Guidelines for the Communication of Biomonitoring Equivalents: Report from the Biomonitoring Equivalents Expert Workshop

LaKind Associates, LLC, 106 Oakdale Avenue, Catonsville, MD 21228, USA.
Regulatory Toxicology and Pharmacology (Impact Factor: 2.03). 06/2008; 51(3 Suppl):S16-26. DOI: 10.1016/j.yrtph.2008.05.007
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Biomonitoring Equivalents (BEs) are screening tools for interpreting biomonitoring data. However, the development of BEs brings to the public a relatively novel concept in the field of health risk assessment and presents new challenges for environmental risk communication. This paper provides guidance on methods for conveying information to the general public, the health care community, regulators and other interested parties regarding how chemical-specific BEs are derived, what they mean in terms of health, and the challenges and questions related to interpretation and communication of biomonitoring data. Key communication issues include: (i) developing a definition of the BE that accurately captures the BE concept in lay terms, (ii) how to compare population biomonitoring data to BEs, (iii) interpreting biomonitoring data that exceed BEs for a specific chemical, (iv) how to best describe the confidence in chemical-specific BEs, and (v) key requirements for effective communication with health care professionals. While the risk communication literature specific to biomonitoring is sparse, many of the concepts developed for traditional risk assessments apply, including transparency and discussions of confidence and uncertainty. Communication of BEs will require outreach, education, and development of communication materials specific to several audiences including the lay public and health care providers.

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    • "BE values are designed to be used as screening tools to assess whether chemicals have a large, a small or no margin of safety compared to existing health-based exposure guidelines (LaKind et al., 2008). A serum lipid-adjusted concentration of approximately 15 pg TEQ g −1 l.w. for 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) was derived based on neurodevelopmental effects in monkeys (Aylward et al., 2008). "
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    ABSTRACT: The body burden of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), dioxin-like (dl-PCBs) and non-dioxin-like (ndl-PCBs) polychlorinated biphenyls, and polybrominated diphenyl ethers (PBDEs) was determined in blood samples from 70 subjects between 4 and 76 years old. The participants of the study were recruited in the neighborhood of a reclamation plant located in a rural area in Southern Germany. The median concentrations (95th percentiles in parentheses), expressed as WHO2005-TEQ (toxic equivalents), for PCDD/Fs and dl-PCBs were 4.5 (17.9) pg g−1 l.w. and 2.6 (13.2) pg g−1 l.w., respectively. The dl-PCBs contributed 40% of the total TEQ (median values), and the most abundant congener was PCB 156. Combined, the sum of the 6 non-dioxin-like PCBs had a median of 0.773 μg L−1 and a 95th percentile of 4.895 μg L−1. For the six tetra to hepta PBDE congeners, the median was 1.8 ng g−1 l.w. (95th percentile: 16.2 ng g−1 l.w.). None of our study subjects had a body burden that exceeded the biomonitoring equivalents for dioxins or PBDE congener 99 or the human biomonitoring values for ndl-PCBs. Likewise the study group did not exceed German reference values or values obtained in similar investigations. Overall, our study did not exhibit elevated internal exposures. The results also hint further decreasing tendencies for PCDD/Fs, PCBs, and PBDEs in Germany and demonstrates that people in the vicinity of a reclamation plant with no indication of an environmental contamination did not exhibit elevated internal exposures.
    International Journal of Hygiene and Environmental Health 12/2014; 218(1). DOI:10.1016/j.ijheh.2014.07.004 · 3.83 Impact Factor
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    • "However, development of such epidemiologically-based guidance is a resource-and time-intensive effort, and in practice, data to support such assessments exist for only a few chemicals. As an interim approach, the concept of Biomonitoring Equivalents (BEs) has been developed (Hays et al., 2007), and guidelines for the derivation and communication of these values have been prepared (Hays et al., 2008; LaKind et al., 2008). A Biomonitoring Equivalent (BE) is defined as the concentration or range of concentrations of a chemical or its metabolites in a biological medium (blood, urine, or other medium) that is consistent with an existing health-based exposure guidance value such as a reference dose (RfD) or Tolerable Daily Intake (TDI). "
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    ABSTRACT: Selenium is an essential nutrient for human health with a narrow range between essentiality and toxicity. Selenium is incorporated into several proteins that perform important functions in the body. With insufficient selenium intake, the most notable effect is Keshan disease, an endemic cardiomyopathy in children. Conversely, excessive selenium intake can result in selenosis, manifested as brittle nails and hair and gastro-intestinal disorders. As such, guidance values have been established to protect against both insufficient and excessive selenium exposures. Dietary Reference Intakes (DRIs) have been established as standard reference values for nutritional adequacy in North America. To protect against selenosis resulting from exposure to excessive amounts of selenium, several government and non-governmental agencies have established a range of guidance values. Exposure to selenium is primarily through the diet, but monitoring selenium intake is difficult. Biomonitoring is a useful means of assessing and monitoring selenium status for both insufficient and excessive exposures. However, to be able to interpret selenium biomonitoring data, levels associated with both DRIs and toxicity guidance values are required. Biomonitoring Equivalents (BEs) were developed for selenium in whole blood, plasma and urine. The BEs associated with assuring adequate selenium intake (Estimated Average Requirements - EAR) are 100, 80 and 10μg/L in whole blood, plasma and urine, respectively. The BEs associated with protection against selenosis range from 400 to 480μg/L in whole blood, 180-230μg/L in plasma, and 90-110μg/L in urine. These BE values can be used by both regulatory agencies and public health officials to interpret selenium biomonitoring data in a health risk context.
    Regulatory Toxicology and Pharmacology 07/2014; 70(1). DOI:10.1016/j.yrtph.2014.07.017 · 2.03 Impact Factor
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    • "technical support documents of AEGLs at An alternative to intervention values is the concept of biological equivalents (BEs, Boogaard and Money, 2008; LaKind et al., 2008). BEs may be useful for conversion of environmental exposure standards (for the general population) or from occupational exposure standards (for emergency responders) chemical substances to the corresponding biomarker of interest in an HBM campaign. "
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    ABSTRACT: Biological monitoring in humans (HBM) is widely used in the field of occupational and environmental health. In the situation of an unexpected release of hazardous materials HBM may contribute to the medical support and treatment of exposed individuals from the general population or of emergency responders. Such exposure information may also be used to respond to individual concerns such as questions about a possible relationship between the chemicals released during the incident and health effects. In the Netherlands a guideline was prepared to support early decision-making about the possible use of HBM for exposure assessment during or as soon as possible following a chemical incident. The application of HBM in such an emergency setting is not much different from situations where HBM is normally used but there are some issues that need extra attention such as the choice of the biomarker, the biological media to be sampled, the time point at which biological samples should be collected, the ethics approval and technical implementation of the study protocol and the interpretation and communication of the study results. These issues addressed in the new guideline will support the use of HBM in the management of chemical disasters.
    Toxicology Letters 03/2014; 231(3). DOI:10.1016/j.toxlet.2014.03.002 · 3.26 Impact Factor
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