DeRosa C T, Stevens Y W, Johnson B L
Agency for Toxic Substances and Disease Registry, Division of Toxicology, Atlanta, GA 30333.
Toxicol Ind Health. 1993 Jul-Aug;9(4):559-75. doi: 10.1177/074823379300900401.
Cancer remains at the forefront of public health concerns in the United States and throughout the world. Over the past 20 years a wide range of federal agencies and other organizations have been involved in developing policy statements, classification strategies, and assessment methods to address carcinogenesis and health risks. Each of these documents was developed in response to issues confronted by those organizations in pursuing their mission, often as a direct function of legislative mandates. In pursuing its mandated responsibilities, the Agency for Toxic Substances and Disease Registry (ATSDR) must address public health concerns associated with exposure to carcinogens in the context of all available relevant information. This information includes both technical data as well as science policy positions adopted by the range of organizations with programs germane to the assessment and/or regulation of carcinogens. Because of distinct differences in perspective, practice, and policy dictated by the mandated activities of these organizations and the rapidly evolving understanding of carcinogenesis, apparently divergent positions may be reflected in their conclusions. The differences outlined above, coupled with requests from the public, other agencies, and the private sector for a statement reflecting the Agency's position on science and science policy issues related to cancer, prompted the development of this policy. This document is intended to serve as a framework to guide the Agency in its programs and actions regarding carcinogens and to harmonize such efforts with those of other federal agencies and relevant organizations. This framework reflects an assessment of current practice within the Agency and defines the appropriate roles of conclusions derived by other groups, professional judgment, and emerging scientific principles in ATSDR's public health assessments of exposures to carcinogens. This Cancer Policy Framework is not intended to encompass the development of operational guidelines per se, although the Agency recognizes the utility of such efforts. A central theme of this Cancer Policy Framework is the use of risk analysis as an organizing construct based on sound biomedical and other scientific judgment to define plausible exposure ranges of concern rather than single numerical conclusions that may convey an artificial sense of precision. The development and use of innovative tools for exposure and dose response assessment (with particular emphasis on molecular epidemiology) are also endorsed.
癌症在美国乃至全世界仍然是公共卫生关注的焦点。在过去20年里,众多联邦机构和其他组织参与制定了政策声明、分类策略及评估方法,以应对致癌作用和健康风险。这些文件中的每一份都是为回应这些组织在履行其使命过程中所面临的问题而制定的,通常是立法授权的直接结果。在履行其法定职责时,有毒物质和疾病登记署(ATSDR)必须在所有可用的相关信息背景下,处理与接触致癌物相关的公共卫生问题。这些信息既包括技术数据,也包括与致癌物评估和/或监管相关项目的各类组织所采取的科学政策立场。由于这些组织的法定活动所决定的视角、实践和政策存在明显差异,以及对致癌作用的理解迅速演变,它们的结论可能会反映出明显不同的立场。上述差异,再加上公众、其他机构和私营部门要求发表一份反映该机构在与癌症相关的科学和科学政策问题上立场的声明,促使制定了本政策。本文件旨在作为一个框架,指导该机构在有关致癌物的项目和行动中,并使其与其他联邦机构和相关组织的工作协调一致。这个框架反映了对该机构当前实践的评估,并界定了其他团体得出的结论、专业判断以及新兴科学原则在ATSDR对致癌物接触的公共卫生评估中的适当作用。本癌症政策框架本身并非旨在涵盖操作指南的制定,尽管该机构认识到此类工作的实用性。本癌症政策框架的一个核心主题是将风险分析用作一种组织架构,它基于可靠的生物医学和其他科学判断,来界定合理的关注接触范围,而不是传达一种虚假精确感的单一数值结论。还认可开发和使用用于接触和剂量反应评估的创新工具(尤其强调分子流行病学)。