Children's health and the environment: public health issues and challenges for risk assessment.
Children's health and the environment: public health issues and challenges for risk assessment.
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DOI：
10.1289/ehp.6115
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发表时间：
2004-02
影响因子：
10.4
通讯作者：
Eskenazi B
中科院分区：
文献类型：
--
作者：
Landrigan PJ;Kimmel CA;Correa A;Eskenazi B
婴儿和儿童不是小成年人。它们特别容易受到环境毒物的伤害。为了保护婴儿和儿童免受有毒物质的危害，国家研究理事会于1993年呼吁制定一种风险评估方法，考虑到儿童接触农药的独特模式及其对农药的特殊脆弱性。这一呼吁的许多方面都被编入1996年《食品质量保护法》（Food Quality Protection Act，简称FQA）的联邦法律。本报告强调了制定儿童保护办法进行风险评估所需的核心要素：（a）改进对儿童在不同生命阶段（从胎儿期到青春期）接触的定量评估，包括急性和慢性接触、通过多种途径接触以及接触多种物剂; B）开发新的化学品毒性测试方法，以检测意外和微妙的结果，并评估实验对象从早期接触到自然死亡的整个生命周期复制人类经验; c）开发新的毒物动力学和毒物动力学模型，以说明婴儿和儿童独特的生理特征; d）开发新的方法，评估整个生命周期的功能、器官、细胞和分子结果;这些措施需要纳入毒性测试和儿童长期前瞻性流行病学研究;以及e）在风险评估中应用不确定性和安全因素，特别考虑儿童的风险。根据FQPA，除非有相反的证据，否则儿童被认为比成人更容易受到农药的影响。因此，在缺乏发育毒性数据或存在发育毒性证据的情况下，必须将保护儿童的不确定性和安全因素纳入风险评估。要充分保护儿童免受环境中有毒物质的危害，就必须从根本上对目前的毒性测试和风险评估办法进行意义深远的修订。
Infants and children are not little adults. They are uniquely vulnerable to environmental toxicants. To protect infants and children against toxicants, the National Research Council in 1993 called for development of an approach to risk assessment that considers children's unique patterns of exposure and their special vulnerabilities to pesticides. Many aspects of that call were codified into federal law in the Food Quality Protection Act (FQPA) of 1996. This report highlights the central elements needed for development of a child-protective approach to risk assessment: a) improved quantitative assessment of children's exposures at different life stages, from fetal life through adolescence, including acute and chronic exposures, exposures via multiple routes, and exposures to multiple agents; b) development of new approaches to toxicity testing of chemicals that can detect unanticipated and subtle outcomes and that evaluate experimental subjects over the entire life span from early exposure to natural death to replicate the human experience; c) development of new toxicodynamic and toxicokinetic models that account for the unique physiologic characteristics of infants and children; d) development of new approaches to assessment of outcomes, functional, organ, cellular and molecular, over the entire life span; these measures need to be incorporated into toxicity testing and into long-term prospective epidemiologic studies of children; and e) application of uncertainty and safety factors in risk assessment that specifically consider children's risks. Under FQPA, children are presumed more vulnerable to pesticides than adults unless evidence exists to the contrary. Uncertainty and safety factors that are protective of children must therefore be incorporated into risk assessment when data on developmental toxicity are lacking or when there is evidence of developmental toxicity. The adequate protection of children against toxic agents in the environment will require fundamental and far-reaching revisions of current approaches to toxicity testing and risk assessment.
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