Issues in arsenic cancer risk assessment.
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Biomedical subjects
Publications and source records attributed to B D Beck.
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When considered from a public health perspective, the central question regarding chemical mixtures is deceptively simple: Are current approaches to risk assessment for chemical mixtures affording effective (adequate) and efficient (cost-effective) protection for members of our society? Answering this question realistically depends on an understanding of the hierarchical goals of public health (i.e. prevention, intervention, treatment) and an accurate evaluation of the extent to which these goals are being achieved. To allow decision makers to make informed judgments about the health risks of chemical mixtures, adequate scientific knowledge and understanding must be available to support risk assessment activities, which are an integral part of the regulatory decision making process. Designing and implementing relevant research depends on the existence of a feedback loop between researchers and regulators, where the information needs of regulators influence the nature and direction of research and the information and understanding generated by researchers improves the scientific basis for public health decisions. A clear, consistent, commonly accepted taxonomy for describing important mixture-related phenomena is a key factor in creating and maintaining the necessary feedback loop. Ultimately, both researchers and regulators share a common goal with regard to chemical mixtures; improving the state-of-the-science so that we can make informed decisions about protecting public health. A survey of research issues and needs that are crucial to attaining this goal is presented.
This paper presents a model for predicting blood lead levels in adults who are exposed to elevated environmental levels of lead. The model assumes a baseline blood lead level based on average blood lead levels for adults described in two recent U.S. studies. The baseline blood level in adults arises primarily from exposure to lead in diet. Media-specific ingestion and absorption parameters are assessed for the adult population, and a biokinetic slope factor that relates uptake of lead into the body to blood lead levels is estimated. These parameters are applied to predict blood lead levels for adults exposed to a hypothetical site with elevated lead levels in soil, dust and air. Blood lead levels ranging from approximately 3-57 micrograms/dl are predicted, depending on the exposure scenarios and assumptions.
We review recent publications by Hopenhayn-Rich et al. and Smith et al. regarding two critical issues in arsenic risk assessment: the role of methylation in the dose-response relationship and the role of internal cancers. Hopenhayn-Rich et al. applied simple linear regression to data from several studies to determine whether the percentage of inorganic arsenic in urine increases with increasing dose. Although their results failed to show a correlation between percent inorganic arsenic and urinary arsenic concentration, their evaluation does not demonstrate the absence of a methylation threshold because of the relatively low level of arsenic in urine and the use of grab samples in evaluating methylating capacity. Using data from an epidemiological study in Taiwan, Smith et al. have indicated that arsenic could be an important risk factor not only for skin cancer (the basis of the current EPA cancer slope factor), but also for several internal cancers including lung, liver, bladder, and kidney. We note the following deficiencies in the analysis of Smith et al: 1) the likely underestimated exposure estimate due to lack of consideration on nonwater sources of arsenic and the underestimate of water consumption, 2) lack of consideration of detoxification in estimating potential risks from low-level exposures typical of the U.S. population, and 3) lack of consideration of key differences, particularly nutritional differences, between the Taiwanese and U.S. populations that could affect potential risks.
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Lead is perhaps the oldest of industrial toxins, dating back to Roman times. Despite the historic knowledge of lead, this metal remains a public health concern today. This is due both to the pervasiveness of lead in the environment and to the awareness of toxic effects of lead occurring at exposure levels lower than previously thought harmful. At the 1991 Annual Meeting in Dallas, Texas, the Society of Toxicology hosted the symposium: "An Update on Exposure and Effects of Lead." The goal of the symposium was to present an overview on critical issues associated with lead toxicity--ranging from fundamental mechanisms, such as the role of lead binding proteins, to assessment of the potential effectiveness of lead abatement measures, such as the impact on blood lead of home deleading. These issues are summarized in Fig. 1 using the four-stage paradigm of risk assessment as described by the National Academy of Science (NRC, 1977). Clearly, understanding potential impacts of lead in humans is interdisciplinary, involving the efforts of toxicologists, pathologists, epidemiologists, environmental chemists, and others. The following is a summary of each of the individual presentations.
Risk assessment practices for noncarcinogens typically employ an uncertainty factor (UF) for animal-to-human extrapolation when defining acceptable levels for humans based on animal studies. EPA has interpreted the use of this factor as addressing interspecies differences due to dose normalization via surface area (exposure-dose relationships) and to innate differences in species susceptibility (dose-response relationships). Thus EPA has concluded that dose normalization via surface area is not necessary when using animal studies to define acceptable levels for noncarcinogens for humans. In this report we challenge this position on both theoretical and practical grounds. It is recommended that the UF for animal-to-human extrapolation for noncarcinogens in the risk assessment process and the technique for dose normalization be considered distinctly.
Alkylphenols are a class of environmentally pervasive compounds, found both in natural (e.g., crude oils) and in anthropogenic (e.g., wood tar, coal gasification waste) materials. Despite the frequent environmental occurrence of these chemicals, there is a limited toxicity database on alkylphenols. We have therefore developed a "toxicity equivalence approach" for alkylphenols which is based on their ability to inhibit, in a specific manner, the enzyme cyclooxygenase. Enzyme-inhibiting ability for individual alkylphenols can be estimated based on the quantitative structure-activity relationship developed by Dewhirst (1980) and is a function of the free hydroxyl group, electron-donating ring substituents, and hydrophobic aromatic ring substituents. We evaluated the toxicological significance of cyclooxygenase inhibition by comparison of the inhibitory capacity of alkylphenols with the inhibitory capacity of acetylsalicylic acid, or aspirin, a compound whose low-level effects are due to cyclooxygenase inhibition. Since nearly complete absorption for alkylphenols and aspirin is predicted, based on estimates of hydrophobicity and fraction of charged molecules at gastrointestinal pHs, risks from alkylphenols can be expressed directly in terms of "milligram aspirin equivalence," without correction for absorption differences. We recommend this method for assessing risks of mixtures of alkylphenols, especially for those compounds with no chronic toxicity data.
Lead has been recognized for years as an environmental pollutant of concern for young children. Nonetheless, many children in the United States still experience high body burdens of lead. Reducing exposure to lead must include an assessment of all potential sources of lead and a definition of routes of exposure. In this paper, the relationships between soil lead and blood lead concentrations in residents in communities with high soil lead concentrations resulting from past mining and ore processing (milling) activities are compared to those derived from studies in urban communities or communities with operating smelters. The impact of mine waste-derived lead in soil (usually in the form of lead sulfide) on blood lead is less than that for lead in soil derived from smelter, vehicle, or paint sources. Possible reasons for a reduced impact of lead sulfide on blood lead in children in mining communities include the following: lead from mining sources contributes less to lead in the immediate environment of children than lead from other sources; mine wastes typically are of larger particle size, which decreases the bioavailability of lead in the gastrointestinal tract; and lead sulfide is absorbed less in the gastrointestinal tract compared to other lead species. A reduced impact of mine waste-derived lead on blood lead may be important from a regulatory point of view. Expensive cleanup actions for lead-contaminated soils in mining communities based on acceptable soil lead concentrations derived from smelter or urban communities may be questionable in terms of reducing blood lead in children.
A cross sectional analysis of the relation between exposure to an artificial aluminium silicate (alunite residue) and pulmonary function changes has been made in 32 subjects, 17 of whom had been previously reported and in whom there was suggestive evidence of a dose response relation between gas transfer and total silicate exposure. Longitudinal data were also available for nine subjects. No dose effect relation was observed in either analysis and only one of the three subjects previously observed to have an abnormal chest radiograph (the index subject) had deteriorated appreciably. Respirable particles of alunite residue were injected intratracheally into Syrian hamsters. No evidence of pulmonary toxicity was seen as judged by bronchoalveolar lavage measurements of the concentrations lactic dehydrogenase, albumin, and the lambda fraction of gold, and the numbers of macrophages, polymorphonuclear cells, and red blood cells (alpha-quartz and ferrous oxide were used as positive and negative controls). These results do not support a significant toxic effect of this aluminium silicate on the lungs.
To determine whether exposure to nitrogen dioxide (NO2) affects respiratory tract susceptibility to viral infection, CD-1 mice were inoculated intratracheally with murine cytomegalovirus (MCMV) during exposure to varying concentrations of NO2. Exposure lasted for 6 h per day; it began 2 consecutive days prior to instillation of MCMV and continued for 4 days after virus inoculation. Exposure to 5 ppm NO2 resulted in MCMV proliferation and a mild bronchopneumonia in some animals inoculated with 10(2) plaque-forming units of virus. Importantly, this inoculum was too low to produce either viral replication or histologic abnormalities in the lungs of air-exposed animals. We also found that the amount of virus required to infect animals exposed to 5 ppm of NO2 was 100-fold lower than that needed to consistently produce infection in air-exposed animals. Animals exposed to 5 ppm NO2 also exhibited depressed phagocytosis of colloidal Au198 in vivo as well as diminished macrophage destruction of instilled MCMV compared to air-exposed animals. These results demonstrate that exposure to 5 ppm NO2, although not associated with evidence of overt lung injury per se, is nevertheless capable of predisposing the lower respiratory tract to viral infection.
Three cytoplasmic enzyme patterns were studied in pulmonary alveolar type II cells isolated from normal adult hamster lung: lactate dehydrogenase (total and isoenzymes), peroxidase, and beta-N-acetylglucosaminidase. Enzyme patterns of freshly-isolated type II cells were found to be different from those of freshly-isolated pulmonary hamster fibroblasts. After both types of cells had been cultured for seven days, no difference in cytoplasmic enzyme patterns remained. Lactate dehydrogenase isoenzyme patterns for type II cells were different from those obtained from polymorphonuclear leukocytes and alveolar macrophages. These data may be useful in detecting sources of lung injury by assessment of enzyme patterns in bronchoalveolar lavage fluid.
A short-term animal bioassay was used to assess the toxicity of occupational dusts. We quantified pulmonary responses in hamsters exposed to granite (12% quartz) and talc (quartz and asbestos-free) dust collected from worksites. Personal samples collected on workers showed similar quartz content and particle-size distributions to the high-volume samples collected for bioassays, thus demonstrating that the particulates were representative of worker exposure. We measured biochemical and cellular indicators of injury in bronchoalveolar lavage fluid (BAL) of animals exposed to dust suspensions by intra-tracheal instillation. The assays measured release of cytoplasmic and lysosomal enzymes into the cell-free supernatant of BAL; levels of albumin and red blood cells; changes in macrophage and polymorphonuclear neutrophil cell numbers; and in situ macrophage phagocytosis. Dose-response (0.15, 0.75, and 3.75 mg/100 g body wt) and time-course (1-14 days postexposure) studies were performed. One day after exposure, both talc and granite dust resulted in elevated enzyme levels, pulmonary edema, and increased cell numbers in BAL. Macrophage phagocytosis was also inhibited. Based on earlier studies, response levels were either intermediate between nontoxic iron oxide and toxic alpha-quartz or comparable with alpha-quartz. The response to granite dust diminished fairly rapidly over time. By contrast, after talc exposure, there was a more persistent elevation in enzyme levels, and macrophage phagocytosis remained depressed. These results indicate that, when a similar mass was deposited in the lungs, talc caused more lung injury than did granite. Better estimates of exposure-dose relationships in talc and granite workers as well as longer-term animal studies are required to evaluate the harmfulness of these work environments at present-day exposure levels.
This paper describes a new application of a viable aerosol sampler, the Liquid Electrostatic Aerosol Precipitator (LEAP), for the collection of diesel particles for bioassays of pulmonary toxicity and mutagenicity or carcinogenicity. Currently used methods (filtration, dry electrostatic precipitation) cause agglomeration of particles and increases in particle size up to twenty-fold, which may alter particle toxicity significantly. Collection of diesel particles with the LEAP preserved submicronic particle size. Differences in chemical composition of extracts of surface adsorbents as compared to particles collected on filters also were observed. This technique may be applicable for collection of other types of combustion products or oil mists that agglomerate when collected by filtration.
Lactate Dehydrogenase Isoenzymes in Hamster Lung Lavage Fluid after Lung Injury. Beck, B. D., Gerson, B., Feldman, H. A., and Brain, J. D. (1983). Toxicol. Appl. Pharmacol. 71, 59-71. Lactate dehydrogenase (LD) levels and isoenzyme patterns were determined in the cell-free supernatant fractions of lung lavage fluid from hamsters exposed to alpha-quartz, iron oxide, Triton X-100, 100% O2, or 200 ppm SO2. The isoenzyme patterns were compared to those derived from hamster lung homogenates, serum, polymorphonuclear neutrophils (PMNs), pulmonary macrophages, and red blood cells. The isoenzyme patterns from alpha-quartz- and iron oxide-exposed animals resembled each other and were similar to that of PMNs. In contrast, the pattern seen after Triton X-100 exposure was similar to those of whole lung homogenates and of red blood cells. A 96-hr exposure to 100% O2 yielded an LD isoenzyme pattern in lung lavage fluid similar to that of serum. Exposure to SO2 did not alter LD levels, showing that upper airways damage is not reflected by changes in LD in lung lavage fluid. We conclude that LD isoenzyme patterns of lung lavage fluid can be used to differentiate among types of pulmonary injury and may help identify the sites of injury.
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Acid-induced esophageal injury in the cat, produced by infusion of 0.1 N HCl (1 ml/min for 30 min) on 4 consecutive days, has been shown previously to adversely affect lower esophageal sphincter (LES) pressure. We studied the role of prostaglandins in acid-induced esophagitis and the associated LES hypotension by simultaneous treatment of some animals with indomethacin (150 micrograms/kg intravenous), a specific inhibitor of prostaglandin synthesis, either during production of esophagitis or during recovery. LES pressures and esophageal histology were compared to control groups which received acid alone. Indomethacin treatment resulted in more rapid healing of the esophageal inflammation and prevented or promptly corrected the esophagitis-associated LES hypotension. These studies provide further evidence that prostaglandins play an important role in the pathogenesis of acid-induced esophagitis and LES hypotension and raise the possibility that indomethacin, a prostaglandin synthetase inhibitor, may be of benefit in prevention or therapy of esophagitis.