Gwinn Maureen R, Axelrad Daniel A, Bahadori Tina, Bussard David, Cascio Wayne E, Deener Kacee, Dix David, Thomas Russell S, Kavlock Robert J, Burke Thomas A
At the time of the writing of this article, all of the authors were with the US Environmental Protection Agency, Washington, DC.
Am J Public Health. 2017 Jul;107(7):1032-1039. doi: 10.2105/AJPH.2017.303771. Epub 2017 May 18.
Preventing adverse health effects of environmental chemical exposure is fundamental to protecting individual and public health. When done efficiently and properly, chemical risk assessment enables risk management actions that minimize the incidence and effects of environmentally induced diseases related to chemical exposure. However, traditional chemical risk assessment is faced with multiple challenges with respect to predicting and preventing disease in human populations, and epidemiological studies increasingly report observations of adverse health effects at exposure levels predicted from animal studies to be safe for humans. This discordance reinforces concerns about the adequacy of contemporary risk assessment practices for protecting public health. It is becoming clear that to protect public health more effectively, future risk assessments will need to use the full range of available data, draw on innovative methods to integrate diverse data streams, and consider health endpoints that also reflect the range of subtle effects and morbidities observed in human populations. Considering these factors, there is a need to reframe chemical risk assessment to be more clearly aligned with the public health goal of minimizing environmental exposures associated with disease.
预防环境化学物质暴露对健康的不良影响是保护个人和公众健康的根本。如果高效且恰当地进行，化学风险评估能够促成风险管理行动，将与化学物质暴露相关的环境诱发疾病的发生率和影响降至最低。然而，传统的化学风险评估在预测和预防人群疾病方面面临多重挑战，而且流行病学研究越来越多地报告称，在动物研究预测对人类安全的暴露水平下，观察到了不良健康影响。这种不一致加剧了人们对当代风险评估做法能否充分保护公众健康的担忧。越来越明显的是，为了更有效地保护公众健康，未来的风险评估将需要利用所有可用数据，采用创新方法整合不同的数据流，并考虑那些也能反映在人群中观察到的细微影响和发病率范围的健康终点。考虑到这些因素，有必要重新构建化学风险评估，使其更明确地与将与疾病相关的环境暴露降至最低这一公共卫生目标保持一致。
