Edward V. Sargent

A Human Health Risk Assessment of Pharmaceuticals in the Aquatic Environment

Analyses were conducted on four pharmaceutical compounds, representing different therapeutic classes, to evaluate the presence and potential adverse human health effects of trace levels of these substances in aqueous environmental media. Acetylsalicylic acid, clofibrate, cyclophosphamide, and indomethacin have been detected in aqueous environmental media including sewage treatment plant effluent, surface water, drinking water, and groundwater. An extensive literature search and chemical-specific risk assessments were performed to assess the potential human health significance of each compounds individual presence in environmental media. Safe water quality limits were estimated for each pharmaceutical by following the USEPA Methodology for Deriving Ambient Water Quality Criteria for the Protection of Human Health and were compared to the concentrations found in the environment. The calculation of the provisional ambient water quality criteria involved estimation of human exposure to contaminated water, including intake via bioaccumulation in fish, and calculation of cancer risk and non-cancer hazard indices. Parameters detailing the toxicological and pharmacological nature, exposure assessment, and environmental fate and transport of each pharmaceutical were also considered. The overall conclusion was that based on available data, no appreciable risk to humans exists, as the detected concentrations of each of these pharmaceutical compounds found in aqueous media were far below the derived safe limits

Performance-Based Exposure Control Limits for Pharmaceutical Active Ingredients

For many years pharmaceutical companies have established employee exposure limits for the active ingredients used in their products. Historically these limits were derived using traditional risk assessment methods. Because the trend in the pharmaceutical industry is to identify and develop more selective drugs of increasing potency, and because of the difficulty in identifying no-effect levels for certain drugs, a new performance-based approach for setting limits was developed. This method involves assigning materials into one of five hazard categories according to their inherent toxicological and pharmacological properties. The criteria used to assign compounds into performance-based exposure control limit (PB-ECL) categories focus on the degree to which exposure impacts human health. These assignments dictate the level of containment required to assure employee safety that is achieved through the use of engineering controls and safe handling practices. Several matrices were developed to specify general design concepts and controls for unit operations in laboratory and manufacturing operations. Containment options range from conventional handling practices for low potency (PB-ECL Category 1) materials, to technologically advanced systems that result in essentially no open handling for potent or toxic (PB-ECL Category 3) materials, to state-of-the-art facilities employing closed processes and use of robotics for extremely potent (PB-ECL Category 5) materials.

Is hexavalent chromium carcinogenic via ingestion? A weight-of-evidence review.

Hexavalent chromium [Cr(VI)] is recognized as a human carcinogen via inhalation, based on elevated rates of lung cancer among occupationally exposed workers in certain industries. Cr(VI) is also genotoxic in bacterial and mammalian cell lines. In contrast, scientific panels in the United States and abroad have reviewed the weight of evidence (WOE) and decided that the available data are insufficient to conclude that Cr(VI) is an oral carcinogen. A criterion of 0.2 ppb was established by a California agency for Cr(VI) in drinking water to prevent cancer, however, this criterion was withdrawn in November, 2001. This criterion was remarkably lower than the promulgated California and federal drinking-water standards for total chromium of 50 ppb and 100 ppb, respectively. Both of the promulgated standards are designed to be protective of humans who ingest Cr(VI). This article describes a WOE analysis to examine the likelihood that Cr(VI) in drinking water poses a cancer hazard at the current U.S. drinking-water standard. The results indicate that: (1) From the historical epidemiological studies, there are a few reports of increased rates of digestive system cancer among Cr(VI)-exposed workers, although most are not statistically significant; (2) the preponderance of evidence from recent epidemiological studies of Cr(VI)-exposed workers does not support an increased risk of cancer outside of the respiratory system; (3) studies of four environmentally exposed populations are negative; (4) there is only one lifetime animal feeding study, and the findings from that study are considered to be flawed and inconclusive; and (5) recent kinetics and in vivo genotoxicity data demonstrate that Cr(VI) is reduced to nontoxic Cr(III) in saliva, in the acidic conditions of the stomach, and in blood. In short, at concentrations at least as high as the current U.S. maximum contaminant level (100 ppb), and probably at least an order of magnitude higher, Cr(VI) is reduced to Cr(III) prior to or upon systemic absorption. The weight of scientific evidence supports that Cr(VI) is not carcinogenic in humans via the oral route of exposure at permissible drinking-water concentrations.

Establishing Airborne Exposure Control Limits in the Pharmaceutical Industry

In the course of employment, workers in the pharmaceutical industry are exposed to compounds which are designed to produce pharmacological effects. For the most part, exposure occurs in the handling of finely divided solids. Data from laboratory animal studies and clinical trials can be extrapolated to predict possible effects of exposure in the workplace. To that end a procedure for establishing workplace exposure control limits (ECLs) for pharmaceutical products is presented. Workplace exposure limits are given for 32 human health drugs.

Establishing Data-Derived Adjustment Factors from Published Pharmaceutical Clinical Trial Data

In non-cancer risk assessment the goal traditionally has been to protect the majority of people by setting limits that account for interindividual variability in the human population. The Environmental Protection Agency (EPA) has assigned a default uncertainty factor (?UF) of 10 to account for interindividual variability in response to toxic agents in the general population. Previous studies have suggested that it is appropriate to equally divide this factor into sub-factors of 3.2 each for variability in human pharmacokinetics (PK) and pharmacodynamics (PD). As an extension of this model, one can envision using scientific data from the literature to modify the default sub-factors with compound-specific adjustment factors (AFs) and to create new and more scientifically based defaults. In this paper, data from published clinical trials on six pharmaceutical compounds were used to further illustrate how to calculate and interpret data-derived AFs. The clinical trial data were analyzed for content and the re...

Comparison of the Industrial Source Complex and AERMOD Dispersion Models: Case Study for Human Health Risk Assessment

Abstract Air quality models are typically used to predict the fate and transport of air emissions from industrial sources to comply with federal and state regulatory requirements and environmental standards, as well as to determine pollution control requirements. For many years, the U.S. Environmental Protection Agency (EPA) widely used the Industrial Source Complex (ISC) model because of its broad applicability to multiple source types. Recently, EPA adopted a new rule that replaces ISC with AERMOD, a state-of-the-practice air dispersion model, in many air quality impact assessments. This study compared the two models as well as their enhanced versions that incorporate the Plume Rise Model Enhancements (PRIME) algorithm. PRIME takes into account the effects of building downwash on plume dispersion. The comparison used actual point, area, and volume sources located on two separate facilities in conjunction with site-specific terrain and meteorological data. The modeled maximum total period average ground-level air concentrations were used to calculate potential health effects for human receptors. The results show that the switch from ISC to AERMOD and the incorporation of the PRIME algorithm tend to generate lower concentration estimates at the point of maximum ground-level concentration. However, the magnitude of difference varies from insignificant to significant depending on the types of the sources and the site-specific conditions. The differences in human health effects, predicted using results from the two models, mirror the concentrations predicted by the models.

Case Studies of Categorical Data-Derived Adjustment Factors

Investigations were performed on representative compounds from five different therapeutic classes to evaluate the use of categorical data-derived adjustment factors to account for interindividual variability. The five classes included antidepressants, angiotensin converting enzyme (ACE) inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDS), cholesterol lowering agents, and antibiotics. Each of the case studies summarized the mode of action of the class responsible for both the therapeutic and adverse effects and the key pharmacodynamic (PD) and pharmacokinetic (PK) parameters that determine the likelihood of these responses for individual compounds in the class. For each class, an attempt was made to identify the key factors that determine interindividual variability and whether there was a common basis to establish a categorical default adjustment factor that could be applied across the class (or at least across specific subclasses within the class). Linking the PK and PD parameters to the critical endpoint used to establish a safe level of exposure was an important underlying theme throughout the investigations. Despite the wealth of PK and PD information in the published literature on the surrogate compounds representing these classes, it was difficult to derive a categorical adjustment factor that could be applied broadly within each class. The amount of information available may have hindered rather than helped the evaluations. Derivation of categorical defaults for different classes of “common” chemicals may be more straightforward if sufficient data are available. In a few cases (e.g., tricyclic antibiotics, ACE inhibitors and selected antiinflammatory agents) categorical defaults could be proposed, although it is unclear whether the reduction in uncertainty resulting from their application would be offset by the additional uncertainties that may have resulted from their application. Residual uncertainties may remain depending on the level of confidence in the underlying assumptions used to support the categorical defaults. Regardless of the conclusions on the utility of categorical defaults, these investigations provided further support for the use of data-derived adjustment factors on a compound-specific basis.

Use of toxicokinetic and toxicodynamic data to reduce uncertainties when setting occupational exposure limits for pharmaceuticals

Abstract Occupational exposure limits for pharmaceutical active ingredients should be based on all of the available preclinical and clinical data generated during drug development, including toxicokinetic (TK) and toxicodynamic (TD) data. The framework for limit setting proposed by the International Programme on Chemical Safety (IPCS) subdivides traditional 10‐fold uncertainty factors (UFs) into separate partial‐log default values based upon TK and TD considerations and allows for incorporation of compound‐specific data when available. We propose an extension of this method by providing more detailed guidance on the development and use of TK and TD data to maximize the use of scientific information in the limit setting process. Specific recommendations are made on how TK and TD parameters may be used to support replacement of default UFs with data‐derived values. Proper application of TK and TD data reduces the uncertainties when establishing limits for specific compounds and provides better assurance tha...

The Importance of Human Data in the Establishment of Occupational Exposure Limits

The use of animal vs. human data for the purposes of establishing human risk was examined for four pharmaceutical compounds: acetylsalicylic acid, cyclophosphamide, indomethacin and clofibric acid. Literature searches were conducted to identify preclinical and clinical data useful for the derivation of acceptable daily intakes (ADIs) from which a number of risk values including occupational exposure limits (OELs) could be calculated. OELs were calculated using human data and then again using animal data exclusively. For two compounds, ASA and clofibric acid use of animal data alone led to higher OELs (not health protective), while for indomethacin and cyclophosphamide use of animal data resulted in the same or lower OELs based on human data alone. In each case arguments were made for why the use of human data was preferred. The results of the analysis support a basic principle of risk assessment that all available data be considered

Investigations of the Use of Bioavailability Data to Adjust Occupational Exposure Limits for Active Pharmaceutical Ingredients

Occupational exposure limits (OELs) for active pharmaceutical ingredients have traditionally been established using no-observed-adverse-effect levels derived from clinical studies employing po and iv routes of administration and by applying default uncertainty factors or chemical-specific adjustment factors. However, exposure by the inhalation or dermal route is more relevant in terms of occupational safety. In this investigation, to explore new methods for route-to-route extrapolation, the bioavailability of MK-0679, a leukotriene D(4) receptor antagonist, was compared following iv, po, intranasal (in), or intratracheal (it) administration. The relative bioavailability of MK-0679 was iv congruent with it > po congruent with in. Bioavailability correction factors (BCFs) of 2.0 and 0.6 were derived from these data to adjust a hypothetical OEL of 0.1 mg/m(3) for MK-0679 with particle sizes of 10 and 50 mum, respectively. These BCFs were used to adjust the OEL established using po clinical data, to reflect the differences in bioavailability following deposition in different regions of the respiratory tract. To further investigate how bioavailability data could be used in setting OELs, a preliminary pharmacokinetic (PK) model was developed to describe the time course of plasma concentrations using the data from the route comparison study. An inhalation study was then performed to test the validity of using either empirical data or modeling approaches to derive BCFs when setting OELs. These investigations demonstrated how the use of route-specific PK data could reduce some of the uncertainties associated with route-to-route extrapolation and allow for improved precision and quantitative adjustments when establishing OELs. Further investigations are needed to better understand the factors responsible for differences in systemic uptake following deposition in different regions of the respiratory tract and how these can be generalized across different classes of soluble compounds.