific as possible. While

The biological assay is often performed at a remote laboratory, therefore

1.5 Legal Requirements

This means an employer needs to be proactive in seeking approval, and

1.6 Issues with Biological Monitoring

Quantitative interpretation of biological monitoring results is often difficult.

1.7 Information prior to Monitoring

a) ACGIH Documentation of the Threshold Limit Values

1.8 Sample Collection

Prior to (next) Shift: Following a period of 16 hours with no exposure.

However, if the exposure has been confined to a portion of the working

Other factors may also compromise test results. Contamination of the

1.9 Interpretation of Results

Further advice on the application of biological monitoring can be obtained

2.1 Female Employees

2.2 Recommended Blood Lead Levels

An employee will normally be suspended by a Departmental Medical Practitioner where a

You might also like