GRADE: Assessing the quality of evidence in environmental and occupational health

There is high demand in environmental health for adoption of a structured process that evaluates and integrates evidence while making decisions and recommendations transparent. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework holds promise to address this demand. For over a decade, GRADE has been applied successfully to areas of clinical medicine, public health, and health policy, but experience with GRADE in environmental and occupational health is just beginning. Environmental and occupational health questions focus on understanding whether an exposure is a potential health hazard or risk, assessing the exposure to understand the extent and magnitude of risk, and exploring interventions to mitigate exposure or risk. Although GRADE offers many advantages, including its flexibility and methodological rigor, there are features of the different sources of evidence used in environmental and occupational health that will require further consideration to assess the need for method refinement. An issue that requires particular attention is the evaluation and integration of evidence from human, animal, in vitro, and in silico (computer modeling) studies when determining whether an environmental factor represents a potential health hazard or risk. Assessment of the hazard of exposures can produce analyses for use in the GRADE evidence-to-decision (EtD) framework to inform risk-management decisions about removing harmful exposures or mitigating risks. The EtD framework allows for grading the strength of the recommendations based on judgments of the certainty in the evidence (also known as quality of the evidence), as well as other factors that inform recommendations such as social values and preferences, resource implications, and benefits. GRADE represents an untapped opportunity for environmental and occupational health to make evidence-based recommendations in a systematic and transparent manner. The objectives of this article are to provide an overview of GRADE, discuss GRADE's applicability to environmental health, and identify priority areas for method assessment and development.     

Modelling microbial health risk of wastewater reuse: A systems perspective

There is a widespread need for the use of quantitative microbial risk assessment (QMRA) to determine reclaimed water quality for specific uses, however neither faecal indicator levels nor pathogen concentrations alone are adequate for assessing exposure health risk. The aim of this study was to build a conceptual model representing factors contributing to the microbiological health risks of reusing water treated in maturation ponds. This paper describes the development of an unparameterised model that provides a visual representation of theoretical constructs and variables of interest. Information was collected from the peer-reviewed literature and through consultation with experts from regulatory authorities and academic disciplines. In this paper we explore how, considering microbial risk as a modular system, following the QMRA framework enables incorporation of the many factors influencing human exposure and dose response, to better characterise likely human health impacts. By using and expanding upon the QMRA framework we deliver new insights into this important field of environmental exposures. We present a conceptual model of health risk of microbial exposure which can be used for maturation ponds and, more importantly, as a generic tool to assess health risk in diverse wastewater reuse scenarios.     

Framework for the uncertainty assessment in the impact pathway analysis with an application on a local scale in Spain

The estimation of damage estimates due to air emissions gives important basic knowledge for decision-making on the level of environmental politics and business strategies. Nowadays, a frequently applied method to estimate environmental damages is the Impact Pathway Analysis (IPA), which can be easily carried out using models such as EcoSense or PathWays. These models produce results in a relatively short term. However, there is a lack of reliability in the results. As in many other environmental software tools, the uncertainty is the key problem that makes it difficult to convince decision-makers by the outcomes of a study. Therefore, a framework that allows assessing the uncertainties within studies in which the IPA is applied on a local scale has been developed. In this assessment framework, the uncertainties of the used parameters, including their spatial and temporal variability, are taken into account. As the model is processing a huge quantity of data, one step of the assessment consists of a screening procedure to determine the parameters that are supposed to be fixed. For the other data, probability distributions have to be selected and classified into two groups: extensively available data for which average and standard deviation can be calculated and data based on little information. A quantification of the uncertainty can be completed by a stochastic model in the form of Monte Carlo (MC) simulation on the basis of the framework. As an illustration of the framework, we have applied it to a study on the installation of an advanced gas treatment in the municipal waste incinerator of Tarragona. It can be shown that the presented stochastic approach gives a lower geometric deviation than the analytical one and that the new gas treatment reduces the environmental damages without any doubt.     

Long-term contaminant migration and impacts from uranium mill tailings

As part of the BIOMOVS II study, a Working Group was established with the primary aim of comparing computer models used to assess the long-term impacts of contaminants released from uranium mill tailings piles, involving multiple pathways, multiple contaminants and multiple environmental receptors. The application of models to two scenarios (V1 and V2) allowed participants to gain an improved understanding of important processes and to compare the representation of these processes in the models. Partly as a result of this, new models were developed and the functionality of existing models was enhanced. Model results for the scenarios were compared quantitatively and agreed well (often within a factor of three) for the more tightly specified V2 scenario. In so far as the scenarios represent generic sites, the following generic conclusions can be drawn.

• •A range of pathways and contaminants affect the total dose/intake and so no single pathway or contaminant is dominant for all scenarios to the exclusion of all other pathways or contaminants.
• •Peak impacts on individuals may not arise for many hundreds of years.
• •Simplification of the ²³⁸U decay chain, by assuming ²¹⁰Pb and ²¹⁰Po are in secular equilibrium in the biosphere with the long-lived parent, ²²⁶Ra, is inappropriate.
• •Whilst models are available for assessing potential radiological and non-radiological health impacts, comparison of health impacts is limited by the absence of comprehensive data for health impacts of stable elements.

     

Sources and environmental behaviors of Dechlorane Plus and related compounds — A review

Although Dechlorane Plus (DP) has been used as a polychlorinated flame retardant for almost half a century, its detection in the environment was not reported until 2006. The subsequent intensive research has confirmed its global ubiquity. A few reviews have presented the properties, analytical methods and environmental occurrence of DP and related compounds in the past several years. The present review emphasizes on the environmental behavior of DP isomers which is assessed by the variation of the isomer ratio of DP in various matrices. Other aspects including the analytical methods, emission sources, general environmental occurrence and bioaccumulation of DP are also summarized.In this review, three typical emission sources in the environment are categorized after introducing the measurement method of DP. The temporal-spatial distribution is then evaluated at the global scale, which provides an integrated representation of the environmental occurrence of DP and potential impact on the human health and ecosystems. The variations of DP isomer ratio in various matrices reinforce its source related distribution and their stereoselective bioaccumulation. Thereafter, DP related compounds and dechlorinated analogs are briefly summarized in regards to their occurrence in various matrices, suggesting their ubiquity in the environment and bioavailability. Further studies are required to better assess the exposures and toxicological effects of DP and its analogs. A special concern is the serious contamination in e-waste recycling areas in developing countries, where long-term monitoring data on the association of DP exposure and adverse effects to human health and ecosystems is urgently needed.     

"Reference Biospheres" for solid radioactive waste disposal: the BIOMASS methodology

The BIOMASS Theme 1 project has developed a methodology for the logical and defensible construction of 'assessment biospheres': mathematical representations of biospheres used in the total system performance assessment of radioactive waste disposal. The BIOMASS Methodology provides a systematic approach to decision making, including decisions on how to address biosphere change. The BIOMASS Methodology was developed through consultation and collaboration with many relevant organisations, including regulators, operators and a variety of independent experts. It has been developed to be practical and to be consistent with recommendations from ICRP and IAEA on radiation protection in the context of the disposal of long-lived solid radioactive wastes. The five main steps in the methodology are described in this paper. The importance of a clear assessment context, to clarify intentions and to support a coherent biosphere assessment process within an overall repository performance assessment, is strongly emphasised. A well described assessment context is an important tool for ensuring consistency across the performance assessment as a whole. The use of interaction matrices has been found to be helpful in clarifying the interactions between different habitats within the biosphere system and the significant radionuclide transfer pathways within the biosphere system. Matrices also provide a useful means of checking for consistency.     

Measuring combined exposure to environmental pressures in urban areas: an air quality and noise pollution assessment approach

This study presents a methodological scheme developed to provide a combined air and noise pollution exposure assessment based on measurements from personal portable monitors. Provided that air and noise pollution are considered in a co-exposure approach, they represent a significant environmental hazard to public health. The methodology is demonstrated for the city of Thessaloniki, Greece. The results of an extensive field campaign are presented and the variations in personal exposure between modes of transport, routes, streets and transport microenvironments are evaluated. Air pollution and noise measurements were performed simultaneously along several commuting routes, during the morning and evening rush hours. Combined exposure to environmental pollutants is highlighted based on the Combined Exposure Factor (CEF) and Combined Dose and Exposure Factor (CDEF). The CDEF takes into account the potential relative uptake of each pollutant by considering the physical activities of each citizen. Rather than viewing environmental pollutants separately for planning and environmental sustainability considerations, the possibility of an easy-to-comprehend co-exposure approach based on these two indices is demonstrated. Furthermore, they provide for the first time a combined exposure assessment to these environmental pollutants for Thessaloniki and in this sense they could be of importance for local public authorities and decision makers. A considerable environmental burden for the citizens of Thessaloniki, especially for VOCs and noise pollution levels is observed. The material herein points out the importance of measuring public health stressors and the necessity of considering urban environmental pollution in a holistic way.     

基于DPSIR概念模型的农业可持续发展宏观分析

DPSIR概念模型继承了PSR模型的优点，是分析评估环境系统有效工具，本文以DPISR概念模型为指导，系统分析了农业业系统的现状，塑造这一现状的驱动力和压力，探讨了农业对于互不干涉和人类健康的影响，以及实现农业可持续发展的政策响应，目的是建立农业可持续发展的指标体系和实现农业资源的优化配置，本文认为DPSIR概念模型有利于分析复杂系统的因果关系，能有效整合资源开发，环境保护和经济发展。     

Effectiveness of EMS in Tunisian companies: framework and implementation process based on ISO 14001 standard

This paper reports environmental analysis results of food and tannery Tunisian companies to identify the features of environmental management system (EMS) that is implemented recently. EMS via ISO 14001 has become one of the principal tools used by companies to handle environmental aspects and impacts through their various complex activities interacted with environment. While several companies have implemented and maintained a formal EMS, it has related mainly to their benefits in short term without responding to the sustainable development recommendations and practices. This study focuses on the strong linkage between the EMS effectiveness of food–tannery Tunisian companies and sustainability. A proactive environmental management approach is proposed and adopts a qualitative and quantitative assessment for factor analysis. It provides a strategic EMS framework and principles for sustainability to evolve the future enterprises’ benefits that has a clear influence on environmental performance in long term.     

Communities and change in the anthropocene: understanding social-ecological vulnerability and planning adaptations to multiple interacting exposures

The majority of vulnerability and adaptation scholarship, policies and programs focus exclusively on climate change or global environmental change. Yet, individuals, communities and sectors experience a broad array of multi-scalar and multi-temporal, social, political, economic and environmental changes to which they are vulnerable and must adapt. While extensive theoretical—and increasingly empirical—work suggests the need to explore multiple exposures, a clear conceptual framework which would facilitate analysis of vulnerability and adaptation to multiple interacting socioeconomic and biophysical changes is lacking. This review and synthesis paper aims to fill this gap through presenting a conceptual framework for integrating multiple exposures into vulnerability analysis and adaptation planning. To support applications of the framework and facilitate assessments and comparative analyses of community vulnerability, we develop a comprehensive typology of drivers and exposures experienced by coastal communities. Our results reveal essential elements of a pragmatic approach for local-scale vulnerability analysis and for planning appropriate adaptations within the context of multiple interacting exposures. We also identify methodologies for characterizing exposures and impacts, exploring interactions and identifying and prioritizing responses. This review focuses on coastal communities; however, we believe the framework, typology and approach will be useful for understanding vulnerability and planning adaptation to multiple exposures in various social-ecological contexts.     

Environmental occurrence,analysis and human exposure to the flame retardant tetrabromobisphenol-A (TBBP-A)-A review

TBBP-A is a high production volume chemical applied widely as a flame retardant in printed circuit boards. Recent studies have raised concern over potential harmful implications of TBBP-A exposure in human and wildlife, leading to its classification under group 2A “Probably carcinogenic to humans” by the International Agency for Research on Cancer. This article provides a comprehensive review of the available literature on TBBP-A analysis, environmental levels and human exposure. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) has been identified as the method of choice for robust, accurate and sensitive analysis of TBBP-A in different matrices. TBBP-A has been detected in almost all environmental compartments all over the world, rendering it a ubiquitous contaminant. Human exposure studies revealed dust ingestion and diet as the major pathways of TBBP-A exposure in the general population. Toddlers are likely to be more exposed than adults via accidental indoor dust ingestion. Moreover, exposure to TBBP-A may occur prenatally and via breast milk. There are no current restrictions on the production of TBBP-A in the EU or worldwide. However, more research is required to characterise human exposure to TBBP-A in and around production facilities, as well as in e-waste recycling regions.     

Properties,use and health effects of depleted uranium (DU): a general overview

Depleted uranium (DU), a waste product of uranium enrichment, has several civilian and military applications. It was used as armor-piercing ammunition in international military conflicts and was claimed to contribute to health problems, known as the Gulf War Syndrome and recently as the Balkan Syndrome. This led to renewed efforts to assess the environmental consequences and the health impact of the use of DU. The radiological and chemical properties of DU can be compared to those of natural uranium, which is ubiquitously present in soil at a typical concentration of 3 mg/kg. Natural uranium has the same chemotoxicity, but its radiotoxicity is 60% higher. Due to the low specific radioactivity and the dominance of alpha-radiation no acute risk is attributed to external exposure to DU. The major risk is DU dust, generated when DU ammunition hits hard targets. Depending on aerosol speciation, inhalation may lead to a protracted exposure of the lung and other organs. After deposition on the ground, resuspension can take place if the DU containing particle size is sufficiently small. However, transfer to drinking water or locally produced food has little potential to lead to significant exposures to DU. Since poor solubility of uranium compounds and lack of information on speciation precludes the use of radioecological models for exposure assessment, biomonitoring has to be used for assessing exposed persons. Urine, feces, hair and nails record recent exposures to DU. With the exception of crews of military vehicles having been hit by DU penetrators, no body burdens above the range of values for natural uranium have been found. Therefore, observable health effects are not expected and residual cancer risk estimates have to be based on theoretical considerations. They appear to be very minor for all post-conflict situations, i.e. a fraction of those expected from natural radiation.     

Novel brominated flame retardants: a review of their analysis, environmental fate and behaviour

This review summarises current knowledge about production volumes, physico-chemical properties, analysis, environmental occurrence, fate and behaviour and human exposure to the "novel" brominated flame retardants (NBFRs). We define the term NBFRs as relating to BFRs which are new to the market or newly/recently observed in the environment. Restrictions and bans on the use of some polybrominated diphenyl ether (PBDE) formulations, in many jurisdictions, have created a market for the use of NBFRs. To date, most data on NBFRs have arisen as additional information generated by research designed principally to study more "traditional" BFRs, such as PBDEs. This has led to a wide variety of analytical approaches for sample extraction, extract purification and instrumental analysis of NBFRs. An overview of environmental occurrence in abiotic matrices, aquatic biota, terrestrial biota and birds is presented. Evidence concerning the metabolism and absorption of different NBFRs is reviewed. Human exposure to NBFRs via different exposure pathways is discussed, and research gaps related to analysis, environmental sources, fate, and behaviour and human exposure are identified.     

Sources of uncertainty in model predictions: lessons learned from the IAEA Forest and Fruit Working Group model intercomparisons

The International Atomic Energy Agency (IAEA), through the BIOMASS program, has provided a unique international forum for assessing the relative contribution of different sources of uncertainty associated with environmental modeling. The methodology and guidance for dealing with parameter uncertainty have been fairly well developed and quantitative tools such as Monte-Carlo modeling are often recommended. The issue of model uncertainty is still rarely addressed in practical applications and the use of several alternative models to derive a range of model outputs (similar to what was done in IAEA model intercomparisons) is one of a few available techniques. This paper addresses the often overlooked issue of what we call 'modeler uncertainty,' i.e., differences in problem formulation, model implementation and parameter selection originating from subjective interpretation of the problem at hand. This study uses results from the Fruit and Forest Working Groups created under the BIOMASS program (BIOsphere Modeling and ASSessment). The greatest uncertainty was found to result from modelers' interpretation of scenarios and approximations made by modelers. In scenarios that were unclear for modelers, the initial differences in model predictions were as high as seven orders of magnitude. Only after several meetings and discussions about specific assumptions did the differences in predictions by various models merge. Our study shows that the parameter uncertainty (as evaluated by a probabilistic Monte-Carlo assessment) may have contributed over one order of magnitude to the overall modeling uncertainty. The final model predictions ranged between one and three orders of magnitude, depending on the specific scenario. This study illustrates the importance of problem formulation and implementation of an analytic-deliberative process in fate and transport modeling and risk characterization.     

可计算一般均衡(CGE)模型与环境政策分析

CGE模型是进行环境政策分析的理想工具，实际上CGE模型也是唯一胡可能精确评估环境政策社会成本的分析手段。本文介绍了在环境政策分析中应用CGE模型的基本思路和不同类型；回顾了CGE模型在环境政策分析中的应用领域及国内应用现状；指出今后的环境政策分析中应用的CGE模型应该更多地结合经济体的现实特征，其发展方向则体现在三个方面；在分析环境政策社会成本的同时也考虑这些政策的社会效益、分析环境政策的分配效应、加强区域CGE模型在环境政策分析中的应用。     

Concentrations of polybrominated diphenyl ethers (PBDEs) in matched samples of human milk,dust and indoor air

Polybrominated diphenyl ethers (PBDEs) are lipophilic, persistent pollutants found worldwide in environmental and human samples. Exposure pathways for PBDEs remain unclear but may include food, air and dust. The aim of this study was to conduct an integrated assessment of PBDE exposure and human body burden using 10 matched samples of human milk, indoor air and dust collected in 2007–2008 in Brisbane, Australia. In addition, temporal analysis was investigated comparing the results of the current study with PBDE concentrations in human milk collected in 2002–2003 from the same region.PBDEs were detected in all matrices and the median concentrations of BDEs -47 and -209 in human milk, air and dust were: 4.2 and 0.3 ng/g lipid; 25 and 7.8 pg/m³; and 56 and 291 ng/g dust, respectively. Significant correlations were observed between the concentrations of BDE-99 in air and human milk (r = 0.661, p = 0.038) and BDE-153 in dust and BDE-183 in human milk (r = 0.697, p = 0.025). These correlations do not suggest causal relationships — there is no hypothesis that can be offered to explain why BDE-153 in dust and BDE-183 in milk are correlated. The fact that so few correlations were found in the data could be a function of the small sample size, or because additional factors, such as sources of exposure not considered or measured in the study, might be important in explaining exposure to PBDEs. There was a slight decrease in PBDE concentrations from 2002–2003 to 2007–2008 but this may be due to sampling and analytical differences. Overall, average PBDE concentrations from these individual samples were similar to results from pooled human milk collected in Brisbane in 2002–2003 indicating that pooling may be an efficient, cost-effective strategy of assessing PBDE concentrations on a population basis.The results of this study were used to estimate an infant's daily PBDE intake via inhalation, dust ingestion and human milk consumption. Differences in PBDE intake of individual congeners from the different matrices were observed. Specifically, as the level of bromination increased, the contribution of PBDE intake decreased via human milk and increased via dust. As the impacts of the ban of the lower brominated (penta- and octa-BDE) products become evident, an increased use of the higher brominated deca-BDE product may result in dust making a greater contribution to infant exposure than it does currently.To better understand human body burden, further research is required into the sources and exposure pathways of PBDEs and metabolic differences influencing an individual's response to exposure. In addition, temporal trend analysis is necessary with continued monitoring of PBDEs in the human population as well as in the suggested exposure matrices of food, dust and air.     

Health effects of polybrominated dibenzo-p-dioxins (PBDDs) and dibenzofurans (PBDFs)

This article reviews the state of the science regarding the health effects of polybrominated dibenzo-p-dioxins (PBDDs) and dibenzofurans (PBDFs). While thousands of articles have been published on the health effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin and related polychlorinated dibenzodioxins (PCDDs) and dibenzofurans (PCDFs), little is know about the brominated and mixed chloro/bromo homologs. Available literature suggests that brominated compounds have similar toxicity profiles to their chlorinated homologs. However, further research investigating health effects will only be useful if exposure scenarios truly exist. Current exposure data is extremely limited, posing a major data gap in assessing potential risk of these chemicals. The rapid increase in the use of brominated flame retardants has raised the level of environmental concern regarding PBDDs/PBDFs as it is likely that human, as well as wildlife, exposure to brominated dioxins and furans will increase with their use.     

Retrospective exposure assessment in a chemical research and development facility

The objective of this exposure assessment was to reconstruct cumulative historical exposures for workers who have been exposed to multiple chemicals and chemical groups to better understand a cluster of brain cancers within a research and development lab. Chemicals of interest, including acrylates, bis-chloromethyl ether (BCME), chloromethyl methyl ether (CMME), isothiazolones and nitrosoamines, were selected on the basis of the plausibility of penetrating the blood-brain barrier and the uniqueness of the chemical's biological activity.In a complicated exposure setting such as a chemical R&D facility, multiple exposure estimation methods were needed. First, similarly exposure groups (SEGs) were created for these materials based on department group, time period of the department's existence and function associated with job titles. A probabilistic framework for assessing exposures was developed using Bayesian analysis of historical monitoring data, mathematical exposure modeling and professional judgments of current and former industrial hygienists at the facility were used to reconstruct the exposure history for acrylates, BCME and CMME for each SEG over the time period of interest. Since sufficient measurement data for isothiazolones and nitrosoamines were not available, the exposure histories for each SEG for these chemicals were estimated. This was done using objective formaldehyde levels and subjective employee interviews. The interviews assessed workplace determinants of exposure as distinct surrogates for estimating inhalation and dermal exposures. The exposure assessments by these methods were compared against each other to estimate the potential for exposure misclassification. A job exposure matrix (JEM) was constructed that contained the exposures obtained from above multiple approaches for each of these chemical groups for each SEG for each year of interest. The combination of methods used in this work is a unique and potentially helpful framework that can be used in analogous workplace settings involving multiple exposures with incomplete objective measurement information.     

A dynamic model for assessing radiological consequences of tritium routinely released in rivers. Application to the Loire River

A dynamic model for assessing the transfer of tritium in a food chain was applied to the Loire River, where 14 nuclear power plants situated on five different sites operate. The model considers several potential exposure pathways in the aquatic and terrestrial ecosystems: transfer of tritium through the aquatic food chain (especially fish); use of river water for agricultural purposes (irrigation) and transfer of radionuclides through the terrestrial food chain (vegetables, meat, milk); subsequent internal exposure of humans due to ingestion of contaminated foodstuffs. For biological environmental compartments, the transfer of tritium to organic matter (i.e. OBT) was simulated. For each of the parameters introduced in this model, a probability density function, allowing further uncertainty and sensitivity analyses, was proposed. Uncertainty/sensitivity analyses were performed to determine a confidence interval for the mean annual dose to critical groups and to identify the parameters responsible for the uncertainty and subsequent research priorities.