Occupational endotoxin-exposure and possible health effects on humans

Background: Endotoxins are commonly found at workplaces where large amounts of bioaerosols are generated. In Germany, especially since the Ordinance on Safety and Health Protection related to work involving biological agents (Biostoff-Verordnung) became effective (1999), threshold limit values are widely discussed. Up to the present, endotoxin values are measured with non-uniform methods and therefore values are of limited benefit for classification of exposure groups. In Germany there is no threshold limit value for endotoxin. Methods: Relevant literature of the last 20 years was selected from Medline and discussed. Results: In this review we focused on the impact of endotoxin exposure on human health with special respect to the measurements on workplace and methodological aspects of endotoxin determination. Methods for sampling and endotoxin determination have to be validated, optimized, and standardized first. Conclusion: The adverse health effects of endotoxins are known, standardization of measurements is a necessary goal and protection measures should be established immediately.