Novel Integrated Tiered Cumulative Risk Assessment of Heavy Metals in Food Homologous Traditional Chinese Medicine Based on a Real-Life-Exposure Scenario

Abstract

In order to serve population health better, the first integrated tiered decision tree for cumulative risk assessment of co-exposure of Pb-, Cd-, and As-associated health risks in food homologous traditional Chinese medicine (TCM) was designed, after measuring their concentrations by inductively coupled plasma-mass spectroscopy (ICP-MS). Basically, our three-step decision tree involving hazard quotient (HQ), hazard index (HI), and target-organ toxicity dose (TTD) modification of the HI method was developed to evaluate the potential risks of 949 batches of 15 types of food homologous TCM. To acquire a real-life exposure scenario, the cumulative risk assessment model was established by optimizing key parameters, such as ingestion rates, frequency, and duration of exposure to food homologous TCM based on questionnaire data. As a result, the mean concentrations of Pb, Cd, and As in 949 batches of food homologous TCM were 0.896, 0.133, and 0.192 mg/kg, respectively. The HQ values of As for Angelica sinensis (Oliv.) Diels and Houttuynia cordata Thunb. were 1.04 and 1.01, respectively, for females. Other HQs of Pb, Cd, or As in food homologous TCM were lower than 1 for both males and females. However, after rapid screening of the co-exposure health risks of heavy metals by the HI method, cumulative risk assessment results acquired by TTD modification of the HI method implied that the potential health risks associated with the co-exposure of Pb, Cd, and As in Lonicera japonica Thunb. and Houttuynia cordata Thunb. ingested as both TCM and food were of concern in the clinic. Additionally, the cumulative risks of Pb, Cd, and As in Mentha canadensis L., Chrysanthemum indicum L., and Zaocys dhumnades (Cantor) only used as food exceeded the human tolerance dose. Collectively, our innovation on the tiered strategy of decision tree based on a real-life exposure scenario provides a novel approach engaging in the cumulative risk assessment of heavy metals in food homologous TCM. All in all, such effort attempts to scientifically guide the rational use of TCM in the treatment of the complex diseases and the improvement of population health.

Cluster approach to the study of population health risks posed by contamination of food products with heavy metals

“…In particular, based on the latest statistical data provided by the National Health Commission of the People's Republic of China in 2020, the average body weight for adult men and women was 69.6 and 59 kg respectively and this value was taken into account when calculating noncarcinogenic and carcinogenic risks. Meanwhile, using individual body weight values in calculations makes it possible to increase the accuracy of determining the level of risk [16].…”

Cluster approach to the study of population health risks posed by contamination of food products with heavy metals

“…Кроме того, расчет экспозиции контаминантами в соответствии с действующими на территории РФ рекомендациями проводится, исходя из стандартной величины массы тела в 70 кг, аналогичным образом и в зарубежных работах используется подход учета средней массы тела в обследованной группе. В част-ности, на основании последних статистических данных, представленных Национальной комиссией здравоохранения КНР в 2020 г., средняя масса тела взрослых мужчин и женщин составила 69,6 и 59 кг соответственно и учитывалась при расчете неканцерогенного и канцерогенного рисков, при этом использование в расчетах индивидуальных значений массы тела позволяет повысить точность определения рисковой нагрузки [16].…”