Health risk assessment

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Health risk assessment: comprehensive analysis and practical application

I. Fundamentals of health risk assessment (acute respiratory infections)

Assessment of health risks (acute respiratory infections), also known as Health Risk Assessment (HRA), is a systematic process aimed at identifying, evaluating and characterizing the potential negative consequences of human health caused by the effects of various environmental factors, lifestyle, professional activity or other danger sources. ARZ is an interdisciplinary science that combines the principles of toxicology, epidemiology, medicine, statistics, engineering and social sciences.

A. Goals and tasks ORZ

The main goal of the ARI is to provide scientifically substantiated information for decision -making aimed at minimizing or eliminating health risks. Specific tasks of acute respiratory infections include:

  1. Dangers identification: Determination of potential factors that can harm health (for example, chemicals, biological agents, physical factors).
  2. Exposition rating: Determination of the degree and duration of the impact of the assessed factor on the population or individual groups of the population.
  3. Assessment of the dependence of “Dose-answer”: Determination of a quantitative relationship between the level of exposure and the probability of an adverse effect.
  4. Risk characteristic: Integration of information obtained in previous stages to assess the probability and severity of potential health consequences.
  5. Risk communication: Providing information about risks to interested parties (population regulatory bodies, health specialists) in an understandable and affordable form.
  6. Risk management: Development and implementation of measures to reduce or eliminate identified risks.

B. The principles of acute respiratory infections

ARI is based on several key principles:

  1. Scientific validity: The assessment should be based on the best available scientific data and methodologies.
  2. Transparency: The evaluation process should be open and understandable, with a clear explanation of the methods used and assumptions.
  3. Complexity: The assessment should take into account all the significant factors affecting the risk, including the characteristics of the population, environmental factors and the features of the exposition.
  4. Assessment of uncertainty: It is necessary to evaluate and report the uncertainty associated with the assessment of risk, and their impact on the results.
  5. Iteration: The evaluation process should be iterative, allowing you to take into account new information and adjust the assessment as necessary.
  6. Human health orientation: The main priority is the protection of human health.

C. Types of acute respiratory infections

There are several types of acute respiratory infections that differ in their goals, scale and methodologies:

  1. Environmental risk assessment (eor): Assesses human health risks associated with the effects of pollutants in the environment (air, water, soil).
  2. Assessment of health risks associated with food products: Evals the risks associated with the consumption of food products containing harmful substances (for example, pesticides, heavy metals, microorganisms).
  3. Professional health risk assessment: Evals the risks of the health of workers associated with their professional activities (for example, the impact of chemicals, physical factors, ergonomic factors).
  4. Assessment of health risks associated with drugs: Evals the risks associated with the use of drugs (for example, side effects, interaction with other drugs).
  5. Assessment of health risks associated with consumer goods: Evals the risks associated with the use of consumer goods (for example, cosmetics, household chemicals, toys).
  6. Assessment of health risks associated with climate change: Assesses health risks associated with climate change, such as thermal waves, floods, the spread of infectious diseases.

II. Stages of assessing health risks

The ARZ process usually consists of four main stages: hazard identification, exposure assessment, assessment of the dependence of the “dose-answer” and risk characteristics.

A. Identification of dangers

Identification of dangers is the first stage of acute respiratory infections aimed at determining potential factors that can harm health. This stage includes the collection and analysis of information about the properties of the evaluated factor, its toxicity, ways of exposure and possible health effects.

  1. Collection and analysis of data: Data from various sources, such as scientific publications, databases, reports of regulatory bodies and toxicological studies, are collected. The physicochemical properties of the evaluated factor, its metabolism, toxic action mechanisms and possible ways of affecting the human body (for example, inhalation, oral, skin) are analyzed.
  2. Assessment of toxicity: The ability of the evaluated factor is evaluated to cause adverse health effects. Animal research data (in vivo) and on cell cultures (in vitro), as well as epidemiological studies in humans, are used. Critical effects (the most sensitive and significant adverse effects) and threshold levels of exposure are determined (levels below which are not expected to occur adverse effects).
  3. Classification of dangers: The evaluated factor is classified according to the degree of danger based on established criteria. Various classification systems are used, such as the classification of the International Cancer Study (IARC) agency for carcinogens or the classification of Globally Harmonized System (GHS) for chemicals.
  4. Determination of the target population: A group of the population is determined for which risk is assessed. This can be a common population, a certain age group (for example, children), a professional group (for example, chemical industry workers) or a population living in a certain geographical zone.
  5. Determination of the end points of the assessment: Specific health indicators are determined that will be used to assess risk. These can be specific diseases (for example, lung cancer, asthma), exposure biomarkers (for example, the concentration of lead in the blood) or mortality indicators.

B. Evaluation of the exposition

The exposure assessment is the second stage of the ARI aimed at determining the degree and duration of the impact of the assessed factor on the population or individual groups of the population. This stage includes the determination of the ways of exposure, the concentration of the evaluated factor in various environments (air, water, soil, food), the duration of exposure and characteristics of the population exposed.

  1. Determining the ways of exposure: The main paths are determined by which the evaluated factor can enter the human body (for example, inhalation path – inhalation of contaminated air, the oral path – the use of contaminated water or food, the skin path – contact with contaminated soil or surfaces).
  2. Determination of concentration: The concentration of the evaluated factor in various environments is determined with which the population contacts (for example, the concentration of pollutants in the air, the concentration of pesticides in food products, the concentration of lead in drinking water). To determine the concentration, environmental monitoring data, analytical measurements, modeling of the spread of pollutants and other methods are used.
  3. Assessment of duration and frequency of influence: The duration and frequency of exposure to the evaluated factor on the population (for example, the length of stay in the contaminated territory, the frequency of consumption of polluted foods, the duration of the working shift under the influence of professional harmfulnesses) is estimated.
  4. Dose rating: Based on the concentration data, ways of exposure, duration and frequency of exposure, the dose of the evaluated factor entering the human body is calculated. To calculate the dose, various models and formulas are used that take into account the physiological parameters of a person (for example, body weight, respiratory rate, water and food consumption rate).
  5. Assessment of susceptibility: The susceptibility of various groups of the population is evaluated to the influence of the evaluated factor. Some groups of the population, such as children, pregnant women, elderly people and people with chronic diseases, can be more susceptible to adverse effects.

C. Assessment of the dependence “Dose-response”

Assessment of the dependence of the “dose-fast” is the third stage of the ARI, aimed at determining the quantitative connection between the level of exposure to the evaluated factor and the probability of an adverse effect on health. This stage includes an analysis of the data of toxicological and epidemiological studies, the construction of the “dose-answer” curves and the determination of reference doses or concentrations.

  1. Analysis of toxicological data: Animal research data (in vivo) and on cell cultures (in vitro) are analyzed to determine the dependence between the dose of the evaluated factor and the frequency or the severity of adverse effects. Key toxicity indicators are determined, such as LD50 (a lethal dose causing death of 50% of animals) and Noael (the level of absence of observed adverse effects).
  2. Analysis of epidemiological data: The data of epidemiological studies in humans are analyzed to determine the dependence between the level of exposure to the assessed factor and the risk of diseases. Various statistical methods are used to evaluate relative risk (RR) and chances (OR) relations.
  3. Building the “Dose-Relate” curves: Based on these toxicological and epidemiological studies, curves are built, displaying the dependence between the dose of the evaluated factor and the probability of an adverse effect.
  4. Determination of reference doses or concentrations: Reference doses (RFD) or reference concentrations (RFC) are determined, which are assessments of the level of exposure to the evaluated factor, in which the occurrence of adverse effects for human health, even with prolonged exposure. Reference doses and concentrations are calculated on the basis of these toxicological studies using various uncertainty factors to take into account differences between animals and people, differences between individuals and insufficient information about the toxicity of the evaluated factor.
  5. Accounting for action mechanisms: When evaluating the dependence of the “dose-answer”, it is necessary to take into account the known mechanisms of the action of the evaluated factor. For example, for carcinogenic substances that do not have a threshold, linear extrapolation is used from high doses to low ones, suggesting that even low levels of exposure can increase the risk of cancer.

D. Risk characteristic

The risk characteristic is the fourth and final stage of acute respiratory infections aimed at integrating information obtained at the previous stages to assess the probability and severity of potential health consequences. This stage includes the calculation of risk indicators, assessment of uncertainty and risk communication.

  1. Calculation of risk indicators: Various risk indicators, such as the hazard quotient, HQ) and hazard index (HI) index are calculated for non -canceular effects, as well as the likelihood of excessive risk (Excess Lifetime Cancer, ElCR) for carcinogenic effects.
    • The danger index (HQ) is calculated as the ratio of the actual dose of exposure to the reference dose (HQ = dose / RFD). If hq 1, then there is a potential risk to health.
    • The danger index (HI) is calculated as the sum of the hazard indices for several substances that affect the same organ or system (Hi = HQ1 + HQ2 + …). If Hi 1, then there is a potential risk to health.
    • The probability of excessive risk of cancer (ELCR) is calculated as a product of the dose of exposure to the inclination factor (Slope Factor, SF), which is an assessment of an increase in the risk of cancer per unit of dose (ELCR = dose X SF). Usually an acceptable ELCR level is considered 10^-6 (one case of cancer per million people).
  2. Assessment of uncertainty: The uncertainty associated with the assessment of risk, and their impact on the results are evaluated. Uncertainty can occur at each stage of acute respiratory infections, for example, due to insufficient information about the toxicity of the evaluated factor, inaccurate data on concentration and exposure, or the use of simplified models.
  3. Risk communication: Information about the risks of interested parties (population regulating bodies, health specialists) in an understandable and affordable form is provided. Risk assessment results, the main sources of uncertainty and recommendations on risk management are reported. It is important to take into account the features of the target audience and use the relevant communication channels (for example, media publications, websites, public hearings).
  4. Sensitivity analysis: The sensitivity analysis is carried out to determine which factors have the greatest impact on the results of risk assessment. This allows you to concentrate efforts to reduce uncertainty in the most important areas.
  5. Comparison with reference values: The resulting results of risk assessment are compared with reference values ​​established by regulatory bodies or other organizations. This allows you to determine how the revealed risk exceeds the permissible levels.

III. The use of acute respiratory infections in various fields

ARI is widely used in various areas, including:

A. Environmental health

ARI is an important tool for evaluating and managing risks associated with environmental pollution. It is used for:

  1. Air pollution risk assessment: Assessment of health risk associated with the effects of pollutants in atmospheric air (for example, solid particles, nitrogen oxides, ozone).
  2. Water pollution risk assessment: Assessment of health risk associated with the consumption of contaminated water (for example, containing heavy metals, pesticides, microorganisms).
  3. Assessment of the risk of soil pollution: Assessment of health risk associated with contact with contaminated soil (for example, containing heavy metals, organic pollutants).
  4. Risk assessment in polluted territories: Assessment of risk to the health of the population living or working in territories polluted by industrial waste or other sources of pollution.
  5. Development of environmental quality standards: ARI is used to develop air quality, water and soil quality standards, which provide protection of public health.
  6. Assessment of the impact of new projects: ARI is carried out to assess the potential impact on the health of the population of new industrial enterprises, infrastructure projects and other activities.

B. Labor protection

ARI is an important tool for ensuring the safety and health of workers at workplaces. It is used for:

  1. Assessment of the risk of chemicals at workplaces: Assessment of the risk of health of workers exposed to chemicals (for example, solvents, acids, alkalis).
  2. Risk assessment of physical factors at workplaces: Assessment of the risk of health of workers exposed to physical factors (for example, noise, vibration, electromagnetic fields).
  3. Assessment of the risk of biological factors at workplaces: Assessment of the risk of health of workers exposed to biological factors (for example, bacteria, viruses, fungi).
  4. Development of measures to reduce professional risks: ARI is used to develop and implement measures to reduce or eliminate identified risks for the health of workers, such as improving ventilation, using personal protective equipment, and the organization of medical examinations.
  5. Risk assessment of ergonomic factors: Assessment of risk to the health of workers associated with the wrong organization of the workplace, repeated movements and other ergonomic factors.

C. Food safety

ARI is an important tool for ensuring food safety and consumer health protection. It is used for:

  1. Assessment of the risk of chemicals in food products: Evaluation of the risk of consumer health associated with food consumption containing chemicals (for example, pesticides, heavy metals, food additives).
  2. Risk assessment of microbiological pollution of food products: Evaluation of the risk of consumer health associated with the consumption of food products infected with microorganisms (for example, bacteria, viruses, parasites).
  3. Risk assessment of allergens in food products: Assessment of risk to consumer health suffering from certain foods.
  4. Development of food safety standards: ARI is used to develop food safety standards that provide consumer health.
  5. Risk assessment of new foods: ARI is carried out to assess the potential risk of consumers of new food products, such as genetically modified products.

D. Development of drugs

ARI is an important stage in the development and assessment of the safety of drugs. It is used for:

  1. Assessment of the toxicity of drugs: Assessment of the toxicity of new drugs at the preclinical stage, including animal research and in vitro.
  2. Risk assessment of side effects of drugs: Assessment of the risk of side effects of medicines on clinical trials and after registration of the drug.
  3. Assessment of the risk of drug interaction: Assessment of the risk of interaction between drugs with other medicines or food products.
  4. Development of measures to minimize risks associated with drugs: ARI is used to develop measures to minimize risks associated with drugs, such as warning about side effects, restrictions on the use and monitoring of medicinal safety.

E. Development of consumer goods

ARI is used to assess the safety of consumer goods, such as cosmetics, household chemicals and toys.

  1. Assessment of the risk of chemicals in consumer goods: Evaluation of the risk of consumer health associated with the effects of chemicals contained in consumer goods.
  2. Assessment of the risk of physical dangers associated with consumer goods: Assessment of the risk of injuries and other physical dangers associated with the use of consumer goods.
  3. Development of consumer security standards: ARI is used to develop consumer safety standards that provide consumer health.

IV. Methodology of acute respiratory infections

There are many methodologies of acute respiratory infections that differ in their complexity and area of ​​application. Some of the most common methodologies include:

A. Traditional ARIS (US EPA RISK ASSESSMENT FRAMEWORK)

The traditional ARI, developed by the US Environmental Protection Agency (US EPA), is the most common acute respiratory system. It consists of four main stages: hazard identification, exposure assessment, assessment of the dependence of the “dose-answer” and risk characteristics.

B. Monte Carlo Modeling

Monte Carlo Modeling is a statistical method used to assess uncertainty in acute respiratory infections. It allows you to simulate random values ​​characterizing various risk assessment parameters, and evaluate the distribution of probability for the final indicators of risk.

C. Events Analysis (Event Tree Analysis, ETA)

Analysis of the tree tree is a method used to identify and assess the sequence of events that can lead to an adverse outcome for health. It allows you to visualize and quantify various scenarios for the development of adverse events.

D. Fairy Tree (Fault Tree Analysis, FTA)

Analysis of the failure tree is a method used to identify and analyze the causes that can lead to the failure of the system and the occurrence of adverse health consequences. It allows you to visualize and quantify various factors that contribute to the emergence of adverse events.

E. Physiologically justified pharmacokinetic (FOFK) Modeling (Physiological Based Pharmacokinetic, PBPK Modeling)

FOFK Modeling is a method used to simulate the distribution and metabolism of chemicals in the human body. It allows you to more accurately evaluate the dose of exposure to target organs and tissues and take into account individual differences in physiological parameters.

F. Approach approaches (Evidence Approaches)

These approaches, more and more often used in acute respiratory infections, are based on a systematic review and analysis of available scientific data to increase the reliability and transparency of the evaluation process. They include methods, such as Grading of Recommentations Assessment, Development and Evaluation) to assess the quality of evidence and approaches to systematic search, select and integrate data.

V. Problems and ORZ prospects

ARI is a complex and constantly developing area of ​​science. There are a number of problems and challenges that experts in the field of acute respiratory infections are faced:

  1. Data lack: The lack of data on the toxicity of many chemicals and other factors affecting health.
  2. Uncertainty: The presence of uncertainties at each stage of acute respiratory infections associated with insufficient information, the use of simplified models and the differences between animals and people.
  3. The difficulty of assessing complex impact: The complexity of assessing the complex effect of several factors that simultaneously affect the human body.
  4. Risk communication: Difficulties in the communication of risks to interested parties in an understandable and affordable form.
  5. Ethical questions: Ethical issues related to the use of acute respiratory infections for making decisions affecting public health.

Despite these problems, ARS continues to develop and improve. In the future, it is expected:

  1. Development of new methods for assessing toxicity: The development of new methods for assessing toxicity based on genomics, proteomics and metabolomics.
  2. Improving the exposition models: Improving the exposure models that allow more accurately evaluate the dose of influence, taking into account individual differences and environmental factors.
  3. Development of methods for evaluating complex impact: The development of methods for evaluating the integrated effects of several factors that affect the human body.
  4. Improving risk communication: Improving the communication of risk to interested parties using interactive tools and social networks.
  5. Integration of ARI with decision -making: Wider integration of acute respiratory infections into the processes of decision -making in the field of environmental protection, labor protection, food safety and healthcare.

VI. Legislative regulation of acute respiratory infections

In many countries, ARI is an integral part of legislative regulation in various areas, such as environmental protection, labor protection, food safety and drug development. Legislative acts establish the requirements for conducting acute respiratory infections, determine the criteria for risk assessment and establish risk management measures.

A. Russian Federation

In the Russian Federation, ARZs are regulated by a number of regulatory legal acts, including:

  1. Federal Law “On the Sanitary and Epidemiological Blessed of the Population” dated March 30, 1999 N 52-ФЗ: Establishes general requirements for ensuring the sanitary and epidemiological well-being of the population and conducting sanitary and epidemiological examinations, investigations, surveys, research, tests and toxicological, hygienic and other types of assessments.
  2. Sanitary rules and norms (SanPiN): Establish hygienic standards and requirements for the quality of the environment, food products, working conditions and other factors affecting public health. Many SanPiN contain provisions on the conduct of acute respiratory infections to assess compliance with the requirements of sanitary legislation.
  3. Technical regulations of the Customs Union: Establish requirements for the safety of products applying in the territory of the Customs Union, and provide for the conduct of acute respiratory infections to evaluate the compliance of products with safety requirements.
  4. Federal Law “On Environmental Protection” dated January 10, 2002 N 7-ФЗ: Determines the legal foundations of state policy in the field of environmental protection and provides for an assessment of environmental impact (EIA), which includes an assessment of public health risks associated with environmental pollution.

B. International regulation

At the international level of acute respiratory infections, it is regulated by various organizations and agreements, including:

  1. World Health Organization (WHO): Develops guidelines and recommendations for the conduct of acute respiratory infections and risk management for public health.
  2. Organization of Economic Cooperation and Development (OECD): Develops guidelines and methods of testing chemicals to assess their toxicity and risks for human health and the environment.
  3. European Union (EU): He accepted a number of directives and regulations that establish the requirements for conducting acute respiratory infections in various areas, such as environmental protection, food safety and drug development.
  4. International Cancer Study Agency (IARC): It assesses the carcinogenicity of chemicals and other factors affecting the risk of cancer.

VII. Examples of practical use of acute respiratory infections

Below are examples of the practical application of acute respiratory infections in various fields:

  1. Air risk assessment of air pollution in industrial cities: Risk to the health of the population living in industrial cities associated with the influence of pollutants ejected by industrial enterprises is carried out. Based on the results of risk assessment, measures are developed to reduce emissions of pollutants and protect public health.
  2. The risk assessment of drinking water pollution: Risk to the health of the population associated with the consumption of drinking water, contaminated with nitrates, pesticides or other substances, is carried out. Based on the results of risk assessment, measures are developed to purify drinking water and provide the population with safe water.
  3. Risk assessment when using pesticides in agriculture: Risk to the health of agriculture and the population living near the fields processed by pesticides is carried out. Based on the results of risk assessment, recommendations are developed for the safe use of pesticides and protecting the health of workers and the population.
  4. Risk assessment in the development of new medicines: Risk to the health of patients taking new drugs is carried out. Based on the results of risk assessment, instructions for the use of drugs and measures to monitor side effects are developed.
  5. Risk assessment in the elimination of the consequences of accidents and disasters: Assessment of the risk of public health associated with the influence of harmful factors arising from accidents and disasters (for example, for accidents at chemical enterprises, with earthquakes and floods).

VIII. Conclusion

Assessment of health risks is an important tool for protecting human health and the environment. It allows you to identify, evaluate and manage risks associated with the influence of various environmental factors, lifestyle, professional activity or other danger sources. Further development of ARI methodologies and their integration into decision -making processes will help improve public health and ensure sustainable development.

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