Using dose addition to estimate cumulative risks from exposures to multiple chemicals.

The Food Quality Protection Act (FQPA) of 1996 requires the EPA to consider the cumulative risk from exposure to multiple chemicals that have a common mechanism of toxicity. Three methods, hazard index (HI), point-of-departure index (PODI), and toxicity equivalence factor (TEF), have commonly been considered to estimate the cumulative risk. These methods are based on estimates of ED(10) (point of departure) and reference doses from the dose-response functions of individual chemicals. They do not incorporate the actual dose-response function of the mixture from multiple chemical exposures. Dose addition is considered to be an appropriate approach to cumulative risk assessment because it assumes that the chemicals of interest act in accordance with a common mode of action (a similar action). This paper proposes a formal statistical procedure to estimate the cumulative risk by fitting the dose-response model of the mixture under dose addition. The relative potency between two chemicals is estimated directly from the joint dose response model of the mixture. An example data set of four drugs representing four chemicals is used to illustrate the proposed procedure and compare it to the HI, PODI, and TEF methods.

Common mechanism of toxicity: a case study of organophosphorus pesticides.

The Food Quality Protection Act of 1996 (FQPA) requires the EPA to consider "available information concerning the cumulative effects of such residues and other substances that have a common mechanism of toxicity ... in establishing, modifying, leaving in effect, or revoking a tolerance for a pesticide chemical residue." This directive raises a number of scientific questions to be answered before the FQPA can be implemented. Among these questions is: What constitutes a common mechanism of toxicity? The ILSI Risk Science Institute (RSI) convened a group of experts to examine this and other scientific questions using the organophosphorus (OP) pesticides as the case study. OP pesticides share some characteristics attributed to compounds that act by a common mechanism, but produce a variety of clinical signs of toxicity not identical for all OP pesticides. The Working Group generated a testable hypothesis, anticholinesterase OP pesticides act by a common mechanism of toxicity, and generated alternative hypotheses that, if true, would cause rejection of the initial hypothesis and provide criteria for subgrouping OP compounds. Some of the alternative hypotheses were rejected outright and the rest were not supported by adequate data. The Working Group concluded that OP pesticides act by a common mechanism of toxicity if they inhibit acetylcholinesterase by phosphorylation and elicit any spectrum of cholinergic effects. An approach similar to that developed for OP pesticides could be used to determine if other classes or groups of pesticides that share structural and toxicological characteristics act by a common mechanism of toxicity or by distinct mechanisms.

Proposed protocols for the determination of potential ocular effects of organophosphorus pesticides.

The US Environmental Protection Agency now requires ocular toxicity testing to support the registration of organophosphorus pesticides. As a first step toward guideline development for the conduct of these studies, preliminary protocols for ocular toxicity testing in the non-rodent and rodent are being proposed by the Office of Pesticide Programs. Proposed protocol parameters include determination of animal health status, measurement of plasma, erythrocyte and retinal cholinesterase activities, ocular assessment by routine ophthalmological examination, slit lamp biomicroscopy, fundic observations, tonometry, electroretinography and determination of objective refractivity, pupillary response and tracking. Gross and detailed histopathological examinations of ocular system components would also be conducted. Associated questions and concerns with regard to ocular toxicity testing are presented. The Agency plans to hold a workshop in the near future to discuss issues related to protocol refinement and guideline development.

Evaluation of the carcinogenic potential of pesticides. 4. Chloroalkylthiodicarboximide compounds with fungicidal activity.

The Health Effects Division of the Office of Pesticide Programs (OPP) assessed the carcinogenic potential of three structurally related chloroalkylthiodicarboximide fungicides using a consensus peer review process and EPA's 1986 guidelines for cancer risk assessment. All of the fungicides were categorized as Group B2 (probable human) carcinogens based upon findings of an increased incidence of malignant tumors, or combined malignant and benign tumors, in multiple experiments involving different strains of mice and rats. The primary sites of tumor formation with the chloroalkylthiodicarboximide fungicides in male and/or female mice (CD-1 and B6C3F1) were the gastrointestinal tract (captan, folpet, and captafol), the lymph system (folpet and captafol), and the vascular system (captafol). The main sites of tumor formation in rats of one or both sexes (CR CD, Wistar, or F344 strains) were the kidney (Captan and captafol), uterus (captan), mammary gland and liver (captafol). In addition, positive trends for thyroid, testicular, mammary gland, and lymph node tumors were observed with folpet in the same strains of rats. All three of the compounds exhibited positive mutagenic activity in a variety of in vitro short-term tests for gene mutation, DNA repair, and chromosomal aberrations in prokaryotic and eukaryotic cells, but were not genotoxic in available studies performed under in vivo conditions. The assessment of human cancer risk for captan, folpet, and captafol was made using low-dose extrapolation models.

Evaluation of the carcinogenic potential of pesticides. 3. Aliette.

Aliette, a fungicide compound, was evaluated for carcinogenic potential by the Health Effects Division of the Office of Pesticide Programs using a consensus peer review process and EPA's guidelines for risk assessment. Aliette was categorized as a group C (possible human) carcinogen based upon evidence of an increased incidence of combined benign and malignant urinary bladder tumors in a single study involving male Charles River (CR) CD rats. The bladder tumors occurred only at the unusually high top dose level of aliette that was tested (40,000/30,000 ppm). The compound was not carcinogenic in female CR-CD rats in the same study, or in CD-1 mice of either sex in a second study. Monosodium phosphite, the main urinary metabolite of aliette, was also not carcinogenic in male or female CR-CD rats. Aliette was not demonstrated to be genotoxic. No structural analogues of aliette were identified. The mechanism of action for the production of bladder tumors was not identified; however, it did not appear to involve a genotoxic effect, a carcinogenic effect of metabolites, or the formation of renal stones. The data were not found to be sufficient to quantify human cancer risk from aliette.

Evaluation of the carcinogenic potential of pesticides. 2. Methidathion.

The carcinogen potential of methidathion, a dimethoxyorganic phosphorus pesticide and cholinesterase inhibitor, was evaluated by the Health Effects Division of the Office of Pesticide Programs using a consensus peer review process and the EPA's guidelines for risk assessment. Methidathion was categorized as a Group C (possible human) carcinogen based upon evidence of an increased incidence of benign and malignant hepatocellular tumors, alone and in combination, in a single study involving male Chr-CD-1 mice. The compound was not carcinogenic in female Chr-CD-1 mice in the same study or in Sprague-Dawley rats of either sex in a second study. Methidathion was not genotoxic in a variety of in vitro or in vivo tests designed to detect DNA damage, chromosome aberrations, gene mutations, and sister chromatid exchange. Although methidathion was identified as being structurally similar to two other organophosphate insecticides, prothidathion and lythidathion, no toxicological data were available on either of these agents for comparative purposes. The biological information on methidathion was reviewed by the agency's FIFRA Scientific Advisory Panel who agreed with the category C designation for methidathion. The data were not found to be sufficient to quantify human risk to methidathion.

Evaluation of the carcinogenic potential of pesticides. 1. Acifluorfen.

The Health Effects Division of the Office of Pesticide Programs evaluates the carcinogenic properties of pesticides by a consensus peer review process in which all available biological information on a compound is evaluated according to EPA's guidelines for cancer risk assessment. In many cases, pesticides are also evaluated by an external group of accomplished scientists who comprise the Agency's Scientific Advisory Panel. The herbicide acifluorfen was evaluated by these processes and was classified as a Category B2 (probable human) carcinogen based upon evidence of an increased incidence of malignant, or combined benign and malignant, tumors in multiple experiments involving two different strains of mice. The compound produced benign and malignant liver tumors in male and female B6C3F1 mice and in female CD1 mice. Stomach papillomas were also observed in male and female B6C3F1 mice. Acifluorfen was mutagenic in bacteria and yeast, but not in mammalian cell systems. In addition, acifluorfen is structurally related to eight other diphenyl ether pesticides, all of which evoke liver tumours in mice or rats. The data were found to be sufficient to quantify human risk to acifluorfen.

The influence of self-efficacy expectations on the treatment of preorgasmic women.

One of the most successful treatments developed for women who never or rarely experience orgasm is Barbach's preorgasmic treatment program. We propose that Bandura's theory of self-efficacy provides a useful framework for understanding the success of Barbach's program. This pilot study was designed to determine whether treatment affects subjects' Certainty of and Comfort with Sexual Efficacy. Treatment (n = 5) and control (n = 6) subjects completed prepoint and postpoint instruments that measured sexual efficacy expectations, body satisfaction, locus of control, and assertiveness. Although most postpoint differences were nonsignificant (probably due to small sample size), intriguing trends emerged. In particular, treatment seemed to contribute to increased Certainty of Sexual Efficacy and body satisfaction.