Open Access Highly Accessed Study protocol

Biomonitoring of complex occupational exposures to carcinogens: The case of sewage workers in Paris

Hamzeh Al Zabadi1, Luc Ferrari12*, Anne-Marie Laurent3, Aziz Tiberguent4, Christophe Paris1 and Denis Zmirou-Navier1

Author Affiliations

1 INSERM-ERI 11, Nancy University Medical School, 9 av de la Forêt de Haye, BP 184, 54505 Vandoeuvre-les-Nancy Cedex, France

2 Faculty of Pharmacy of Nancy, 5 rue Albert Lebrun, 54000 Nancy, France

3 Hygiene Laboratory of the City of Paris, 11, rue George Eastman, 75013 Paris, France

4 Department of Occupational Medicine, Municipality of Paris, 44 rue Charles Moureu, 75013 Paris, France

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BMC Cancer 2008, 8:67  doi:10.1186/1471-2407-8-67

Published: 6 March 2008



Sewage workers provide an essential service in the protection of public and environmental health. However, they are exposed to varied mixtures of chemicals; some are known or suspected to be genotoxics or carcinogens. Thus, trying to relate adverse outcomes to single toxicant is inappropriate. We aim to investigate if sewage workers are at increased carcinogenic risk as evaluated by biomarkers of exposure and early biological effects.


This cross sectional study will compare exposed sewage workers to non-exposed office workers. Both are voluntaries from Paris municipality, males, aged (20–60) years, non-smokers since at least six months, with no history of chronic or recent illness, and have similar socioeconomic status. After at least 3 days of consecutive work, blood sample and a 24-hour urine will be collected. A caffeine test will be performed, by administering coffee and collecting urines three hours after. Subjects will fill in self-administered questionnaires; one covering the professional and lifestyle habits while the a second one is alimentary. The blood sample will be used to assess DNA adducts in peripheral lymphocytes. The 24-hour urine to assess urinary 8-oxo-7, 8-dihydro-2'-deoxy-Guanosine (8-oxo-dG), and the in vitro genotoxicity tests (comet and micronucleus) using HeLa S3 or HepG2 cells. In parallel, occupational air sampling will be conducted for some Polycyclic Aromatic Hydrocarbons and Volatile Organic Compounds. A weekly sampling chronology at the offices of occupational medicine in Paris city during the regular medical visits will be followed. This protocol has been accepted by the French Est III Ethical Comitee with the number 2007-A00685-48.


Biomarkers of exposure and of early biological effects may help overcome the limitations of environmental exposure assessment in very complex occupational or environmental settings.