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Correspondence to: Dr D S-Q Koh, Department of Community, Occupational and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Block MD3, 16 Medical Drive, Singapore 117597, Singapore; cofkohd@nus.edu.sg  T he use of saliva as a diagnostic fluid is a relatively recent trend. This is not surprising when one considers its many advantages and the fact that saliva contains a wide array of constituents. Saliva collection is non-invasive compared with phlebotomy, and, as a result, more acceptable to patients. As obtaining saliva is easy, self-collection after instruction is possible and there is no need for trained staff. Moreover, it does not carry the risk of needle-stick injuries. Saliva collection is also less likely to cause stress compared with other invasive procedures such as phlebotomy, an important consideration when researching biomarkers of stress. Lastly, saliva samples can reflect real-time levels of biomarkers, unlike other biological fluids, such as urine, which is stored in the bladder for a few hours before sampling.

The use of salivary biomarkers in occupational and environmental medicine