Monday, May 18, 2015

Joined At the Hip

Toxicological Testing

Whether the potentially marketable chemical is a drug, a pesticide, a food additive, or an industrial chemical, toxicology studies done for the purpose of getting government approval are conducted to meet guidelines that are directed by regulatory policy.   Studies for drugs and food additive are designed to get FDA approval, while studies for pesticides and industrial chemicals are done to get EPA approval.  As a result, it is pretty much known exactly how the results are going to be used before the study is ever done.  Some scientific reasoning presumably goes into the design of the guidelines, but once that is done, special permission is required to do something that is not by the book (e.g. USFDA, 2007, USEPA, 2015).

But not all toxicology is like that.  In particular, studies on “unintentional” chemicals that are not governed by premarket approval regulations are usually far less structured.  Even if the same testing guidelines are used, it is often not possible to predict the impact that a study will have on any action the government may take.   For one thing, it will depend on what is possible.  Therefore, the science of and policy for unintentional chemicals do not necessarily move in concert.

Science-Policy

The White House has an Office of Science and Technology Policy (OSTP).  The primary mission of OSTP is as follows:

The mission of the Office of Science and Technology Policy is threefold; first, to provide the President and his senior staff with accurate, relevant, and timely scientific and technical advice on all matters of consequence; second, to ensure that the policies of the Executive Branch are informed by sound science; and third, to ensure that the scientific and technical work of the Executive Branch is properly coordinated so as to provide the greatest benefit to society.

In short, the primary function of OSTP is to provide scientific information to federal decision makers.  

The US Environmental Protection Agency has an Office of Science Policy (OSP) that at first glance seems to have a similar mission.  But instead of “informing policy”, OSP seeks to incorporating ORD science and technology into regulatory and non-regulatory actions taken by the agency.   It oversees the Office of Research and Development (ORD) that is responsible for most of the scientific research conducted by the agency.  But, ORD also is responsible for what the agency refers to a Human Health Risk Assessment that is directly involved in formulating agency regulatory policy.  Here, it is hard to distinguish the science from the policy; instead the subject becomes hyphenated “science-policy” where the technical jargon and the regulatory jargon are inextricably intertwined.   The primary reason for this is simple: Ever since its inception, the EPA has primarily relied on a decision making regimen (The Safety Assessment Paradigm) that was designed for premarket approval that dictates how scientific information will be used.  When EPA changed the terminology associated with the Safety Assessment Paradigm in 1986 (e.g. the ADI became the RfD), one of the reasons was because different programs were doing safety assessments in different ways (Barnes and Dourson, 1986, see section 1.2.2.2.4.):

In addition to occasionally selecting different critical toxic effects, Agency scientists have reflected their best scientific judgments in the final ADI by adopting factors different from the standard factors. For example, if the toxic endpoint for a chemical in experimental animals is the same as that which has been established for a related chemical in humans at similar doses, one could argue for an SF of less than the traditional 100.  On the other hand, if the total toxicologic data base is incomplete, one could argue that an additional SF should be included, both as a matter of prudent public policy and as an incentive to others to generate the appropriate data.

Since the use of the safety assessment paradigm is justified as a matter of statute and agency policy, it is actually not unreasonable for different programs to do safety assessments somewhat differently.  For example an extra safety factor for inadequate data may make sense for a chemical subject to premarket approval (e.g. a pesticide or a chemical released in to the environment)), but it may not for a naturally occurring element like arsenic or oxygen.   Furthermore, for some regulatory decisions, the Safety Assessment Paradigm may not be a good fit at all.

Dehyphenation

In theory, the solution is simple.  If Safety Assessment Paradigm isn’t working, do a risk assessment instead.  Well, actually no, since the EPA has called the Safety Assessment Paradigm “risk assessment” for the last 30 years, let’s say we need a “risk analysis” instead.  The point is the same: instead of a regulatory decision that takes the form of an acceptable level of exposure, the assessment needs to deliver information about what the risks are.   The broken cog in the risk analysis wheel is pretty well recognized within the agency; while exposure assessment has improved tremendously over the last 30 years, dose-response modeling has gone almost nowhere (EPA, 2012):

Although dose-response analysis is an integral part of human health risk assessment, it has been decades since there have been any major fundamental changes in how dose-response is characterized. The combination of increased demands on risk assessment and the recent explosion of scientific knowledge presents unique opportunities to modernize the practice of dose-response analysis. This has been echoed in several NRC recommendations to advance dose-response analyses, particularly in the areas of increasing the throughput of chemical assessments, characterizing uncertainty and variability, quantifying incremental risk and addressing susceptibility.  During the October 2010 Human Health Risk Assessment Colloquium, risk managers indicated that advancing dose-response analysis would be useful for their decision making needs.

The most obvious reason why dose-response analysis has gone stagnant is that the current noncancer and cancer EPA guidelines both discourage it.  So, part of the solution is to revise the guidelines so dose-response analysis is welcomed.  But there is a fundamental underlying cause that needs to be overcome – the toxicology testing that goes into scripted regulatory approval processes are often designed by toxicologists for toxicologists.  A quantitative risk analysis changes all that.  The value of a study will depend on its information value rather than it’s conformity to protocol.  In addition, since a technocratic decision process is being replaced by a democratic one, many regulatory players in academia and the federal government will have less control over the decision process.  That’s the inevitable result when the public gets more information.  Therefore, when they realize that their ox is being gored, complaints about the unreliability of modeling from the powers that be are just as sure to follow.

The other science-policy obstacle is that most chemicals worthy of quantitative risk assessment have gained their notoriety from human epidemiological studies.  Yet, most human studies are not designed with dose-response characterization in mind.  This is also attributable to decades of quantitative malaise.   In the Safety Assessment Paradigm, statistical significance is often equated with regulatory significance.  For a dose response analysis more weighty evidence is needed.   Because informing regulatory decision is the main purpose for the conduct of many epidemiological studies, establishing a regulatory market for studies that can establish a biological gradient is prerequisite to actually getting them.

References

Barnes DG and Dourson ML (1988).  Reference Dose (RfD): Description and Use in Health Risk Assessments.  Regul Pharmacol Toxicol 8:471-486.  Also at http://www.epa.gov/IRIS/rfd.htm

USEPA (2012).   Human Health Risk Assessment.  STRATEGIC RESEARCH ACTION PLAN 2012-2016. EPA 601/R-12/007

USEPA (2015).   Harmonized Test Guidelines.


Official Post Soundtrack

Doors (1967).  Break on Through (to the Other Side).  In: The Doors, Track 1.

Post Notes

Thesis Post #41.  Introductory thesis for a Public Health Risk Analysis thread.

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