The Assessment of Environmental and Occupational Exposure to Hazardous Substances by Biomonitoring: Sum of Many Factors

by PD Dr. rer. nat. Lygia T. Budnik, Univ.-Prof. Dr. med. Xaver Baur in volume 6/2009

Although biomonitoring for lead toxicity is based on hemotoxicity, lead is known to act through many other pathological mechanisms. For example, lead is known to damage beta-receptors and the renin-angiotensin-aldosterone system, leading to increases in blood pressure (1); this is not included in biomonitoring. At any rate, lead's hypertensive activity has been known for 120 years and the American environmental agency considered it appropriate to publish a systematic review of cardiovascular damage from lead in March 2007, containing 130 references (2). This should be considered in Germany too.

It was repeatedly clear in this article that the toxicity of a substance is influenced by the sum of many different factors. This has also been pointed out by Emily F. Madden of the American Food and Drug Administration (FDA). At the end of a review of the interactions between multiple environmental or occupational exposures to heavy metals in the development of cancer, she concluded that the combined effects of different metals may be greater than the sum of their individual effects (3). Perhaps then the cumulative effects of different metals might also effect the development of disease, even when they are all within the normal ranges. In my opinion, these aspects of chronic and complex exposure to heavy metals and pollutants deserve more attention, as this could help to guarantee comprehensive protection of the population, particularly of children and of people who are already ill. DOI: 10.3238/arztebl.2009.0507a


Peter Jennrich
Marienstr. 1, 97070 Würzburg, Germany
[e-mail]

References

1. Tsao DA, Yu HS, Cheng JT, Ho CK, Chang HR: The change of b-adrenergic system in lead-induced hypertension. Toxicol Appl Pharmacol 2000; 164(2): 127–33.

2. Navas-Acien A, Guallar E, Silbergeld EK, Rothenberg SJ: Lead exposure and cardiovascular disease—a systematic review. Environ Health Perspect 2007; 115: 472–82.

3. Madden EF: The role of combined metal interactions in metal carcinogenesis: a review. Rev Environ Health 2003; 18(2): 91–109.

4. Budnik LT, Baur X: The assessment of environmental and occupational exposure to hazardous substances by biomonitoring [Biomonitoring zur Erfassung umwelt- und arbeitsbedingter Schadstoffbelastungen]. Dtsch Arztebl Int 2009; 106: 91–7.