Methods are now available for the quantification of carcinogen-DNA adducts in human tissues and can be used to screen populations for exposure to environmental carcinogens. One approach utilizes highly specific antibodies in sensitive immunoassays for quantifying adduct levels in DNA from various tissues. We have recently developed a panel of monoclonal antibodies that specifically recognize DNA modified by methoxsalen and ultraviolet A light (320-400 nm) (UVA). These antibodies have been characterized as to sensitivity and specificity by an enzyme-linked immunosorbent assay (ELISA). In a competitive ELISA, 50% inhibition of antibody binding occurred with 17 fmol methoxsalen-DNA photo adducts. There was also some antibody cross-reactivity with DNA modified by 4'-aminomethyl-4,5,8-trimethylpsoralen and 4',5-dimethylangelicin but not with free methoxsalen. A more sensitive ELISA has also been developed using fluorescence detection of enzyme activity. With this assay, one adduct per 10(8) bases can now be detected reliably. Adduct levels have been quantified in myeloma cells and lymphocytes treated in vitro with methoxsalen and UVA. In addition, in preliminary studies, adducts have been measured in lymphocytes isolated from patients undergoing extracorporeal photophoresis for cutaneous T-cell lymphoma. Quantification of methoxsalen adducts in patients should provide a basis for estimating risk resulting from psoralen plus UVA (PUVA) treatment.