Retrospective analysis of dog study data from food and color additive petitions.

As part of the US FDA CFSAN's efforts to explore alternatives to animal testing, we retrospectively analyzed a sample of food additive (FAP) and color additive petitions (CAP) submitted to the FDA for the utility of dog study data in safety assessment. FAPs and CAPs containing dog studies (161 petitions) were classified as decisive (38%), supportive (27%), supplemental (29%) or undermined (6%) based on the impact the dog study data had on the final safety decision. Petitions classified as decisive were further categorized based on if the dog study data were used to a) address a safety concern (35/61); b) calculate an acceptable daily intake (ADI) (11/61); c) withdraw a petition (4/61); d) the effect was unique to the dog (2/61); or e) unclear (9/61). Of 11 petitions where the dog study was used to set an ADI, 7 contained studies where the points of departure (POD) from the dog studies were within an 8-fold range of the rodent with differences in study design likely contributing to the difference in PODs. Future research should include the development and use of qualified alternative studies to replace the use of animal testing for food and color additive safety assessment while ensuring human safety.

Reassessment of the cadmium toxicological reference value for use in human health assessments of foods.

The U.S. Food and Drug Administration (FDA) developed an oral toxicological reference value (TRV) for characterizing potential health concerns from dietary exposure to cadmium (Cd). The development of the TRV leveraged the FDA's previously published research including (1) a systematic review for adverse health effects associated with oral Cd exposure and (2) a human physiological based pharmacokinetic (PBPK) model adapted from Kjellstrom and Nordberg (1978) for use in reverse dosimetry applied to the U.S. population. Adverse effects of Cd on the bone and kidney are associated with similar points of departure (PODs) of approximately 0.50 µg Cd/g creatinine for females aged 50-60 based on available epidemiologic data. We also used the upper bound estimate of the renal cortical concentration (50 µg/g Cd) occurring in the U.S. population at 50 years of age as a POD. Based on the output from our reverse dosimetry PBPK Model, a range of 0.21-0.36 µg/kg bw/day was developed for the TRV. The animal data used for the animal TRV derivation (0.63-1.8 µg/kg bw/day) confirms biological plausibility for both the bone and kidney endpoints.

A systematic review of adverse health effects associated with oral cadmium exposure.

Scientific data characterizing the adverse health effects associated with dietary cadmium (Cd) exposure were identified in order to make informed decisions about the most appropriate toxicological reference value (TRV) for use in assessing dietary Cd exposure. Several TRVs are available for Cd and regulatory organizations have used epidemiologic studies to derive these reference values; however, risk of bias (RoB) evaluations were not included in the assessments. We performed a systematic review by conducting a thorough literature search (through January 4, 2020). There were 1714 references identified by the search strings and 328 studies identified in regulatory assessments. After applying the specific inclusion and exclusion criteria, 208 studies (Human: 105, Animal: 103) were considered eligible for further review and data extraction. For the epidemiologic and animal studies, the critical effects identified for oral Cd exposure from the eligible studies were a decrease in bone mineral density (BMD) and renal tubular degeneration. A RoB analysis was completed for 49 studies (30 epidemiological and 19 animal) investigating these endpoints. The studies identified through the SR that were considered high quality and low RoB (2 human and 5 animal) can be used to characterize dose-response relationships and inform the derivation of a Cd TRV.

Cadmium physiologically based pharmacokinetic (PBPK) models for forward and reverse dosimetry: Review, evaluation, and adaptation to the U.S. population.

The goal of this study was to assess a cadmium (Cd) physiologically based pharmacokinetic (PBPK) model to evaluate Cd toxicological reference values (e.g. reference dose, tolerable intake, minimum risk level) adapted to the U.S. population. We reviewed and evaluated previously published Cd PBPK models and developed further adaptations to the 1978 Kjellström and Nordberg (KN) model. Specifically, we propose adaptations with updated U.S.-specific bodyweight, kidney weight and creatinine excretion models by using NHANES data as well as a stochastic PBPK model that provides credible intervals of uncertainty around mean populational estimates. We provide our model review and adaptations as well as present estimates from the newly adapted models using observed U.S. urinary Cd values as a function of gender and age and given dietary exposure as evaluated from NHANES/WWEIA and U.S. Total Diet Study data. Results show all newly adapted models provide acceptable mean estimates of urinary Cd in the U.S. The stochastic model provides credible intervals to further inform regulatory decision making. Validation of the estimated K-Cd concentration values was not possible as data for a representative population was not available. We developed a web-based tool implementing these models and other potential adaptations to facilitate PBPK model estimate comparisons.

A scoping review of infant and children health effects associated with cadmium exposure.

The U.S. FDA initiative, Closer to Zero, identifies actions the agency will take to reduce toxic element exposure from foods eaten by babies and young children with the goal for exposure to be as low as possible. In support of these efforts, this scoping review sought to characterize the available data for primarily dietary cadmium (Cd) exposure and adverse health effects in infants and children. Based on pre-determined inclusion and exclusion criteria, data were extracted from 59 epidemiology studies, and organ systems/anthropometric data supported by > 3 studies were discussed further. For children, most data available were categorized into the nervous (full-scale IQ and attention), cardiovascular (blood pressure) and urinary systems. Studies identified a negative association between urinary Cd and full-scale IQ, though this was dependent on age and sex. More data are needed to support the associations between Cd exposure and adverse nervous system effects. Studies suggested no association between Cd exposure and blood pressure. Data on renal effects in children were too few and diverse to draw conclusions. For infants, anthropometric measurements and birth timing were studied the most. Some studies found a negative relationship between Cd exposure and birthweight, particularly in females. This finding needs further investigation.

Cadmium: Mitigation strategies to reduce dietary exposure.

Cadmium has long been recognized as an environmental contaminant that poses risks to human health. Cadmium is of concern since nearly everyone in the general population is exposed to the metal through the food supply and the ability of the element to accumulate in the body over a lifetime. In support of the United States Food and Drug Administration's (FDA) Toxic Element Working Group's efforts to reduce the risks associated with elements in food, this review sought to identify current or new mitigation efforts that have the potential to reduce exposures of cadmium throughout the food supply chain. Cadmium contamination of foods can occur at various stages, including agronomic production, processing, and consumer preparation for consumption. The presence of cadmium in food is variable and dependent on the geographical location, the bioavailability of cadmium from the soil, crop genetics, agronomic practices used, and postharvest operations. Although there are multiple points in the food supply system for foods to be contaminated and mitigations to be applied, a key step to reducing cadmium in the diet is to reduce or prevent initial uptake by plants consumed as food or feed crops. Due to complex interactions of soil chemistry, plant genetics, and agronomic practices, additional research is needed. Support for field-based experimentation and testing is needed to inform risk modeling and to develop practical farm-specific management strategies. This study can also assist the FDA in determining where to focus resources so that research and regulatory efforts can have the greatest impact on reducing cadmium exposures from the food supply. PRACTICAL APPLICATION: The presence of cadmium in food is highly variable and highly dependent on the geographical location, the bioavailability of cadmium from the soil, crop genetics, and agronomic practices used. This study can assist the FDA in determining where to focus resources so that research and regulatory efforts can have the greatest impact on reducing cadmium exposures from the food supply.

Guidelines for performing systematic reviews in the development of toxicity factors.

The Texas Commission on Environmental Quality (TCEQ) developed guidance on conducting systematic reviews during the development of chemical-specific toxicity factors. Using elements from publicly available frameworks, the TCEQ systematic review process was developed in order to supplement the existing TCEQ Guidelines for developing toxicity factors (TCEQ Regulatory Guidance 442). The TCEQ systematic review process includes six steps: 1) Problem Formulation; 2) Systematic Literature Review and Study Selection; 3) Data Extraction; 4) Study Quality and Risk of Bias Assessment; 5) Evidence Integration and Endpoint Determination; and 6) Confidence Rating. This document provides guidance on conducting a systematic literature review and integrating evidence from different data streams when developing chemical-specific reference values (ReVs) and unit risk factors (URFs). However, this process can also be modified or expanded to address other questions that would benefit from systematic review practices. The systematic review and evidence integration framework can improve regulatory decision-making processes, increase transparency, minimize bias, improve consistency between different risk assessments, and further improve confidence in toxicity factor development.

Development of an inhalation unit risk factor for ethylene dibromide.

The Texas Commission on Environmental Quality (TCEQ) follows standard scientific methods to develop up-to-date toxicity factors for chemicals emitted in the state of Texas. An inhalation unit risk factor (URF) was developed for ethylene dibromide (EDB, CAS 106-93-4) based on an increased incidence of nasal cavity adenocarcinomas observed in female rats in a 2-year inhalation cancer bioassay conducted by the National Toxicology Program (NTP). The NTP study provided evidence of several EDB-induced tumors in male and female rats and in female mice. Tumor incidences that were statistically increased at the low dose and that showed a statistically significant increasing trend were considered in identifying the critical effect. Following benchmark concentration (BMC) modeling and animal-to-human dosimetric adjustments, the increased incidence of nasal cavity adenocarcinomas observed in female rats was determined to be the most sensitive tumorigenic effect in the most sensitive species and sex and was utilized as the carcinogenic endpoint for the development of the URF. The 95% lower confidence limit of the BMC at the 10% excess risk level (BMCL10 of 292.8 ppb) was determined for calculation of the URF. The resulting URF based on increased nasal cavity adenocarcinomas observed in female rats is 3.4E-04 per ppb (4.4E-05 per µg/m3). The lifetime air concentration corresponding to a no significant excess risk level of one in 100,000 is 0.029 ppb (0.22 µg/m3), which is considered sufficiently health-protective for use in protecting the general public against the potential carcinogenic effects of chronic exposure to EDB in ambient air.