title: Uncertainty and variability in human exposure limits - a chemical-specific approach for ciprofloxacin and methotrexate.
abstract: Human exposure limits (HELs) for chemicals with a toxicological threshold are traditionally derived using default assessment factors that account for variations in exposure duration, species sensitivity and individual sensitivity. The present paper elaborates a probabilistic approach for human hazard characterization and the derivation of HELs. It extends the framework for evaluating and expressing uncertainty in hazard characterization recently proposed by WHO-IPCS, i.e. by the incorporation of chemical-specific data on human variability in toxicokinetics. The incorporation of human variability in toxicodynamics was based on the variation between adverse outcome pathways (AOPs). Furthermore, sources of interindividual variability and uncertainty are propagated separately throughout the derivation process. The outcome is a two-dimensional human dose distribution that quantifies the population fraction exceeding a pre-selected critical effect level with an estimate of the associated uncertainty. This enables policy makers to set separate standards for the fraction of the population to be protected and the confidence level of the assessment. The main sources of uncertainty in the human dose distribution can be identified in order to plan new research for reducing uncertainty. Additionally, the approach enables quantification of the relative risk for specific subpopulations. The approach is demonstrated for two pharmaceuticals, i.e. the antibiotic ciprofloxacin and the antineoplastic methotrexate. For both substances, the probabilistic HEL is mainly influenced by uncertainty originating from: (1) the point of departure (PoD), (2) extrapolation from sub-acute to chronic toxicity and (3) interspecies extrapolation. However, when assessing the tails of the two-dimensional human dose distributions, i.e. the section relevant for the derivation of human exposure limits, interindividual variability in toxicodynamics also becomes important.
authors.affiliation: a Department of Environmental Science , Institute for Wetland and Water Research, Radboud University Nijmegen , Nijmegen , The Netherlands.
authors.forename: Rik
authors.initials: R
authors.lastname: Oldenkamp
authors.affiliation: a Department of Environmental Science , Institute for Wetland and Water Research, Radboud University Nijmegen , Nijmegen , The Netherlands.
authors.forename: Mark A J
authors.initials: MA
authors.lastname: Huijbregts
authors.affiliation: a Department of Environmental Science , Institute for Wetland and Water Research, Radboud University Nijmegen , Nijmegen , The Netherlands.
authors.forename: Ad M J
authors.initials: AM
authors.lastname: Ragas
mesh_terms: D002939:Ciprofloxacin / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000633:toxicity*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008727:Methotrexate / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000633:toxicity*; D019055:No-Observed-Adverse-Effect Level; D011634:Public Health; D035501:Uncertainty
chemical_list: D002939:Ciprofloxacin; D008727:Methotrexate
keywords: Monte Carlo; benchmark dose; pharmaceuticals; probabilistic; risk assessment; toxicodynamics; toxicokinetics; two-dimensional