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Transcript of Beyond Risk Assessment to Precautionary A Small Dose of Toxicology.
Beyond Risk Assessment to Precautionary A Small Dose of Toxicology
Beyond Risk Assessment to Precautionary A Small Dose of Toxicology
Precautionary Assessment
Steven G. Gilbert, PhD, DABT
www.asmalldoseof.orgwww.toxipedia.org
“Precautionary Assessment"-- a community approach to risk assessment
(Critical Analysis of Risk Assessment & Alternative Approaches)
Northwest Toxic Communities CoalitionApril 5,, 2009
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Doubt Is Their Product
David Michaels
2008 - Oxford
How Industry’s Assault on Science Threatens Your Health”
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
A Small Dose of Toxicology
See: www.asmalldoseof.org -- smdose
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Small Dose of Toxicology
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Milestones of Toxicology
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
www.toxipedia.org
A free toxicology encyclopedia and resource center that anyone can edit. Toxipedia provides comprehensive, accurate, and scientifically based information on the hazards and risks of chemical and physical agents, with the goal of advancing human and environmental health. Toxipedia
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
www.ipmopedia.org
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Healthy World Theater
Healthy World Theater reaches to the heart to promote awareness and understanding through the arts to create a more healthy and peaceful world so that all creatures may reach, maintain, and enjoy their potential.
Coupling art and science to forge a more healthy
and peaceful world
www.healthyworldtheater.org
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
World Library of Toxicology – www.wltox.org
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
LDDI Consensus Statement
Scientific Consensus Statement on Environmental Agents Associated with
Neurodevelopmental DisordersDeveloped by the Collaborative on
Health and the Environment’s Learning and Developmental Disabilities
InitiativeNovember 7, 2007
http://www.iceh.org/LDDI.html
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Child Health
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
So Many Chemicals so Little Data
2863 above 1 Million pounds
78.2% no data
21.4% some data
12 or 0.4% good data
www.preventingharm.org
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Nearly 12 million children (17%) under age 18 in the US suffer from one or more developmental disabilities
Learning disabilities – 5-10% of kids in public school
ADHD – 3-6% of all school kids, maybe higher
The Consequences
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Risk Assessment
"We should remember that risk assessment data can be like the captured spy: If you torture it long enough, it will tell you anything you want to know."
(William Ruckelshaus -1st administrator of U.S. EPA 1984.)
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Risk Assessment
Philip Handler said about balancing risks and benefits:
“A sensible guide would surely be to reduce exposure to hazard whenever possible, to accept substantial hazard only for great benefit, minor hazard for modest benefit, and no hazard at all when the benefit seems relatively trivial.” (Handler, 1979).
Handler P. 1979. Some comments on risk. In: The National Research Council in 1979; Current Issues and Studies. Washington, DC: National Academy of Sciences, 3-24.
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Outline
Risk Assessment – Arbitrary and Capricious
Vision and Ethics Principles of Risk Assessment Risk Assessment - examples Weaknesses of Risk Assessment Beyond Risk Assessment to
Precautionary Assessment
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
“Children can develop and mature in an
environment that allows them to reach and maintain their full
potential.”
Vision for Child Health
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
“Conditions that ensure that all living things have the best opportunity to reach and maintain their full genetic potential.”
S. Gilbert (1999)
Human & Environmental Health
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Socially responsible white guys?
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
"A thing is right when it tends to preserve the integrity, stability, and beauty of the biotic community. It is wrong when it tends otherwise." -
Aldo Leopold, 1949, A Sand County Almanac
The First Bioethicist
---------- 1887 - 1948 ----------
Aldo Leopold
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
“An ethic, ecologically, is a limitation on freedom of action in the struggle for
existence”Aldo Leopold
Limits on Freedom
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
“The Commons”
The Tragedy of the CommonsBy Garrett Hardin, Science, 1968
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Technical Solutions
“It is our considered professional judgment that
this dilemma has no technical solution.”
The Tragedy of the CommonsBy Garrett Hardin, Science, 1968
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Problems – Solutions?
Lead and kids Fetal alcohol syndrome Nuclear disarmament Bioterrorism Ocean Fisheries Persistent chemicals The Commons
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
"All scientific work is incomplete - whether it be observational or experimental. All scientific work is liable to be upset or modified by advancing knowledge. That does not confer upon us a freedom to ignore the knowledge we already have or postpone the action that it appears to demand at a given time. "
Sir Austin Bradford Hill (1965)
Sir Austin Bradford Hill
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
1. Strength of association
2. Consistency of findings
3. Biological gradient
4. Temporal sequence
5. Biologic or theoretical plausibility
6. Coherence with established knowledge
7. Specificity of association
Sir Austin Bradford Hill (1965)
Determining Causation
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
“When an activity raises threats of harm to human health or the environment,
precautionary measures should be take even if some cause and effect relationships are not
fully established scientifically.”
Wingspread Conference, 1998.
Precautionary Principle
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
• Setting goals (Health indicators)• Taking preventive action in the face of
uncertainty• Shifting the burden of responsibility to the
proponents of an activity (Who benefits?)• Exploring a wide range of alternatives to
possibly harmful actions (Is it necessary?)• Increasing public participation in decision
making (transparency of information & environmental justice)
Central components
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Key Words of Toxicology
Hazard X Exposure = Risk
Individual Susceptibility
Dose / Response
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Developed in 1960-1970s Concern over increased cancer ratesExpanded to non-cancer effects
Modern Risk Assessment
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
"If someone had evaluated the risk of fire right after it was invented, they may well have decided to eat their food raw."
Julian Morris of the Institute of Economic Affairs in London
Perspective
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Quantitative Risk Assessment
Process of estimating association between an
exposure to a chemical or physical agent and the
incidence of some adverse outcome.
National Research Council, Risk Assessment in the Federal Government: Managing the Process. National Academy Press,
Washington, DC, 1983
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Steps in Risk Assessment
Hazard IdentificationExposure AssessmentDose-Response AssessmentRisk Characterization
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
What Hazard?
ObviousDeath, Cancer, Acid burn, Birth defect, asthma …..
SubtleDecreases in learning and memory (lead)
Loss of potential
Sensitivity of the individual (child)
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Hazard Identification
Review human and animal data to determine if a chemical or agent has biological effects.
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Toxicity Endpoints
Carcinogenicity Mutations Altered immune function Teratogenicity Altered reproductive function Neuro-behavioral toxicity Organ-specific effects Ecological effects (wildlife,
environmental persistence)
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Exposure Assessment
Route of exposure (skin, oral, inhalation)
Amount of exposure (dose)Duration of exposureTo whom (animals, humans,
environment) Children, other sensitive individuals
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
• Home environment• Workplace (occupational)• School• Food• Consumer products• Global and local environment
Exposure Issues
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Dose-Response Assessment
How much exposure to a chemical or agent will cause what effect?
Dose – Response
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Some Jargon
LOAEL – Lowest Observed Adverse Effect Level (mg/kg)
NOAEL – No Observed Adverse Effect Level (mg/kg)
RfD – Reference Dose (mg/kg-day)
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Greater Dose – Greater Response
Dose
Res
po
nse
Threshold (NOAEL)
ED50
LOAEL
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Hazard (including sensitive populations)
–Low dose extrapolationExposure
– Route of exposure, amount, duration• dermal, oral, inhalation, injection
– To Whom? Sensitive Individuals?
Risk Characterization
Risk = Hazard X Exposure
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Use of Uncertainty Factors
Divide Dose by Power of 10• Human variability• Interspecies extrapolation• Children• Subchronic to chronic extrapolation• Absence of a NOAEL• Database uncertainty
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Human Variability
Human Subject Variability
• Lifestyle – risk of exposure to ….• Occupation – risk of exposure to ….• Breathing & digestion – uptake of chemicals• Metabolism & kidney function – elimination• Age, gender & disease – susceptibility to
toxicity• Socio/economic facts
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Doubt / Uncertainty
"Doubt is our product since it is the best means of competing with the 'body of fact' that exists in the mind of the general public.“
1969 an executive at Brown & Williamson owned by R. J. Reynolds Tobacco Company
(Doubt Is Their Product by David Michaels in Scientific American, June 15, 2005)
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Use of Uncertainty Factors
Animal Dose Response Data
NOAEL (No Observed Adverse Effect Level) or LOAEL
Divide by 10
(Account for inadequate animal data)
Divide by 10
(Animal to Human Extrapolation)
Divide by 10
(Human Variability or Individual Sensitivity)
Reference Dose (RfD) Or Acceptable Daily Intake (ADI)
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
What Is This?
N
NN
N
CH3
CH3
CH3
O
O
1
3
7
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Mercury & Toxicology
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
The Mercury Cycle
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Atmospheric Hg
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
• Blindness - Deafness• Cerebral Palsy - Seizures• Abnormal reflexes & muscle tone• Retarded motor development• Visual and Auditory Deficits• Delayed motor development• Human and animal data
Neurobehavioral Effects
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Decrease in Brain Size Cell loss Disorganization of cells Cell migration failures Behavioral effects –
learning and memory
Effects On The Brain
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Fetal Effects of MeHg
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
MONKEY - 25 µg/kg - LOAELRAT - 10 µg/kg - LOAELRAT - 50 µg/kg - replicated
Animal - Risk Assessment
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
2.5 µg/kg - NOAEL (animals) 0.25 µg/kg - Human 0.025 µg/kg - Sensitive populations
Animal - Risk Assessment
(the rule of dividing by 10)
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
• 10-20 ppm hair - LOAEL •• 40-80 ppb blood - LOAEL •
• 0.645 µg/kg •• 0.06 µg/kg - RfD •
Human - Risk Assessment
Gilbert, S.G., and Grant-Webster, K.S. Neurobehavioral effects of developmental methylmercury exposure. Env. Health Persep. 103(Suppl 6), 135-142, 1995.
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
MeHg Consumption Limits
US EPA – 0.1 ug/kg-day
US FDA – 1 ppm (mg/kg) in tuna
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
"Lead makes the mind give way."
Ancient Awareness
GreekDioscerides - 2nd BC
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Agency Blood Lead Levels
60
40
3025
2015
10
20
10
20
30
40
50
60
Blo
od
Lea
d (
ug
/dl)
CDC1960
CDC1973
CDC1975
CDC1985
WHO1986
EPA1986
CDC1990
CDC2006?
Agency and Year
Acceptable Childhood Blood Lead Levels
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Recycling Lead
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Limitations of Risk Assessment
Lack of adequate data Most sensitive endpoint Low dose extrapolation Exposure information Multiple chemical exposures Complex – expert driven –
undemocratic Individual sensitivity Narrow perspective – Ethical??
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Community / Social Issues
Exposure Issues
Hazard / Toxicity
Precautionary Assessment
An approach to evaluating the scientific, safety, community, ethical, and social issues related to a compound or procedure.
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Community / Social Issues G = Goal
N = Need
F = Future Generations
D = Democratic, community based process
A = Alternatives
Precautionary Assessment
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Precautionary Assessment
Initial Parameter Score Comment
Community / Social Issues
Evaluate effects on the community and related social issues.
G G=Goal 1-31-a lot, 2-some, 3-little. Does this move forward the goal of human and environmental health?
N N=Need 1-31-a lot, 2-some, 3-little or not sure. Ask the question: Is it necessary? Do we really need this?
FF=Future Generations 1-3
1-little, 2-some, 3-high impact. Is there a potential impact on future generations of humans and other species?
D
D=Democratic, community based process 1-3
1-a lot of community involvement and consultation, 2-some, 3-little. Was the community consulted early and often in the process? Was the process democratic and inclusive.
A A=Alternatives 1-3
1-alternatives were carefully considered, 2-some consideration, 3-no consideration. Where alternatives considered?
Total 5-155-good, supportive of health and community15-poor, not supportive of health or community
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Exposure Issues E = Exposure
M = Multiple exposures
Ch = Children exposed
CP = Consumer products
O = Occupational exposure
F = Food exposure
Precautionary Assessment
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Precautionary Assessment
Exposure Issues Evaluate potential exposure issues.
E E=Exposure 0-30-none, 1-little, 2-some, 3-high. Do we have control over the exposure?
MM=Multiple exposures 0-3
0-none, 1-little, 2-some, 3-high. Is there exposure to other chemicals with similar hazard?
ChCh=Children exposed 0,3,5
0-none, 3-little, 5-some or high or don't know. Children are often more vulnerable. Are children being exposed.
CPCP=Consumer products 0-3
0-not in consumer products, 1-little, 2-some, 3- a lot or do not know. Is this compound in consumer products?
OO=Occupational exposure 0-3
0-no occupational exposure, 1-little, 2-some, 3- a lot or do not know. Is there occupational exposure?
FF=Food exposure 0-3
0-not in food supply, 1-little, 2-some, 3- a lot or do not know. Is the compound present in the food supply.
Total 0-200-no exposure, no problems20-significant exposure, serious concern
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Hazard / Toxicity H = Hazard
IS = Individual Sensitivity
EC = Ecological hazard
UC = Uncertainty
V = Volume
P = Persistent
Precautionary Assessment
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Precautionary Assessment
Hazard / Toxicity Evaluate potential hazards.
H H=Hazard 1,5,10
1-low, 5-some, 10-high. Follow classical hazard evaluation, pick endpoint, exam relevant quality studies (cancer, reproductive, neurotoxicity, irreversible)
ISIS=Individual Sensitivity 1-3
1-little 2-some, 3-a lot. Determine if any individuals are more sensitive than health adult such as the very young or old.
ECEC=Ecological hazard 1-3
1-little 2-some, 3-a lot. Is it a hazard to other species or the environment?
V V=Volume 1-5 how much is produced (1=research only, 2=<1000 lbs, 3=<10,000, 4=<100,000, 5=>100,000 or do not know)
P P=Persistent 1-31-little persistence 2-some, 3-a lot of persistence or do not know. Is the compound presistent in the environment?
BB=Bioaccumulate 1-3
1-little 2-some, 3-a lot. Does it bioaccumulative in humans or animals or move up the food chain?
UCUC=Uncertainty 1-3 1-little 2-some, 3-a lot. How certain is the information?
Total 7-307-low hazard30-significant hazards or unknowns, serious concern
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Community / Social Issues - 12/15
Exposure Issues – 16/20
Hazard / Toxicity – 27/30
Precautionary Assessment
Lead
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
• We have a right to an environment in which we can reach and maintain our potential
• A matter of POLICY not Risk Assessment
Rights and Policy
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
“When an activity raises threats of harm to human health or the environment,
precautionary measures should be take even if some cause and effect relationships are not
fully established scientifically.”
Wingspread Conference, 1998.
Precautionary Principle
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
• Setting goals (Health indicators)• Taking preventive action in the face of
uncertainty• Shifting the burden of responsibility to the
proponents of an activity (Who benefits?)• Exploring a wide range of alternatives to
possibly harmful actions (Is it necessary?)• Increasing public participation in decision
making (transparency of information & environmental justice)
Central components
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
The Washington State Public Health Association (WSPHA at www.wspha.org) unanimously adopted two important resolutions at the 13th Annual Washington State Joint Conference on Health that addressed human health and the environment.
“Endorsing the Precautionary Principle as a Public Health Tool for Preventing Harm from Persistent Bioaccumulative Toxic Chemicals (PBTs)”Resolved that - “The WSPHA endorses the precautionary principle as a vital component of our preventive approach to public health in Washington State, advancing the goal that all people have an opportunity to reach and maintain their full potential.”
WSPHA 2006 Resolutions
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
“Supporting Safer Chemicals Policies to Benefit Human and Environmental Health”.
This resolution addressed the need to 1) reduce exposure to PBTs, 2) encourages development and use of safer, cost-effective alternative products, materials, and processes, 3) development of ‘green chemistry’, and 4) provide full information on the health effects of all chemicals placed into the marketplace.
WSPHA 2006 Resolutions
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Submittal: October 2008 Annual Meeting
Title: Supporting Actions to Reduce Exposures to Lead to Benefit Children’s Health, Learning and Futures
RESOLVED, THAT:
WSPHA supports a reduction of the CDC blood lead level guidelines for action from 10 μg/dL to 2 μg/dL as a crucial step toward achieving a goal that no child in Washington State hasa blood lead level above 2 μg/dL
WSPHA 2008 Resolutions
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
City Comprehensive Plans
• Every citizen of Seattle has an equal right to a healthy and safe environment.
• Seattle sees the Precautionary Principle approach as its policy framework to develop laws for a healthier and more just Seattle.
• Seattle Precautionary Principle White Paper (www.asmalldoseof.org)
Seattle PP working group – CHE-WA
Seattle Initiative
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
The Precautionary Principle is part of the evolution in our
thinking and decision making toward ensuring human and
environmental health.
Conclusion
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
The Potential of Children
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Additional Information
National Research Council, Risk Assessment in the Federal Government: Managing the Process. National Academy Press, Washington, DC, 1983
World Health Organization - The International Programme on Chemical Safety (IPCS) – Risk Assessment –http://www.who.int/pcs/ra_main.html
U.S. Environmental Protection Agencies - National Center for Environmental Assessment (NCEA) – http://cfpub.epa.gov/ncea/
A Small Dose of Toxicology – Risk Assessment - http://www.asmalldoseof.org/toxicology/risk_assessment.php
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Risk Assessment
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07Adapted from Kraus and Slovic (1988), Risk Anal., 8: 435.
Characteristics of RiskCharacteristic Level Examples
Knowledge Little known Food additivesMuch known Alcoholic drinks
Newness Old GunsNew Space travel
Voluntariness Not voluntary CrimeVoluntary Rock climbing
Control Not controllable Natural disastersControllable Smoking
Dreadedness Little dread VaccinationGreat dread Nerve gas
Catastrophic Not likely Sunbathingpotential Likely WarEquity Distributed Skiing
Undistributed Hazardous dump
Beyond Risk Assessment to Precautionary A Small Dose of Toxicology
Overweight & ObeseSurvey Measures of Percent Overweight and Obese, Seattle, 1994-2002
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
1994 1995 1996 1997 1998 1999 2000 2001 2002
year
wei
gh
ted
per
cen
t o
f su
rvey
res
po
nd
ents
overweight
obese
Data Source: Behavioral Risk Factor Surveillance System, Washington State Department of Health and Centers for Disease ControlPrepared by: Public Health- Seattle & King County, EPE, 5/04
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Food coloring
Saccharin
Microwave ovens
Aspirin
Anesthetics
Power Tools
Alcohol
Motor vehicles
DNA Research
Nuclear Power
Asbestos
HerbicidesPesticides
Smoking
Dynamite
Warfare
Handguns
Risk Perceptions
Catastrophic potentialInvoluntariness
Personal riskInequity
Dread
NewnessLack of scientific knowledge
Exposure is unknown/unknowable
Knowable
Unknown
Known
DreadedLittle Dread
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Estimated Costs - National
Best Estimate
Low Estimate High Estimate
Lead Poisoning $43.4 $43.4 $43.4
Asthma $2.0 $0.7 $2.3
Cancer $0.3 $0.2 $0.7
Neurobehavioral Disorders
$9.2 $4.6 $18.4
TOTAL $54.9 $48.8 $64.8
Estimated Costs of Pediatric Disease of Environmental Origin, United States,1997 (billions)
(From “Environmental Pollutants and Disease in American Children,” Landrigan, Schechter, et.al., 2002)
A Small Dose of Toxicology Beyond Risk Assessment to Prec – 09/19/07
Estimated Costs - Washington
Diseases and disabilities (asthma, cancer, lead exposure, birth defects, and neurobehavioral effects) attributable to environmental contaminants.
Best Estimate
Direct Costs
Indirect Costs
Range
Childhood $1,875 $310.6 $1,565
$1,600-$2,200
Adult & child $2,734 $782.1 $1,953
$2,800-$3,500
Disease/Disability (2004 $ million)
Kate Davies Economic costs of diseases and disabilities attributable to environmental contaminants in Washington State. Antioch University Seattle 2005. http://washington.chenw.org/pdfs/EnvironmentalCosts.pdf
Beyond Risk Assessment to Precautionary A Small Dose of Toxicology
Asthma & DiabetesSurvey Measures of Percent Ever Having Had Asthma and Diabetes Diagnoses, Seattle, 1994-
2002
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
1994 1995 1996 1997 1998 1999 2000 2001 2002
wei
gh
ted
per
cen
t o
f su
rvey
res
po
nd
ents
Data Source: Behavioral Risk Factor Surveillance System, Washington State Department of Health and Centers for Disease ControlPrepared by: Public Health- Seattle & King County, EPE, 5/04
asthma
diabetes (excluding during pregnancy)