Современные вызовы и пути совершенствования оценки и управления рисками здоровью населения

Современные вызовы и пути совершенствования оценки и управления рисками здоровью населения

Автор: Ракитский В.Н., Кузьмин С.В., Авалиани С.Л., Шашина Т.А., Додина Н.С., Кислицин В.А.

Журнал: Анализ риска здоровью @journal-fcrisk

Рубрика: Профилактическая медицина: актуальные аспекты анализа риска здоровью

Статья в выпуске: 3 (31), 2020 года.

Бесплатный доступ

С учетом международного опыта проанализированы основные направления совершенствования оценки и управления рисками в России, вытекающие из потребностей современного развития гигиенической науки и необходимости усиления противодействия новым угрозам здоровью населения. Обоснованы конкретные задачи развития методологии анализа риска здоровью, исходя из предпосылок для их решения в России, и определен круг практических проблем ее применения, которые особенно важно решить в ближайшей перспективе для устранения вредного влияния на среду обитания и здоровье населения. Основные результаты заключаются в формировании долгосрочной стратегии развития принципов анализа риска здоровью, учитывающей последние научные данные для решения следующих методических и практических задач: внедрение системного подхода при оценке канцерогенного / неканцерогенного риска; развитие единого подхода к проведению и интерпретации результатов токсикологических исследований «доза - ответ», который будет учитывать уровни фоновой заболеваемости и фоновые дозовые нагрузки, устанавливать восприимчивые группы населения и модели поведения; пороговые уровни, полученные путем определения реперных (benchmark) концентраций с учетом спонтанного фона, для установления новых и пересмотра уже имеющихся RfD и RfC; использование микросредового подхода при оценке экспозиции; применение методологии оценки риска при внедрении показателей наилучших доступных технологий для контролирования безопасности здоровью населения после внедрения новых природоохранных подходов, направленных на снижение выбросов. Необходимость совершенствования подходов к оценке и управлению рисками здоровью и решаемые при этом задачи учтены при разработке «Отраслевой научно-исследовательской программы Роспотребнадзора на 2021-2025 гг.».

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Оценка риска, управление риском, здоровье населения, окружающая среда, канцерогенные и неканцерогенные эффекты, доза - ответ, микросредовое воздействие, наилучшие доступные технологии

Короткий адрес: https://sciup.org/142226415

IDR: 142226415   |   УДК: 614.78   |   DOI: 10.21668/health.risk/2020.3.03

Contemporary challenges and ways to improve health risk assessment and management

We analyzed basic trends in improving risk assessment and management in Russia taking into account international experience; these trends arise from needs occurring in contemporary hygienic science and necessity to provide stronger resistance against new threats to population health. We substantiated specific tasks in development of health risk analysis mythology basing on preconditions for finding solutions to them in Russia; we also determined practical issues in its implementation that are the most vital and need solu-tions in the nearest future in order to eliminate adverse impacts on the environment and population health. The primary results are creation of a long-term strategy for the development of health risk analysis principles that takes into account the latest scientific data and is aimed at solving the following methodological and practical tasks: imple-mentation of a systemic approach in estimating carcinogenic / non-carcinogenic risks; development of a unified approach to accomplishing toxicological «dose – response» examinations and interpreting their results which will take into account background morbidity and background dose burdens and determine susceptible population groups and behavioral models; threshold levels obtained via determining «benchmark» concentrations taking spontaneous background into account in order to determine new RfD and RfC and revise existing ones; use of micro-environmental approach in exposure estimation; use of risk assessment methodology in BAT parameters implementation for providing control over health safety after new ap-proaches aimed at reducing emissions have been implemented in environmental protection. The necessity to improve ap-proaches to health risk assessment and management and tasks solved within the process have been taken into account when the Branch scientific research program for 2021–2025 was developed by Rospotrebnadzor.

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Список литературы Современные вызовы и пути совершенствования оценки и управления рисками здоровью населения

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  • Onishchenko G.G., Novikov S.M., RakhmaninYu.A., Avaliani S.L., Bushtueva K.A. Osnovy otsenki riska dlya zdorov'ya naseleniya pri vozdeistvii khimicheskikh veshchestv, zagryaznyayushchikh okruzhayushchuyu sredu [Basics of health risk assessment under exposure to chemicals that pollute the environment]. In: Yu.A. Rakhmanin, G.G. Onishchenko eds. Moscow, Nauchno-issledovatel'skii institute ekologii cheloveka i gigieny okruzhayushchei sredy imeni A.N. Sysina Publ., 2002, 408 p. (in Russian).
  • Novikov S.M., Shashina T.A., Dodina N.S., Kislitsin V.A., Skovronskaya S.A., Matsyuk A.V., Panchenko S.V., Arakelyan A.A. The experience of empirical research on comparative assessment of radiation and chemical health risks due to exposure to environmental factors. Gigiena i sanitariya, 2019, vol. 98, no. 12, pp. 1425-1431 (in Russian).
  • Revich B.A., Shaposhnikov D.A., Pershagen G. New epidemiological model for assessment of the impact of extremely hot weather and air pollution on mortality (in case of the Moscow heat wave of 2010). Profilakticheskaya meditsina, 2015, vol. 18, no. 5, pp. 29-33 (in Russian).
  • IPCS (International Program on Chemical Safety), 2014. Guidance Document on Evaluating and Expressing Uncertainty in Hazard Characterization. World Health Organization. Available at: http://www.who.int/ipcs/methods/harmonization/areas/hazard_assessment/en/ (01.04.2020).
  • National Research Council. Science and Decisions: Advancing Risk Assessment. Washington, DC, The National Academies Press Publ., 2009, 423 p.
  • Rodricks J.V., Levy J.I. Science and Decisions: Advancing Toxicology to Advance Risk Assessment. Toxicological Sciences, 2013, vol. 131, no. 1, pp. 1-8.
  • DOI: 10.1093/toxsci/kfs246
  • Recommendations on use of "concentration - effect" function regarding particulate matter, ozone and nitrogen dioxide in analyzing costs and benefits. Copenhagen, World Health Organization, 2015, 66 p. (in Russian).
  • Chiu W.A., Slob W.A. Unified Probabilistic Framework for Dose-Response Assessment of Human Health Effects. Environ Health Perspect, 2015, vol. 123, no. 12, pp. 1241-1254.
  • DOI: 10.1289/ehp.1409385
  • Gehlhaus M.W., Gift J.S., Hogan K.A., Kopylev L., Schlosser P.M., A.-Kadry R. Approaches to cancer assessment in EPA's Integrated Risk Information System. Toxicol. Appl. Pharmacol., 2011, vol. 254, no. 2, pp. 170-180.
  • DOI: 10.1016/j.taap.2010.10.019
  • Slob W., Bakker M.I., Biesebeek J.D.T., Bokkers B.G.H. Exploring the Uncertainties in Cancer Risk Assessment Using the Integrated Probabilistic Risk Assessment (IPRA) Approach. Risk Analysis, 2014, no. 34, pp. 1401-1422.
  • DOI: 10.1111/risa.12194
  • Slob W., Setzer R.W. Shape and steepness of toxicological dose-response relationships of continuous endpoints. Critical Reviews in Toxicology, 2014, vol. 44, no. 3, pp. 270-297.
  • DOI: 10.1111/risa.12194
  • Hardy A., Benford D., Halldorsson T., Jeger M.J., Knutsen K.H., More S., Mortensen A. [et al.]. U.S. EPA. Benchmark Dose Technical Guidance. EFSA Journal, 2017, vol. 15, no. 1 (4658), pp. 41.
  • DOI: 10.2903/j.efsa.2017.4658
  • Air: Fate, Exposure, and Risk Analysis (FERA). EPA. Available at: https://www.epa.gov/fera/ (10.08.2020).
  • Gubernskii Yu.D., Novikov S.M., Kalinina N.V., Matsyuk A.V. Assessing risks of effects produced on population health by chemicals that pollute air in residential areas. Gigiena i sanitariya, 2002, no. 6, pp. 27-30 (in Russian).
  • Further Technical Details about HAPEM4. EPA. Available at: https://archive.epa.gov/airtoxics/nata/web/html/hapem4followup2.html (10.08.2020).
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  • Shchelchkov K.A., Volosatova M.A., Grevtsov O.V. Basic aspects related to applying reference and technical guides on BAT. Ekologiya proizvodstva, 2019, no. 5, pp. 20-26 (in Russian).
  • Clean. Air. Act., 1990. EPA. Available at: http://www.epa.gov/air/caa/ (10.04.2020).
  • Avaliani S.L., Mishina A.L. Harmonization of approaches to management of air quality. Zdorov'e naseleniya i sreda obitaniya, 2011, vol. 216, no. 3, pp. 44-48 (in Russian).
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