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Tools for investigating workplace-related risks from mycotoxin exposure

There is growing recognition and interest in the role of mycotoxins as health hazards in the workplace. Examples will illustrate what we know about certain mycotoxins in some occupational settings and what we need to know to make further progress in assessing their impact on human health. A range of mycotoxins has been detected in different workplaces, e.g. in agricultural and food processing facilities, greenhouses, and the waste management sector. Their occurrence, mainly in dust from different raw materials or processed products, is indicative of a potential health hazard. However, assessing risks for workplace-related mycotoxin exposures remains a challenging task for several reasons, including uncertainties with regard to the transfer from contaminated material into air (inhalable mycotoxin concentrations) and/or the toxin fraction absorbed upon dermal contact or after respiratory intake. Human biomonitoring studies can considerably reduce these uncertainties, and serve to assess workplace-related exposures (in addition to dietary mycotoxin intake). These studies require not only sensitive methods for analysis of mycotoxins and/or their metabolites in blood or urine (biomarkers of exposure) in a cohort of workers, but also data on the levels/range of these biomarkers in non-occupationally exposed persons to account for exposures resulting from oral intake of mycotoxin-contaminated food (dietary 'background'). Biomonitoring methods were first developed for aflatoxin B1, then for ochratoxin A, and more recently for deoxynivalenol and for fumonisin B. But, there are no such methods for many other important mycotoxins. So far, only a small number of biomonitoring studies have addressed the question whether occupational mycotoxin exposures (by inhalation) add significantly to those from dietary exposure to mycotoxins, as observed in the general population. Therefore, a risk assessment is hampered by major uncertainties regarding the true impact of occupational mycotoxin exposures. Human biomonitoring (with biomarkers of exposure and/or effect) is considered a valuable instrument, and should be developed further for mycotoxins of relevance in the workplace.