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CBRA Bulletin - August 2008
This new Community-Based Risk Assessment (CBRA) Listserv is sponsored by the Environmental Protection Agency (EPA) and managed through the EPA's National Center of Environmental Research (NCER). Please feel free to forward the listserv messages to interested colleagues or ask them to join!
News and Opportunities | Featured Resource | Featured Science Articles
- EPA Releases "Concepts, Methods, and Data Sources for Cumulative Health Risk Assessment of Multiple Chemicals, Exposures, and Effects: A Resource Document"
The final report is a resource document that provides concepts, methods and data sources to assist in the conduct of multi-chemical, population-focused cumulative risk assessments. It is not guidance, but rather a presentation of information that could assist in the development of future guidance on cumulative risk assessment. This report addresses a subset of issues related to chemical mixtures risk assessment that are identified in the 2003 Framework for Cumulative Risk Assessment. In addition, it evaluates health risks from exposures to multiple chemicals, including multiple exposure routes and times as well as multiple health endpoints. The final report, as well as related links, can be accessed at: http://cfpub.epa.gov/ncea/cfm/recordisplay.cfm?deid=190187. - CDC Releases "National Report on Biochemical Indicators of Diet and Nutrition in the U.S. Population 1999-2002"
Using advanced laboratory science and innovative techniques, the Division of Laboratory Sciences at the Center for Disease Control and Prevention (CDC), National Center for Environmental Health (NCEH) has been in the forefront of efforts to assess the nutritional status of the U.S. population through monitoring nutritional indicators. This publication offers information on a wide range of biochemical indicators in a single document. Access the report at: http://www.cdc.gov/nutritionreport/#. - The Association of Schools of Public Health Announces - This is Public Health Toolkit
In April, the Association of Schools of Public Health (ASPH) launched a grass-roots "This is Public Health" awareness campaign using removable stickers as the focal point. Over 3,000 stickers have been distributed to over 100 individuals and organizations. The toolkit serves as a resource for anyone who is interested in educating others about public health issues or the field of public health. It is a dynamic site that will be continuously updated. To view the toolkit, please visit: www.thisispublichealth.org/toolkit
. - Sign-Up To Get Environmental Research Publications and News from EPA by Email
You can tailor any combination of email notifications for new publications, news or other updates from EPA's Office of Research and Development. Topics of interest include human health, land, ecological, and global change research. Go to www.epa.gov/ord and click on "Email Alerts" in the right-hand corner box. You can unsubscribe at any time.
The Maryland Partnership for Prevention, Inc.'s Coalition University -- Training on Coalition Building Coalition University is a unique, national training series thoughtfully designed to provide the multi-disciplinary skill sets necessary for creating, sustaining, and participating in a successful coalition. Students participate in interactive classes on subjects that have proven critical to the development and stability of community and corporate partnerships. Coalition University offers three "semesters" of learning that incrementally provide students a comprehensive foundation for coalition-building. Utilizing a multi-disciplinary staff, Coalition University provides instruction on topics including:
Meeting Management
Program Planning
Conflict Resolution
Cultural Competency
Media Relations
Program Evaluation
Registration and "semester" course information can be accessed at: http://edcp.org/pdf/Coalition_University_Registration_08-09.pdf (PDF) (4 pp, 179 K) . Please note that registration for the first semester (Sept 24-25) is due by August 29th. Questions about Coalition University can be directed to 410-902-4677 or info@immunizemaryland.org. Information regarding Maryland Partnership for Prevention can be found at: http://www.mdhealthcoalitions.org/ .
- "Moving Upstream: Evaluating Adverse Upstream Endpoints for Improved Risk Assessment and Decision-Making" Environmental Health Perspectives by Woodruff TJ, Zeise L, Axelrad DA, Guyton KZ, Janssen S, Miller M, Miller GG, Schwartz JM, Alexeeff G, Anderson H, Birnbaum L, Bois F, Cogliano VJ, Crofton K, Euling SY, Foster PMD, Germolec DR, Gray E, Hattis DB, Kyle AD, Luebke RW, Luster MI, Portier C, Rice DC, Solomon G, Vandenberg J, Zoeller RT.
Abstract:
BACKGROUND: Assessing adverse effects from environmental chemical exposure is integral to public health policies. Toxicology assays identifying early biological changes from chemical exposure are increasing our ability to evaluate links between early biological disturbances and subsequent overt downstream effects. A workshop was held to consider how the resulting data inform consideration of an "adverse effect" in the context of hazard identification and risk assessment.OBJECTIVES: To review what is known about the relationships between chemical exposure, early biological effects (upstream events), and later overt effects (downstream events) through three case studies (thyroid hormone disruption, anti-androgen effects, immune system disruption) and to consider how to evaluate hazard and risk when early biological effect data are available.
DISCUSSION: Each case study presents data on the toxicity pathways linking early biological perturbations with downstream overt effects. Case studies also emphasize several factors that can influence risk of overt disease as a result from early biological perturbations, including background chemical exposures, underlying individual biological processes, and disease susceptibility. Certain effects resulting from exposure during periods of sensitivity may be irreversible. A chemical can act through multiple modes of action resulting in similar or different overt effects.
CONCLUSIONS: For certain classes of early perturbations, sufficient information on the disease process is known so hazard and quantitative risk assessment can proceed using information on upstream biological perturbations. Upstream data will support improved approaches for considering developmental stage, background exposures, disease status, and other factors important to assessing hazard and risk for the whole population.
Access the article for free at: http://ehp.niehs.nih.gov/docs/2008/11516/abstract.html
- "Environmental Epidemiology and Risk Assessment" Toxicology Letters by Bert Brunekreef
Abstract: Epidemiology is the science of public health. Environmental epidemiology specially focuses on human health risks related to exposures in the general (non-occupational) environment. Epidemiology studies may contribute to human risk assessment by identifying hazards, by assessing human exposures to toxicants, and by establishing exposure response functions that can then be used to generate risk assessments. Examples are provided for each of these. The strengths and weaknesses compared to experimental toxicology studies are discussed.
- "An Adjustment Factor for Mode-of-Action Uncertainty with Dual-Mode Carcinogens: The Case of Naphthalene-Induced Nasal Tumors in Rats" Risk Analysis by KT Bogen
Abstract: The U.S. Environmental Protection Agency (USEPA) guidelines for cancer risk assessment recognize that some chemical carcinogens may have a site-specific mode of action (MOA) involving mutation and cell-killing-induced hyperplasia. The guidelines recommend that for such dual MOA (DMOA) carcinogens, judgment should be used to compare and assess results using separate "linear" (genotoxic) versus "nonlinear" (nongenotoxic) approaches to low-level risk extrapolation. Because the guidelines allow this only when evidence supports reliable risk extrapolation using a validated mechanistic model, they effectively prevent addressing MOA uncertainty when data do not fully validate such a model but otherwise clearly support a DMOA. An adjustment-factor approach is proposed to address this gap, analogous to reference-dose procedures used for classic toxicity endpoints. By this method, even when a "nonlinear" toxicokinetic model cannot be fully validated, the effect of DMOA uncertainty on low-dose risk can be addressed. Application of the proposed approach was illustrated for the case of risk extrapolation from bioassay data on rat nasal tumors induced by chronic lifetime exposure to naphthalene. Bioassay data, toxicokinetic data, and pharmacokinetic analyses were determined to indicate that naphthalene is almost certainly a DMOA carcinogen. Plausibility bounds on rat-tumor-type-specific DMOA-related uncertainty were obtained using a mechanistic two-stage cancer risk model adapted to reflect the empirical link between genotoxic and cytotoxic effects of the most potent identified genotoxic naphthalene metabolites, 1,2- and 1,4-naphthoquinone. Bound-specific adjustment factors were then used to reduce naphthalene risk estimated by linear extrapolation (under the default genotoxic MOA assumption), to account for the DMOA exhibited by this compound.
- "A Possible Approach for Setting A Mercury Risk-Based Action Level Based on Tribal Fish Ingestion Rates" Environmental Research (Vol. 107 No. 1: 60-68) by Barbara L. Harper and Stuart G. Harris
Abstract: Risks from mercury and other contaminants in fish for a large Columbia River dataset are evaluated in this paper for a range of consumption rates. Extensive ethnohistorical, nutritional, recent ethnographic surveys, and other documentation was reviewed to confirm previous determinations that the traditional subsistence fish consumption rate is 500 pounds per capita annually, or 620 g per day (gpd). Lower contemporary consumption rates for other population subsets are also discussed. The causes of the current suppression of fish consumption are discussed and the cultural, educational, social, and trade and economic impacts of the loss of fish are considered. Action levels for mercury for riverine Tribes in the Columbia Basin are suggested at 0.1 ppm or less based on the combined risk from mercury plus other contaminants, the higher fish consumption rates, the existing cultural deficit due to loss of salmon and other stressors, the health benefits of fish, and the cultural and economic importance of fish. The goal of fish advisories is to reduce fish consumption even further, which shifts the burden of avoiding risk to the very people who already bear the burdens of contaminant exposure, socio-economic impacts and cultural loss. However, because Tribal communities often do not have the choice of giving up more food, income, religion, culture, and heritage in order to avoid contamination, they are forced into choosing between culture and health. Many tribal members choose to incur chemical risk rather than giving up their culture and religion. We believe that lowering the action level for mercury is part of the federal fiduciary responsibility to American Indian Tribes.
- "Integrating Research and Action: A Systematic Review of Community-Based Participatory Research to Address Health Disparities in Environmental and Occupational Health in the USA" Journal of Epidemiology and Community Health by W.K. Cook
Abstract:
INTRODUCTION: Integrating research and action represents a goal and key principles of community-based participatory research (CBPR), but there has been little effort to synthesise the literature to evaluate whether such integration is occurring.OBJECTIVES: (1) To examine the extent to which CBPR integrates action to effect community-level change and (2) to ascertain factors that facilitate such integration.
METHODS: Original articles reporting on CBPR in environmental and occupational health in the USA were identified primarily through a MEDLINE search. Inceptions, processes, methods and outcomes of the projects were reviewed.
RESULTS: In 14 of the 20 studies reviewed, CBPR led to community-level action to improve the health and well-being of the community members. Observational studies that investigated problems posed by the affected community and that incorporated qualitative methods were more likely to lead to action. The collaboration among government scientists, university researchers and community partners emerged as a new model of CBPR partnerships that effectively integrates research and action.
CONCLUSIONS: To help CBPR better integrate research and action, a shift towards community-initiated and action-oriented observational studies might be needed.
- "Preliminary Risk Assessment Database and Risk Ranking of Pharmaceuticals in the Environment" Science of the Total Environment by Emily R. Cooper, Thomas C. Siewicki, and Karl Phillips
Abstract: There is increasing concern about pharmaceuticals entering surface waters and the impacts these compounds may have on aquatic organisms. Many contaminants, including pharmaceuticals, are not completely removed by wastewater treatment. Discharge of effluent into surface waters results in chronic low-concentration exposure of aquatic organisms to these compounds, with unknown impacts. Exposure of virulent bacteria in wastewater to antibiotic residues may also induce resistance, which could threaten human health. The purpose of this study was to provide information on pharmaceutical threats to the environment. A preliminary risk assessment database for common pharmaceuticals was created and put into a web-accessible database named "Pharmaceuticals in the Environment, Information for Assessing Risk" (PEIAR) to help others evaluate potential risks of pharmaceutical contaminants in the environment. Information from PEIAR was used to prioritize compounds that may threaten the environment, with a focus on marine and estuarine environments. The pharmaceuticals were ranked using five different combinations of physical-chemical and toxicological data, which emphasized different risks. The results of the ranking methods differed in the compounds identified as high risk; however, drugs from the central nervous system, cardiovascular, and anti-infective classes were heavily represented within the top 100 drugs in all rankings. Anti-infectives may pose the greatest overall risk based upon our results using a combination of factors that measure environmental transport, fate, and aquatic toxicity. The dataset is also useful for highlighting information that is still needed to assuredly assess risk.