The biological exposure indices: a key component in protecting workers from toxic chemicals.

Biological monitoring of exposure to chemicals in the workplace is an important component of exposure assessment and prevention of adverse health effects. It should be employed in conjunction with ambient air monitoring to provide information on the absorbed dose of a chemical agent and the effect of all routes of exposure. Judgments regarding the acceptable level of a chemical or its metabolite in biological samples are facilitated by comparison to a reference value. The American Conference of Governmental Industrial Hygienists has established a series of recommended reference values called the Biological Exposure Indices (BEI). The history and characteristics of the BEI are reviewed, and their suitability for use by occupational health specialists is examined. A number of challenges and stimuli to the continued development and improvement of these reference values are described, and the impact of recent advances in macromolecular biology is assessed.