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Risk Assessment. Dec 3 - 5, 2007. Toxicology – the dismal science Toxicology + Risk Assessment = the predictive science. The Risk Assessment Paradigm. National Research Council's 1983 report Risk Assessment in the Federal Government: Managing the Process , called the "Red Book" .
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Risk Assessment Dec 3 - 5, 2007
Toxicology – the dismal science • Toxicology + Risk Assessment = the predictive science
The Risk Assessment Paradigm National Research Council's 1983 report Risk Assessment in the Federal Government: Managing the Process, called the "Red Book" • Hazard Evaluation • Dose-Response Evaluation • Exposure Assessment • Risk Characterization Risk = Probability (of adverse outcome) Hazard ≠ Risk
Food and Drug Administration(FDA) • Food and Drugs Act (1906) prohibits interstate commerce in misbranded and adulterated foods, drinks and drugs.
“Anyone who says saccharin is injurious to health is an idiot” Theodore Roosevelt (26th President of the USA, 1901-1909)
1938 Food, Drug and Cosmetic Act • Requires that “safe tolerances” be set for “unavoidable poisonous substances”. • 1940 FDA transferred from USDA to Federal Security Agency, first Commissioner of Food and Drugs appointed • 1944 Public Health Service Act • 1968 FDA placed in Public Health Service
Miller Amendment (1954) Chemical pesticides and other residues tolerated at levels at which evidence can show that they “do not cause any deleterious effects”
1958 Food Additives Amendment Generally Regarded As Safe • GRAS List • Delaney Clause
The Delaney ClauseNo Food Additive Shall be Deemed to be Safe if it is Found to Induce Cancer when Ingested by Man or Animals, or if it is Found, After Tests which Are Appropriate for the Evaluation of the Safety of Food Additives, to Induce Cancer in Man or Animals
Carcinogens • No safe dose • Acceptable dose: dose that causes 1 in 106 lifetime risk of cancer
Dose-Response Increasing Response 0 Dose No Threshold
For effects other than cancer: Is there a “safe” dose ?
Dose-Response Increasing Response 0 Dose Threshold
Non-carcinogens No Observed Adverse Effects Level NOAEL
ACCEPTABLE DAILY INTAKE (ADI) or TOLERABLE DAILY INTAKE (TDI) The amount of a substance that can be ingested over a lifetime without significant health risk ADI = NOAEL Safety Factor(s) Poor quality of data Safety Factor = 10 x 10 [x 10] [x 10] Inter-species Animal-to-human Intra-species Particularly variability inter-individual severe effect variability Units: mg/kg/day Based on most sensitive species and most sensitive end-point
Extrapolations • From short-term studies to lifetime exposure • From animals to humans
Scale from animal to human • Scale according to body weight (BW) • Scale according to surface area – (BW)2/3 • Scale according to relative metabolic rates – (BW)3/4 • Biological modeling – physiologically-based (PBPK)
Factors in determining acceptable dose • Species differences, gender, age, body weight • Approach has been chemical by chemical. • Multiple chemical exposure - combined risk assessment approach. Multiple sources of exposure need to be accounted for.
1996 Food Quality Protection Act • Amendment to FDCA, removes application of Delaney Clause to pesticides and pesticide residues • The “Risk Cup”
The Risk Cup • Food Quality Protection Act (1996) • “Assess the risk of the pesticide chemical residue [to infants and children] based on…available information concerning the cumulative effects of infants and children of such residues and other substances that have a common mechanism of toxicity”
Interactions • Additivity • Synergism • Potentiation • Antagonism
Interactions can be expected between chemicals that • Act by binding to the same receptor • Act through the same mechanism • Require the same enzyme for activation/detoxication
Combinations • Binary mixtures • Ternary mixtures • Four- , five-component mixtures • Six, seven, eight…. • ... • Complex mixtures
Additivity • Chemicals A, B, C…N are all toxic • Potency of mixture = Sum of potencies * concentrations of constituents • Effecttotal = PotencyA * DoseA + PotencyB * DoseB + PotencyC * DoseC +…..+PotencyN * DoseN
Synergism • The whole is greater than the sum of the individual constituents Effecttotal >> PotencyA* DoseA + PotencyB* DoseB… +… + PotencyN* DoseN
Potentiation • One constituent A is toxic, the other B is not. • Effect of the combination A + B is greater than the effect of the active constituent Effecttotal >> PotencyA* DoseA where PotencyB = 0
Antagonism • Effect of the whole is less than the sum of the effects of the individual components Effecttotal << PotencyA* DoseA + PotencyB* DoseB… +… + PotencyN* DoseN
Competing risks Drinking water disinfectant by-products ↔ infectious diseases
“Acceptable” risks • Carcinogens: 1 in 106 over lifetime • Occupational exposures: 1 in 103 – 1 in 104 over working lifetime • Enteric diseases: 1 in 104 per year
Comparison of Risks Disability Adjusted Life Years