Biological Monitoring
Biological monitoring is a useful tool for occupational hygienists to assess exposure and the
adequacy of controls. It is based on the analysis of hazardous substances or their metabolites in
urine or, less commonly, other biological fluids. Biological monitoring was once the sole preserve
of occupational physicians collecting blood samples from workers exposed to lead with the
emphasis on detecting and preventing ill-health. Now, most biological monitoring is based on
urine samples, that can be collected by occupational hygienists, and the emphasis is on exposure
assessment and the adequacy of controls. The aim is still to prevent ill-health but to intervene
much earlier in the progression from exposure to disease (fig 1).
Dermal
inhalation Occupational
ingestion
Increasing exposure/risk
EXPOSURE UPTAKE EFFECT DISEASE
Biological Monitoring Biological Effect Monitoring
Environmental Exposure Assessment Health Surveillance
Role for biological monitoring
Over 10 years ago HSE developed its current policy on biological monitoring. It made a clear
distinction between biological monitoring (BM) to assess exposure and biological effect monitoring
(BEM) to assess the consequences of exposure. BEM looks at effects that can be complicated by
individual susceptibility and pre-existing medical conditions and requires an occupational
physician. HSE published a guide to biological monitoring for hygienists and physicians (HSG
167) and also a one page guide for workers (http://www.hse.gov.uk/pubns/indg245.htm)
HSE’s policy was that biological monitoring was useful where hazardous substances could be
absorbed through the skin or where control relied on RPE. The emphasis was on non-invasive
sampling (usually urine) where possible and to develop guidance values to aid the assessment of
exposure and control. Biological monitoring has roles throughout COSHH. A physician or nurse
should carry out biological monitoring for health surveillance but an occupational hygienist or
safety manager may carry out biological monitoring for exposure assessment (HSG 167) using
urine or breath samples. The essential ethical issues are that whoever collects the samples gets
informed written consent from the workers and treats the biological monitoring data as confidential.
In practice this means explaining why a sample is being collected (to assess exposure not health),
what is being analysed (substance or metabolite), what is not being analysed (drugs, alcohol etc),
who will see the results, who will keep them and what will be done (improve controls if required).
The HSG 167 guide has more details and also an example consent form.
The most recent
guidance values for
isocyanates,
polyaromatic
hydrocarbons and
hexavalent chromium
are not health-based
but are based on
good control practice.
This type of
biological monitoring
and control-based
guidance value is
more a tool for
hygienists than
physicians. The recent biological monitoring guidance value for isocyanates illustrates the
distinction. Isocyanates cause asthma and health surveillance involving lung function tests
carried out by physicians or nurses is required for exposed workers. HSE is now encouraging
the use of biological monitoring for isocyanates (particularly for paint sprayers) carried out by
hygienists, safety managers and occupational health providers to assess the control of exposure
under COSHH Regs. 9 and 10. The intention is to control exposure to prevent impairment of
lung function. (www.hse.gov.uk/pubns/indg388.pdf,
www.hse.gov.uk/pubns/guidance/p47.pdf).
Interpreting Biological monitoring results
Biological monitoring results are an aid to assessing exposure not (directly) health. Guidance
values are available from HSE (16), ACGIH (47) and the DFG (86). Guidance values are also
developed in other countries and in Europe by SCOEL. Some of the more commonly used
guidance values are summarized in Table 1.
HSE has produced 16 guidance values compared to the 47 or 86 of the ACGIH and DFG but its
ability to set guidance values based on the 90th percentile of data from workplaces with good
control means it can do so with much less data than that required for a health-based limit. This
type of guidance value is in line with the current approach to controlling exposure based on
good occupational hygiene practice. If the guidance value is exceeded it should trigger an
examination of the controls, remediation if appropriate, and retesting. Biological monitoring
effectively provides a feedback loop on the controls including the worker behavioural aspects.
It is a pragmatic approach that targets resources and action where it is needed. This type of
guidance value is also a model for developing in-house guidance values. It depends on the
judgment of occupational hygienists to assess the adequacy of controls and then associates a
biological monitoring value with it.
The latest developments in biological monitoring are guidance values for isocyanates, PAHs
and chromium VI. Further details can be found at: http://www.hse.gov.uk/coshh/table2.pdf and
also www.hsl.gov.uk/capabilities/biological.htm
If you have concerns about workplace hazards to substances that can be absorbed through the
skin (Sk notations in EH40) or where control relies on RPE –please consider biological
monitoring as part of the assessment of control. If guidance values are not available contact
COR SIG we may be able to help.
Table 1 Biological monitoring guidance values for some common hazards
Hazard Sample Time Guidance value1 Comment
Isocyanates Urine EoE HSE:1μmol NEW Used to assess exposure particularly
isocyanate-derived where RPE used , e.g. paint spraying
diamines/mol
creatinine
Poly aromatic Urine EoS HSE: 4μmol 1- NEW used to assess dermal absorption
Hydrocarbons hydroxy pyrene /mol and/or RPE
creatinine
Chromium VI Urine EoS HSE:10 μmol Cr/mol NEW. Value is close to background levels
creatinine
MbOCA Urine EoS HSE: 15 μmol Old value but under study by HSE
MbOCA*/mol
creatinine
MDA Urine EoS HSE 50 μmol Old value but under study by HSE
MDA*/mol creatinine
Mercury Urine Any HSE 20 μmol Hg/mol Old value but under study by ACGIH
creatinine
Arsenic Urine EoS ACGIH 35 μg/l (~53 ‘inorganic’ As reduces interference from
μmol/mol) dietary seafood

Lead Blood Any HSE Suspension level Statutory requirement for lead workers
60μg/dl (50 μg/dl for done by Appointed Doctors
young people, 30
μg/dl for women of Control of Risk
reproductive capacity
(WRC), Action levels
50 μg/dl (40μg/dl (COR) SIG
young people, 25

Benzene Urine EoS

μg/dl for WRC)
ACGIH 25 μg S- Phenol is no longer recommended A Hygienist’s
phenyl mercapturic
acid /g creatinine (12
μmol/mol) Guide to Biological
Toluene Urine EoS ACGIH 0.5mg o- Hippuric acid is no longer recommended
cresol/l (~500
μmol/mol) Monitoring in
Xylene Urine EoS HSE 650 mmol

1
methyle hippuric
acid/mol creatinine
2007
Preference for HSE value if available, otherwise the lower value from ACGIH or DFG
* After hydrolysis, EoE End of exposure; EoS End of Shift
References
or
1) EH40/2005 Workplace exposure limits. Published by HSE Books ISBN 0 7176 2977 5.
www.hsebooks.co.uk
2) HSG 167 Biological Monitoring in the Workplace. A guide to its practical application to chemical
How do you know
exposure. Published by HSE Books ISBN 0 7176 1279 1
3) ACGIH® 2006 TLVs and BEIs® Based on the Documentation of the threshold limit values &
Biological Exposure indices. Published by ACGIH® Worldwide. www.acgih.org
the controls are
4) Deutsche Forschungsgemeinschaft List of MAK and BAT values 2006. Commission of the
Investigation of Health Hazards of Chemical Compounds in the work area Report No. 42. Published
by Wiley VCH Verlag GmbH & Co KgaA Weinheim ISBN 3-527-31599-3. www.dfg.de
working
and being used
correctly ?