A Bayesian Approach to Integrated Ecological and Human Health Risk Assessment for the South River,Virginia Mercury‐Contaminated Site

We conducted a regional‐scale integrated ecological and human health risk assessment by applying the relative risk model with Bayesian networks (BN‐RRM) to a case study of the South River, Virginia mercury‐contaminated site. Risk to four ecological services of the South River (human health, water quality, recreation, and the recreational fishery) was evaluated using a multiple stressor–multiple endpoint approach. These four ecological services were selected as endpoints based on stakeholder feedback and prioritized management goals for the river. The BN‐RRM approach allowed for the calculation of relative risk to 14 biotic, human health, recreation, and water quality endpoints from chemical and ecological stressors in five risk regions of the South River. Results indicated that water quality and the recreational fishery were the ecological services at highest risk in the South River. Human health risk for users of the South River was low relative to the risk to other endpoints. Risk to recreation in the South River was moderate with little spatial variability among the five risk regions. Sensitivity and uncertainty analysis identified stressors and other parameters that influence risk for each endpoint in each risk region. This research demonstrates a probabilistic approach to integrated ecological and human health risk assessment that considers the effects of chemical and ecological stressors across the landscape.     

Quantitative Risk Assessment of Listeria monocytogenes in French Cold-Smoked Salmon: II. Risk Characterization

A model for the assessment of exposure to Listeria monocytogenes from cold-smoked salmon consumption in France was presented in the first of this pair of articles (Pouillot et al ., 2007, Risk Analysis, 27:683–700). In the present study, the exposure model output was combined with an internationally accepted hazard characterization model, adapted to the French situation, to assess the risk of invasive listeriosis from cold-smoked salmon consumption in France in a second-order Monte Carlo simulation framework. The annual number of cases of invasive listeriosis due to cold-smoked salmon consumption in France is estimated to be 307, with a very large credible interval ([10; 12,453]), reflecting data uncertainty. This uncertainty is mainly associated with the dose-response model. Despite the significant uncertainty associated with the predictions, this model provides a scientific base for risk managers and food business operators to manage the risk linked to cold-smoked salmon contaminated with L. monocytogenes. Under the modeling assumptions, risk would be efficiently reduced through a decrease in the prevalence of L. monocytogenes or better control of the last steps of the cold chain (shorter and/or colder storage during the consumer step), whereas reduction of the initial contamination levels of the contaminated products and improvement in the first steps of the cold chain do not seem to be promising strategies. An attempt to apply the recent risk-based concept of FSO (food safety objective) on this example underlines the ambiguity in practical implementation of the risk management metrics and the need for further elaboration on these concepts.     

Challenges in Development and Implementation of Health‐Risk‐Based Soil Quality Guidelines: Turkey's Experience

Management of contaminated sites is a critical environmental issue around the world due to the human health risk involved for many sites and scarcity of funding. Moreover, clean‐up costs of all contaminated sites to their background levels with existing engineering technologies may be financially infeasible and demand extended periods of operation time. Given these constraints, to achieve optimal utilization of available funds and prioritization of contaminated sites that need immediate attention, health‐risk‐based soil quality guidelines should be preferred over the traditional soil quality standards. For these reasons, traditional soil quality standards are being replaced by health‐risk‐based ones in many countries and in Turkey as well. The need for health‐risk‐based guidelines is clear, but developing these guidelines and implementation of them in contaminated site management is not a straightforward process. The goal of this study is to highlight the problems that are encountered at various stages of the development process of risk‐based soil quality guidelines for Turkey and how they are dealt with. Utilization of different definitions and methodologies at different countries, existence of inconsistent risk assessment tools, difficulties in accessing relevant documents and reports, and lack of specific data required for Turkey are among these problems. We believe that Turkey's experience may help other countries that are planning to develop health‐risk‐based guidelines achieve their goals in a more efficient manner.     

Risk analysis of PCB exposure via the soil-food crop pathway, and alternatives for remediation at Serpukhov, Russian Federation.

A risk assessment was conducted to determine the likelihood of certain health risks resulting from exposure to soils and food crops contaminated with polychlorinated biphenyl (PCBs). PCBs have contaminated soils, river sediments, and air in the past as a result of industrial activities at a capacitor plant located in the City of Serpukhov, Russian Federation. This risk assessment and suggestions for remediation are designed to aid in decision-making efforts by a joint Russian-American research team developing a community, national, and international response to industrial contamination. Bobovnikova et al. (The Science of the Total Environment 139/140, 357-364, [1993]) have reported that PCBs are elevated in soils and sediments, breast milk, and locally grown foods in the Serpukhov area. Data from these and other investigators have been used in this risk assessment to calculate a potential cancer risk resulting from exposure to PCBs. Our assessment indicates that members of the local population may be at increased risk of cancer, and possibly other adverse health effects, as a result of PCB contamination of their environment. Because previously unassessed environmental contamination is a common problem in the former Soviet Republics, as well as many other areas of the world, we believe this type of evaluation, using known methods, can serve as a model for assessment efforts in other parts of the globe and result in remediative efforts in regions constrained by faltering economies.     

Risk Analysis of PCB Exposure via the Soil–Food Crop Pathway, and Alternatives for Remediation at Serpukhov, Russian Federation

A risk assessment was conducted to determine the likelihood of certain health risks resulting from exposure to soils and food crops contaminated with polychlorinated biphenyl (PCBs). PCBs have contaminated soils, river sediments, and air in the past as a result of industrial activities at a capacitor plant located in the City of Serpukhov, Russian Federation. This risk assessment and suggestions for remediation are designed to aid in decision-making efforts by a joint Russian–American research team developing a community, national, and international response to industrial contamination. Bobovnikova et al. ( The Science of the Total Environment 139/140 , 357–364, [1993]) have reported that PCBs are elevated in soils and sediments, breast milk, and locally grown foods in the Serpukhov area. Data from these and other investigators have been used in this risk assessment to calculate a potential cancer risk resulting from exposure to PCBs. Our assessment indicates that members of the local population may be at increased risk of cancer, and possibly other adverse health effects, as a result of PCB contamination of their environment. Because previously unassessed environmental contamination is a common problem in the former Soviet Republics, as well as many other areas of the world, we believe this type of evaluation, using known methods, can serve as a model for assessment efforts in other parts of the globe and result in remediative efforts in regions constrained by faltering economies.     

Multi‐Exposure Pathway Model to Compare Escherichia coli O157 Risks and Interventions

The relative contributions of exposure pathways associated with cattle‐manure‐borne Escherichia coli O157:H7 on public health have yet to be fully characterized. A stochastic, quantitative microbial risk assessment (QMRA) model was developed to describe a hypothetical cattle farm in order to compare the relative importance of five routes of exposure, including aquatic recreation downstream of the farm, consumption of contaminated ground beef processed with limited interventions, consumption of leafy greens, direct animal contact, and the recreational use of a cattle pasture. To accommodate diverse environmental and hydrological pathways, existing QMRAs were integrated with novel and simplistic climate and field‐level submodels. The model indicated that direct animal contact presents the greatest risk of illness per exposure event during the high pathogen shedding period. However, when accounting for the frequency of exposure, using a high‐risk exposure‐receptor profile, consumption of ground beef was associated with the greatest risk of illness. Additionally, the model was used to evaluate the efficacy of hypothetical interventions affecting one or more exposure routes; concurrent evaluation of multiple routes allowed for the assessment of the combined effect of preharvest interventions across exposure pathways—which may have been previously underestimated—as well as the assessment of the effect of additional downstream interventions. This analysis represents a step towards a full evaluation of the risks associated with multiple exposure pathways; future incorporation of variability associated with environmental parameters and human behaviors would allow for a comprehensive assessment of the relative contribution of exposure pathways at the population level.     

Use of Multicriteria Decision Analysis to Support Weight of Evidence Evaluation

Weight of evidence (WOE) methods are key components of ecological and human health risk assessments. Most WOE applications rely on the qualitative integration of diverse lines of evidence (LOE) representing impact on ecological receptors and humans. Recent calls for transparency in assessments and justifiability of management decisions are pushing the community to consider quantitative methods for integrated risk assessment and management. This article compares and contrasts the type of information required for application of individual WOE techniques and the outcomes that they provide in ecological risk assessment and proposes a multicriteria decision analysis (MCDA) framework for integrating individual LOE in support of management decisions. The use of quantitative WOE techniques is illustrated for a hypothetical but realistic case study of selecting remedial alternatives at a contaminated aquatic site. Use of formal MCDA does not necessarily eliminate biases and judgment calls necessary for selecting remedial alternatives, but allows for transparent evaluation and fusion of individual LOE. It also provides justifiable methods for selecting remedial alternatives consistent with stakeholder and decision‐maker values.     

Evaluating the Potential for a Helicobacter pylori Drinking Water Guideline

Helicobacter pylori is a microaerophilic, gram‐negative bacterium that is linked to adverse health effects including ulcers and gastrointestinal cancers. The goal of this analysis is to develop the necessary inputs for a quantitative microbial risk assessment (QMRA) needed to develop a potential guideline for drinking water at the point of ingestion (e.g., a maximum contaminant level, or MCL) that would be protective of human health to an acceptable level of risk while considering sources of uncertainty. Using infection and gastric cancer as two discrete endpoints, and calculating dose‐response relationships from experimental data on humans and monkeys, we perform both a forward and reverse risk assessment to determine the risk from current reported surface water concentrations of H. pylori and an acceptable concentration of H. pylori at the point of ingestion. This approach represents a synthesis of available information on human exposure to H. pylori via drinking water. A lifetime risk of cancer model suggests that a MCL be set at <1 organism/L given a 5‐log removal treatment because we cannot exclude the possibility that current levels of H. pylori in environmental source waters pose a potential public health risk. Research gaps include pathogen occurrence in source and finished water, treatment removal rates, and determination of H. pylori risks from other water sources such as groundwater and recreational water.     

Uncertainty and Sensitivity Analysis in Assessment of the Thyroid Cancer Risk Related to Chernobyl Fallout in Eastern France

The increase in the thyroid cancer incidence in France observed over the last 20 years has raised public concern about its association with the 1986 nuclear power plant accident at Chernobyl. At the request of French authorities, a first study sought to quantify the possible risk of thyroid cancer associated with the Chernobyl fallout in France. This study suffered from two limitations. The first involved the lack of knowledge of spontaneous thyroid cancer incidence rates (in the absence of exposure), which was especially necessary to take their trends into account for projections over time; the second was the failure to consider the uncertainties. The aim of this article is to enhance the initial thyroid cancer risk assessment for the period 1991-2007 in the area of France most exposed to the fallout (i.e., eastern France) and thereby mitigate these limitations. We consider the changes over time in the incidence of spontaneous thyroid cancer and conduct both uncertainty and sensitivity analyses. The number of spontaneous thyroid cancers was estimated from French cancer registries on the basis of two scenarios: one with a constant incidence, the other using the trend observed. Thyroid doses were estimated from all available data about contamination in France from Chernobyl fallout. Results from a 1995 pooled analysis published by Ron et al. were used to determine the dose-response relation. Depending on the scenario, the number of spontaneous thyroid cancer cases ranges from 894 (90% CI: 869-920) to 1,716 (90% CI: 1,691-1,741). The number of excess thyroid cancer cases predicted ranges from 5 (90% UI: 1-15) to 63 (90% UI: 12-180). All of the assumptions underlying the thyroid cancer risk assessment are discussed.     

Some Considerations on the Definition of Risk Based on Concepts of Systems Theory and Probability

The concept of risk has been applied in many modern science and technology fields. Despite its successes in many applicative fields, there is still not a well‐established vision and universally accepted definition of the principles and fundamental concepts of the risk assessment discipline. As emphasized recently, the risk fields suffer from a lack of clarity on their scientific bases that can define, in a unique theoretical framework, the general concepts in the different areas of application. The aim of this article is to make suggestions for another perspective of risk definition that could be applied and, in a certain sense, generalize some of the previously known definitions (at least in the fields of technical and scientific applications). By drawing on my experience of risk assessment in different applicative situations (particularly in the risk estimation for major industrial accidents, and in the health and ecological risk assessment for contaminated sites), I would like to revise some general and foundational concepts of risk analysis in as consistent a manner as possible from the axiomatic/deductive point of view. My proposal is based on the fundamental concepts of the systems theory and of the probability. In this way, I try to frame, in a single, broad, and general theoretical context some fundamental concepts and principles applicable in many different fields of risk assessment. I hope that this article will contribute to the revitalization and stimulation of useful discussions and new insights into the key issues and theoretical foundations of risk assessment disciplines.     

Probabilistic Health Risk Assessment for Exposures to Estuary Sediments and Biota Contaminated with Polychlorinated Biphenyls, Polychlorinated Terphenyls and Other Toxic Substances

A Latin Hypercube probabilistic risk assessment methodology was employed in the assessment of health risks associated with exposures to contaminated sediment and biota in an estuary in the Tidewater region of Virginia. The primary contaminants were polychlorinated biphenyls (PCBs), polychlorinated terphenyls (PCTs), polynuclear aromatic hydrocarbons (PAHs), and metals released into the estuary from a storm sewer system. The exposure pathways associated with the highest contaminant intake and risks were dermal contact with contaminated sediment and ingestion of contaminated aquatic and terrestrial biota from the contaminated area. As expected, all of the output probability distributions of risk were highly skewed, and the ratios of the expected value (mean) to median risk estimates ranged from 1.4 to 14.8 for the various exposed populations. The 99th percentile risk estimates were as much as two orders of magnitude above the mean risk estimates. For the sediment exposure pathways, the stability of the median risk estimates was found to be much greater than the stability of the expected value risk estimates. The interrun variability in the median risk estimate was found to be +/-1.9% at 3000 iterations. The interrun stability of the mean risk estimates was found to be approximately equal to that of the 95th percentile estimates at any number of iterations. The variation in neither contaminant concentrations nor any other single input variable contributed disproportionately to the overall simulation variance. The inclusion or exclusion of spatial correlations among contaminant concentrations in the simulation model did not significantly effect either the magnitude or the variance of the simulation risk estimates for sediment exposures.     

Remedial Policies in Radiologically-Contaminated Forests: Environmental Consequences and Risk Assessment

As a result of the Chernobyl nuclear power plant accident in 1986, large forested areas in Europe were contaminated by radionuclides. Extensive societal pressure has been exerted to decrease the radiation dose to the population and to the environment. Thus, in making abatement and remediation policy decisions not only economic costs, but also human and environmental risk assessment are desired. Forest remediation by organic layer removal, one of the most promising cleanup policies, is considered in this paper. Ecological risk assessment requires evaluation of the radionuclide distribution in forests. The FORESTPATH model^(1,2) is used for predicting the radionuclide fate in forest compartments after deposition as well as for evaluating the application of the remedial policy. Time of intervention and radionuclide deposition profile was predicted as being crucial for the remediation efficiency. Risk assessment conducted for a critical group of forest users in Belarus shows that consumption of forest products (berries and mushrooms) leads to about 0.004% risk of a fatal cancer. Cost-benefit analysis for forest cleanup suggests that complete removal of organic layer is too expensive for application in Belarus.     

The Contrast Between Risk Assessment and Rules of Evidence in the Context of International Trade Disputes: Can the U.S. Experience Inform the Process?

Risk assessment provides a formalized process to evaluate human, animal, and ecological responses associated with exposure to environmental agents. The purpose of risk assessment is to answer two related questions.

• ? How likely is an (adverse) event to occur?
• ? If it does, how severe will the impact be?

In the United States, the science of risk assessment has evolved out of the necessity to make public health decisions in the face of scientific uncertainty. Its basic propositions have been established over the past three decades and its applications have impacted virtually every aspect of public health and environmental protection in many countries, including the United States. More recently, the World Trade Organization's (WTO) dispute‐settlement process has provided additional incentive for the reliance on risk assessments internationally through the requirement that member countries be able to provide scientific justification, based on a risk assessment, for public health and environmental regulatory measures that are challenged. The purpose of this article is to review the history of risk assessment in the United States, emphasizing the development of both its scientific and policy aspects, as one example of the development of institutional capacity for risk assessment. This article discusses the importance of the social, political, and economic contexts of risk assessment and risk management in shaping the approaches taken while highlighting the reality that the analytic or risk assessment part of the decision‐making process, in the absence of scientific data, can be completed only by inserting inferences, or policy judgments, which may differ among countries. This article recognizes these differences, and the consequent difference between risk assessment that incorporates public health protective assumptions and the rules of evidence that seek to answer questions of causality, and discusses implications for the WTO dispute‐settlement process. It further explores the value of country‐specific risk assessment guidelines to facilitate consistency within a country along with the appropriateness and feasibility of international risk assessment guidelines.     

Communicating Food Risks in an Era of Growing Public Distrust: Three Case Studies

The communication and regulation of risk has changed significantly over the past 30 years in Europe and to a noticeable but lesser extent in the United States. In Europe, this is partly due to a series of regulatory mishaps, ranging from mad cow disease in the United Kingdom to contamination of the blood supply in France. In the United States, general public confidence in the American government has been gradually declining for more than three decades, driven by a mix of cultural and political conflicts like negative political advertising, a corrosive news media, and cuts in regulatory budgets. While the former approach is based on an objective assessment of the risk, the latter is driven more by the perception of the risk, consumer sentiment, political will, and sectoral advocacy. In this article, the author examines three U.S.‐based food case studies (acrylamide, bisphenol A, and artificial food colorings) where regulations at the local and state levels are increasingly being based on perceived risk advocacy rather than on the most effective response to the risk, be it to food safety or public health, as defined by regulatory interpretation of existing data. In the final section, the author puts forward a series of recommendations for how U.S.‐based regulators can best handle those situations where the perceived risk is markedly different from the fact‐based risk, such as strengthening the communication departments of food regulatory agencies, training officials in risk communication, and working more proactively with neutral third‐party experts.     

Waterborne Disease‐Related Risk Perceptions in the Sonora River Basin,Mexico

Waterborne disease is estimated to cause about 10% of all diseases worldwide. However, related risk perceptions are not well understood, particularly in the developing world where waterborne disease is an enormous problem. We focus on understanding risk perceptions related to these issues in a region within northern Mexico. Our findings show how waterborne disease problems and solutions are understood in eight small communities along a highly contaminated river system. We found major differences in risk perceptions between health professionals, government officials, and lay citizens. Health professionals believed that a high level of human‐waste‐related risk existed within the region. Few officials and lay citizens shared this belief. In addition, few officials and lay citizens were aware of poor wastewater‐management‐related disease outbreaks and water contamination. Finally, aside from health professionals, a few interviewees understood the importance of basic hygiene and water treatment measures that could help to prevent disease. Our results add to the literature on environmentally‐related risk perceptions in the developing world. We discuss recommendations for improving future human‐wastewater‐related risk communication within the region.     

Workplace Change and Employee Mental Health: Results from a Longitudinal Study

This study is intended to improve understanding of the impact of workplace change on employee mental health and well‐being. We construct and test a comprehensive measure of organizational change, which is then applied in a prospective longitudinal study of nearly 5400 employees in six UK National Health Service Trusts. Self‐rated mental health was assessed using the 12‐item version of the General Health Questionnaire (GHQ). Just under a quarter of the sample were at increased risk of psychiatric morbidity (‘cases’). After controlling for a wide range of personal characteristics and work variables, it was found that respondents who reported an increase in the amount of work over the previous year were more likely to be classed as GHQ cases, whereas increased training and promotion and improved job security had a beneficial effect on employee mental health (less likelihood of being GHQ cases). Quantity or degree of change showed a somewhat ambiguous relationship with GHQ status. Our findings challenge the assumption that change will necessarily have an adverse effect on health, indicating areas, such as promotion and development, where a positive impact might be anticipated.     

Building a Human Health Risk Assessment Ontology (RsO): A Proposed Framework

Over the last decade the health and environmental research communities have made significant progress in collecting and improving access to genomic, toxicology, exposure, health, and disease data useful to health risk assessment. One of the barriers to applying these growing volumes of information in fields such as risk assessment is the lack of informatics tools to organize, curate, and evaluate thousands of journal publications and hundreds of databases to provide new insights on relationships among exposure, hazard, and disease burden. Many fields are developing ontologies as a way of organizing and analyzing large amounts of complex information from multiple scientific disciplines. Ontologies include a vocabulary of terms and concepts with defined logical relationships to each other. Building from the recently published exposure ontology and other relevant health and environmental ontologies, this article proposes an ontology for health risk assessment (RsO) that provides a structural framework for organizing risk assessment information and methods. The RsO is anchored by eight major concepts that were either identified by exploratory curations of the risk literature or the exposure‐ontology working group as key for describing the risk assessment domain. These concepts are: (1) stressor, (2) receptor, (3) outcome, (4) exposure event, (5) dose‐response approach, (6) dose‐response metric, (7) uncertainty, and (8) measure of risk. We illustrate the utility of these concepts for the RsO with example curations of published risk assessments for ionizing radiation, arsenic in drinking water, and persistent pollutants in salmon.     

Cross-Contamination During Food Preparation: A Mechanistic Model Applied to Chicken-Borne Campylobacter

We develop a model for bacterial cross-contamination during food preparation in the domestic kitchen and apply this to the case of Campylobacter-contaminated chicken breast. Building blocks of the model are the routines performed during food preparation, with their associated probabilities of bacterial transfer between food items and kitchen utensils. The model is used in a quantitative microbiological risk assessment (QMRA) of Campylobacter in the Netherlands. Using parameter values from the literature and performing elementary sensitivity analyses, we show that cross-contamination can contribute significantly to the risk of Campylobacter infection and find that cleaning frequency of kitchen utensils and thoroughness of rinsing of raw food items after preparation has more impact on cross-contamination than previously emphasized. Furthermore, we argue that especially more behavioral data on hygiene during food preparation is needed for a comprehensive Campylobacter risk assessment.     

Quantitative Risk Assessment of Listeria monocytogenes in French Cold-Smoked Salmon: I. Quantitative Exposure Assessment

A quantitative assessment of the exposure to Listeria monocytogenes from cold-smoked salmon (CSS) consumption in France is developed. The general framework is a second-order (or two-dimensional) Monte Carlo simulation, which characterizes the uncertainty and variability of the exposure estimate. The model takes into account the competitive bacterial growth between L. monocytogenes and the background competitive flora from the end of the production line to the consumer phase. An original algorithm is proposed to integrate this growth in conditions of varying temperature. As part of a more general project led by the French Food Safety Agency (Afssa), specific data were acquired and modeled for this quantitative exposure assessment model, particularly time-temperature profiles, prevalence data, and contamination-level data. The sensitivity analysis points out the main influence of the mean temperature in household refrigerators and the prevalence of contaminated CSS on the exposure level. The outputs of this model can be used as inputs for further risk assessment.     

A Stochastic Model to Assess the Effect of Meat Inspection Practices on the Contamination of the Pig Carcasses

The objective of meat inspection is to promote animal and public health by preventing, detecting, and controlling hazards originating from animals. With the improvements of sanitary level in pig herds, the hazards profile has shifted and the inspection procedures no longer target major foodborne pathogens (i.e., not risk based). Additionally, carcass manipulations performed when searching for macroscopic lesions can lead to cross‐contamination. We therefore developed a stochastic model to quantitatively describe cross‐contamination when consecutive carcasses are submitted to classic inspection procedures. The microbial hazard used to illustrate the model was Salmonella, the data set was obtained from Brazilian slaughterhouses, and some simplifying assumptions were made. The model predicted that due to cross‐contamination during inspection, the prevalence of contaminated carcass surfaces increased from 1.2% to 95.7%, whereas the mean contamination on contaminated surfaces decreased from 1 logCFU/cm² to ?0.87 logCFU/cm², and the standard deviations decreased from 0.65 to 0.19. These results are explained by the fact that, due to carcass manipulations with hands, knives, and hooks, including the cutting of contaminated lymph nodes, Salmonella is transferred to previously uncontaminated carcasses, but in small quantities. These small quantities can easily go undetected during sampling. Sensitivity analyses gave insight into the model performance and showed that the touching and cutting of lymph nodes during inspection can be an important source of carcass contamination. The model can serve as a tool to support discussions on the modernization of pig carcass inspection.