Human biomonitoring guidance values (HBM-GVs) for priority substances under the HBM4EU initiative - New values derivation for deltamethrin and cyfluthrin and overall results

Biomonitoring-Based Risk Assessment of Pyrethroid Exposure in the U.S. Population: Application of High-Throughput and Physiologically Based Kinetic Models

Pyrethroid insecticides have been extensively utilized in agriculture and residential areas in the United States. This study evaluated the exposure risk by age using available biomonitoring data. We analyzed pyrethroid metabolite concentrations in urine using the National Health and Nutrition Examination Survey (NHANES) data. Reverse dosimetry was conducted with a high-throughput model and a physiologically based kinetic (PBK) model integrated with a Bayesian inference framework. We further derived Benchmark Dose (BMD) values and systemic points of departure in rats using Bayesian BMD and PBK models. Margins of exposure (MOE) were calculated to assess neurotoxic risk based on estimated daily oral intake and dose metrics in plasma and brain. Results from both models indicated that young children have higher pyrethroid exposure compared to other age groups. All estimated risk values were within acceptable levels of acute neurotoxic effect. Additionally, MOEs calculated from oral doses were lower than those derived from internal doses, highlighting that traditional external exposure assessments tend to overestimate risk compared to advanced internal dose-based techniques. In conclusion, combining high-throughput and PBK approaches enhances the understanding of human health risks associated with pyrethroid exposures, demonstrating their potential for future applications in exposure tracking and health risk assessment.

Unraveling the occupational exposure to mycotoxins in a waste management setting: results from a case study in Norway

Introduction

Waste management represents an occupational setting where fungi are significant contaminants. This study aimed to assess the exposure of waste workers to mycotoxins through a human biomonitoring study.

Methods

A total of 33 workers and 19 controls provided spot urine samples to determine 10 mycotoxins' urinary biomarkers using liquid chromatography coupled with mass spectrometry. Risk characterization was performed using hazard quotient and margin of exposure assessments.

Results

The results indicated that workers were exposed to six out of the 10 mycotoxins tested, with the following detection rates: deoxynivalenol (91%, 30/33), ochratoxin A (33%, 11/33), zearalenone (17%, 5/33), α-zearalenol (12%, 4/33), β-zearalenol (12%, 4/33), and HT-2 toxin (3%, 1/33). Within controls and outwith controls, were exposed to 5/10 and 2/10 mycotoxins, respectively. All participants exhibited hazard quotients for deoxynivalenol and zearalenone below one, indicating that the exposure is unlikely to pose a health risk. However, when considering the margin of exposure determined for ochratoxin A, 18% of the total participants presented results below 200 for non-neoplastic effects, and 100% of the total participants presented values below 10,000 for neoplastic effects, suggesting potential health concerns that require further assessment.

Discussion

This study highlights the need for future research on occupational exposure to mycotoxins in waste management settings.

Next Generation Risk Assessment to Address Disease-Related Vulnerability-A Proof of Concept for the Sunscreen Octocrylene

Risk assessment for cosmetics in the European Union (EU) are triggered by a ban on animal testing and concerns of endocrine disruption (ED). The risk assessment focuses on healthy populations and, for potential ED, includes specific developmental stages as vulnerable due to specific concerns on endocrine effects. However, the assessment focuses on healthy individuals and does not consider that some pathologies may increase dermal absorption and even vulnerability to endocrine disruptors. Data from the EU risk assessment, human pharmacokinetic studies and ToxCast bioactivity were combined in a hypothesis-driven Next-Generation Risk Assessment to identify possible risk drivers for vulnerable populations including oncological patients and atopic dermatitis. In vitro effects are observed at concentration in the order of measured plasmatic levels under normal use patterns. The induction of hepatic enzymes is the most relevant bioactivity endpoint, in line with animal findings. The information on endocrine potential is inconclusive, and the possibility for skin effects and endocrine mechanism linked to tumor induction require further elucidation. The information on octocrylene (CAS number: 6197-30-4) bioactivity is limited, lacking information on the metabolites and the immunotoxicity potential, particularly relevant for oncological patients.

Plasticizer exposure in Germany from 1988 to 2022: Human biomonitoring data of 20 plasticizers from the German Environmental Specimen Bank

The German Environmental Specimen Bank (ESB) annually archives 24-h urine samples since the early 1980s. In this study, we analyzed 420 of these samples from the years 2014 to 2022 for metabolites of 18 phthalates and two substitutes. We merged the new data with the data from previous measurement campaigns to a combined dataset of 1825 samples covering a 35-year period from 1988 to 2022 to investigate time trends, calculate daily intakes and perform an anti-androgenic mixture risk assessment. With the extended set of 41 biomarkers, we are now able to monitor the exposure to all EU-labelled reprotoxic phthalates. Most phthalate exposures continued to decrease since first measurements in the 80s, with biggest drops for DnBP (96.6 %) and DEHP (90.9 %). DiNP and DiDP, seen on the rise in earlier campaigns, now declined. Exposures to the newly included, reprotoxic phthalates were generally negligible. Regarding mixture risk, 5 % of the highly exposed still exceeded the Hazard Index (HI) of 1 in 2009. In the current measurement campaign only three individuals (0.7 %) exceeded the HI of 1 (with exceedances still driven by DEHP and DnBP).In 2022, 20 % of the individuals still had an HI > 0.2, which we propose as a benchmark for interpreting phthalate mixture risk, considering concurrent exposures to other anti-androgens. Exposure to the substitutes DINCH and DEHTP continues to increase, with daily intakes of DEHTP exceeding those of DEHP since 2018. Compared with the United States (US) National Health and Nutrition Examination Survey (NHANES) phthalate exposures seem to align, except for DEHTP with up to ten times higher levels in the US. Human biomonitoring (HBM) is the ideal tool to capture actual mixture exposures per individual, integrating all external exposure sources and pathways, thus we will continue to use HBM in exposure and risk assessment of phthalates and other (anti-androgenic) chemicals.

Exposure assessment of the European adult population to deoxynivalenol - Results from the HBM4EU Aligned Studies

Mycotoxins are natural toxins produced by fungi that may cause adverse health effects thus constituting a public health concern. Deoxynivalenol (DON), a mycotoxin affecting the immune system and causing intestinal disorders, was selected as a priority under the European Human Biomonitoring Initiative (HBM4EU). Urinary total DON levels (tDON) of 1270 participants from six countries were used to characterize the internal exposure of the adult European population and identify the most relevant determinants of exposure. tDON concentrations' P50 and P95 were in the range of 0.41-10.16 µg/L (0.39-9.05 µg/g crt) and 3.25-46.58 µg/L (2.12-33.50 µg/g crt) respectively. Higher tDON levels were observed for (i) male participants from France and Germany, (ii) samples collected in spring and summer, (iii) participants with a lower educational level, (iv) participants living in rural areas, (v) individuals without a job in France and Luxembourg, while in Portugal higher exposure was observed in working individuals, (vi) individuals with higher consumption of cereals and bread. The proportion of individuals with exposure levels exceeding the HBM-GV of 23 µg/L was 12.3 %, ranging from 0.8 % to 20.7 % in the individual countries. This study on mycotoxins exposure has used post harmonized questionnaire data and validated analytical methodologies for analysis and covered countries representing the four geographical regions of Europe, having produced much needed knowledge on the exposure of the European adult population to deoxynivalenol.

Longitudinal biomonitoring of mycotoxin exposure during pregnancy in the Yale Pregnancy Outcome Prediction Study

Mycotoxins are fungal toxins that may trigger adverse health effects in pregnant women and their unborn children. Yet, data is scarce on the dynamic exposure patterns of mycotoxins in pregnant women, especially in the United States. This study assessed mycotoxin exposure profiles in women (n = 50) from the Yale Pregnancy Outcome Prediction Study (YPOPS) cohort at four distinct time points. Multi-analyte human biomonitoring assays based on liquid chromatography tandem mass spectrometry (LC-MS/MS), were developed for human serum and plasma matrices. The serum method was applied, together with an established urine method, to quantify mycotoxin levels in longitudinally collected matched serum (n = 200) and spot urine (n = 200) samples throughout pregnancy. The serum samples were mostly contaminated by the potential carcinogen ochratoxin A (detection rate: 46 %; median: 0.09 ng/mL), the hepato- and nephrotoxic citrinin (detection rate: 32 %; median: 0.02 ng/mL) and two enniatins (EnnB; detection rate: 97 %; median: 0.01 ng/mL and EnnB1; detection rate: 12 %; median: 0.003 ng/mL) which may act as immunotoxins. The most prevalent mycotoxins quantified in urine included deoxynivalenol (detection rate: 99 %; median: 23 ng/mL), alternariol monomethyl ether (detection rate: 69 %; median: 0.04 ng/mL), and zearalenone (detection rate: 63 %; median: 0.16 ng/mL). Seven other biomarkers of exposure including the highly estrogenic α-zearalenol and genotoxic Alternaria toxins, were also determined. Carcinogenic aflatoxins were not detected in any of the samples. Exposure assessment was based on the urinary data and performed by calculating probable daily intakes and comparing the human biomonitoring guidance value (HBM-GV) for deoxynivalenol. The results showed that the individuals exceeded the tolerable daily intake for deoxynivalenol and zearalenone on average at 28 % and 2 % over the different time points. Using the HBM-GV approach, the average exceedances for deoxynivalenol increased to 48 % indicating high exposure. For all the samples in which ochratoxin A was quantified, the estimated margin of exposure for neoplastic effects was below 10,000, indicating possible health concerns. Overall, this study showed that pregnant women were exposed to several regulated and emerging mycotoxins and that exposome-scale assessment should be a future priority in susceptible populations to better characterize xenobiotic exposure.

Toxicokinetic model of the pyrethroid pesticide lambda-cyhalothrin, main exposure route and dose reconstruction predictions in agricultural workers

A toxicokinetic model of the pyrethroid insecticide lambda-cyhalothrin (LCT) was developed to relate absorbed doses to urinary cis-3-(2-chloro-3,3,3-trifluoroprop-1-en-1-yl)-2,2-dimethylcyclopropanecarboxylic acid (CFMP) metabolite levels used as a biomarker of exposure. The model then served to reconstruct absorbed doses in agricultural workers and their probability of exceeding the EFSA Acceptable occupational Exposure Level (AOEL). The toxicokinetic model was able to reproduce the temporal profiles of CFMP in the urine of operators spraying pesticides using the optimized model parameters (adjusted to human volunteer data). Modeling also showed that simulation of an inadvertent oral exposure mainly was the exposure scenario giving the best fit to CFMP urinary time-course data in applicators. With the dermal model parameters optimized from data in volunteers, simulation of a dermal exposure in applicators did not allow to reproduce the observed peak excretions and urinary metabolite levels; extremely high applied dermal doses would be required but still simulated dermal penetration rate would remain too slow. Simulation of an inhalation exposure allowed to reproduce the observed time-courses, but with unrealistic air concentrations. For applicators with the highest urinary concentrations, there was a probability of exceeding the AOEL at some points during the biomonitoring period [>50% probability of exceeding for 27% of 24-h samples]; for non-applicator workers the probability of exceeding the AOEL value was very low [corresponding value of 5%]. Furthermore, the median [95% CI] estimates of 10 000 Monte Carlo simulations led to a biological reference value corresponding to the AOEL of 116 [113-119] ng/kg bw/d and 7.5 [7.3-7.7] μg/L. Overall, 7% of applicators and 1% of workers performing weeding and strawberry picking had a probability of exceeding this biological reference value. As a next step, it would be interesting to apply these methods to multiple exposure to various contaminants.

Phthalates and substitute plasticizers: Main achievements from the European human biomonitoring initiative HBM4EU

Phthalates and the substitute plasticizer DINCH belong to the first group of priority substances investigated by the European Human Biomonitoring Initiative (HBM4EU) to answer policy-relevant questions and safeguard an efficient science-to-policy transfer of results. Human internal exposure levels were assessed using two data sets from all European regions and Israel. The first collated existing human biomonitoring (HBM) data (2005-2019). The second consisted of new data generated in the harmonized "HBM4EU Aligned Studies" (2014-2021) on children and teenagers for the ten most relevant phthalates and DINCH, accompanied by a quality assurance/quality control (QA/QC) program for 17 urinary exposure biomarkers. Exposures differed between countries, European regions, age groups and educational levels. Toxicologically derived Human biomonitoring guidance values (HBM-GVs) were exceeded in up to 5% of the participants of the HBM4EU Aligned Studies. A mixture risk assessment (MRA) including five reprotoxic phthalates (DEHP, DnBP, DiBP, BBzP, DiNP) revealed that for about 17% of the children and teenagers, health risks cannot be excluded. Concern about male reproductive health emphasized the need to include other anti-androgenic substances for MRA. Contaminated food and the use of personal care products were identified as relevant exposure determinants paving the way for new regulatory measures. Time trend analyses verified the efficacy of regulations: especially for the highly regulated phthalates exposure dropped significantly, while levels of the substitutes DINCH and DEHTP increased. The HBM4EU e-waste study, however, suggests that workers involved in e-waste management may be exposed to higher levels of restricted phthalates. Exposure-effect association studies indicated the relevance of a range of endpoints. A set of HBM indicators was derived to facilitate and accelerate science-to-policy transfer. Result indicators allow different groups and regions to be easily compared. Impact indicators allow health risks to be directly interpreted. The presented results enable successful science-to-policy transfer and support timely and targeted policy measures.

Human Biomonitoring Guidance Values for Deoxynivalenol Derived under the European Human Biomonitoring Initiative (HBM4EU)

The mycotoxin deoxynivalenol (DON) was one of the priority substances in the European Joint Human Biomonitoring Initiative (HBM4EU) project. In this study, to better interpret the actual internal exposure of DON in the general population and safeguard public health, human biomonitoring guidance values of DON for the general population (HBM-GVGenPop) were derived. The HBM-GVGenPop of DON was based on either the total DON (DON and its glucuronides) or DON's main metabolite (DON-15-GlcA) levels in 24-h urine samples, resulting in a HBM-GVGenPop of 0.023 µg/mL for the total DON or a HBM-GVGenPop of 0.020 µg/mL for DON-15-GlcA. The use of 24-h urine samples is recommended based on the fact that DON and its metabolites have a short elimination half-life (T1/2), and 95% of the cumulative amount was excreted within 12 h after DON intake. The T1/2 for DON, DON-15-GlcA, and total DON were estimated to be 2.55 h, 2.95 h, and 2.95 h, respectively. Therefore, a 24-h urine sample reflects almost all of the DON exposure from the previous day, and this type of sample was considered for the derivation of a HBM-GVGenPop for DON.

Spatial distribution and risk assessment of pyrethroid insecticides in surface waters of East China Sea estuaries

Pyrethroid insecticides are the most commonly used household insecticides and pose substantial risks to marine aquatic organisms. many studies have detected pyrethroid insecticides in the waters and estuaries of the western United States, but their distributions within western Pacific estuaries have not been reported. Accordingly, we used high-throughput organic analyses combined with high volume solid-phase extraction to comprehensively assess 13 pyrethroid insecticides in East China Sea estuaries and the Huangpu River. The results demonstrated the presence of various ∑13pyrethroid insecticides in East China Sea estuaries (mean and median values of 8.45 ± 5.57 and 7.78 ng L-1, respectively), among which cypermethrin was the primary contaminant. The concentrations of ∑12pyrethroid insecticide detected in the surface waters at the Huangpu River (mean 6.7 ng L-1, outlet 16.4 ng L-1) were higher than those in the Shanghai estuary (4.7 ng L-1), suggesting that runoff from inland areas is a notable source of insecticides. Wetlands reduced the amount of runoff containing pyrethroid insecticides that reached the ocean. Several factors influenced pesticide distributions in East China Sea estuaries, and higher proportions were derived from agricultural sources than from urban sources, with a higher proportion of agricultural sources than urban sources, influenced by anthropogenic use in the region. Permethrin and cypermethrin were the main compounds contributing to the high ecological risk in the estuaries. Consequently, to prevent risks to marine aquatic life, policymakers should aim to reduce insecticide contaminants derived from urban and agricultural sources.

Human biomonitoring and toxicokinetics as key building blocks for next generation risk assessment

Human health risk assessment is historically built upon animal testing, often following Organisation for Economic Co-operation and Development (OECD) test guidelines and exposure assessments. Using combinations of human relevant in vitro models, chemical analysis and computational (in silico) approaches bring advantages compared to animal studies. These include a greater focus on the human species and on molecular mechanisms and kinetics, identification of Adverse Outcome Pathways and downstream Key Events as well as the possibility of addressing susceptible populations and additional endpoints. Much of the advancement and progress made in the Next Generation Risk Assessment (NGRA) have been primarily focused on new approach methodologies (NAMs) and physiologically based kinetic (PBK) modelling without incorporating human biomonitoring (HBM). The integration of toxicokinetics (TK) and PBK modelling is an essential component of NGRA. PBK models are essential for describing in quantitative terms the TK processes with a focus on the effective dose at the expected target site. Furthermore, the need for PBK models is amplified by the increasing scientific and regulatory interest in aggregate and cumulative exposure as well as interactions of chemicals in mixtures. Since incorporating HBM data strengthens approaches and reduces uncertainties in risk assessment, here we elaborate on the integrated use of TK, PBK modelling and HBM in chemical risk assessment highlighting opportunities as well as challenges and limitations. Examples are provided where HBM and TK/PBK modelling can be used in both exposure assessment and hazard characterization shifting from external exposure and animal dose/response assays to animal-free, internal exposure-based NGRA.

Quantitative Metabolism and Urinary Elimination Kinetics of Seven Neonicotinoids and Neonicotinoid-Like Compounds in Humans

Reverse dosimetry, i.e., calculating the dose of hazardous substances that has been taken up by humans based on measured analyte concentrations in spot urine samples, is critical for risk assessment and requires metabolic and kinetic data. We quantitatively studied the metabolism of seven major neonicotinoid and neonicotinoid-like compounds (NNIs) after single oral doses in male volunteers and determined key kinetic parameters and urinary elimination for NNIs together with their metabolites. Complete and consecutive urine samples were collected over 48 h. All samples were analyzed by tandem mass spectrometry, following liquid or gas chromatographic separation. Single- and group-specific NNI metabolites were quantified, i.e., hydroxylated and N-dealkylated NNIs and NNI-associated carboxylic acids and their glycine derivatives. Large, substance-dependent variations of key toxicokinetic parameters were observed. Mean times of concentration maxima (tmax) in urine varied between 2.0 (imidacloprid) and 25.8 h (N-desmethyl-clothianidin), whereas mean urinary elimination half-times (t1/2) were between 2.5 (acetamiprid) and 49.5 h (sulfoxaflor). Mean 48 h excretion fractions (Fue's) were between 0.03% (2-chloro-1,3-thiazole-5-carboxylic acid glycine) and 84% (clothianidin). In contrast, the interindividual differences of Fue's between the volunteers for each of the NNIs and their metabolites remained low (below a factor of 2 between the maximum and minimum derived Fue with the exception of 6-chloronicotinic acid in the acetamiprid dose study). The obtained quantitative data enabled choosing appropriate biomarkers for exposure assessment and, at the same time, for risk assessment by reverse dosimetry at current environmental exposures, i.e., comparing the calculated doses that have been taken up to currently available acceptable daily intakes of NNIs.

Increasing exposure to the UV filters octocrylene and 2-ethylhexyl salicylate in Germany from 1996 to 2020: Human biomonitoring in 24-h urine samples of the German Environmental Specimen Bank (ESB)

The UV filters octocrylene (OC) and 2-ethylhexyl salicylate (EHS) are commonly used in sunscreens and frequently detected in environmental media. However, knowledge on human exposures is scarce. In this human biomonitoring (HBM) study, we analyzed concentrations of exposure biomarkers specific to OC (CPAA, DOCCA, 5OH-OC) and EHS (5OH-EHS, 5oxo-EHS, 5cx-EPS) in 24-h urine samples (n = 420) from the German Environmental Specimen Bank (ESB). These samples were collected from German students (20-29 years; 30 males/30 females per year) between 1996 and 2020 (4-year intervals; collection in winter). We found continuously increasing OC and EHS exposures (Jonckheere-Terpstra; p < 0.001) documented by very few to no samples with concentrations of the most sensitive biomarkers CPAA and 5cx-EPS above the limit of quantification (LOQ) in 1996 (5 % and 0 %, respectively) and reaching 100 % and 93 % above the LOQ in 2016, with median concentrations of 4.79 and 0.071 µg/L, respectively. In 2020, biomarker concentrations slightly decreased to 3.12 µg/L CPAA (97 %>LOQ) and 0.060 µg/L 5cx-EPS (88 %>LOQ). This general trend was confirmed by the other biomarkers, however at lower detection rates. Based on metabolite excretion in the 24-h urine samples and human toxicokinetic data, we calculated maximum daily intakes (DI) of 17 µg/(kg bw * d) OC and 59 µg/(kg bw * d) EHS. Based on a derived no-effect level (DNEL) of 0.8 mg/(kg bw * d), the OC exposures of individuals in our study did not indicate any health risk. Similarly, for EHS all biomarker concentrations were well below the HBM-I values of 12 µg/L 5OH-EHS and 11 µg/L 5cx-EPS. Our data proves the general applicability of specific OC and EHS metabolites for HBM in the general population and shows clearly increasing exposures. Higher (co-)exposures must be expected in populations with increased sunscreen use such as (summer) vacationers, children and outdoor workers.

Human biomonitoring of deoxynivalenol (DON) - Assessment of the exposure of young German adults from 1996 - 2021

The mycotoxin deoxynivalenol (DON) is a frequently found contaminant in cereals and cereal-based products. As a German contribution to the European Joint Programme HBM4EU, we analysed the total DON concentration (tDON) in 24-h urine samples from the German Environmental Specimen Bank (ESB). In total, 360 samples collected in 1996, 2001, 2006, 2011, 2016, and 2021 from young adults in Muenster (Germany), were measured by high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) after enzymatic deconjugation of the glucuronide metabolites. tDON was found in concentrations above the lower limit of quantification (0.3 μg/L) in 99% of the samples. Medians of the measured concentrations and the daily excretion were 4.3 μg/L and 7.9 μg/24 h, respectively. For only nine participants, urinary tDON concentrations exceeded the provisional Human biomonitoring guidance value (HBM GV) of 23 μg/L. Urinary tDON concentrations were significantly higher for male participants. However, 24-h excretion values normalized to the participant's body weight did not exhibit any significant difference between males and females and the magnitude remained unchanged over the sampling years with exception of the sampling year 2001. Daily intakes were estimated from excretion values. Exceedance of the tolerable daily intake (TDI) of 1 μg/kg bw per day was observed for less than 1% of all participants. TDI exceedances were only present in the sampling year 2001 and not in more recent sampling years while exceedance of the HBM guidance value was also observed in 2011 and 2021.

Toxicity Weighting for Human Biomonitoring Mixture Risk Assessment: A Proof of Concept

Chemical mixture risk assessment has, in the past, primarily focused on exposures quantified in the external environment. Assessing health risks using human biomonitoring (HBM) data provides information on the internal concentration, from which a dose can be derived, of chemicals to which human populations are exposed. This study describes a proof of concept for conducting mixture risk assessment with HBM data, using the population-representative German Environmental Survey (GerES) V as a case study. We first attempted to identify groups of correlated biomarkers (also known as 'communities', reflecting co-occurrence patterns of chemicals) using a network analysis approach (n = 515 individuals) on 51 chemical substances in urine. The underlying question is whether the combined body burden of multiple chemicals is of potential health concern. If so, subsequent questions are which chemicals and which co-occurrence patterns are driving the potential health risks. To address this, a biomonitoring hazard index was developed by summing over hazard quotients, where each biomarker concentration was weighted (divided) by the associated HBM health-based guidance value (HBM-HBGV, HBM value or equivalent). Altogether, for 17 out of the 51 substances, health-based guidance values were available. If the hazard index was higher than 1, then the community was considered of potential health concern and should be evaluated further. Overall, seven communities were identified in the GerES V data. Of the five mixture communities where a hazard index was calculated, the highest hazard community contained N-Acetyl-S-(2-carbamoyl-ethyl)cysteine (AAMA), but this was the only biomarker for which a guidance value was available. Of the other four communities, one included the phthalate metabolites mono-isobutyl phthalate (MiBP) and mono-n-butyl phthalate (MnBP) with high hazard quotients, which led to hazard indices that exceed the value of one in 5.8% of the participants included in the GerES V study. This biological index method can put forward communities of co-occurrence patterns of chemicals on a population level that need further assessment in toxicology or health effects studies. Future mixture risk assessment using HBM data will benefit from additional HBM health-based guidance values based on population studies. Additionally, accounting for different biomonitoring matrices would provide a wider range of exposures. Future hazard index analyses could also take a common mode of action approach, rather than the more agnostic and non-specific approach we have taken in this proof of concept.

Priorities and Challenges in Methodology for Human Health Risk Assessment from Combined Exposure to Multiple Chemicals

This paper reviews key elements in the assessment of human health effects from combined exposure to multiple chemicals taking into consideration current knowledge and challenges to identify areas where scientific advancement is mostly needed and proposes a decision-making scheme on the basis of existing methods and tools. The assumption of dose addition and estimation of the hazard index (HI) is considered as a starting point in component-based risk assessments. When, based on the generic HI approach, an unacceptable risk is identified, more specific risk assessment options may be implemented sequentially or in parallel depending on problem formulation, characteristics of the chemical group under assessment, exposure levels, data availability and resources. For prospective risk assessments, the reference point index/margin of exposure (RPI/MOET) (Option 1) or modified RPI/normalized MOET (mRPI/nMOET) (Option 2) approaches may be implemented focusing on the specific mixture effect. Relative potency factors (RPFs) may also be used in the RPI approach since a common uncertainty factor for each mixture component is introduced in the assessment. Increased specificity in the risk assessment may also be achieved when exposure of selected population groups is considered (Option 3/exposure). For retrospective risk assessments, human biomonitoring data available for vulnerable population groups (Option 3/susceptibility) may present more focused scenarios for consideration in human health risk management decisions. In data-poor situations, the option of using the mixture assessment factor (MAF) is proposed (Option 4), where an additional uncertainty factor is applied on each mixture component prior to estimating the HI. The magnitude of the MAF may be determined by the number of mixture components, their individual potencies and their proportions in the mixture, as previously reported. It is acknowledged that implementation of currently available methods and tools for human health risk assessment from combined exposure to multiple chemicals by risk assessors will be enhanced by ongoing scientific developments on new approach methodologies (NAMs), integrated approaches to testing and assessment (IATA), uncertainty analysis tools, data sharing platforms, risk assessment software as well as guideline development to meet legislative requirements.