A fundamental pre-requisite for the realization of biological monitoring programs for health surveillance is the availability of sufficiently accurate tests and adequate knowledge of the relationship between biomarkers and health effects. In this respect, epidemiology plays an essential role: in conjunction with other disciplines (industrial hygiene, toxicology, occupational medicine), it provides a conceptual and methodological framework for many biological monitoring activities. Compared to biomarkers of dose and effect, susceptibility markers (for example, metabolic polymorphisms), for which we have seen an explosion of research in recent years, need a specific consideration in that they pose (or may pose in a non-remote future) special problems. For different reasons, the use of genetic tests for predictive aims at the individual level should now be avoided; their use should be restricted to the research field for a better understanding of etiopathogenetic mechanisms.