Dose effect relationships/models

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Scope
According to WHO guidelines ERFs may be reported as a slope of a regression line or as a relative risk (RR) for a given change in exposure. ERFs may be derived from studies in the field of epidemiology and/or toxicology. In addition to the central estimate, the uncertainty of the central estimate should be available as well, e.g. as a confidence interval.

Exposure is sometimes also called external dose. The internal dose is the amount of a substance penetrating across the absorption barriers or exchange boundaries of an organism, via either physical or biological process, sometimes termed absorbed dose. The biologically effective dose is the amount of an agent that reaches the cells or target site where an adverse occurs, or where that agent interacts with a membrane surface. Exposure can be characterised in different ways (personal exposure, environmental measurements,modeling)

In summary, ‘exposure response’ functions can potentially be derived for different exposure indicators when assessing the same stressor.

In this workshop we'll have to decide which ERFs we are going to use, and if there has to be some guidance in general when it is for example more appropriate to make use of internal dose to health effect, instead of external dose to health effect. Often at least in the case of air pollution, most measurements are generally obtained from stationary ambient monitoring stations that routinely measure background concentrations at a number of points in the area where the subjects live. I can imagine that in the case of for example some chemical (with complicating biotransformation and uptake in the body) it is more useful to calculate internal dose at the targe organ.


Description

How to derive an ERF? In principal WP 1.3 Exposure-health effect recommend that if there is already a published and up-to-date Exposure-response function (ERF) available, preferably from an authoritative and influential institute or organisation, like for example the World Health Organization, one should use that in the HIA. If not available, they recommend using the frequentists systematic review (including if appropriate a meta-analysis) to derive a certain ERF for the policy assessments.

But of course in this workshop we are not going to perform a systemtic review, as this will take a lot of time (for a good review it can take months?)


References

  • NEEDS ExternE methodology [1] (new figures)

Definition

Causality

List of parents:

We need the accumulated exposure. I.e. the sum of ("the concentration change per grid cell" by "population living there").

Data

  • Particles < 2.5 µm
Health endpoints Risk group fraction Factor to be multiplied by accumulated exposure to get the cases of physical impacts (1 per t of emissions)
Life expectancy reduction - YOLLchronic Adults_30andAbove 4,557E-04
New cases of chronic bronchitis (1) Adults_27andAbove 3,731E-05
Restricted activity days (RADs) Adults_15_to_64_years 6,061E-02
Work loss days (WLD) Adults_15_to_64_years 1,391E-02
Minor restricted activity days (MRAD) Adults_18_to_64_years 3,693E-02


  • Particles < 10 µm
Health endpoints Risk group fraction Factor to be multiplied by accumulated exposure to get the cases of physical impacts (1 per t of emissions)
Respiratory hospital admissions Total 7,030E-06
Cardiac hospital admissions Total 4,340E-06
Medication use / bronchodilator use Children_PEACE_criteria_for_asthma_5_to_14 4,032E-04
Medication use / bronchodilator use Adults_20andAbove_asthmatics 2,234E-02
Lower respiratory symptoms (adult) Adults_symptomatic_adults 3,185E-02
Lower respiratory symptoms (child) Children_5_to_14_years 2,083E-02
  • Ozone
Health endpoints Risk group fraction Factor to be multiplied by accumulated exposure to get the cases of physical impacts (1 per t of emissions)
Increased mortality risk Total 8,219E-07
Respiratory hospital admissions Elderly_65andAbove 5,411E-09
MRAD Adults_18_to_64_years 2,016E-05
Medication use / bronchodilator use Adults_20andAbove_asthmatics 4,900E-05
LRS excluding cough Children_5_to_14_years 4,910E-06
Cough days Children_5_to_14_years 2,854E-05

(Please notice that these data are newly developed by NEEDS and not yet published!!!!!)

Formula

Analytica_id:

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Unit

Result

Category:Kuopio workshop