Send to

Choose Destination
Int J Environ Res Public Health. 2011 Mar;8(3):629-47. doi: 10.3390/ijerph8030629. Epub 2011 Feb 24.

Combined toxic exposures and human health: biomarkers of exposure and effect.

Author information

Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77 Stockholm, Sweden.


Procedures for risk assessment of chemical mixtures, combined and cumulative exposures are under development, but the scientific database needs considerable expansion. In particular, there is a lack of knowledge on how to monitor effects of complex exposures, and there are few reviews on biomonitoring complex exposures. In this review we summarize articles in which biomonitoring techniques have been developed and used. Most examples describe techniques for biomonitoring effects which may detect early changes induced by many chemical stressors and which have the potential to accelerate data gathering. Some emphasis is put on endocrine disrupters acting via epigenetic mechanisms and on carcinogens. Solid evidence shows that these groups of chemicals can interact and even produce synergistic effects. They may act during sensitive time windows and biomonitoring their effects in epidemiological studies is a challenging task.


biomarkers; chemical mixture; combined exposure; occupational exposure

[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Multidisciplinary Digital Publishing Institute (MDPI) Icon for PubMed Central
Loading ...
Support Center