Risks associated with toxicants in food are often controlled by exposure reduction. When exposure recommendations are developed for foods with both harmful and beneficial qualities, however, they must balance the associated risks and benefits to maximize public health. Although quantitative methods are commonly used to evaluate health risks, such methods have not been generally applied to evaluating the health benefits associated with environmental exposures. A quantitative method for risk-benefit analysis is presented that allows for consideration of diverse health endpoints that differ in their impact (i.e., duration and severity) using dose-response modeling weighted by quality-adjusted life years saved. To demonstrate the usefulness of this method, the risks and benefits of fish consumption are evaluated using a single health risk and health benefit endpoint. Benefits are defined as the decrease in myocardial infarction mortality resulting from fish consumption, and risks are defined as the increase in neurodevelopmental delay (i.e., talking) resulting from prenatal methylmercury exposure. Fish consumption rates are based on information from Washington State. Using the proposed framework, the net health impact of eating fish is estimated in either a whole population or a population consisting of women of childbearing age and their children. It is demonstrated that across a range of fish methylmercury concentrations (0-1 ppm) and intake levels (0-25 g/day), individuals would have to weight the neurodevelopmental effects 6 times more (in the whole population) or 250 times less (among women of child-bearing age and their children) than the myocardial infarction benefits in order to be ambivalent about whether or not to consume fish. These methods can be generalized to evaluate the merits of other public health and risk management programs that involve trade-offs between risks and benefits.

One of the goals of the National Environmental Public Health Tracking Network is to link environmental data with chronic disease data as a means of improving our understanding of the environmental determinants of disease. Such efforts will rely on the ongoing collection of population exposure information, and there are few systems in place to track population exposures. In many cases, exposures can be estimated by combining environmental contaminant data with data about human behaviors. The Behavioral Risk Factor Surveillance System (BRFSS) provides a good opportunity to implement tracking of exposure-related behaviors. Washington State has used the BRFSS to collection information on environmentally related knowledge, attitudes, and behaviors. In this article we present case studies of modules covering drinking water, perceptions of environmental risk, and radon awareness and testing. Data on exposure-related behaviors have been useful for population exposure assessments and program evaluation. Questions about knowledge and attitudes and perceptions of environmental issues were not as useful because they lacked sufficient detail from which to modify existing education efforts. In some cases these data had not been used at all, indicating that the need for the data had not been well established. National development efforts should focus on compiling existing questions and developing questions on topics that are a priority at the state and national levels to be included as core questions and optional modules in future BRFSS surveys.

DDT, DDE, and DDD have been detected at elevated concentrations in sediments and fish of the Yakima River, its tributaries and drainages. An assessment was conducted to evaluate the public health significance of eating fish from the river. This was accomplished by establishing a daily intake level of DDT for the population of greatest concern, and comparing this level to a tolerable daily intake. The most sensitive and highly exposed group was determined to be breastfeeding infants. Infant daily intakes of DDT, based on estimated mother's DDT-breast milk levels, were compared to a recommended tolerable daily intake. Results indicate that mothers who frequently consume Yakima River bottom-feeding fish could have breast milk DDT concentrations sufficiently high to expose their infants to levels above the tolerable daily intake.

The purpose of this study was to evaluate the influence of four toxic equivalency factor (TEF) schemes (i.e., human/mammalian [Tl, T2], fish [T3], bird [T4]) and three substitution methods for treating non-detect (ND) data (i.e., ND = 0 [Nl], ND = 0.5 DL [N2], ND = DL [N3] where DL = detection limit) on polychlorinated dibenzo-p-dioxin (PCDD) and dibenzofuran (PCDF) toxic equivalent (TEQ) concentrations in agricultural soils in Washington state (USA). Soil TEQs (n = 54) were determined for 12 combinations of TEF and ND levels and log-transformed for statistical analysis. Significant bivariate correlations (Bonferroni p < .05) were observed for TEQ among all TEF levels within each ND level and between N2 and N3 within and among TEF levels. A two-factor ANOVA demonstrated significant effects (p < .0001) for TEF, ND, and their interaction. Mean TEQ at T3 was significantly lower (p < .05) than other TEF levels at Nl, whereas mean TEQ at T4 was significantly higher (p < .05) than Tl both at N2 and N3. Mean TEQs at all ND levels differed significantly (p < .05) at each TEF level with Nl < N2 < N3. These results illustrate that TEF and ND methods can notably impact calculations for low concentrations of soil dioxin.

No abstract