Human Biomonitoring of Methyl Bromide Exposure in Fumigation Workers

Introduction. Methyl bromide (MB) is a fumigant used to control pests in agriculture and shipping. MB is an ozone depleting agent with mainly neurotoxic effect. The used of MB in Indonesia still high. Because MB may be harmful to humans, biomonitoring needs to be taken into consideration. Methods. A thorough systematic search of PubMed, Scopus, and Embase produced relevant reviews. The Oxford Centre for Evidence-Based Medicine Levels of Evidence assessment was used to critically evaluate each article. Results. Of the 52 articles identified, 17 studies met the inclusion criteria, and 3 studies were eligible and applicable after following exclusion criteria. All subjects are workers exposed to MB (fumigator and MB manufacturing). Discussion. MB main exposure route through inhalation rapidly metabolized to methanol and bromide and can be distributed to various body tissues with the most prevalent effects in neurotoxicity. There was a significant difference in urine bromide concentration and changes in neurological function tests (electroencephalogram (EEG) and hearth rate variability (HRV)) between before and after work in MB exposed workers. Conclusion. Its important to implement a medical surveillance program for all employees exposed to MB. Comprehensive control and monitoring of MB concentration in workplace environment, work practice management (training/education, proper use of PPE, and regulatory compliance monitoring), and reguler health examination is necessary to achieve effective health management. Routine urine bromide concentration examination is recommended, at least annually, with additional HRV examination especially for workers whose urine bromide concentrations exceed the recommended values and don’t have any sign or symptoms of intoxication.