title: An integrated framework to identify significant human exposures (SHELs).
abstract: Typically, health risk assessment methodologies have been designed to assess risks associated with exposure to individual chemicals through one specific medium, such as air, water, or food. This is partly because classical experimental methodology is used to study pure chemicals, and partly because a majority of early promulgated environmental laws (e.g., Clean Air Act, Clean Water Act) regulated chemicals in a given matrix via a specific route. Often, however, exposures in the ambient environment are through multiple routes, multiple media and to multiple chemicals. Presented here is a multimedia framework that health risk assessors can use to identify significant human exposure levels (SHELs) on a site-specific basis. This framework is presented in the context of a decision tree that links health guidance values such as minimal risk levels (MRLs) with site-specific data, using a range of decision-support models. It includes a provision to estimate a level of concern by comparing the estimated total dose (exposures) with guidance values established by the Agency, by other federal organizations, and by basket-survey results. If a SHEL has been identified, a range of follow-up public health actions may be indicated (i.e., surveillance, health education, or other preventive interventions). This framework serves to (1) integrate the overall health assessment process, (2) evaluate the need for public health interventions, (3) incorporate innovative decision-support methods/models, and (4) demonstrate utility of such methods in public health practice and the pursuit of the Agency's mission.
authors.affiliation: Agency for Toxic Substances and Disease Registry, U.S. Department of Health and Human Services, Atlanta, Georgia 30333, USA.
authors.forename: M M
authors.initials: MM
authors.lastname: Mumtaz
authors.forename: W
authors.initials: W
authors.lastname: Cibulas
authors.forename: C T
authors.initials: CT
authors.lastname: DeRosa
mesh_terms: D000393:Air Pollutants / Q000009:adverse effects*; D003247:Conservation of Natural Resources; D003625:Data Collection; D004781:Environmental Exposure; D005506:Food Contamination; D006801:Humans; D011634:Public Health / Q000191:economics / Q000331:legislation & jurisprudence / Q000592:standards; D018570:Risk Assessment; D012989:Soil Pollutants / Q000009:adverse effects*; D014874:Water Pollutants, Chemical / Q000009:adverse effects*
chemical_list: D000393:Air Pollutants; D012989:Soil Pollutants; D014874:Water Pollutants, Chemical