Application of biomarkers in population studies for respiratory non-malignant diseases.

Though the use of biomarkers has been mainly suggested for cancer studies, the possibility of its use in non malignant disease is considered. Markers of internal dose, markers of biologically effective dose and markers of early biologically effect have been typically used in basic research and, more recently, in epidemiology to characterize genotoxic carcinogenic agents. These markers (e.g. adducts to DNA or proteins) may be used mainly in the presence of chronic exposure to toxic agents (e.g. benzene or benzopyrene), additional markers such as carboxyhemoglobin, expired air to measure various VOC and heavy metals in biological fluids are also considered in the paper. Since airway obstructive disease (asthma, chronic bronchitis, emphysema) are the main disorders influenced by environmental factors (including air pollution), markers of individual susceptibility, such as atopy increased responsiveness of airways, initial level of lung function, must be considered for a more precise evaluation of the relationship between environmental exposure and health effects. Currently, the application of the determination of markers of exposure in non malignant disorders is very limited. In fact, the relationships between acute adverse respiratory effects and the exposure to air pollutants appears difficult since markers for common air pollutants are not available, and their detection appears difficult in acute conditions. Characterization of long term exposure may be performed in organ fluids (blood, urine, saliva) however it is important to recognize that concentration at that level may not reflect that observed in the target organ (e.g. lung).