Sand Salomon, Victorin Katarina, Filipsson Agneta Falk
Institute of Environmental Medicine, Karolinska Institutet, PO Box 210, SE-17177 Stockholm, Sweden.
J Appl Toxicol. 2008 May;28(4):405-21. doi: 10.1002/jat.1298.
This review deals with the current state of knowledge on the use of the benchmark dose (BMD) concept in health risk assessment of chemicals. The BMD method is an alternative to the traditional no-observed-adverse-effect level (NOAEL) and has been presented as a methodological improvement in the field of risk assessment. The BMD method has mostly been employed in the USA but is presently given higher attention also in Europe. The review presents a number of arguments in favor of the BMD, relative to the NOAEL. In addition, it gives a detailed overview of the several procedures that have been suggested and applied for BMD analysis, for quantal as well as continuous data. For quantal data the BMD is generally defined as corresponding to an additional or extra risk of 5% or 10%. For continuous endpoints it is suggested that the BMD is defined as corresponding to a percentage change in response relative to background or relative to the dynamic range of response. Under such definitions, a 5% or 10% change can be considered as default. Besides how to define the BMD and its lower bound, the BMDL, the question of how to select the dose-response model to be used in the BMD and BMDL determination is highlighted. Issues of study design and comparison of dose-response curves and BMDs are also covered.
本综述探讨了基准剂量(BMD)概念在化学物质健康风险评估中的应用现状。BMD方法是传统未观察到有害作用水平(NOAEL)的替代方法,被视为风险评估领域的一项方法学改进。BMD方法主要在美国使用,但目前在欧洲也受到了更多关注。本综述提出了一些相对于NOAEL而言支持BMD的论据。此外,它详细概述了已提出并应用于BMD分析的几种程序,包括用于定量数据和连续数据的程序。对于定量数据,BMD通常定义为对应于5%或10%的额外风险。对于连续终点,建议将BMD定义为相对于背景或相对于反应动态范围的反应变化百分比。在这些定义下,默认可考虑5%或10%的变化。除了如何定义BMD及其下限BMDL外,还强调了如何选择用于确定BMD和BMDL的剂量反应模型的问题。还涵盖了研究设计以及剂量反应曲线和BMD比较的问题。