Indoor air is a variable complex mixture of chemicals and airborne particles. Volatile organic
compounds (VOC) constitute a major group of indoor air pollutants encompassing diverse
chemicals such as aldehydes, terpenes. and aromatic, aliphatic and halogenated hydrocarbons.
Of many of these compounds, our knowledge of their possible health effects is very
limited. To improve the situation, combined information should be assembled about the
nature of VOC, the degree of human exposure, the number of people exposed and, most
importantly, the toxicology of VOC. Evidence of carcinogenic potential in animals is convincing
for formaldehyde and acetaldehyde vapor. Formaldehyde carcinogenesis is a highdose
phenomenon with a determining role for cytolethahty. This may also be true for acetaldehyde
carcinogenesis, but further studies are needed to verify this assumption. Being a reactive,
potent DNA-protein cross-linker and a major indoor air contaminant, acrolein should
be tested in a long-term rat inhalation carcinogenicity study. Studies with combinations of
aldehydes, including superimposed peak exposures, would contribute a great deal to a realistic
health hazard assessment of this class of compounds. Short-term inhalation toxicity studies,
including toxicokinetics of a number of relevant terpenes. are deemed desirable to find
out whether this category of chemicals forms a priority indoor air issue. Benzene is a human
carcinogen at high hemotoxic exposure levels. There is evidence to suggest that at non-hemotoxic
exposure concentrations the risk of leukemia decreases more than proportionally, soon
becoming negligibly small. In comparison with benzene, detoxification of toluene and xylene
is rapid which may explain the non-carcinogenicity of these benzene homologues. In nonoccupational
situations, indoor air hexane concentrations are orders of magnitude lower than
exposure levels associated with clinically overt neuropathy. Therefore, hexane is not regarded
as an indoor air pollutant of major concern. Main elements of a strategy for further toxicological
studies of (VOC in) indoor air include: (a) setting of priorities for testing individual
compounds, classes of compounds and combinations of compounds; (b) identification of the
type of information to be assembled; (c) prediction and experimental verification of synergism
or additiveness between compounds; (d) application of biologically or physiologically
based pharmacokinetic modelling to optimize extrapolation of toxicodynamic data obtained
in fixed-time animal experiments to low-dose/long-time human situations, and (e) (geno)toxicity
testing of relevant existing combinations of chemicals (e.g. 20 to 30) at concentrations
of, e.g., a factor 3 or 10 higher than those occurring in indoor air. Studies along the lastmentioned
practical line may be very helpful in narrowing down the number of indoor situations
of real health concern.