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1Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, Texas 2Inhalation Toxicology Research Institute, Albuquerque, New Mexico
Abstract
Interest in the use of biological markers to evaluate future disease risk has increased greatly in recent years. Biomarkers are observable end points in a continuum of events leading from exposure to toxic agents to diseases that ultimately result from exposure. Because many significant diseases develop over long periods of time, methods for detecting early events that can predict risk are important for disease prevention. Biomarkers are generally categorized as detecting exposure, effects of exposure, or individual susceptibility to exposure. Although there has been significant progress in the technical development of biomarkers, implementation of their use in human populations has progressed much more slowly. We discuss four major needs in the development of biomarkers. First, new biomarkers need to be developed to fill gaps in our ability to observe steps in the continuum from exposure to disease. Second, the relationships between biomarker responses and disease pathology needs to be better understood. Third, the sensitivity, specificity, and variability of biomarkers need to be better characterized and they must be better validated as predictors of disease risk. Fourth, there are several societal impediments to the practical implementation of biomarker studies as public health tools. A common agreement among employers, employees, regulators, and the legal community must be established regarding appropriate and ethical uses and interpretation of biomarker data. -- Environ Health Perspect 104(Suppl 5):895-900 (1996)
Key words: biomarkers, susceptibility, medical ethics, exposure, disease risk
This paper was presented at the Conference on Air Toxics: Biomarkers in Environmental Applications held 27-28 April 1995 in Houston, Texas. Manuscript received 24 May 1996; manuscript accepted 5 June 1996.
The work of Dr. Ward was supported by grants from the U.S. EPA (R820108) and the National Institute of Environmental Health Sciences (R01 ES06015). The research of Dr. Henderson at the Inhalation Toxicology Research Institute is conducted under contract DE-AC04-76EV001013 with the U.S. Department of Energy.
Address correspondence to Dr. J.B. Ward Jr., Department of Preventive Medicine and Community Health, University of Texas Medical Branch, 2.102 Ewing Hall, Galveston, TX 77555-1110. Telephone: (409) 772-9109. Fax: (409) 772-9108. E-mail: jonathan.ward@utmb.edu
