Abstract
This chapter discusses the use of biologic markers for environmental monitoring and exposure assessment in clinical neurotoxicology. There is growing interest in the use of biologic markers to supplement environment monitoring data in evaluating toxic exposures. In the clinical setting, the specific features of each individual case and the suspected hazardous agent(s) of interest determine the most appropriate and feasible exposure assessment method. This chapter outlines important points regarding the assessment of neurotoxicant exposure by environmental measures as they pertain to the clinical setting. Neurotoxic agents can be placed in three distinct categories, chemical, physical, and biological; however, the primary focus in this chapter is assessment of exposure to chemical agents. Sources of information to assist in the estimation of past exposures are described, along with industrial hygiene methods and environmental sampling strategies to identify the potential current neurotoxic exposures in the workplace or in the environment. The use of biologic markers in the assessment of exposure for the individual patient is also examined in this chapter. This chapter also discusses a case of arsenic neurotoxicity to demonstrate the use of environmental and biologic measures in exposure assessment in the clinical setting and to discuss the strengths and weaknesses of these data.
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