Considering Changes in Exposure and Sensitivity in an Early Life Cumulative Risk Assessment

2009 ◽  
Vol 29 (1) ◽  
pp. 71-77 ◽  
Author(s):  
Robert A. Howd
Keyword(s):  
Risk Assessment ◽  
Early Life ◽  
Developmental Stages ◽  
Cumulative Risk ◽  
The Elderly ◽  
Common Mechanism ◽  
Time Period ◽  
Dioxins And Furans ◽  
Exposure Routes ◽  
Susceptible Subpopulations

A cumulative risk assessment is generally intended to address concurrent exposure by all exposure routes to a group of chemicals that share a common mechanism of toxicity. However, the contribution of different exposure routes will change over time. This is most critical when estimating risks to infants and children because their exposure sources change rapidly during the first few years of life because of dietary and behavioral changes. In addition, there may be changes in sensitivity to toxicants during this time period, associated with various developmental stages. Traditional risk assessments do not address this progression. Examples of how these factors might be incorporated into an early life risk assessment are provided for lead, dioxins and furans, and organophosphate pesticides. The same concepts may apply to other potentially susceptible subpopulations, such as the elderly.

Letter to the Editor: Craniopharyngiomas in the elderly: the crucial influence of tumor topography on surgical risk assessment

2021 ◽  
Author(s):  
José M. Pascual ◽  
Ruth Prieto
Keyword(s):  
Risk Assessment ◽  
Elderly Patients ◽  
Tumor Tissue ◽  
Significant Proportion ◽  
Wide Band ◽  
The Elderly ◽  
Surgical Risk ◽  
Definition Of ◽  
Weighted Sequences ◽  
Tumor Topography

Classifying CPs within the overly vague, uninformative category “suprasellar” prevents gaining any true insight regarding the risks associated with the surgical procedure employed. Routine MRI obtained with conventional T1- and T2-weighted sequences along the midsagittal and coronal trans-infundibular planes allow an accurate and reliable preoperative definition of CP topography. CPs developing primarily within the infundibulum and/or tuberal region of the hypothalamus, as well as those wholly located within the 3V, should be distinguished preoperatively from those lesions originally expanding beneath the 3V floor (3VF), the true suprasellar tumors. Among adult patients, about 40% of CPs correspond to infundibulo-tuberal tumors expanding primarily within the 3VF, above an intact pituitary gland and stalk. This subgroup of CPs shows strong adherences to the surrounding hypothalamus, as they are embedded within a wide band of reactive gliotic tissue, usually infiltrated by microscopic finger-like solid cords of tumor tissue. In elderly patients, a significant proportion of CPs correspond to papillary tumors developing above an intact 3VF, usually showing small pedicle-like or sessile-like attachments to the infundibulum. With the current diagnostic MRI workup routinely employed for CPs, it is possible, for the majority of lesions, to preoperatively differentiate these topographical variants and predict the type of CP-hypothalamus relationship that will be found during surgery.

scholarly journals Cumulative Risks from Stressor Exposures and Personal Risk Factors in the Workplace: Examples from a Scoping Review

2021 ◽  
Vol 18 (11) ◽  
pp. 5850
Author(s):  
Mary A. Fox ◽  
Richard Todd Niemeier ◽  
Naomi Hudson ◽  
Miriam R. Siegel ◽  
Gary Scott Dotson
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Scoping Review ◽  
Multiple Stressors ◽  
Cumulative Risk ◽  
Real Life ◽  
Personal Factors ◽  
Exposure Limits ◽  
Personal Risk ◽  
Personal Risk Factors

Protecting worker and public health involves an understanding of multiple determinants, including exposures to biological, chemical, or physical agents or stressors in combination with other determinants including type of employment, health status, and individual behaviors. This has been illustrated during the COVID-19 pandemic by increased exposure and health risks for essential workers and those with pre-existing conditions, and mask-wearing behavior. Health risk assessment practices for environmental and occupational health typically do not incorporate multiple stressors in combination with personal risk factors. While conceptual developments in cumulative risk assessment to inform a more holistic approach to these real-life conditions have progressed, gaps remain, and practical methods and applications are rare. This scoping review characterizes existing evidence of combined stressor exposures and personal factors and risk to foster methods for occupational cumulative risk assessment. The review found examples from many workplaces, such as manufacturing, offices, and health care; exposures to chemical, physical, and psychosocial stressors combined with modifiable and unmodifiable determinants of health; and outcomes including respiratory function and disease, cancers, cardio-metabolic diseases, and hearing loss, as well as increased fertility, menstrual dysfunction and worsened mental health. To protect workers, workplace exposures and modifiable and unmodifiable characteristics should be considered in risk assessment and management. Data on combination exposures can improve assessments and risk estimates and inform protective exposure limits and management strategies.

Sign in / Sign up

Export Citation Format

Share Document