Individual Biomonitoring: Current Practice in Germany

In Germany biological monitoring is part of the medical surveillance program. The BEI concept of the ACGIH and the BLV concept of the European SCOEL are instruments for the exposure and risk assessment of groups. The German concept, however, is an instrument to assess the individual health risk. In terms similar to those of clinical medicine (e.g. via determination of the LDL cholesterol, arterial blood pressure etc.) it should be possible, using the results of biological monitoring, to assess the individual risk of an exposure to chemical substances by using the results of biological monitoring. This takes account of the fact that biological monitoring is a method of individual prevention used by the company? physician which, among other factors, is subject to full medical discretion confidentiality. However, the knowledge obtained by the company physician from biological monitoring should be used in advising the employer according to with regard to occupational health measures without violating professional secrecy.     The biological limit value used in Germany is the BAT value (“Biologischer Arbeitsstoff-Toleranzwert”). The BAT is exceeded if the average concentration of the parameter in one person is above the BAT value after several investigations. Values exceeding the BAT value must be evaluated on an occupational medical and toxicological basis. If the BAT value is exceeded only once, an adverse effect on health cannot necessarily be inferred.    In general, health based biological exposure limits are established for the use of biological monitoring in the prevention of occupational diseases. However, this approach is not feasible for chemical agents with the ability to produce adverse effects without fixable threshold limits, e.g. genotoxic carcinogens. An assessment of the exposure to these chemicals compounds can be achieved by the comparison to safety values based on best practice or to background exposure.