Modeling for Risk Assessment of Neurotoxic Effects

The regulation of noncancer toxicants, including neurotoxicants, has usually been based upon a reference dose (allowable daily intake). A reference dose is obtained by dividing a no-observed-effect level by uncertainty (safety) factors to account for intraspecies and interspecies sensitivities to a chemical. It is assumed that the risk at the reference dose is negligible, but no attempt generally is made to estimate the risk at the reference dose. A procedure is outlined that provides estimates of risk as a function of dose. The first step is to establish a mathematical relationship between a biological effect and the dose of a chemical. Knowledge of biological mechanisms and/or pharmacokinetics can assist in the choice of plausible mathematical models. The mathematical model provides estimates of average responses as a function of dose. Secondly, estimates of risk require selection of a distribution of individual responses about the average response given by the mathematical model. In the case of a normal or lognormal distribution, only an estimate of the standard deviation is needed. The third step is to define an adverse level for a response so that the probability (risk) of exceeding that level can be estimated as a function of dose. Because a firm response level often cannot be established at which adverse biological effects occur, it may be necessary to at least establish an abnormal response level that only a small proportion of individuals would exceed in an unexposed group. That is, if a normal range of responses can be established, then the probability (risk) of abnormal responses can be estimated. In order to illustrate this process, measures of the neurotransmitter serotonin and its metabolite 5-hydroxyindoleacetic acid in specific areas of the brain of rats and monkeys are analyzed after exposure to the neurotoxicant methylene-dioxymethamphetamine. These risk estimates are compared with risk estimates from the quantal approach in which animals are classified as either abnormal or not depending upon abnormal serotonin levels.     

A comparative approach to assessing the quality of life of intercollegiate athletes

Although concerns have frequently been raised recently regarding the quality of life of intercollegiate athletes, information is seldom available on which college and university administrators can base policy decisions. Particularly lacking are studies that provide administrators with assessments of their own athletics programs relative to athletics programs at other institutions. We describe here a method we used in conducting a comparative evaluation of the status of student-athletes at a large public university, involving comparisons of student-athletes at this university to student-athletes at a subset of the institutions that participated in the 1987–88 National Study of Intercollegiate Athletes. By utilizing existing data sets to construct comparison samples, relative assessments of the status of student-athletes at a given institution can be performed without the excessive costs of gathering data on student-athletes at comparison institutions. Techniques employed in data collection and analysis are discussed as well as the format of the report in which the findings of the study were presented.     

The impact of ideology on regulation: The case of board and care homes

Debates about regulatory efforts to monitor the delivery of health and long-term care have become commonplace in health policy. Efforts to examine the key assumptions underlying the current regulatory strategies have been limited, however. Using the board and care industry as an example, this article examines how ideology influences the regulatory strategy developed. Three ideological perspectives-a free-market approach, a market correction strategy, and a critical policy framework-are reviewed in the context of efforts to regulate board and care homes in the United States. Differences in approaches to regulating board and care are presented for each of the major perspectives.     

Partner Choice and the Differential Retreat From Marriage

The contemporary retreat from marriage in the United States has had a differential impact across socioeconomic and racial groups. Here, 1990 marriage rates and propensities for Virginia, North Carolina, and Wisconsin are analyzed regarding (a) the likelihood that persons in different groups ever marry and (b) patterns of partner choice with respect to race and educational level. Marriage remains strong in most race‐education groups but is substantially lower among Blacks and among those with less than 12 years of education. Patterns of partner choice have shifted to show greater symmetry between the educational levels of brides and grooms. Changes have been modest with regard to the level and pattern of interracial (Black‐White) marriage. Marriage is increasingly a union of equals, but a union chosen more by Whites than by Blacks and more by the well educated than by the poorly educated.     

Exposure Reconstruction for the TCDD-Exposed NIOSH Cohort Using a Concentration- and Age-Dependent Model of Elimination

Recent studies demonstrating a concentration dependence of elimination of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) suggest that previous estimates of exposure for occupationally exposed cohorts may have underestimated actual exposure, resulting in a potential overestimate of the carcinogenic potency of TCDD in humans based on the mortality data for these cohorts. Using a database on U.S. chemical manufacturing workers potentially exposed to TCDD compiled by the National Institute for Occupational Safety and Health (NIOSH), we evaluated the impact of using a concentration- and age-dependent elimination model (CADM) (Aylward et al., 2005) on estimates of serum lipid area under the curve (AUC) for the NIOSH cohort. These data were used previously by Steenland et al. (2001) in combination with a first-order elimination model with an 8.7-year half-life to estimate cumulative serum lipid concentration (equivalent to AUC) for these workers for use in cancer dose-response assessment. Serum lipid TCDD measurements taken in 1988 for a subset of the cohort were combined with the NIOSH job exposure matrix and work histories to estimate dose rates per unit of exposure score. We evaluated the effect of choices in regression model (regression on untransformed vs. ln-transformed data and inclusion of a nonzero regression intercept) as well as the impact of choices of elimination models and parameters on estimated AUCs for the cohort. Central estimates for dose rate parameters derived from the serum-sampled subcohort were applied with the elimination models to time-specific exposure scores for the entire cohort to generate AUC estimates for all cohort members. Use of the CADM resulted in improved model fits to the serum sampling data compared to the first-order models. Dose rates varied by a factor of 50 among different combinations of elimination model, parameter sets, and regression models. Use of a CADM results in increases of up to five-fold in AUC estimates for the more highly exposed members of the cohort compared to estimates obtained using the first-order model with 8.7-year half-life. This degree of variation in the AUC estimates for this cohort would affect substantially the cancer potency estimates derived from the mortality data from this cohort. Such variability and uncertainty in the reconstructed serum lipid AUC estimates for this cohort, depending on elimination model, parameter set, and regression model, have not been described previously and are critical components in evaluating the dose-response data from the occupationally exposed populations.     

The prevalence rates of pathological gambling: A look at methods

Planning the gambling environment requires protection of the public's health, safety and welfare. Whereas most public gaming provisions and statutes address the public's fears of organized crime as well as some welfare needs, rarely do they safeguard the public's health regarding the spread of the mental disease known as pathological gambling. Measurement of the prevalence and incidence of this disease would enable policy planners to evaluate both the state's responsibility for an epidemic and the adequacy of publicly funded treatment programs. The purpose of this paper is to examine the methods which underlie three different estimates of the prevalence rate of pathological gambling and to critique them in the light of sound epidemiological procedure. In 1975, the Institute for Social Research (ISR) of the University of Michigan conducted a national survey and a survey of the state of Nevada on behalf of the U.S. Commission on a National Policy Toward Gambling. Using discriminant function analysis coupled with subjective inspection of cases in the at-risk pool, the researchers estimated rates of probable and potential pathological gamblers. In 1984 and 1985, this author surveyed residents in the Delaware Valley and the state of Ohio using the cumulative clinical signs method which also posited rates of probable and potential pathological gamblers. In 1986, researchers at the Office of Mental Health for the State of New York employed a formal screening device to survey residents and proposed a rate of probable pathological gamblers and a rate of problem — although not pathological — gamblers. All three approaches produced different estimates. The utility of prevalence and incidence rate research in this field is threatened by a lack of consensus about the proper epidemiological procedure to be employed in arriving at these estimates. There is also confusion about the distinction between a probable and a potential pathological gambler. The planning purpose, method, validity and reliability of prevalence rate research about pathological gambling are addressed in this paper.     

Policies and strategies for integrating women in agriculture and rural development

Continued economic stagnation, civil unrest, rural-urban migration, and a series of natural disasters have impeded efforts in the Sudan to integrate women into the development process. Although the Four-Year (1988-1989 to 1991-92) Salvation, Recovery, and Development Programs Plan does not explicitly addresses women's issues, its emphasis on food security, appropriate technology for the agricultural sector, small-scale industries and handicrafts, balanced regional development, and the needs of the poorest 20% of the population guarantees that women will be major recipients. There remains a need, however, to increase women's participation in the development planning process and to base projects on reliable data on women's economic activities. More successful in defining women's needs have been community development projects--Western Savannah Development Corporation, Blue Nile Integrated Rural Development Project, Nuba Mountain Project, and Jebel Marra Rural Development Project--that combine income generation, social welfare, and agricultural research. It is recommended that all such large integrated rural development or agricultural projects allot funds specifically for women's activities and ensure coordination with women's organizations to avoid duplication and identify areas of greatest need. Also urged is the development of appropriate technologies that will alleviate women's double burden of poverty and household chores and address the inequitable distribution of income. Establishment of a women's bureau for women's affairs and development within the National Planning Department would facilitate project formulation and evaluation. In need of change if women in development projects in the Sudan are to be successful are laws that limit female land ownership and practices that deny women loans and credit.