A Review of Biomonitoring for Atrazine and Atrazine Metabolites Using Blood, Urine, and Sweat-Based Assays

In current clinical medicine, urinary profiling and blood tests are the primary toxicological exposure assessments for endocrine-disrupting chemicals (EDCs), including atrazine. Recent research suggests that analog monitoring of EDC concentrations and metabolites in sweat may be a less invasive, yet equally reliable method for conducting toxicological exposure assessments. However, no systematic reviews have identified whether concentrations of atrazine in sweat serve as a valid biomarker of environmental exposure. Thus, we performed a systematic review of the peer-reviewed literature to assess (1) if there is a correlation between the concentration of atrazine present in blood and urine and evaluate the evidence for sweat-based biomonitoring and (2) whether atrazine concentrations in sweat are a reliable and valid measurement of atrazine exposure based on the current state of evidence in the peer-reviewed literature. Databases included PubMed, Embase, Google Scholar, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and WHO Global Index Medicus. Stratified by exposure context, the average blood concentration of atrazine and atrazine metabolites in acute poisoning patients was 261 ng/mL, and the average blood concentration in prenatal exposure contexts was 31.68 ng/mL maximum in the included studies. While physicochemical properties of atrazine metabolites, particularly deisopropylatrazine (DIA), suggest potential suitability for sweat-based monitoring, empirical validation through controlled sweat collection studies is required before this approach can be recommended for clinical or occupational use. The results of the systematic review were heterogeneous, and a narrative review was conducted. To conclude, no studies have examined the concentration of atrazine in sweat and whether sweat can be used as a statistically valid toxicological assessment of atrazine exposure.