Biomarkers of Effect and Biomarkers of Exposure Among Firefighters: Is There Any Correlation? A Review

Abstract

AbstractBackground Firefighting encompasses several health risks caused by exposure to toxic chemicals and due to the highly physical- and psychological demanding activities. Biomonitoring, based on biomarkers of effect and exposure, has been increasingly used to characterize the health status of firefighters and promote occupationally safer environments. Objective This study aims to identify possible correlations between biomarkers of exposure and effect among firefighters. Method Scientific databases were used to retrieve all the published information until December 2021. Results A total of eleven studies was found to explore the application of both types of biomarkers (exposure and effect). Chemicals such as polycyclic aromatic hydrocarbons, metals and other woodsmoke components, per- and polyfluoroalkyl substances, and flame retardants were biomonitored in blood, and urine. Generally, there were associations between these chemicals and altered biological mechanisms in blood and in urine including oxidative stress, inflammation, DNA damage, metabolic syndrome and thyroid hormone levels. However, overall, these findings, alone, are not sufficient to establish causality. Nevertheless, they are important starting points to address this problem and to stimulate the development of future studies, especially follow-up cohorts, which can gather more information and better confirm these associations.KeywordsHuman biomonitoringHealth risksFirefightingFiremenOccupational exposure