Is it possible to use biomonitoring for the quantitative assessment of formaldehyde occupational exposure?

The European classification, labeling and packaging classified formaldehyde as human carcinogen Group 1B and mutagen 2, fostering the re-evaluation of the exposure risk in occupational settings. Although formaldehyde exposure is traditionally measured in air, many efforts were made to identify specific exposure biomarkers: urinary formaldehyde, formic acid and DNA damage indicators. Though used in combination, none of these seems satisfactory. The influence of the metabolism on exogenous formaldehyde levels, the exposure to other xenobiotics, the difference in genetic background and metabolism efficiency, misled the relationship between genotoxicity and exposure data. Nevertheless, the limitation of adverse effects to the local contact sites hampers biomonitoring. Here we discuss the feasibility of formaldehyde biomonitoring and the use of DNA, DNA-protein cross-links and protein adducts as potential biomarkers.