Gold Lois Swirsky, Gaylor David W, Slone Thomas H
Lawrence Berkeley National Laboratory, One Cyclotron Rd, Berkeley, CA 94720, USA.
Regul Toxicol Pharmacol. 2003 Feb;37(1):45-53. doi: 10.1016/s0273-2300(02)00026-0.
The EPA guidelines recommend a benchmark dose as a point of departure (PoD) for low-dose cancer risk assessment. Generally the PoD is the lower 95% confidence limit on the dose estimated to produce an extra lifetime cancer risk of 10% (LTD(10)). Due to the relatively narrow range of doses in two-year bioassays and the limited range of statistically significant tumor incidence rates, the estimate of the LTD(10) is constrained to a relatively narrow range of values. Because of this constraint, simple, quick estimates of the LTD(10) can be readily obtained for hundreds of rodent carcinogens from the Carcinogenic Potency Database (CPDB) of Gold et al. Three estimation procedures for LTD(10) are described, using increasing information from the CPDB: (A) based on only the maximum tolerated dose (the highest dose tested); (B) based on the TD(50); and (C) based on the TD(50) and its lower 99% confidence limit. As expected, results indicate overall similarity of the LTD(10) estimates and the value of using additional information. For Method (C) the estimator based on the [[(TD(50))(0.36) x (LoConf)(0.64)]/6.6] is generally similar to the estimator based on the one-hit model or multistage model LTD(10). This simple estimate of the LTD(10) is applicable for both linear and curved dose responses with high or low background tumor rates, and whether the confidence limits on the TD(50) are wide or tight. The EPA guidelines provide for a margin of exposure approach if data are sufficient to support a nonlinear dose-response. The reference dose for cancer for a nonlinear dose-response curve based on a 10,000-fold uncertainty (safety) factor from the LTD(10), i.e., the LTD(10)/10,000, is mathematically equivalent to the value for a linear extrapolation from the LTD(10) to the dose corresponding to a cancer risk of <10(-5) (LTD(10)/10,000). The cancer risk at <10(-5) obtained by using the q(1)(*) from the multistage model, is similar to LTD(10)/10,000. For a nonlinear case, an uncertainty factor of less than 10,000 is likely to be used, which would result in a higher (less stringent) acceptable exposure level.
美国环境保护局(EPA)的指南推荐使用基准剂量作为低剂量癌症风险评估的出发点(PoD)。一般来说,基准剂量是估计产生10%额外终生癌症风险(LTD(10))的剂量的较低95%置信限。由于两年生物测定中的剂量范围相对较窄,且具有统计学意义的肿瘤发生率范围有限,LTD(10)的估计被限制在相对较窄的值范围内。由于这一限制,可以很容易地从Gold等人的致癌效力数据库(CPDB)中为数百种啮齿动物致癌物快速获得LTD(10)的简单估计值。本文描述了三种LTD(10)的估计程序,使用来自CPDB的越来越多的信息:(A)仅基于最大耐受剂量(测试的最高剂量);(B)基于半数致死剂量(TD(50));(C)基于TD(50)及其较低99%置信限。正如预期的那样,结果表明LTD(10)估计值总体相似,且使用额外信息的价值也相似。对于方法(C),基于[[(TD(50))(0.36)×(LoConf)(0.64)]/6.6]的估计器通常与基于单 hit 模型或多阶段模型LTD(10)的估计器相似。这种LTD(10)的简单估计适用于具有高或低背景肿瘤率的线性和曲线剂量反应,以及TD(50)的置信限是宽还是窄的情况。如果数据足以支持非线性剂量反应,EPA指南提供了暴露边际方法。基于来自LTD(10)的10000倍不确定性(安全)因子的非线性剂量反应曲线的癌症参考剂量,即LTD(10)/10000,在数学上等同于从LTD(10)线性外推到对应癌症风险<10(-5)的剂量的值(LTD(10)/10000)。使用多阶段模型的q(1)(*)获得的<10(-5)的癌症风险与LTD(10)/10000相似。对于非线性情况,可能会使用小于10000 的不确定性因子,这将导致更高(更宽松)的可接受暴露水平。