N-2-cyanoethylvaline (CEV) is the adduct formed by reaction of ACN with the N-terminal valine in human globin. This adduct is highly specific for exposure to ACN and, because it is built in erythrocytes, follows zero order kinetics, gradually disappearing as the erythrocyte pool is being replaced, i.e. after 126 days in humans ( Granath et al., 1992). Other biomarkers

of exposure exist for ACN but they have shorter half-lives or are less specific ( Schettgen et al., 2012 and Wu et al., 2012). Hence, the measurement of CEV in blood allows to carry out a biomonitoring program specifically for ACN over a more extended period of time. Consequently, CEV has been recommended as the biomarker of choice for chronic as well as for acute ACN exposure ( Osterman-Golkar et al., 1994, GDC-0980 Van Sittert et al., 1997 and Bader and Wrbitzky, 2006). A biomonitoring study was set up 2–3 weeks after the train accident to assess the exposure to ACN in the residents and in the persons that assisted occupationally in the accident. The aims of this specific study are (1) to determine exposure to ACN by means of CEV adducts in the blood of the residents of Wetteren with the highest suspected exposure, and (2) to assess the geographical distribution pattern of ACN exposure. The evacuation zone (EZ) was defined by the Crisis Management Cell. The different zones are depicted in Fig. 1. Selleck Romidepsin Zone

1 corresponds to the 250 m perimeter of the EZ that was evacuated at night in the hours immediately following the accident. Zone 2 was evacuated later, i.e. in the days following the accident, and included the streets parallel with the sewage system and the streets downwind of the train click here accident. Three groups of adult inhabitants of the EZ were invited to participate in the biomonitoring study. A first group consisted of residents of zone 1 (group ‘EZ1’). A second group consisted of residents of zone 2 that were known to have presented at the emergency services of the surrounding hospitals (group ‘EZ2 Emerg’). A third group consisted of a 10% sample of the residents of zone 2 that had been evacuated,

but had not visited the emergency services (group ‘EZ2 Evac’). This 10% sample was taken with the household as sampling unit: in a same household, the person who was the first to have his birthday following the accident was selected. In case the selected person was unable to attend the sampling, another member of the household was offered to participate in the biomonitoring program. Finally, residents of Wetteren living outside the predefined EZ, and who had visited the emergency services in the surrounding hospitals, were also eligible for the biomonitoring study (group ‘Controls’). Table 1 presents the descriptive statistics of the study population. Blood, urine and questionnaires were collected from 242 (51.1%) of the eligible 474 residents. The participation rate varied between 47.