Risk Assessment and Child Health

PEDIATRICS ◽  
2004 ◽  
Vol 113 (Supplement_3) ◽  
pp. 952-956
Author(s):  
Jonathan M. Samet

Risk assessment, an approach for organizing information about hazards to health, safety, and the environment, provides a framework for gauging the threat to child health from environmental pollutants. A qualitative risk assessment has 4 components: hazard identification, dose-response assessment, exposure assessment, and risk characterization. In a risk assessment, consideration can be given to a population group that potentially has increased susceptibility, whether arising from having a high level of exposure or from increased susceptibility to the agent of concern on a biological basis. Children have been proposed as being at increased risk from some environmental agents, and there has long been concern and debate that the current approach of determining acceptable exposure levels or intake for a person may not yield safe intake limits for infants and children, who may be placed at greater risk than adults because of exposure patterns and inherent susceptibility. The persistence of debate on this critical public health issue reflects, in part, the difficulty of developing sufficiently sensitive and validated animal bioassays for critical outcomes. Epidemiologic studies can play only a limited role, given the complexity of establishing cohorts and tracking exposures from conception forward to assess risks across the lifespan. Meeting society’s call for healthy environments for children poses an extraordinary challenge to researchers and to the policy makers who seek to develop evidence-based policies to protect children.

2010 ◽  
Vol 5 (1) ◽  
Author(s):  
Annalie Roux ◽  
Cedric Robillot ◽  
Heather Chapman ◽  
Frederic Leusch ◽  
Mary Hodge ◽  
...  

This paper explains how the results of the source water characterisation for the Western Corridor Recycled Water Project in South East Queensland was used to augment the qualitative water quality risk assessment process and design of the monitoring programs. Results were evaluated against health standards published in 2008 by Queensland Health and also against level of reporting. This determined the relative risk of exceeding the health standard for parameters detected in the source. The relative risk was used to inform the qualitative risk assessment as well as the frequency of monitoring in both the source and purified water. Categorising hazards using their ionic charge and hydrophobicity enabled the selection of indicators for both source and purified water compliance monitoring programs.


1985 ◽  
Vol 1 (4) ◽  
pp. 65-91 ◽  
Author(s):  
Linda S. Erdreich ◽  
Carol Burnett

Epidemiologic data with quantitative exposure measures is infrequently available for specific environmental agents. This lack of exposure measures creates confusion in interpreting epidemiologic data and therefore has impeded its efficient use in health risk analysis. This paper discusses screening and evaluating epidemiologic studies for use in assessing health risk. It also describes the larger role of epidemiology in reducing uncertainties in risk analysis. The approach recognizes that the various designs used to increase statistical power and to control for covariables have different functions in contemporary risk assessment as practiced by regulatory agencies. Each of these study designs is categorized for its role in risk analysis as useful for hazard identification or for dose-response assessment. Studies presenting geographic correlations are construed to be not directly useful in health risk assessment. The numerical level of the exposure data is a deciding factor in using valid epidemiologic studies. However, data measured on an ordinal scale can be used in qualitative assessments and can demonstrate the strength of the relationship. The application of this procedure is illustrated using epidemiologic studies on the carcinogenicity of chemicals contaminated with dioxins.


2016 ◽  
Vol 5 (4) ◽  
pp. 63-70 ◽  
Author(s):  
Грановский ◽  
E. Granovskiy

The problems of hazard identification in the structure of technological systems’ risk analysis are considered. Various methods of brainstorming used in the danger analysis are presented. It has been demonstrated that HAZOP investigation is the most structured brainstorming method for identification of system hazards. Roles, tasks and requirements for expert group’s leader and participants are considered. It has been demonstrated that experts’ competence needed for the hazard analysis does not meet the requirements to the competence for qualitative risk assessment. Decisions needed to achieve sufficient system safety must be taken after a quantitative risk assessment.


2009 ◽  
Vol 29 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Andrew G. Salmon

Existing risk assessment data and procedures can be used to address the estimation of cumulative risk, but there are several uncertainties. These are explored in the context of the State of California’s Air Toxic Hot Spots program. Hazard identification for single agents is an established procedure but is much more complex for incompletely characterized or variable mixtures. Hazards from exposure to multiple agents are often only identified by chance. Similar concerns affect dose-response assessment. Although additivity is assumed by default for similar effects at low doses, exceptions are known for specific mixtures and for higher dose rates. Exposure assessment is especially complex for multiple sources, multiple agents from different sources, and target populations or individuals who face cumulative, but not necessarily simultaneous, impacts. With these contributory uncertainties, providing an integrated analysis that can inform risk management and presenting this to a diverse and often already stressed community are challenging.


1986 ◽  
Vol 5 (4) ◽  
pp. 249-259 ◽  
Author(s):  
H. Zenick ◽  
E. D. Clegg

Efforts in the area of risk assessment have concentrated primarily on cancer as an outcome. However, attention is now being directed toward the development of strategies for assessing risk to other target systems. The Reproductive Effects Assessment Group in the Office of Health and Environmental Assessment, U.S. EPA, is involved extensively in that effort in the areas of developmental and reproductive toxicology and mutagenicity. This group is currently preparing risk assessment guidelines for the male and female reproductive systems. Some of the issues associated with hazard identification and dose-response assessment with respect to male reproductive toxicity are discussed in the present paper.


BJGP Open ◽  
2020 ◽  
pp. bjgpopen20X101139
Author(s):  
Lonneke Maria Elisabeth Nies ◽  
Looijmans I ◽  
Rozendaal Rozendaal ◽  
Brenda Baar ◽  
Rimke C Vos ◽  
...  

Background: Patients with COPD have an independent increased risk of cardiovascular (CV) disease. CV-risk (CVR) assessment should be offered to all COPD-patients according to the new Dutch ‘CVR management’ (CVRM) guideline (May-2019). Aim: To evaluate the impact of this new guideline for the care of COPD-patients in primary care. Design and Setting: A retrospective study within five primary healthcare centres located in the Netherlands. Methods: In accordance with the guideline we estimated and categorized the CVR of all COPD-patients. Data from 2014–2019 were used for the qualitative risk assessment based on comorbidities, and the quantitative Systematic Coronary Risk Assessment (SCORE). In addition, we investigated the guideline-based follow-up. Results: Of the 391 COPD-patients, 84.1% (n=329) had complete data on CVR assessment: 90.3% (n=297) had a (very)-high risk and 9.7% (n=32) a low-to-moderate risk. Of the patients with (very)-high risk, 73.4% (n=218) received guideline-based follow-up (primary care: 95.4%, secondary care: 4.6%). In 15.9% (n=62) of all COPD-patients, the CVR profile was not measured and of the (very)-high-risk patients, 26.6% (n=79) was not enrolled in a CV-care program. Conclusion: Whereas in the majority of patients the CVR is already known, for one out of six COPD-patients this CVR still has to be assessed according to the recently updated guideline. Moreover, once a (very)-high risk has been assessed, as a consequence CV treatment of risk factors should be intensified in one out of four COPD-patients. Adherence to the new CVRM guideline could provide improvement in CVRM in more than a third of all COPD-patients.


2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Moiz Mumtaz ◽  
Jeffrey Fisher ◽  
Benjamin Blount ◽  
Patricia Ruiz

Post-exposure risk assessment of chemical and environmental stressors is a public health challenge. Linking exposure to health outcomes is a 4-step process: exposure assessment, hazard identification, dose response assessment, and risk characterization. This process is increasingly adopting “in silico” tools such as physiologically based pharmacokinetic (PBPK) models to fine-tune exposure assessments and determine internal doses in target organs/tissues. Many excellent PBPK models have been developed. But most, because of their scientific sophistication, have found limited field application—health assessors rarely use them. Over the years, government agencies, stakeholders/partners, and the scientific community have attempted to use these models or their underlying principles in combination with other practical procedures. During the past two decades, through cooperative agreements and contracts at several research and higher education institutions, ATSDR funded translational research has encouraged the use of various types of models. Such collaborative efforts have led to the development and use of transparent and user-friendly models. The “human PBPK model toolkit” is one such project. While not necessarily state of the art, this toolkit is sufficiently accurate for screening purposes. Highlighted in this paper are some selected examples of environmental and occupational exposure assessments of chemicals and their mixtures.


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