Applicability of toxicological reference values (TRVs) to children: perspectives from various organizations that develop TRVs
Objectives - In a context of uncertainty, when seeking to determine a health risk associated with population exposure to a chemical substance, it is often necessary to conduct a health risk assessment. This process requires organizing the available knowledge regarding the hazards (adverse effects) associated with exposure and the available toxicological benchmarks for these adverse effects, while simultaneously determining the exposure levels of the target populations (adults and children). The data are then compared to ultimately define, for this population, the measures that need to be taken from a public health perspective. At the heart of this process, the choice of toxicological reference values (TRVs) to be used depending on the context carries significant weight. These are developed by various organizations (US EPA, ATSDR, Health Canada, WHO, RIVM, EFSA, ANSES, etc.) for specific exposure durations (acute, subchronic, chronic) and for two types of effects (so-called threshold toxic effects and non-threshold toxic effects). While each agency aims to account as fully as possible for the variability in human sensitivity when defining the most appropriate TRV to protect the greatest number of people, it is not possible to guarantee that so-called hypersensitive individuals, for example, are adequately accounted for. Apart from the case of hypersensitive individuals, some question the applicability of TRVs to specific populations, such as children, because, although factors of uncertainty regarding inter-species and intra-species transfer are most often taken into account (for substances with a threshold effect), the fact remains that most of the toxicological studies used establish a toxic effect in adult animals. Method - Through the literature review conducted and the compilation of various documents produced by agencies issuing TRVs, the perspectives of each agency regarding the applicability of TRVs to children are presented. Results - Regarding threshold-based TEVs, opinions are divided between agencies (US EPA, Health Canada, and ATSDR) that believe TEVs provide protection for the general population, including children, and those (Danish EPA, KEMI, RIVM, OEHHA, JECFA, FAO-WHO, ECHA) that consider TEVs do not protect children. The latter propose either adding additional safety factors (Danish EPA, KEMI, RIVM), establishing a specific TRV (OEHHA, ECHA), or recommending the application of the TRV only starting at a certain age (JECFA, FAO/WHO). Regarding non-threshold TRVs, three agencies have taken a position. Two of them (UBA and US EPA) recommend using an additional uncertainty factor for carcinogenic and mutagenic substances based on children’s age. This factor is applied in the exposure calculation (the child’s exposure is multiplied by the factor proposed for the relevant age group). The OEHHA, for its part, recommends the use of these factors regardless of the carcinogenic mechanism of action: mutagenic or non-mutagenic. Conclusion - On the subject of the applicability of TRVs to children, there is no international consensus. In France, ANSES currently considers that TRVs protect the entire population. (R.A.)
Author(s): Mathieu Huart A, Kairo C
Publishing year: 2013
Pages: 404-14
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