Approaches for describing and communicating overall uncertainty in toxicity characterizations: U.S. Environmental Protection Agency's Integrated Risk Information System (IRIS) as a case study

Variability of groundwater fluoride and its proportionate risk quantification via Monte Carlo simulation in rural and urban areas of Agra district, India

This study quantifies the groundwater fluoride contamination and assesses associated health risks in fluoride-prone areas of the city of Taj Mahal, Agra, India. The United States Environmental Protection Agency (USEPA) risk model and Monte Carlo Simulations were employed for the assessment. Result revealed that, among various rural and urban areas Pachgain Kheda exhibited the highest average fluoride concentration (5.20 mg/L), while Bagda showed the lowest (0.33 mg/L). Similarly, K.K. Nagar recorded 4.38 mg/L, and Dayalbagh had 1.35 mg/L. Both urban and rural areas exceeded the WHO-recommended limit of 1.5 mg/L, signifying significant public health implications. Health risk assessment indicated a notably elevated probability of non-carcinogenic risk from oral groundwater fluoride exposure in the rural Baroli Ahir block. Risk simulations highlighted that children faced the highest health risks, followed by teenagers and adults. Further, Monte Carlo simulation addressed uncertainties, emphasizing escalated risks for for children and teenagers. The Hazard Quotient (HQ) values for the 5th and 95th percentile in rural areas ranged from was 0.28-5.58 for children, 0.15-2.58 for teenager, and 0.05-0.58 for adults. In urban areas, from the range was 0.53 to 5.26 for children, 0.27 to 2.41 for teenagers, and 0.1 to 0.53 for adults. Physiological and exposure variations rendered children and teenagers more susceptible. According to the mathematical model, calculations for the non-cancerous risk of drinking water (HQ-ing), the most significant parameters in all the targeted groups of rural areas were concentration (CW) and Ingestion rate (IR). These findings hold relevance for policymakers and regulatory boards in understanding the actual impact and setting pre-remediation goals.

Practical Opportunities to Improve the Impact of Health Risk Assessment on Environmental and Public Health Decisions

Following alerts about the diminishing role of health risk assessment (HRA) in informing public health decisions, this study examines specific HRA topics with the aim of identifying possible solutions for addressing this compelling situation. The study administered a survey among different groups of stakeholders involved in HRA or decision-making, or both. The responses show various understandings of HRA in the decision-making context-including confusion with the health impact assessment (HIA)-and confirm recurring foundational issues within the risk analysis field that contribute to the growth of inconsistency in the HRA praxis. This inconsistency lowers the effectiveness of HRA to perform its primary purpose of informing public health decisions. Opportunities for improving this situation come at the beginning of the assessment process, where greater attention should be given to defining the assessment and decision-making contexts. Both must reflect the concerns and expectations of the stakeholders regarding the needs and purpose of an HRA on one side, and the methodological and procedural topics relevant for the decision case at hand on the other. The HRA process should end with a decision follow-up step with targeted auditing and the participation of stakeholders to measure its success.

Health risk assessment with multiple reference indices

BACKGROUND

Conducting a risk assessment can be challenging, especially when dealing with several reference indices, which could lead to conflicting conclusions between studies. The common approach is to use a reference index from a single source based on the risk assessor's preference.

OBJECTIVES

To propose an approach for constructing a multi-reference index-based aggregated risk estimate using mathematical objectivity to reflect all of the available information.

METHODS

The aggregated risk estimate based on multiple reference indices (AREMRI) results from the weighted linear combination of risk distributions that were obtained with each reference index available. The weights were calculated using the degree of agreement among the reference index-based risk distributions. The approach is illustrated through three practical cases of benzene inhalation cancer risk assessment using inhalation unit risks (IURs) from six different regulatory agencies.

RESULTS

The degrees of agreement between the reference index-based risk distribution, obtained with the six IURs, ranged from 0.7 to 92%. The highest weights were attributed to reference index-based risk distributions that had the highest degree of agreement with the maximum number of other reference index-based risk distributions. Regardless of the practical case considered, the AREMRI risk distribution resulted in the third highest risk compared to the six single risk distributions.

CONCLUSION

Our approach can be useful in the presence of several reference indices by providing useful insights, consistency and direct comparisons between studies to support better-informed risk assessment and management decisions. This approach can shed some light on some of the uncertainties associated with the toxicological reference values in a risk assessment associated with the toxicological reference values. If the uncertainty is large, more detailed evaluation of the toxicological reference values would be needed.

Improving Health Risk Assessment as a Basis for Public Health Decisions in the 21st Century

One-fifth of the way through the 21st century, a commonality of factors with those of the last 50 years may offer the opportunity to address unfinished business and current challenges. The recommendations include: (1) Resisting the tendency to oversimplify scientific assessments by reliance on single disciplines in lieu of clear weight-of-evidence expressions, and on single quantitative point estimates of health protective values for policy decisions; (2) Improving the separation of science and judgment in risk assessment through the use of clear expressions of the range of judgments that bracket protective quantitative levels for public health protection; (3) Use of comparative risk to achieve the greatest gains in health and the environment; and (4) Where applicable, reversal of the risk assessment and risk management steps to facilitate timely and substantive improvements in public health and the environment. Lessons learned and improvements in the risk assessment process are applied to the unprecedented challenges of the 21st century such as, pandemics and climate change. The beneficial application of the risk assessment and risk management paradigm to ensure timely research with consistency and transparency of assessments is presented. Institutions with mandated stability and leadership roles at the national and international levels are essential to ensure timely interdisciplinary scientific assessment at the interface with public policy as a basis for organized policy decisions, to meet time sensitive goals, and to inform the public.

The Evolving Field of Risk Communication

The 40th Anniversary of the Society for Risk Analysis presents an apt time to step back and review the field of risk communication. In this review, we first evaluate recent debates over the field's current state and future directions. Our takeaway is that efforts to settle on a single, generic version of what constitutes risk communication will be less productive than an open-minded exploration of the multiple forms that comprise today's vibrant interdisciplinary field. We then review a selection of prominent cognitive, cultural, and social risk communication scholarship appearing in the published literature since 2010. Studies on trust in risk communication messengers continued to figure prominently, while new research directions emerged on the opportunities and critical challenges of enhancing transparency and using social media. Research on message attributes explored how conceptual insights particularly relating to framing, affective and emotional responses, and uncertainty might be operationalized to improve message effectiveness. Studies consistently demonstrated the importance of evaluation and how varying single attributes alone is unlikely to achieve desired results. Research on risk communication audiences advanced on risk perception and multiway engagement with notable interest in personal factors such as gender, race, age, and political orientation. We conclude by arguing that the field's interdisciplinary tradition should be further nurtured to drive the next evolutionary phase of risk communication research.

Facilitation of risk assessment with evidence-based methods - A framework for use of systematic mapping and systematic reviews in determining hazard, developing toxicity values, and characterizing uncertainty

Systematic review tools and approaches developed for clinical medicine are often difficult to apply "off the shelf" in order to meet the needs of chemical risk assessments. To address such, we propose an approach that can be used by practitioners for using evidence-based methods to facilitate the risk assessment process. The framework builds on and combines efforts conducted to date by a number of agencies and researchers; the novelty is in combining these efforts with a practical understanding of risk assessment, and translating such into a 'step-by-step' guide. The approach relies on three key components: problem formulation, systematic evidence mapping, and systematic review, applied using a stepwise approach. Unique to this framework is the consideration of exposure in selecting, prioritizing, and evaluating data (e.g., dose-relevance, routes of exposure, etc.). Using the proposed step-by-step process, critical appraisal of individual studies (e.g., formal and structured assessment of both relevance and reliability) and integration efforts are considered in context of specified risk assessment objectives (e.g., mode of action, dose-response) as well as chemical-specific considerations. The resulting framework provides a logical approach of how evidence-based methods can be used to facilitate risk assessment, and elevates the use of systematic methods beyond hazard identification to directly facilitating transparent and objective selection of candidate studies and/or datasets used to quantitatively characterize risk, and to better use the underlying process to inform the approaches used to develop toxicity values.

Quantifying Uncertainty in Ecotoxicological Risk Assessment: MUST, a Modular Uncertainty Scoring Tool

Whether conducting a risk, hazard, or alternatives assessment, one invariably struggles with the task of reconciling multiple available values of toxicological thresholds into a single outcome. When combining multiple pieces of evidence from many different sources, it is important to consider the role of data uncertainty. Uncertainty is inherent to all scientific data. However, in toxicological assessments, controversies and uncertainties are typically understated; they lack methodological transparency; or they poorly integrate qualitative and quantitative sources of information. Similarly, in model development, data curation is rarely performed with sufficient rigor, particularly when applying big data statistics. To overcome the hurdles of a decision process that must reconcile divergent data, we developed an uncertainty scoring tool that can be trained to reproduce specific decision-making paradigms and ensure consistency in the practitioner's judgment across complex scenarios. While designed to aid with ecotoxicological assessments and predictive model development, the tool's applicability extends to any decision-making process that calls for synthesis of incongruent data. Here, we highlight the development process, as well as demonstrate the method's utility in several prototypical ecotoxicological case studies.

Conceptualising, evaluating and communicating uncertainty in forensic science: Identifying commonly used tools through an interdisciplinary configurative review

This study provides a set of tools for conceptualising, evaluating and communicating uncertainty in forensic science. Given that the concept of uncertainty is one that transcends disciplinary boundaries, an interdisciplinary configurative review was carried out incorporating the disciplines of medicine, environmental science and economics, in order to identify common themes which could have valuable applications to the discipline of forensic science. Critical Interpretive Synthesis was used to develop sub-synthetic and synthetic constructs which interpreted and synthesised the underlying evidence and codes. This study provides three toolkits, one each for conceptualisation, evaluation and communication. The study identified an underlying theme concerning the obstacles that would need to be overcome for the effective application of these toolkits and achieving effective conceptualisation, evaluation and communication of uncertainty in forensic science to lay-stakeholders. These toolkits offer a starting point for developing the conversation for achieving greater transparency in the communication of uncertainty. They also have the potential to offer stakeholders enhanced understanding of the nuances and limitations of forensic science evidence and enable more transparent evaluation and scrutiny of the reliability, relevance and probative value of forensic materials in a crime reconstruction.

Radiation risks and uncertainties: a scoping review to support communication and informed decision-making

Although radiation protection is challenged by many uncertainties, there is no systematic study investigating the definitions and types of these uncertainties. To address this gap, in this paper we offer a scoping review to comprehensively analyse, for the first time, peer-reviewed scientific articles (n = 33) related to uncertainties in the following radiation exposure situations: nuclear emergencies, decommissioning of nuclear/radiological installations and long-term radiological exposure situations (e.g. naturally occurring radioactive materials). The results suggest that firstly, there is no agreement regarding definitions of uncertainty, which is mainly defined based on its sources, types or categories rather than by its meaning. Secondly, different actors are faced with different types of uncertainties. Uncertainties of the scientific community are mostly data and methodology-driven (e.g. dose-response relationships), those of the decision-makers are related to the likely consequences of decision options and public reactions, while laypeople's uncertainties are mainly related to the trustworthiness of experts or the emotional potential of specific risk exposures. Furthermore, the majority of articles focus on the uncertainties of the scientific community, while those of the information receivers (i.e. decision-makers and laypeople) receive much less consideration. Finally, there was no difference in types of uncertainties across the different risk-related study areas analysed (radiation versus other risks). Based on these findings, we provide some preliminary recommendations regarding research on uncertainty related to radiation protection, as well as communication practices.

Exposure of adult mice to perfluorobutanesulfonate impacts ovarian functions through hypothyroxinemia leading to down-regulation of Akt-mTOR signaling

Perfluorobutanesulfonate (PFBS), a short-chain perfluoroalkyl substance, is used in many industrial products. Preliminary evidence suggests that exposure to PFBS may increase the risk of infertility. The aim of this study was to investigate the influence of PFBS on ovarian function. Herein, we show that exposure of adult female mice to PFBS (200 mg/kg/day) (PFBS-mice) caused a decrease in the levels of serum total triiodothyronine and thyroxine, which depended on the activation of peroxisome proliferator-activated receptor α (PPARα). The numbers of secondary, early antral and antral follicles were reduced in PFBS-mice with an increase in the atretic follicles, and these changes were recovered by the replacement of L-thyroxinein or the treatment with PPARα antagonist GW6471. PFBS-induced hypothyroxinemia led to a decrease in the levels of Akt, mTOR and p70S6K phosphorylation in ovarian granular cells and cumulus cells, which suppressed the proliferation of these cells and enhanced autophagic death of granular cells and cumulus cells. The levels of serum estradiol and progesterone were reduced in PFBS-mice with a low expression of the steroidogenic genes Star and P450scc in ovarian tissues, which were sensitive to the replacement of L-thyroxinein or the blockade of PPARα. The results indicate that exposure to PFBS (≥200 mg/kg/day) through reducing thyroid hormones causes down-regulation of Akt-mTOR signaling in granular cells and cumulus cells, leading to the deficits in the development of follicles and the biosynthesis of ovarian hormones.

Application of qualitative and quantitative uncertainty assessment tools in developing ranges of plausible toxicity values for 2,3,7,8-tetrachlorodibenzo-p-dioxin

Increasing interest in characterizing risk assessment uncertainty is highlighted by recent recommendations from the National Academy of Sciences. In this paper we demonstrate the utility of applying qualitative and quantitative methods for assessing uncertainty to enhance risk-based decision-making for 2,3,7,8-tetrachlorodibenzo-p-dioxin. The approach involved deconstructing the reference dose (RfD) via evaluation of the different assumptions, options, models and methods associated with derivation of the value, culminating in the development of a plausible range of potential values based on such areas of uncertainty. The results demonstrate that overall RfD uncertainty was high based on limitations in the process for selection (e.g., compliance with inclusion criteria related to internal validity of the co-critical studies, consistency with other studies), external validity (e.g., generalizing findings of acute, high-dose exposure scenarios to the general population), and selection and classification of the point of departure using data from the individual studies (e.g., lack of statistical and clinical significance). Building on sensitivity analyses conducted by the US Environmental Protection Agency in 2012, the resulting estimates of RfD values that account for the uncertainties ranged from ~1.5 to 179 pg/kg/day. It is anticipated that the range of RfDs presented herein, along with the characterization of uncertainties, will improve risk assessments of dioxins and provide important information to risk managers, because reliance on a single toxicity value limits the information needed for making decisions and gives a false sense of precision and accuracy.

Recommendations to address uncertainties in environmental risk assessment using toxicokinetic-toxicodynamic models

Providing reliable environmental quality standards (EQSs) is a challenging issue in environmental risk assessment (ERA). These EQSs are derived from toxicity endpoints estimated from dose-response models to identify and characterize the environmental hazard of chemical compounds released by human activities. These toxicity endpoints include the classical x% effect/lethal concentrations at a specific time t (EC/LC(x, t)) and the new multiplication factors applied to environmental exposure profiles leading to x% effect reduction at a specific time t (MF(x, t), or denoted LP(x, t) by the EFSA). However, classical dose-response models used to estimate toxicity endpoints have some weaknesses, such as their dependency on observation time points, which are likely to differ between species (e.g., experiment duration). Furthermore, real-world exposure profiles are rarely constant over time, which makes the use of classical dose-response models difficult and may prevent the derivation of MF(x, t). When dealing with survival or immobility toxicity test data, these issues can be overcome with the use of the general unified threshold model of survival (GUTS), a toxicokinetic-toxicodynamic (TKTD) model that provides an explicit framework to analyse both time- and concentration-dependent data sets as well as obtain a mechanistic derivation of EC/LC(x, t) and MF(x, t) regardless of x and at any time t of interest. In ERA, the assessment of a risk is inherently built upon probability distributions, such that the next critical step is to characterize the uncertainties of toxicity endpoints and, consequently, those of EQSs. With this perspective, we investigated the use of a Bayesian framework to obtain the uncertainties from the calibration process and to propagate them to model predictions, including LC(x, t) and MF(x, t) derivations. We also explored the mathematical properties of LC(x, t) and MF(x, t) as well as the impact of different experimental designs to provide some recommendations for a robust derivation of toxicity endpoints leading to reliable EQSs: avoid computing LC(x, t) and MF(x, t) for extreme x values (0 or 100%), where uncertainty is maximal; compute MF(x, t) after a long period of time to take depuration time into account and test survival under pulses with different periods of time between them.

Assessment of some heavy metal accumulation and nutritional quality of shellfish with reference to human health and cancer risk assessment: a seafood safety approach

This study was conducted to assess the proximate analysis (protein, carbohydrate, lipid, and moisture content) and concentration levels of metals (Zn, Cu, Cd, Pb, and Cr) in the muscles of selected shellfish (Portunus reticulatus, P. segnis, P. sanguinolentus, Scylla olivaceae, Penaeus monodon, and P. indicus) species. The concentration of metals showed significant difference (p > 0.05) among species. The detected concentrations of the analyzed heavy metals were below the daily intake and legal limits set by national and international standards. The THQs and CR index were calculated to evaluate the risk estimation of the metal contamination associated with the human health. The THQ values of all metals were below 1 in all species, indicated that there is no risk of adverse health effect, but the risk of elevated intakes of heavy metals adversely affecting food safety for the studied species. The CR index indicated that Cd and Pb caused the greatest cancer risk. The correlation and multivariate (principle component analysis) among metal concentration and nutritional quality were also evaluated. The carbohydrate and moisture showed the positive correlation (p > 0.05) with metals. The biochemical results of the present work clearly indicate that there was a significant difference in the muscles of shellfish. It was concluded that more effective controls should be focused on Cd and Pb to reduce pollution for quality and seafood safety concern.

Guidance on Communication of Uncertainty in Scientific Assessments

This document provides guidance for communicators on how to communicate the various expressions of uncertainty described in EFSA's document: 'Guidance on uncertainty analysis in scientific assessments'. It also contains specific guidance for assessors on how best to report the various expressions of uncertainty. The document provides a template for identifying expressions of uncertainty in scientific assessments and locating the specific guidance for each expression. The guidance is structured according to EFSA's three broadly defined categories of target audience: 'entry', 'informed' and 'technical' levels. Communicators should use the guidance for entry and informed audiences, while assessors should use the guidance for the technical level. The guidance was formulated using evidence from the scientific literature, grey literature and two EFSA research studies, or based on judgement and reasoning where evidence was incomplete or missing. The limitations of the evidence sources inform the recommendations for further research on uncertainty communication.

Probabilistic approach for assessing infants' health risks due to ingestion of nanoscale silver released from consumer products

Silver nanoparticles (n-Ag) are widely used in consumer products and many medical applications because of their unique antibacterial properties. Their use is raising concern about potential human exposures and health effects. Therefore, it is informative to assess the potential human health risks of n-Ag in order to ensure that nanotechnology-based consumer products are deployed in a safe and sustainable way. Even though toxicity studies clearly show the potential hazard of n-Ag, there have been few attempts to integrate hazard and exposure assessments to evaluate risks. The underlying reason for this is the difficulty in characterizing exposure and the lack of toxicity studies essential for human health risk assessment (HHRA). Such data gaps introduce significant uncertainty into the risk assessment process. This study uses probabilistic methods to assess the relative uncertainty and potential risks of n-Ag exposure to infants. In this paper, we estimate the risks for infants potentially exposed to n-Ag through drinking juice or milk from sippy cups or licking baby blankets containing n-Ag. We explicitly evaluate uncertainty and variability contained in available dose-response and exposure data in order to make the risk characterization process transparent. Our results showed that individual margin of exposures for oral exposure to sippy cups and baby blankets containing n-Ag exhibited minimal risk.