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It could be said that exposure analysis emerged as a distinct discipline — indeed, this journal was founded — as an outgrowth of the study of indoor air. The founders of this new discipline, steeped in the historical study of air pollution, recognized that a focus limited to the ambient environment was becoming less relevant. They shifted their study of hazards to the "interface" between the receptor and the environment, and they turned their attention first to the most obvious "microenvironment," indoors, where people often experience their greatest exposures.

Climate change is anticipated to alter the production, use, release, and fate of environmental chemicals, likely leading to increased uncertainty in exposure and human health risk predictions. Exposure science provides a key connection between changes in climate and associated health outcomes. The theme of the 2015 Annual Meeting of the International Society of Exposure Science-Exposures in an Evolving Environment-brought this issue to the fore. By directing attention to questions that may affect society in profound ways, exposure scientists have an opportunity to conduct "consequential science"-doing science that matters, using our tools for the greater good and to answer key policy questions, and identifying causes leading to implementation of solutions. Understanding the implications of changing exposures on public health may be one of the most consequential areas of study in which exposure scientists could currently be engaged. In this paper, we use a series of case studies to identify exposure data gaps and research paths that will enable us to capture the information necessary for understanding climate change-related human exposures and consequent health impacts. We hope that paper will focus attention on under-developed areas of exposure science that will likely have broad implications for public health.

A correction to this paper has been published and can be accessed via link at the top of the paper.

Maximum cumulative ratio (MCR) is a person's cumulative exposure to multiple chemicals divided by the maximum chemical-specific exposure where exposure is expressed on a toxicologically equivalent basis. It is a tool for assessing the need for performing cumulative exposure assessments. In this paper, MCR values were calculated for the three groups of individuals with biomonitoring data of 26 dioxin-like compounds (DLCs) based on the World Health Organization toxic equivalent factors (TEFs). Although the two occupational groups have higher total toxicity equivalence (TEQ) levels than the NHANES group, average MCR values of the three groups are similar (3.5, 3.6, and 3.2). These MCR values are higher than those seen in our earlier studies, supporting the practice of performing cumulative assessments for DLCs. The MCR values also indicate that only 2-5 of the 26 chemicals make significant contributions to total TEQ values. Interestingly, MCR is negatively correlated with total TEQ (in all the three groups) and age (in the NHANES group). Additionally, MCR is lower in workers where occupational exposures are larger than background exposures. Although overall exposure is the first factor to consider in any mixtures assessment, this paper confirms the usefulness of MCR as a tool for analyzing the pattern of chemical-specific contributions to the total exposure levels of mixtures based on biomonitoring data when TEFs or similar approaches are available.

The U.S. Environmental Protection Agency (EPA) and the U.S. Centers for Disease Control (CDC) co-organized a symposium on “Air Pollution Exposure and Health” at Research Triangle Park, North Carolina on September 19–20, 2006. The symposium brought together health and environmental scientists to discuss the state of the science and the cross-jurisdictional and methodological challenges in conducting air pollution epidemiology, environmental public health tracking and accountability research. The symposium was held over 2 days and consisted of technical presentations and breakout group discussions on each of the three principal themes of this meeting: (1) monitoring and exposure modeling information, (2) health effects data and (3) linkage of air quality and health data for research, tracking and accountability. This paper summarizes the symposium presentations and the conclusions and recommendations developed during the meeting. The accompanying two papers, which appear in this issue of the Journal, provide more in-depth discussion of issues pertinent to obtaining and analyzing air pollution exposure and health information. The symposium succeeded in identifying areas where there are critical gaps of knowledge in existing air pollution exposure and health information and in discovering institutional or programmatic barriers, which impede accessing and linking disparate data sets. Several suggestions and recommendations emerged from this meeting, directed toward (1) improving the utility of air monitoring data for exposure quantification, (2) improving access to and the quality of health data, (3) studying emerging air quality and health issues, (4) exploring improved or novel methods for linking data and (5) developing partnerships, building capacity and facilitating interdisciplinary communication. The meeting was successful in promoting an interdisciplinary dialogue around these issues and in formulating strategies to support these recommended activities. Finally, this symposium subsequently led to strengthening and initiating new partnerships or interactions between the EPA, CDC, States, academia and the research community at large.

In 1991, Neas et al. reported that indoor nitrogen dioxide (NO(2)), a byproduct of high-temperature combustion, was significantly associated with lower respiratory symptoms among a cohort of 1,159 white children aged 7-11 years in six US cities studied from 1983 to 1988. For each 15 p.p.b. increment of NO(2), the multivariate adjusted odds ratio (OR) was 1.4 (95% confidence interval (CI)=[1.1, 1.7]). Although indoor NO(2) concentration in the ambient air was assessed only in a subset of the children, the prevalence of lower respiratory symptoms and surrogate exposure variables were available in all of the children at the time of the indoor monitoring program. This paper evaluates the effect of indoor NO(2) exposure on the annual risk of lower respiratory symptoms by applying a regression calibration method to the 2,891 children in the overall study with complete covariate and outcome data, 1,137 of whom had NO(2) directly measured and 1,754 of whom only surrogate exposure data were available. An estimate of the indoor annual NO(2) exposure effect (p.p.b.) is obtained, which is adjusted for measurement error induced by the use of surrogate NO(2) sources among the 1,754. These sources include the presence of a gas stove with or without a pilot light, the presence of a kerosene space heater, the presence of a wood stove, and the usage of a stove for heating, and residential characteristics, including fan usage for kitchen ventilation and the total number of rooms in the home. After adjusting for age, gender, city, parental history of respiratory diseases, and smoking inside the children's home (packs/day), a 15-p.p.b. increment in NO(2) exposure was found to be associated with a significant 50% increased annual risk of lower respiratory symptoms (OR=1.5, 95% CI=[1.2, 1.8]). Simulation results indicated that, under conditions similar to those observed in these data, the estimator is unbiased and has a coverage probability close to the nominal value. Using the methodology illustrated in this paper, it became possible to utilize all data available and obtain a 34% more precise estimate of the NO(2) exposure effect on lower respiratory symptoms, which was adjusted for measurement error due to using NO(2) surrogates instead of directly measured NO(2).

The recent movement of regulatory agencies toward probabilistic analyses of human health and environmental risks has focused greater attention on the quality of the estimates of variability and uncertainty that underlie them. Of particular concern is how uncertainty — a measure of what is not known — is characterized, as uncertainty can play an influential role in analyses of the need for regulatory controls or in estimates of the economic value of additional research. This paper reports the second phase of a study, conducted as an element of the National Human Exposure Assessment Survey (NHEXAS), to obtain and calibrate exposure assessment experts judgments about uncertainty in residential ambient, residential indoor, and personal air benzene concentrations experienced by the nonsmoking, nonoccupationally exposed population in U.S. EPA's Region V. Subjective judgments (i.e., the median, interquartile range, and 90% confidence interval) about the means and 90th percentiles of each of the benzene distributions were elicited from the seven experts participating in the study. The calibration or quality of the experts' judgments was assessed by comparing them to the actual measurements from the NHEXAS Region V study using graphical techniques, a quadratic scoring rule, and surprise and interquartile indices. The results from both quantitative scoring methods suggested that, considered collectively, the experts' judgments were relatively well calibrated although on balance, underconfident. The calibration of individual expert judgments appeared variable, highlighting potential pitfalls in reliance on individual experts. In a surprising finding, the experts' judgments about the 90th percentiles of the benzene distributions were better calibrated than their predictions about the means; the experts tended to be overconfident in their ability to predict the means. This paper is also one of the first calibration studies to demonstrate the importance of taking into account intraexpert correlation on the statistical significance of the findings. When the judgments were assumed to be independent, analysis of the surprise and interquartile indices found evidence of poor calibration (P

This paper presents the results of the first phase of a study, conducted as an element of the National Human Exposure Assessment Survey (NHEXAS), to demonstrate the use of expert subjective judgment elicitation techniques to characterize the magnitude of and uncertainty in environmental exposure to benzene. In decisions about the value of exposure research or of regulatory controls, the characterization of uncertainty can play an influential role. Classical methods for characterizing uncertainty may be sufficient when adequate amounts of relevant data are available. Frequently, however, data are neither abundant nor directly relevant, making it necessary to rely to varying degrees on subjective judgment. Since the 1950s, methods to elicit and quantify subjective judgments have been explored but have rarely been applied to the field of environmental exposure assessment. In this phase of the project, seven experts in benzene exposure assessment were selected through a peer nomination process, participated in a 2-day workshop, and were interviewed individually to elicit their judgments about the distributions of residential ambient, residential indoor, and personal air benzene concentrations (6-day integrated average) experienced by both the non-smoking, non-occupationally exposed target and study populations of the US EPA Region V pilot study. Specifically, each expert was asked to characterize, in probabilistic form, the arithmetic means and the 90th percentiles of these distributions. This paper presents the experts' judgments about the concentrations of benzene encountered by the target population. The experts' judgments about levels of benzene in personal air were demonstrative of patterns observed in the judgments about the other distributions. They were in closest agreement about their predictions of the mean; with one exception, their best estimates of the mean fell within 7-11 microg/m(3) although they exhibited striking differences in the degree of uncertainty expressed. Their estimates of the 90th percentile were more varied with the best estimates ranging from 12 to 26 microg/m(3) for all but one expert. However, their predictions of the 90th percentile were far more uncertain. The paper demonstrates that coherent subjective judgments can be elicited from exposure assessment scientists and critically examines the challenges and potential benefits of a subjective judgment approach. The results of the second phase of the project, in which measurements from the NHEXAS field study in Region V are used to calibrate the experts' judgments about the benzene exposures in the study population, will be presented in a second paper.

In 2002, two studies were published, both of which reported that indices of peak magnetic field exposure were associated with an increased risk of miscarriage, whereas measures of central tendency of magnetic field exposure were not (Lee et al., 2002; Li et al., 2002). These were the first epidemiological studies of reproductive health outcomes to consider measures of peak exposure. In the spirit of opening further dialogue and to advance the understanding of the relationship between peak magnetic field exposure and miscarriage, Savitz (2002) introduced a testable hypothesis in an accompanying commentary. According to this hypothesis, the status and ultimate outcome of a woman's pregnancy may (through discomfort or cumbersomeness) affect her mobility and physical activity, which in turn could affect the measurement of her magnetic field exposure (Figure 1). In the wake of these papers and commentary, two studies were conducted to empirically address specific elements of Savitz' hypothesis of a non-causal basis for the association between peak magnetic field exposure and miscarriage. These efforts were intended to provide empirical data to help discriminate between causal and non-causal explanations for the observed EMF–miscarriage association. These are the papers that form the subject of the Neutra–Li letter.

Average levels of exposure to radiofrequency (RF) electromagnetic fields (EMFs) of the general public in Europe are difficult to summarize, as exposure levels have been reported differently in those studies in which they have been measured, and a large proportion of reported measurements were very low, sometimes falling below detection limits of the equipment used. The goal of this paper is to present an overview of the scientific literature on RF EMF exposure in Europe and to characterize exposure within the European population. A comparative analysis of the results of spot or long-term RF EMF measurements in the EU indicated that mean electric field strengths were between 0.08 V/m and 1.8 V/m. The overwhelming majority of measured mean electric field strengths were

Personal exposure sampling provides the most accurate and representative assessment of exposure to a pollutant, but only if measures are implemented to minimize exposure misclassification and reduce confounders that may cause misinterpretation of the collected data. Poor compliance with personal sampler wearing protocols can create positive or negative biases in the reported exposure concentrations, depending on proximity of the participant or the personal sampler to the pollutant source when the monitor was not worn as instructed. This paper presents an initial quantitative examination of personal exposure monitor wearing protocol compliance during a longitudinal particulate matter personal exposure monitoring study of senior citizens of compromise health in North Carolina. Wearing compliance varied between participants because of gender or employment status, but not longitudinally or between cohorts. A minimum waking wearing compliance threshold, 0.4 for this study of senior citizens, is suggested to define when personal exposure measurements are representative of a participant's exposure. The ability to define a minimum threshold indicates data weighting techniques may be used to estimate a participant's exposure assuming perfect protocol compliance.

This paper presents analyses of data from surveys of radio base stations in 23 countries across five continents from the year 2000 onward and includes over 173,000 individual data points. The research compared the results of the national surveys, investigated chronological trends and compared exposures by technology. The key findings from this data are that irrespective of country, the year and cellular technology, exposures to radio signals at ground level were only a small fraction of the relevant human exposure standards. Importantly, there has been no significant increase in exposure levels since the widespread introduction of 3G mobile services, which should be reassuring for policy makers and negate the need for post-installation measurements at ground level for compliance purposes. There may be areas close to antennas where compliance levels could be exceeded. Future potential work includes extending the study to additional countries, development of cumulative exposure distributions and investigating the possibility of linking exposure measurements to population statistics to assess the distribution of exposure levels relative to population percentiles.

Pollution exhibits significant variations horizontally and vertically within cities; therefore, the size and three-dimensional (3D) spatial distribution of population are significant determinants of urban health. This paper presents a novel methodology, 3D digital geography (3DIG) methodology, for investigating 3D spatial distributions of population in close proximity to traffic, thus the potential highly exposed population under traffic impacts. 3DIG applies geographic information system and fine-resolution (5 m) digital terrain models to obtain the number of building floors in residential zones of the Taipei metropolis; the vertical distribution of population at different floors was estimated based on demographic data in each census tract. In addition, population within 5, 10, 20, 50, and 100 m from the roadways was estimated. Field validation indicated that model results were reliable and accurate; the final population estimation differs only by 0.88% from the demographic database. The results showed that among the total 6.5 million Taipei residents, 0.8 (12.3%), 1.5 (22.9%), 2.3 (34.9), and 2.7 (41.1%) million residents live on the first or second floor within 5, 10, 20, and 50 m, respectively, of municipal roads. There are 22 census tracts with more than half of their residents living on the first or second floor within 5 m of municipal roads. In addition, half of the towns in Taipei city and county with >13.9% and 12.1% of residents live on the first and second floors within 5 m of municipal roads, respectively. These findings highlight the huge number of Taipei residents in close proximity to traffic and have significant implications for exposure assessment and environmental epidemiological studies. This study demonstrates that 3DIG is a versatile methodology for various research and policy planning in which 3D spatial population distribution is the central focus.

In Brazil, in the last 20 years, dietary risk assessments have been conducted on pesticides, mycotoxins, food additives, heavy metals (mainly mercury), environmental contaminants (mainly DDT) and acrylamide, a compound formed during food processing. The objectives of this paper were to review these studies, discuss their limitations and uncertainties and identify the most critical chemicals that may pose a health risk to Brazilian consumers. The studies have shown that the cumulative intake of organophosphorus and carbamate pesticides by high consumers of fruits and vegetables may represent a health concern (up to 169% of the ARfD), although the benefits of consuming large portions of those foods most probably overcome the risks. High consumers of maize products may also be at risk due to the presence of fumonisin (355% of the PMTDI), a mycotoxin present at high levels in Brazilian maize. The studies conducted in the Brazilian Amazon have shown that riparian fish consumers are exposed to unsafe levels of mercury. However, this is a more complex issue, as mercury levels in the region are naturally high and the health benefits of a fish-based diet are well known. Studies conducted both in Brazil and internationally on acrylamide have shown that the exposure to this genotoxic compound, mainly from the consumption of French fries and potato chips, is of health concern. Reducing the population dietary exposure to toxic chemicals is a challenge for government authorities and food producers in all countries. Management strategies aimed at decreasing exposure to the critical chemicals identified in this review involve limiting the use or eliminating highly toxic pesticides, implementing good agricultural practices to decrease maize contamination by fumonisins, educating local fish-eating communities toward a fish diet less contaminated by mercury, and changing dietary habits concerning the consumption of fried potatoes, the main processed food containing acrylamide.

Time-activity data are traditionally collected by telephone interviews or through paper diaries, which are time consuming and costly. As a potential alternative that may greatly save staff time, a web survey to collect time-activity data was developed and tested in this study. We collected 24-h recall web diaries from 151 parents of young children mostly under 55 years of age (who also answered for their children) and 55 older adults (≥ 55 years of age) both on a weekday and a weekend day every 3 months during an 18-month period. The performance and reliability of the web surveys collected were evaluated, including the survey-completion rate, and the percentage of surveys with unreasonable time being reported as spent sleeping and with missing reports of being in transit between locations. We also compared the web-survey data with time-activity information we collected from the same subjects in telephone interviews and found that these data sources were fairly consistent with each other. However, we observed slightly more compliance issues for the web than the telephone survey, but most of these issues could be addressed and minimized by refining some questions or the survey interface. Our study suggests that it is critical to reduce participants' burden and improve survey interface design for optimal compliance and data quality. In conclusion, web surveys are a promising method to consider for time-activity data collection.

Measurement is the foundation of exposure science. Associations between illness and environmental agents have been observed for millennia, but the ability to quantify exposure and dose has been possible only in the last century. Improved means of measurement and refined concepts of who, what, when, where, and why to measure have been the seminal contributions of exposure science to the study of disease causation and prevention. This paper examines critical advancements in exposure assessment associated with workplace health and safety, and the groundbreaking work of the US Public Health Service. Many of the key concepts of modern exposure science have their origin in these early studies. Occupational hygiene scientists have conducted receptor-based exposure analyses for more than 80 years, evaluating indoor air, defining microenvironments, and developing personal sampling techniques. Biological monitoring of community populations including children, dermal exposure monitoring, duplicate diet studies, and multi-pathway, aggregate exposure assessments can be traced to early public health studies. As we look to the future, we see that new technologies and techniques are expanding the scope of exposure science dramatically. We need to ensure that the highest of scientific standards are maintained, make a greater effort to include occupational hygiene scientists, microbiologists, and behavioral scientists in the field, and promote new sources of training and research support. Exposure science has a critical role to play in the prevention strategy that is central to public health.

Nationally representative data on urinary levels of bisphenol A (BPA) and its metabolites in the United States from the 2005–2006 National Health and Nutrition Examination Survey (NHANES) were used to estimate daily BPA intakes. In addition, NHANES data on potential sources of BPA exposure and personal characteristics were explored for their association with urinary BPA levels. On the basis of 2005–2006 NHANES urinary BPA data and assumptions described in this paper, median daily intake for the overall population is approximately 34 ng/kg-day. Median daily BPA intakes for men are statistically significantly higher than for women; there is a significant decrease in daily BPA intake with increasing age. Gender- and age-specific median intakes differ from the overall population by less than a factor of 2. Although estimates of daily BPA intake have decreased compared with those from the 2003–2004 NHANES, it is premature to draw conclusions regarding trends at this time, as there is no indication that BPA use declined from 2003 to 2006. On the basis of an assessment of urinary BPA and questionnaire data from the 2005–2006 NHANES, consumption of soda, school lunches, and meals prepared outside the home — but not bottled water or canned tuna — was statistically significantly associated with higher urinary BPA.

This review paper examines and evaluates urine-sampling methodologies in infants and young children, to determine which methods are suitable for use in large biomonitoring surveys or studies of environmental chemicals in children younger than 6 years. Methods for non-toilet-trained children include the use of urine bags, collection pads (e.g., cotton or gauze inserts), disposable diapers, cotton diapers, and the clean catch method. In toilet-trained children, collection methods include use of a commode insert pan as well as specimen collection cups. The advantages and disadvantages of these various methods need to be evaluated with respect to the target population, timing and frequency of collection, minimum sample volume required, method of urine extraction, potential for contamination of the sample, stability of the analyte of interest, and burden on participants and research team. Collection methods must not introduce contamination or affect the integrity of the sample, should be logistically practical, and should minimize discomfort experienced by the child. Although collection of urine samples from children who are not toilet-trained is more challenging than collection from older toilet-trained children, the vulnerability of younger children to the exposure to and health effects of environmental chemicals makes finding suitable methods a priority.

This paper summarizes and assesses over 70 tools that could aid with gathering information and taking action on environmental issues related to community-based cumulative risk assessments (CBCRA). Information on tool use, development and research needs, was gathered from websites, documents, and CBCRA program participants and researchers, including 25 project officers who work directly with community groups. The tools were assessed on the basis of information provided by project officers, community members, CBCRA researchers, and by case study applications. Tables summarize key environmental issues and tool features: (1) a listing of CBCRA-related environmental issues of concern to communities; (2) web-based tools that map environmental information; (3) step-by-step guidance documents; (4) databases of environmental information; and (5) computer models that simulate human exposure to chemical stressors. All tools described here are publicly available, with the focus being on tools developed by the US Environmental Protection Agency. These tables provide sources of information to promote risk identification and prioritization beyond risk perception approaches, and could be used by CBCRA participants and researchers. The purpose of this overview is twofold: (1) To present a comprehensive, though not exhaustive, summary of numerous tools that could aid with performing CBCRAs; and (2) To use this toolset as a sample of the current state of CBCRA tools to critically examine their utility and guide research for the development of new and improved tools.

Communities are faced with challenges in identifying and prioritizing environmental issues, taking actions to reduce their exposures, and determining their effectiveness for reducing human health risks. Additional challenges include determining what scientific tools are available and most relevant, and understanding how to use those tools; given these barriers, community groups tend to rely more on risk perception than science. The U.S. Environmental Protection Agency's Office of Research and Development, National Exposure Research Laboratory (NERL) and collaborators are developing and applying tools (models, data, methods) for enhancing cumulative risk assessments. The NERL's “Cumulative Communities Research Program” focuses on key science questions: (1) How to systematically identify and prioritize key chemical stressors within a given community?; (2) How to develop estimates of exposure to multiple stressors for individuals in epidemiologic studies?; and (3) What tools can be used to assess community-level distributions of exposures for the development and evaluation of the effectiveness of risk reduction strategies? This paper provides community partners and scientific researchers with an understanding of the NERL research program and other efforts to address cumulative community risks; and key research needs and opportunities. Some initial findings include the following: (1) Many useful tools exist for components of risk assessment, but need to be developed collaboratively with end users and made more comprehensive and user-friendly for practical application; (2) Tools for quantifying cumulative risks and impact of community risk reduction activities are also needed; (3) More data are needed to assess community- and individual-level exposures, and to link exposure-related information with health effects; and (4) Additional research is needed to incorporate risk-modifying factors (“non-chemical stressors”) into cumulative risk assessments. The products of this research program will advance the science for cumulative risk assessments and empower communities with information so that they can make informed, cost-effective decisions to improve public health.

The aim of this research was to assess dermal and respiratory exposure of workers to imidacloprid during manual operations with ornamental plants previously treated in greenhouses or tunnels. A total of 10 female workers, 5 in greenhouses and 5 in tunnels, were monitored for 3 or 5 consecutive days. Actual skin contamination, excluding hands, was evaluated using nine filter paper pads placed directly on the skin. To evaluate the efficacy of protective clothing in reducing occupational exposure we also placed four pads on top of the outer clothing. Hand contamination was evaluated by washing with 95% ethanol. Respiratory exposure was evaluated by personal air sampling. Respiratory dose was calculated on the basis of a lung ventilation of 15 l/min. Absorbed doses were calculated assuming a skin penetration of 10% and a respiratory retention of 100%. Dislodgeable foliar residues (DFRs) were determined during the days of re-entry in order to determine the dermal transfer factor. From the dependence of dermal exposure of hands from DFRs, a mean transfer factor was estimated to be 36.4 cm(2)/h. Imidacloprid was determined by liquid chromatography with selective mass detection and electrospray interface in all matrices analysed. Respiratory dose was 4.1+/-4.0 (0.1-14.3)% and 3.0+/-2.0 (0.6-6.9)% (mean+/-SD (range)) of the total real dose during work in tunnels and greenhouses, respectively. The estimated absorbed doses, 0.29+/-0.45 microg/kg (0.06-2.25 microg/kg) body weight and 0.32+/-0.18 microg/kg (0.07-0.66 microg/kg) body weight (mean+/-SD (range)) in tunnels and in greenhouses, respectively, were less than the acceptable operator exposure level of 0.15 mg/kg body weight and than the acceptable daily intake of 0.05 mg/kg body weight. The hands and exposed skin of all workers were found to be contaminated, indicating that greater precautions, such as daily changing of gloves and clothing, are necessary to reduce skin exposure.

Water ingestion estimates are important for the assessment of risk to human populations of exposure to water-borne pollutants. This paper reports mean and percentile estimates of the distributions of daily average per capita water ingestion for a number of age range groups. The age ranges, based on guidance from the US EPA's Risk Assessment Forum, are narrow for younger ages when development is rapid and wider for older ages when the rate of development decreases. Estimates are based on data from the United States Department of Agriculture's (USDA's) 1994-1996 and 1998 Continuing Survey of Food Intake by Individuals (CSFII). Water ingestion estimates include water ingested directly as a beverage and water added to foods and beverages during preparation at home or in local establishments. Water occurring naturally in foods or added by manufacturers to commercial products (beverage or food) is not included. Estimates are reported in milliliters (ml/person/day) and milliliters per kilogram of body weight (ml/kg/day). As a by-product of constructing estimates in terms of body weight of respondents, distributions of self-reported body weights based on the CSFII were estimated and are also reported here.

In December 2006, the U.S. Environmental Protection Agency (EPA) sponsored a 2-day workshop on "Interpretation of Epidemiologic Studies of Multipollutant Exposure and Health Effects" in Chapel Hill, NC. The final session at this workshop was devoted to assessing the biological plausibility of epidemiological findings with regard to criteria air pollutants. The presentations and the panel contributions of this last session primarily focused on controlled exposure studies and led to wide-ranging discussions, some of which were provocative. The panel summary provides some guidance to future evaluations of the biological plausibility of the epidemiological reports on criteria pollutants and is intended to stimulate thinking, without drawing any definitive conclusions. This paper does not approach, nor was it intended to approach, the more formal analytical approach such as that used in EPA's development of its Science Assessment Document for the criteria pollutants.

Under the new REACH system, companies importing, producing and marketing chemical substances will be obliged to register the single substances and to carry out a safety assessment for all identified uses during the life cycle of the substance. This duty will apply to about 10,000 existing substances in the EU market exceeding an annual production or import volume of 10 t per company. If the substance is already known to be dangerous or turns out to be dangerous(1) during the hazard assessment, the registrant is obliged to carry out an exposure assessment and a risk characterisation for all identified uses. The goal of the safety assessment is to define the conditions of use that allow for adequate control of risk with regard to health and safety at the work place, consumer safety and protection of the environment. Once the registrant has established and documented these conditions in the Chemicals Safety Report (CSR), that information is to be communicated down the supply chain by means of the Extended Safety Data Sheet (eSDS). The ultimate aim of the new legislation is to establish duties and mechanisms that systematically prevent or limit exposure to dangerous industrial chemicals. The current paper explains this concept with regard to environmental exposure and highlights the challenges and possible solutions.

ECETOC has been developed an approach by which the health and environmental risks arising from the supply and use of chemicals can be quickly and reliably evaluated by chemical suppliers. The approach has been available as a web-based tool since 2004. During the development and implementation of the approach, ECETOC has consulted widely so that the approach is seen to meet the required levels of science while also meeting the differing needs of affected stakeholders. The consultation process has yielded a number of findings in terms of the considerations necessary for implementing successful risk-informed decision-making in a multi-stakeholder environment. Concurrently, as the European Commission's REACH legislative package has begun to take shape, it has also become apparent that the approach has a number of potential applications for aiding the process of risk assessment under REACH. This paper reviews these experiences within the broader context of the expectations that REACH places on chemical manufacturers and suppliers. In particular, it highlights the key role that REACH Exposure Scenarios have for evaluating, managing and communicating chemical risks.

As diet has been considered as the major exposure pathway for toxic chemicals, such as heavy metals and pesticides, we have developed a web-based questionnaire system, the internet data logger (iDL), in order to facilitate the collection of detailed self-recording of standardized daily dietary consumption. An iDL prototype optimized for hand-held devices was tested in the on-going Children's Pesticide Exposure Study (CPES) in Atlanta, GA in which 15 consecutive days of dietary consumption information were recorded by 11 children or their parents and transmitted to a server via broadband wireless internet connection. Participants spent an average of 6.2 min in day 1 to enter a meal into iDL and approximately 4 min per meal for the remaining 14 study days. Approximately 75% of 446 total meals were entered into iDL on the date of consumption. A within-person comparison revealed that many food items recorded on paper diary were later classified as "unknown" according to iDL standards due to the lack of detailed information provided by the participants. The development of iDL represents a novel and pioneering tool, which integrates dietary data collection, transmission, and management in a real-time and automated manner. iDL provides the needed flexibility and mobility for research focused on collecting not only dietary consumption data but also other time-sensitive behavior data. This study has demonstrated that iDL can be deployed to collect long-term dietary consumption information in a population-based study, though future modifications/enhancements will undoubtedly improve its usability and application.

Health Effects of Arsenic Longitudinal Study (HEALS), a multidisciplinary and large prospective cohort study in Araihazar, Bangladesh, was established to evaluate the effects of full-dose range arsenic (As) exposure on various health outcomes, including premalignant and malignant skin tumors, total mortality, pregnancy outcomes, and children's cognitive development. In this paper, we provide descriptions of the study methods including study design, study population, data collection, response rates, and exposure and outcome assessments. We also present characteristics of the study participants including the distribution of exposure and the prevalence of skin lesion at baseline recruitment. A total of 11,746 married men and women between 18 and 75 years of age participated in the study at baseline (a response rate of 98%) and completed a full questionnaire interview that included a food frequency questionnaire, with a response rate of 98%. Among the 98% of the participants who completed the clinical evaluation, over 90% provided blood samples and spot urine samples. Higher educational status, male gender, and presence of premalignant skin lesions were associated with an increased likelihood of providing blood and urine samples. Older participants were less likely to donate a blood sample. About one-third of the participants consumed water from a well with As concentration in each of three groups: >100 microg/l, 25-100 microg/l, and

According to European Union Council directive 2001/83, an application for the marketing authorization of a medicinal product shall be accompanied by an environmental risk assessment, including an exposure assessment. Computerized exposure models constitute an important tool in predicting environmental exposure to substances yet to be introduced on the market. This paper reports the process of identifying appropriate exposure models for estimating PECs (Predicted Environmental Concentrations) for pharmaceuticals and veterinary products, focusing on emissions to Swedish aquatic and terrestrial environments via water and sludge from sewage treatment plants. From a large number of information sources, a set of 181 potentially relevant exposure models was identified. A process of scrutinizing and testing these models resulted in a final selection of two models, namely SimpleTreat 3.1 that is used to estimate distribution and elimination of chemicals in sewage treatment plants (resulting in a PEC), and VetPec, suited for veterinary products, that estimates PEC in soil (including pore water), groundwater, and surface water. It is concluded that there is still potential for further development of exposure model(s) specifically designed for pharmaceutical emissions to the Nordic environment and climate. Furthermore, increased regulatory data requirements would facilitate the use of existing models, and improve the quality of the output data from these models.

Computer simulation programs have been identified as useful tools for characterizing uncertainty and variability in longitudinal exposures to multiple sources by multiple routes of exposures. This paper provides a conceptual framework for such programs that separates and appropriately models the processes that determine uncertainty, inter- and intraindividual variability, as well as the processes that determine the relationships between the individuals and sources of exposure. The framework is based on a series of four nested loops. These are: the exposure event loop that models the route-specific doses to a person from one or more sources at one point in time; the time step loop that moves a person through time updating the sources and the person's characteristics, the interindividual variation loop that determines the initial characteristics of each person modeled, and finally the uncertainty loop that characterizes the uncertainty from model and parameter uncertainties. This framework provides a flexible and internally consistent approach for the design of simulation software.

Samples of drinking water are routinely analysed for four trihalomethanes (THMs), which are indicators of by-products of disinfection with chlorine, by UK water suppliers to demonstrate compliance with regulations. The THM data for 1992-1993 to 1997-1998 for three water suppliers in the north and midlands of England were made available for a UK epidemiological study of the association between disinfection by-products and adverse birth outcomes. This paper describes the THM levels in these three supply regions and discusses possible sources of variation. THM levels varied between different suppliers' water, and average THM levels were within the regulatory limits. Chloroform was the predominant THM in all water types apart from the ground water of one supplier. The supplier that distributed more ground and lowland surface water had higher dibromochloromethane (DBCM) and bromoform levels and lower chloroform levels than the other two suppliers. In the water of two suppliers, seasonal fluctuations in bromodichloromethane (BDCM) and DBCM levels were found with levels peaking in the summer and autumn. In the other water supplier, chloroform levels followed a similar seasonal trend whereas BDCM and DBCM levels did not. For all three water suppliers, chloroform levels declined throughout 1995 when there was a drought period. There was a moderate positive correlation between the THMs most similar in their structure (chloroform and BDCM, BDCM and DBCM, and DBCM and bromoform) and a slight negative correlation between chloroform and bromoform levels.

Concerns regarding consequences of hazardous chemical accidents and children's environmental health have increased substantially in recent years. The objectives of this paper are to: (a) demonstrate a methodology for identifying areas potentially exposed to accidental releases of hazardous substances in a large metropolitan region (Hillsborough County, Florida); (b) examine the number and type of schools and school children at risk; and (c) explore the relationship between potential exposure levels and school enrollment patterns in the region. Methods based on the integration of environmental modeling and geographic information systems (GIS) technology are used to achieve these goals. The results indicate that almost 80% of schools and enrolled students in the study area is potentially exposed to worst-case accidents. Compared to elementary school children, a higher proportion of middle school children and a lower proportion of high school students are exposed to multiple releases of hazardous chemicals. A significant and negative association is observed between exposure levels and school enrollment size, which suggests fewer children in regions of highest exposure.

Personal exposures, indoor and outdoor concentrations, and questionnaire data were collected in three retirement center settings, supporting broader particulate matter (PM)--health studies of elderly populations. The studies varied geographically and temporally, with populations studied in Baltimore, MD in the summer of 1998, and Fresno, CA in the winter and spring of 1999. The sequential nature of the studies and the relatively rapid review of the mass concentration data after each segment provided the opportunity to modify the experimental designs, including the information collected from activity diary and baseline questionnaires and influencing factors (e.g., heating, ventilation, and air-conditioning (HVAC) system operation, door and window openings, air exchange rate) measurements. This paper highlights both PM2.5 and PM10 personal exposure data and interrelationships across the three retirement center settings, and identifies the most probable influencing factors. The current limited availability of questionnaire results, and chemical speciation data beyond mass concentration for these studies, provided only limited capability to estimate personal exposures from models and apportion the personal exposure collections to their sources. The mean personal PM2.5 exposures for the elderly in three retirement centers were found to be consistently higher than the paired apartment concentrations by 50% to 68%, even though different facility types and geographic locations were represented. Mean personal-to-outdoor ratios were found to 0.70, 0.82, and 1.10, and appeared to be influenced by the time doors and windows were open and aggressive particle removal by the HVAC systems. Essentially identical computed mean PM2.5 personal clouds of 3 micrograms/m3 were determined for two of the studies. The proposed significant contributing factors to these personal clouds were resuspended particles from carpeting, collection of body dander and clothing fibers, personal proximity to open doors and windows, and elevated PM levels in nonapartment indoor microenvironments.

Children can be exposed to pesticides from multiple sources and through multiple pathways. In addition to the standard pathways of diet, drinking water and residential pesticide use, children in agricultural communities can be exposed to pesticides used in agricultural production. A research program on children and pesticides was established at the University of Washington (UW) in 1991 and has focused on two major exposure pathway issues: residential proximity to pesticide-treated farmland and transfer of pesticides from the workplace to the home (paraoccupational or take-home exposure). The UW program selected preschool children of agricultural producers and farm workers in the tree fruit region of Washington state as a population that was likely to have elevated exposures from these pathways. The organophosphorus (OP) pesticides were selected as a common class of chemicals for analysis so that issues of aggregate exposure and cumulative risk could be addressed. This paper provides an overview of key findings of our research group over the past 8 years and describes current studies in this field. Soil and housedust concentrations of OP pesticides were elevated in homes of agricultural families (household members engaged in agricultural production) when compared to non-agricultural reference homes in the same community. Dialkyl phosphate metabolites of OP pesticides measured in children's urine were also elevated for agricultural children when compared to reference children and when compared to children in the Seattle metropolitan area. Proximity to farmland was associated with increased OP pesticide concentrations in housedust and OP pesticide metabolites in urine. Current studies include a community-based intervention to reduce parental transfer of pesticides from the workplace, and a systematic investigation of the role of agricultural spray drift in children's exposure to pesticides.

Substantial evidence supports an association of particulate matter (PM) with cardiorespiratory illnesses, but little is known regarding characteristics of PM that might contribute to this association and the mechanisms of action. The Atlanta superstation sponsored by the Electric Power Research Institute as part of the Aerosol Research and Inhalation Epidemiology Study (ARIES) study is monitoring chemical composition of ambient particles by size fraction, as well as a comprehensive suite of other pollutants, at a site in downtown Atlanta during the 25-month period, August 1, 1998-August 31, 2000. Our investigative team is making use of this unique resource in several morbidity studies, called the "Study of Particulates and Health in Atlanta (SOPHIA)". The study includes the following components: (1) a time series investigation of emergency department (ED) visits for the period during which the superstation is operating; (2) a time series investigation of ED visits during the 5 years prior to implementation of the superstation; and (3) a study of arrhythmic events in patients equipped with automatic implantable cardioverter defibrillators (AICDs) for the period January 1, 1993-August 31, 2000. Thirty-three of 39 Atlanta area EDs are participating in the ED studies, comprising over a million annual ED visits. In this paper, we present initial analyses of data from 18 of the 33 participating EDs. The preliminary data set includes 1,662,713 ED visits during the pre-superstation time period and 559,480 visits during the superstation time period. Visits for four case groupings--asthma, chronic obstructive pulmonary disease (COPD), dysrhythmia, and all cardiovascular diseases (CVDs) combined--have been assessed relative to daily air quality indices, controlling for long-term temporal trends and meteorologic variables, using general linear models, generalized estimating equations and generalized additive models. Single-pollutant models predicting case visitation rates using moving averages of 0-, 1-, and 2-day lagged air quality variables were run. For the pre-superstation period, PM10 (24-h), ozone (8-h), SO2 (1-h), NO2 (1-h) and CO (1-h) were studied. For the first 12 months of superstation operation, the following air quality variables of a priori interest were available: ozone (8-h), NO2 (1-h), SO2 (1-h), CO (1-h), and 24-h measurements of PM10, coarse PM (PM 2.5-10 microm), PM2.5, polar VOCs, 10-100 nm particulate count and surface area, and in the PM2.5 fraction: sulfates, acidity, water-soluble metals, organic matter (OM), and elemental carbon (EC). During the pre-superstation time period, statistically significant, positive associations were observed for adult asthma with ozone, and for COPD with ozone, NO2 and PM10. During the superstation time period, the following statistically significant, positive associations were observed: dysrhythmia with CO, coarse PM, and PM2.5 EC; and all CVDs with CO, PM2.5 EC and PM2.5 OM. While covariation of many of the air quality indices limits the informativeness of this analysis, the study provides one of the first assessments of PM components in relation to ED visits.