Strategies for use of biological markers of exposure

A major public health concern is the degree to which environmental or occupational exposures to exogenous chemicals result in adverse health effects. Biological markers have the potential for helping to answer this important question by providing links between markers of exposures and markers of early stages of the development of disease. However, that potential requires in-depth, mechanistic research to be fully realized. Biological markers of exposure have been extensively investigated, and mathematical models of the toxicokinetics of agents have been developed to relate exposures to internal doses. The field of clinical medicine has long used clinical signs and symptoms to detect disease. However, the critical area of research needed to improve the application of biomarkers to environmental health research is mechanistic research to link dose to critical tissues to the development of early, pre-clinical signs of developing disease. Only if the mechanism of disease induction is known can one determine the 'biologically effective' dose and the earliest biological changes leading to disease.