Objectives Workers in three types of occupations with potential exposure to acrylamide were examined for the purpose of excluding or confirming exposure, evaluating actions for reducing exposure, or investigating the possible cause of ill health.

Methods Workers were examined through the measurement of adducts from acrylamide (and N-methylolacrylamide) to the N-terminal valines in hemoglobin.

Results The first case concerned workers transporting acrylamide-contaminated waste soil. The measured acrylamide-adduct levels were in the range of the normal background levels (ie, any potential occupational exposure was too low to be detected). The second case included workers handling a sealing product containing acrylamide and N-methylolacrylamide. One worker had an acrylamide-adduct level of 0.3 nmol/g globin, close to the level at which acrylamide-exposed persons have shown mild reversible symptoms of the peripheral nervous system. After actions to reduce exposure, the adduct levels were still elevated, and, as a precautionary measure, the sealing product was replaced. The third case concerned a man with observed neurotoxic symptoms, working with a sealing product containing acrylamide. This worker had an extremely high acrylamide-adduct level (23 nmol/g globin) (ie, the acrylamide exposure was probably the cause of his ill health). The acrylamide product was replaced, and after 5 months the adduct level had decreased to 2.4 nmol/g globin, and after another 6 months it was about 0.4 nmol/g globin.

Conclusions These studies illustrate the usefulness of in vivo dose measurement through the use of hemoglobin adducts for occupational surveillance and as a basis for the health risk assessment of electrophilically reactive compounds.

Key terms acrylamide; case report; hemoglobin adducts; in vivo dose monitoring; N-methylolacrylamide; neurotoxic symptom; occupational exposure; sealing product