Beitzke Bernhard, Pate David W
EIHA Advisory Committee, European Industrial Hemp Association, Brussels, Belgium.
NICM Health Research Institute, Western Sydney University, Westmead, Australia.
Crit Rev Toxicol. 2021 Sep;51(8):695-722. doi: 10.1080/10408444.2021.2008867. Epub 2022 Feb 17.
An Acute Reference Dose (ARfD) of 1 µg of -9-tetrahydrocannabinol (THC) per kilogram (kg) of body weight (bw) per day was recommended by the European Food Safety Authority (EFSA) for its assessment of possible acute health risks from the intake of industrial hemp food products. The scientific basis for this opinion, such as their choice of a Point of Departure for identification of the Lowest Observed Adverse Effect Level (LOAEL) for THC on the central nervous system, and the seeming absence of an experimental No Observed Adverse Effect Level (NOAEL), is critically reviewed. Moreover, the risk assessment for an ARfD derivation for THC is then reconsidered. In contrast to the EFSA Scientific Opinion of 2015, a higher LOAEL is presently identified from pharmacokinetic and pharmacodynamic studies, and forensic data, in representative cohorts of healthy humans after oral administrations of low THC doses. A NOAEL for THC is derived through this combination of results, demonstrating a threshold for impairment of psychomotor function only after intake of an oral THC bolus beyond 2.5 mg for the average healthy adult. This 2.5 mg dose produces mean THC blood serum levels of <2 ng/mL, as well as do two doses when taken daily within a time interval of ≥6 h. The forensic threshold of THC that is correlated with the impairment of psychomotor function is known to be between 2 and 5 ng/mL in blood serum for adults. For an appropriately spaced intake of 2 × 2.5 mg THC per day, an adult can therefore be regarded as being at the NOAEL. Applying a default uncertainty factor of 10 for intraspecies variability to a NOAEL of 2 × 2.5 mg (over ≥6 hours) for THC, yields a "daily dose of no concern" or a "tolerable upper intake level" of 0.50 mg, corresponding to 7 µg/kg bw. Starting with a NOAEL of only 2.5 mg, consumed as a single bolus, the lowest possible daily ARfD of THC would therefore be 0.25 mg, or 3.5 µg/kg bw for healthy adults, as the absolutely most conservative estimate. Other justifiable estimates have ranged up to 14 µg/kg bw per day.
欧洲食品安全局(EFSA)在评估工业大麻食品摄入可能带来的急性健康风险时,建议每日每千克体重(bw)的急性参考剂量(ARfD)为1微克的Δ⁹ - 四氢大麻酚(THC)。本文对该观点的科学依据进行了批判性审查,例如其在确定THC对中枢神经系统的最低观察到有害作用水平(LOAEL)时选择的起始点,以及明显缺乏实验性未观察到有害作用水平(NOAEL)。此外,还重新考虑了THC的ARfD推导的风险评估。与EFSA 2015年的科学意见不同,目前从药代动力学和药效学研究以及法医数据中,在低剂量THC口服给药后的健康人类代表性队列中确定了更高的LOAEL。通过这些结果的组合得出了THC的NOAEL,表明对于平均健康成年人,仅在口服THC大剂量超过2.5毫克后才会出现精神运动功能受损的阈值。这2.5毫克的剂量使THC血清平均水平<2纳克/毫升,每天在≥6小时的时间间隔内服用两剂时也是如此。已知成人血清中与精神运动功能受损相关的THC法医阈值在2至5纳克/毫升之间。因此,对于每天适当间隔摄入2×2.5毫克THC的成年人,可以认为处于NOAEL。将种内变异性的默认不确定性系数10应用于THC的2×2.5毫克(超过≥6小时)的NOAEL,得出“每日无关注剂量”或“可耐受的最高摄入量水平”为0.50毫克,相当于7微克/千克bw。因此,从仅作为单次大剂量摄入的2.5毫克的NOAEL开始,THC的最低可能每日ARfD对于健康成年人将为0.25毫克,或3.5微克/千克bw,这是绝对最保守的估计。其他合理估计范围高达每天14微克/千克bw。