Comparing alternative approaches to establishing regulatory levels for reproductive toxicants: DBCP as a case study

Environmental toxins; their impact on children's health

Contamination of the environment by man-made and natural toxins has a direct impact on the health of children. This review considers how toxic contamination is identified and regulated, and highlights specific hazards.

Mathematical modelling and quantitative methods

The present review reports on the mathematical methods and statistical techniques presently available for hazard characterisation. The state of the art of mathematical modelling and quantitative methods used currently for regulatory decision-making in Europe and additional potential methods for risk assessment of chemicals in food and diet are described. Existing practices of JECFA, FDA, EPA, etc., are examined for their similarities and differences. A framework is established for the development of new and improved quantitative methodologies. Areas for refinement, improvement and increase of efficiency of each method are identified in a gap analysis. Based on this critical evaluation, needs for future research are defined. It is concluded from our work that mathematical modelling of the dose-response relationship would improve the risk assessment process. An adequate characterisation of the dose-response relationship by mathematical modelling clearly requires the use of a sufficient number of dose groups to achieve a range of different response levels. This need not necessarily lead to an increase in the total number of animals in the study if an appropriate design is used. Chemical-specific data relating to the mode or mechanism of action and/or the toxicokinetics of the chemical should be used for dose-response characterisation whenever possible. It is concluded that a single method of hazard characterisation would not be suitable for all kinds of risk assessments, and that a range of different approaches is necessary so that the method used is the most appropriate for the data available and for the risk characterisation issue. Future refinements to dose-response characterisation should incorporate more clearly the extent of uncertainty and variability in the resulting output.

Critical effect sizes in toxicological risk assessment: a comprehensive and critical evaluation

A key issue in toxicological risk assessment is determining the effect level below which there is no reason for concern. In the Benchmark approach, this breaking point between adverse and non-adverse is called the critical effect size (CES). This study aimed to investigate the possibilities to determine CESs for toxicological effect parameters commonly used in human risk assessment and includes a literature review and an opinion analysis among European toxicologists. The results indicate that the current knowledge is insufficient to define CESs for all individual parameters. Furthermore, the use of a single universal CES seems no option. It is concluded that it is not yet possible to reach international consensus on CESs for most toxicological parameters. However, every parameter for which consensus on the CES is reached is a step forward, because this can facilitate discussions on the adversity and relevance of certain changes in that parameter, irrespective of the method applied in risk assessment.

Modeling adverse environmental impacts on the reproductive system

When priority topics are being established for the study of women's health, it is generally agreed that one important area on which to focus research is reproduction. For example, increasing attention has been directed to environmental exposures that disrupt the endocrine system and alter reproduction. These concerns also suggest the need to give greater attention to the use of animal toxicologic testing to draw inferences about human reproductive risks. Successful reproduction requires multiple simultaneous and sequential processes in both the male and female, and the effect of toxicity on reproduction-related processes is time dependent. Currently, however, the risk assessment approach does not allow for the use of multiple processes or for considering the reproductive process response as a function of time. We discuss several issues in modeling exposure effects on reproductive function for risk assessment and present an overview of approaches for reproductive risk assessment. Recommendations are provided for an effective animal study design for determining reproductive risk that addresses optimization of the duration of dosing, observation of the effects of exposure on validated biomarkers, analysis of several biomarkers for complete characterization of the exposure on the underlying biologic processes, the need for longitudinally observed exposure effects, and a procedure for estimating human reproductive risk from the animal findings. An approach to characterizing reproductive toxicity to estimate the increased fertility risks in a dibromochloropropane (DBCP)-exposed human population is illustrated, using several reproductive biomarkers simultaneously from a longitudinal rabbit inhalation study of DBCP and an interspecies extrapolation method.

Calculation of benchmark doses for reproductive and developmental toxicity observed after exposure to isopropanol

Reproductive, including developmental, toxicity risk assessment has typically relied on estimation of toxicity criteria values derived from no-observed-adverse-effect levels (NOAELs). The benchmark dose (BMD) approach has been proposed as an alternative that avoids problems with NOAELs. In this analysis of the reproductive and developmental toxicity observed in a multigeneration study of rats exposed to isopropanol, the BMD approach has been applied to all effects exhibiting significant dose-response relationships. The BMD estimates were very consistent across models and across end points; they were within the range of doses (100 to 500 mg/kg/day) that has been suggested as being the NOAEL. The use of the BMD approach for analysis of isopropanol reproductive toxicity is shown to avoid the experiment-specific argument of whether a particular treatment has induced statistically significant differences, compared to controls, in favor of the estimation of experiment-independent doses corresponding to risk levels of interest. The consistency of the BMD estimates, with values of about 420 mg/kg/day, suggests that, for isopropanol, the available multigeneration study data may provide a suitable basis for considering safe exposure.

Characterizing dose-response: I: Critical assessment of the benchmark dose concept

We present a critical assessment of the benchmark dose (BMD) method introduced by Crump as an alternative method for setting a characteristic dose level for toxicant risk assessment. The no-observed-adverse-effect-level (NOAEL) method has been criticized because it does not use all of the data and because the characteristic dose level obtained depends on the dose levels and the statistical precision (sample sizes) of the study design. Defining the BMD in terms of a confidence bound on a point estimate results in a characteristic dose that also varies with the statistical precision and still depends on the study dose levels. Indiscriminate choice of benchmark response level may result in a BMD that reflects little about the dose-response behavior available from using all of the data. Another concern is that the definition of the BMD for the quantal response case is different for the continuous response case. Specifically, defining the BMD for continuous data using a ratio of increased effect divided by the background response results in an arbitrary dependence on the natural background for the endpoint being studied, making comparison among endpoints less meaningful and standards more arbitrary. We define a modified benchmark dose as a point estimate using the ratio of increased effect divided by the full adverse response range which enables consistent placement of the benchmark response level and provides a BMD with a more consistent relationship to the dose-response curve shape.

Comparison of noncancer risk assessment approaches for use in deriving drinking water criteria

The development and promulgation of drinking water regulations to protect exposed human populations from contaminants that may occur in public drinking water supplies has been a major regulatory concern and effort of the United States Environmental Protection Agency for decades. Risk assessment, as applied in the development of drinking water regulations, involves the quantification of the level below which adverse health effects are not expected to occur. Traditionally, the oral reference dose (RfD) has been the preferred approach for characterizing these noncancer health risks. The benchmark dose approach to derive RfDs has increasingly gained scientific and regulatory acceptance as a risk assessment methodology since its introduction in 1984. Similarly, the use of categorical regression techniques were introduced at about the same time. The objective of this paper is to present an evaluation of the strengths and weaknesses of each risk assessment method as related to the development of drinking water criteria for noncarcinogenic chemicals. The data base requirements, performance record, mathematical or statistical basis, and other parameters are described and compared.

Toxicology of male reproduction in animals and humans

Environmental contaminants can interfere with the male reproduction function. A review is presented of those pollutants with adverse effects on human reproduction. The possible effects of occupational and environmental exposure to various substances on male reproductive health are evaluated. This analysis considers studies showing damage of men exposed to halogenated hydrocarbons, other organic compounds, heavy metals and some physical agents, and some lifestyles, such as continuous stress, alcohol consumption, cigarette and marijuana smoking, and other addictions. Possible influences of these agents on the neuroendocrine system with the decrease of male fertility during the last decades are also discussed.

In Vitro Toxicology Methods in Risk Assessment

The title of this paper is challenging, because the question of how in vitro methods and results contribute to human health risk assessment is rarely considered. The process of risk assessment usually begins with hazard assessment, which provides a description of the inherent toxicological properties of the chemical. The next step is to assess the relevance of this to humans, i.e. the human hazard assessment. Finally, information on exposure is examined, and risk can then be assessed.

In vitro methods have a limited, but important, role to play in risk assessment. The results can be used for classification and labelling; these are methods of controlling exposure, analogous to risk assessment, but without considering exposure. The Ames Salmonella test is the only in vitro method which is incorporated into regulations and used widely. Data from this test can, at best, lead to classification of a chemical with regard to genotoxicity, but cannot be used for classification and labelling on their own. Several in vitro test systems which assess the topical irritancy and corrosivity of chemicals have been reasonably well validated, and the results from these tests can be used for classification.

The future development of in vitro methods is likely to be slow, as it depends on the development of new concepts and ideas. The in vivo methods which currently have reasonably developed in vitro alternatives will be the easiest to replace. The remaining in vivo methods, which provide toxicological information from repeated chronic dosing, with varied endpoints and by mechanisms which are not understood, will be more difficult to replace.

Workshop on perinatal exposure to dioxin-like compounds. VI. Role of biomarkers

Studies of perinatal exposures to dioxin-like compounds (DLCs), coplanar polycyclic halogenated aromatics whose prototype is 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), have employed a variety of outcome measures to investigate effects on the reproductive/developmental, endocrine, immune, and neurobehavioral systems. The effects include infertility, growth retardation, fetal loss, changed sexual differentiation, reduced cognitive/motor function, dermatologic and other ectodermal effects, and decreased immune response. Significant biomarkers have included sperm count; CD4/CD8 ratio; and levels of testosterone, T4, and dopamine. Using specific dioxin or PCB congeners, these and other markers were used to investigate the mechanisms of the observed effects. The DLCs, which include some PCB congeners, are characterized by high-affinity binding to the Ah receptor; most biological effects are thought to be mediated by the ligand-Ah receptor complex. Other PCB congeners have low affinity for the Ah receptor, and operate by non-Ah receptor mechanisms. The biologic activity of a PCB mixture is the sum of the agonist and antagonist activities of the different constituents in the mixture. Animal studies with specific PCB congeners can help to clarify these activities. With similar approaches, biologic markers of effect can be developed and applied in epidemiologic studies to monitor for, and predict, adverse effects in humans.

Sites of female reproductive vulnerability: implications for testing and risk assessment

All reproductive toxicity testing, whether in vivo or in vitro, should be conducted with consideration of the ultimate use of the data for reproductive risk assessment and the protection of human reproductive health. In this review selected sites of vulnerability in the female reproductive system are identified. These sites of female reproductive vulnerability may be utilized for in vitro toxicity testing assays, and the data from assays may be employed in the hazard identification and hazard characterization steps necessary for reproductive risk assessment. Using biomarkers of female reproductive function derived from in vitro toxicity testing it is possible to define functions that characterize female fecundity. These characterizations of female fecundity may be used to quantitate reproductive risk in human populations.