BIOMONITORING OF HUMAN EXPOSURE TO LEAD: A REVIEW OF THE SCIENTIFIC LITERATURE

Abstract

Objectives. Lead remains one of the most hazardous and persistent environmental toxicants and continues to pose a major public health concern, particularly for children and women of reproductive age. The harmonization of national legislation with European Union standards necessitates the establishment and implementation of an effective human lead biomonitoring system in the Republic of Moldova. This review aimed to synthesize current scientific evidence on lead exposure, toxicity, endocrine-disrupting effects, and human biomonitoring approaches to support the development of a national protocol for human lead biomonitoring in the Republic of Moldova.

Methods. A review of the scientific literature was conducted using the HINARI (WHO), PubMed/MEDLINE, ScienceDirect, Cochrane Library, Medscape, and Google Scholar databases. The search strategy employed combinations of the following key terms: lead, lead exposure, lead toxicity, endocrine disruption, human biomonitoring, biological matrices, biomarkers, human exposure, and public health. The search was limited to English-language publications published between January 1993 and June 2026. The final search was conducted on September 9, 2026. The review included original research articles, systematic and narrative reviews, guidelines issued by international organizations, and official documents relevant to the aim and objectives of the review.

Results. Current scientific evidence on human lead biomonitoring was reviewed, with a focus on environmental sources and exposure pathways, mechanisms of toxicity, adverse health effects, relevant biological matrices and biomarkers, and the role of biomonitoring in identifying high-risk populations and informing evidence-based public health strategies.

Conclusions. Lead continues to pose a major public health challenge because it affects virtually all organ systems, no safe level of exposure has been established, children are particularly vulnerable to its toxic effects, and lead exposure imposes a substantial socioeconomic burden. Human lead biomonitoring is essential for strengthening and harmonizing Moldova’s public health surveillance system with European standards. Current priorities include the implementation of standardized human lead biomonitoring protocols and the identification of the most informative biological matrices and relevant biomarkers according to age-specific characteristics and health-based exposure reference values.