Bias in biologic monitoring caused by concomitant medication

Medication of the worker with pharmacotherapeutic agents and its meaning for individual pharmacokinetics of the agent(s) to which the worker is exposed is a largely unexplored zone, on the border of both occupational and clinical medicine. Medication and exposure to occupational agents can result in pharmacodynamic and/or pharmacokinetic interactions; the latter type of interactions will be discussed in this paper. Using styrene, toluene, tetrachloroethylene, and 1,1,1-trichloroethane as examples of solvents with various kinetic properties, it is demonstrated in what way concomitant therapy can influence the elimination of the solvent. Major emphasis is laid on the effects on conclusions drawn from biomonitoring studies in exhaled air and venous blood. To achieve this purpose, a physiologic simulation model, run on a 640-kilobyte microcomputer, is used. The simulated variation of several parameters is illustrated with examples from pharmacologic practice.