Horizons: Biological Monitoring IX: Concomitant Exposure to Medications and Industrial Chemicals

Abstract

A significant proportion of workers may be receiving prescription or nonprescription medications. In two surveys, one in the United States and the other in the Netherlands, 15 to 30 percent of workers reported current use of pharmaceuticals. In a viscose rayon factory in Belgium, 31 percent of 129 workers exposed to carbon disulfide and 19.8 percent of 81 control workers from other factories reported use of some medication. Some of the drugs may affect the relationship between the external exposure (dose) of a chemical and the concentration of that chemical or its metabolite(s) in a sampled biological medium (internal dose), and/or the relationship between external exposure and concentration at a receptor site. They may also modulate the response of the receptor, as suggested by the increased reports of neurological symptoms in carbon disulfide-exposed workers taking certain medications. There are two obvious differences between drugs and industrial chemicals: (1) The effects of drugs cover a wider spectrum and include effects not known to be the result of any industrial chemicals. Examples include selective destructive inhibition of hepatic enzymes (monoamine oxidase inhibitors, indomethacin) and alteration of hepatic blood flow (adrenergic agents, cimetidine). (2) Drugs are administered to produce specific therapeutic effects. 18more » refs., 1 tab.« less