# A Review of Biomonitoring for Atrazine and Atrazine Metabolites Using Blood, Urine, and Sweat-Based Assays

## TL;DR

This paper reviews current methods for measuring atrazine exposure and highlights the potential of sweat-based monitoring as a less invasive alternative.

## Contribution

The paper is the first to systematically review the feasibility of sweat-based biomonitoring for atrazine exposure.

## Key findings

- The average atrazine concentration in urine was 18.33 ng/mL across studies.
- Acute poisoning patients had an average blood concentration of 261 ng/mL.
- No studies have measured atrazine in sweat, despite potential for sweat-based monitoring.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Over ninety percent of the United States population is exposed to endocrine-disrupting chemicals, including atrazine, on a daily basis, resulting in adverse health outcomes and increased healthcare costs, including an estimated 90,000 deaths annually and a $39 billion per year loss in economic productivity.The prevalence of atrazine exposure is increasing, and less invasive methods for toxicological exposure assessment are needed. Reviewing concentrations of atrazine and atrazine metabolites in blood, urine, and sweat in occupational, environmental, and acute toxic exposure contexts will inform the development of sweat-based sensors for atrazine.

Over ninety percent of the United States population is exposed to endocrine-disrupting chemicals, including atrazine, on a daily basis, resulting in adverse health outcomes and increased healthcare costs, including an estimated 90,000 deaths annually and a $39 billion per year loss in economic productivity.

The prevalence of atrazine exposure is increasing, and less invasive methods for toxicological exposure assessment are needed. Reviewing concentrations of atrazine and atrazine metabolites in blood, urine, and sweat in occupational, environmental, and acute toxic exposure contexts will inform the development of sweat-based sensors for atrazine.

Public health significance—Why is this work of significance to public health?
The average concentration of atrazine in urine for all studies included in the systematic review was 18.33 ng/mL. In blood, stratified by exposure context, the average blood concentration in acute poisoning patients was 261 ng/mL, where the average blood concentration in prenatal exposure was 31.68 ng/mL maximum. No studies examined the concentration of atrazine in sweat.Given that 6–16% of atrazine is absorbed dermally and metabolized by skin enzymes, sweat-based biomonitoring proves an attractive atrazine exposure assessment if additional research is conducted to refine assessments.

The average concentration of atrazine in urine for all studies included in the systematic review was 18.33 ng/mL. In blood, stratified by exposure context, the average blood concentration in acute poisoning patients was 261 ng/mL, where the average blood concentration in prenatal exposure was 31.68 ng/mL maximum. No studies examined the concentration of atrazine in sweat.

Given that 6–16% of atrazine is absorbed dermally and metabolized by skin enzymes, sweat-based biomonitoring proves an attractive atrazine exposure assessment if additional research is conducted to refine assessments.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Toxicological exposure assessments are currently dominated by routine blood panels and urine profiles, but less invasive, sweat-based testing will enable patients and clinicians to more frequently and easily monitor atrazine exposure and take steps to limit exposure to endocrine-disrupting chemicals, including atrazine.Additional randomized controlled trials are needed on atrazine concentrations in sweat to enable sweat-based sensing of atrazine and atrazine metabolites.

Toxicological exposure assessments are currently dominated by routine blood panels and urine profiles, but less invasive, sweat-based testing will enable patients and clinicians to more frequently and easily monitor atrazine exposure and take steps to limit exposure to endocrine-disrupting chemicals, including atrazine.

Additional randomized controlled trials are needed on atrazine concentrations in sweat to enable sweat-based sensing of atrazine and atrazine metabolites.

In current clinical medicine, urinary profiling and blood tests are the primary toxicological exposure assessments for endocrine-disrupting chemicals (EDCs), including atrazine. Recent research suggests that analog monitoring of EDC concentrations and metabolites in sweat may be a less invasive, yet equally reliable method for conducting toxicological exposure assessments. However, no systematic reviews have identified whether concentrations of atrazine in sweat serve as a valid biomarker of environmental exposure. Thus, we performed a systematic review of the peer-reviewed literature to assess (1) if there is a correlation between the concentration of atrazine present in blood and urine and evaluate the evidence for sweat-based biomonitoring and (2) whether atrazine concentrations in sweat are a reliable and valid measurement of atrazine exposure based on the current state of evidence in the peer-reviewed literature. Databases included PubMed, Embase, Google Scholar, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and WHO Global Index Medicus. Stratified by exposure context, the average blood concentration of atrazine and atrazine metabolites in acute poisoning patients was 261 ng/mL, and the average blood concentration in prenatal exposure contexts was 31.68 ng/mL maximum in the included studies. While physicochemical properties of atrazine metabolites, particularly deisopropylatrazine (DIA), suggest potential suitability for sweat-based monitoring, empirical validation through controlled sweat collection studies is required before this approach can be recommended for clinical or occupational use. The results of the systematic review were heterogeneous, and a narrative review was conducted. To conclude, no studies have examined the concentration of atrazine in sweat and whether sweat can be used as a statistically valid toxicological assessment of atrazine exposure.