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OCR for page 103
103
FEDERAL RISK ASSESSMENTS FOR POlENl:161 CARCINOGENS:
AN EMl?IBICAL REVIEW
Robert I . Fie Id
Lawrence E. McCray
INl:ROOlJCT ION
There is danger that discussion of federal agency performance in
assessing risks are based on anecdotal and inaccurate conceptions of
actual agency practices. The evaluation of ways to improve risk
assessment is necessarily based on some notion of what a ''typical"
agency risk assessment is like, and wit! not be helpful if the
evaluator is misinformed about current practice.
Me purpose of thin paper is to summarize available empirical
information on the nature of the policy problem of chemical carcino-
genicity and the federal regulatory response. In general, the results
are somewhat disappointing: ~ detailed empirical documentation of
risk assessment practices in federal agencies would be a massive
undertaking, which perhaps helps to explain why none has yet
appeared. Some literature does exist on discrete aspects of the area,
however, and a partial picture can be assembled. We have attempted to
provide below what objective answers exist to basic questions concern-
ing risk assessments. The ques tions include:
How big is the overall regulatory problem? One often hears the
plaintive remark that "everything seems to cause cancer nowadays, " but
the number of chemical regulations that actually reach national head-
lines remains relatively small. How many suspected carcinogens are
there, and what is the state of scientific knowledge about them?
To regulates. and how much? What legislation governs the
regulat ion of potential carcinogens, and what agenc ies and programs
implement there laws? Has the government, as some have said, rushed
to ban all suspect chemicals, or has it, has others have feared, moved
only deliberately after it has assembled substantial proof of human
hazard?
-
NOTE: This paper was original l~r prepared for the use of the National
Research Council's Committee on the Institutional Means for Assessment
of Risks to Public Health. It is not intended to present independent
positions or interpretations on scientific or policy matters. It does
not necessarily reflect the judgment or position of the Committee or
the National Research Council. It has not been subjected to the
internal review procedures chat apply to reports prepared by NRC
commi ttees .
OCR for page 104
104
What i ~ ~ ~~ Discussions of risk
· ~ ~
assessment often assume that federal risk assessment as a we. t_
characterized, routinized and homogeneous process. Is the assumption
accurate? If not, why not?
KNOWLEDGE ABOUT CHEMICAL CARC INOGENS ANl) THE FEI)E RAL
REGULATORY RE SPONSE
One American in four will contract cancer during his or her lifetime,
and the weekly death toll from the disease exceeds 1000. Current
scientific understanding of cancer incidence leads to a conclusion
that a large faction of these cases could have been prevented if the
causative agent could have been identified and public exposures
reduced or eliminated. The actual proportion of preventable cancers
is still being discussed, with figures as high as 90: suggested; the
UOSo Government' s Second Annual Report on Carcinogens more cautiously
states that "many scientists now believe that about one-third to
two-~hirds of al 1 cancers are agents contained in the air, water,
food, or soil'' (NTP9 198L).
What We Know About Chemicals and Cancer
Me basic problem for public policy, of course, is that current
scienti fic theories of cancer do not permit a definitive identi-
fication of general classes of chemicals that cause cancer, and,
accordingly, this leaver a very large number of chemicals to be
assessed individually. The Chemical Abstract Service of the American
Chemical Society lists well over 4 million known substances, with the
number increasing by an average of 6,000 each week (Maugh, 1978~. As
of this time, it is thought that as many as 63 ,000 chemicals were "in
common use" (Maugh, 1978) and EPA estimated that as of 1979, 449O00
were used commerc tally (Roderick, 1981) O About 559 Q00 synthetic
chemicals were produced and used in significant quantities as of 197S,
with 1, 000 new ones being introduced each year (Ames, 1979) . Accord-
ing to one estimate, the manufacture of synthetic organic chemicals
has doubled every seven to eight years (Davis and Magee, 1979~.
The number of chemicals under the jurisdiction of any single
federal program may be very large. For example, EPA estimates that
there may be as many as 1,500 different active ingredients in
pesticides O FDA extirpates that about 4,000 active ingredients are
used in drugs, and about 2,000 other compounds are used for purposes
such as promoting stability and restricting bacteria growth. In
foods, there are thought to be 2 g 500 additives used for nutritional
value and flavoring and 3 ,000 used to promote product life (Maugh,
1978~. Another 12,000 chemicals are indirect food additives (Flamm,
1981 ) .
OCR for page 105
105
The evidence on carcinogenicity for any one of these chemicals is
likely to be highly limited. The most direct type of evidence is that
from epidemilogical studies of the effects of exposure of a chemical
to humans. However, epidemiological studies of cancer are expensive,
time-consuming, and fraught with difficulties--not the least of which
is the problem of establishing the actual existence and level of past
human exposures to any particular suspect chemical. As a result,
direct human evidence is available for only a few cne~cal~; in fact,
the International Agency for Research on Cancer lists fewer than 60
chemicals as having been adequately evaluated as cancer hazards in
humans (IARC, 1980~. IARC lists 32 chemicals and 4 industrial
processes that have been associated with cancer through analysis of
human data (Davi~, 1981) 0 At least fragmentary evidence is available
on other compounds; in fact, 82 chemicals are counted as showing "some
epidemiological evidences of carcinogenicity (Maugh, 19783.
Lee limitations on direct human evidence necessarily throw the
spotlight on animal testing. While reliance on bioassays can be used
to inform policy decisions on many more chemicals, the overall supply
of test data cannot be characterized as rich. It has been estimated,
for example, that only about 7000 chemi cals--less than 20: of the
number of chemicals said to be in common commercial use--have ever
been tested. Of these, only 1500 are said to have been tested under
what are presently considered to be scientifically adequate conditions
(Toxic Substances Strategy Committee, 1980), although one NCI official
estimates that only 3500 of the 7000 are "completely inadequate"
(Maugh, l978~. Tore striking is the fact that the volume of test
results is not expanding very rapidly. I ~ is estimated that only 100
to 300 chemicals are newly subjected to animal bioassay annually
(Maugh, 1918 ~ . This number is limited somewhat by the current expense
of lifetime animal exposure studies--~n the range of $300,000 to
$500,000. In addition, the total volume is limited by the total
available supply of toxicotogise~, pathologists, and lab facilities,
which is said to permit no more than 500 new bioassays each year
(Maugh, 1978~.
How many chemicals have been identified as carcinogens from the
tee tiny that has been completed? There is no simple answer to this
simple question, and a review of published estimates demonstrates that
estimates depend heavily on the assessor's standard of proof. It is
estimated that 1500 (a little over 20%) of the 7000 chemicals tested
show at least some positive results; if one-half of these are assumed
to reflect adequate test methods, 750 chemicals can be counted as
animal carcinogens (Maugh, 1978?. This number is consistent with the
Toxic Substance Strategy Committee' s ( 1980) estimate that 600-800
compounds show "substantial positive evidences in animal tests.
IARC's estimate for the number of "suspect human carcinogens" based on
animal studies is about 300; while the number of "carcinogens'' is less
than 900 (Tomatis, 1978) . OSHA's controversial classification scheme
for carcinogens reflected results from short-term tests as well as
longer-term bioas says . OSHA counted 961 "proven" c arc inogens, which
OCR for page 106
106
it said has produced either two positive bioassays or one positive
bioassay and two or more positive short-em tests. OSHA listed
another 196 ''suspect" chemicals 5 which had produced one positive
bioassay or positive short-term test (Maugh, 1978~.
What do we know about exposure patterns for these suspect
carcinogens? Other than the obvious conclusion that, sincemany are
produced commercially, workplace risk of exposure to many must be
assumed, we found no empirical Hungary. NIP analyzed where exposures
to S~ carcinogens substances are found (National Toxicology Program,
1981) . While not a comprehensive died, the compounds studies are
described as those thought to have the strongest positive results
based on the findings of IARC, the ~P/NCI Carcinogenesis Bioassay
Program, ant various agencies. Two occur naturally (aflatoxin and
cyeas~n), and two are sources of major exposure in food and cosme~cics
(saccharin and safrole). Where are eight pesticides and 14 pharma-
ceuticals among the S8. Me remaining 62 include industrial
chemicals, miscellaneous chemicals and analogs, industrial processes,
and incus t rial byproduc t s .
The Regulatory Response
Authority to restrict public exposures to toxic substances is
distributed among 24 statutes that are administered by regulatory
agencies (Toxic Substances Strategy Committee, 19801. Although the
oldest of these is the Federal Food, Drug and Cosmetic Act of 1938,
the laws are remarkable for their relative regency; on average, the 24
laws have been on the books for only 16 years in 19830 For potential
carcinogens g the ma jor regulatory programs are concentrated in EPA,
FBA. and OSHA. The sheer number of chemicals in commerce gives any one
regulatory program an enormous queue of chemicals to review for
regulatory action. EPA has subjected 3,500 chemicals to some sort of
ac tive review as shown in i ts _ ~0
.
There are so many suspects in the workplace that ~~ has been e~matec
plan it would take OSHA over 100 years to regulate all the known
hazards on a substance-by-substance basis (Davis, 1981) .
tie discovered no convincing attempt to account for the federal
government 'a cumulative disposition of ache chemicals on any of the
various lists of suspected care inogens. One account (Roderick, 1981 )
reports that the U. S i has regulated only ten of the approximately 30
agents listed by IARC as carcinogens from evidence in epidem ological
studies, and that only ~ have been regulated that appear on an IARC
list of lit chemicals for which bioassay results indicate carcinoma
genicity. While this record may give credence to a theory that the
government moves slowly on potential carcinogens, in fact many more
than 18 chemicals Zaire been controlled g and it has proven difficult to
compile definitive lists of government actions that are based on
cancer hazard.
OCR for page 107
107
~ review of federal carcinogen regulation reported 43 subs tances
that had been regulated as of 1978 as recognized carcinogens
(Roderick, 1981~. Six different statutes provide authority for these
actions, arid 43 rules were issued, although not in a one-to-one cor-
respondence to the chemicals . ~ cons iderab le amount of interagency
overlap is evident, with asbestos being regulated under three
programs, viny! chloride under five, ant DOT under two.
Another, more comprehensive study found a total of 102 substances
that have either been regulated, been proposed or cons idered for
regulation under several ~ but not all) sta~u~ce~ (OTA, 1981) . A
summary of the status of these chemicals, prepared in 1980, is
presented as Tab le 1. I t reveals two dominant trends in the
distribution of federal efforts:
I. EPA has had the widest experience, FDA and OSHA somewhat less,
and CPSC the least:
55 were addressed under the clean water program at EPA
29 were addressed under the clean air program at EPA
tS were addressed under the pesticides program at EPA
2 were addressed under the drinking water program an EPA
24 -were addressed under the food program at FDA
18 were addressed by OSHA
- 5 were addres sed by CPSC
2. There is a fair amount of interprogram overlap and some
interagency overlap:
The Art of Risk Assessment
there were 152 agency actions on the 102 chemicals;
about 40% of all chemicals are subject of action under
two or more statutes
39 are addressed by two or more programs
14 are addressed by two or more distinct agencies
the FDA food program overlaps very little (only
twice) with other federal programs
CPSC almost always addresses substances of interest
to other agencies, (four out of five instances), and
OSHA often does, (11 of 18 instances) .
FE1)ERAL RISK ASSESSMENT PRACTICES
-
For all of the chemicals that are subjected to regulatory review of
one kind or another, some sort of risk assessment must--by definition--
have taken place. In some cases this may cons titute a full-blown
analysis of the subs tance including the generation of a quantitative
conclusion and a formal report, while in others it may merely involve
an informal, qualitative judgment that the presence of carc~nogenicity
is or is not established.
OCR for page 108
108
TILE 1
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Source: Assessment of Technologies f or Determining
Cancer Risks f rom the Environment, OTA, June 1981.
OCR for page 109
109
TABLE ~ - Continued
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OCR for page 110
110
A brief examination of two draft documents describing risk
assessment at EPA reveal on the one hand the extensiveness of the
assessment, and on the other hand the infrequency with which detailed
formal analyses are perf armed. A review of 155 chemicals under
current examination by two or more EPA offices shows that all but four
have undergone risk assessments. The great majority, moreover, have
been assessed more than once, with 53 barring been studied from two to
seven times. The assessments vary from formal analyses to shorter
reports by the Carcinogen Assessment Group (CAG) to brief summary risk
assessments. In all 9 only 18 of the 155 substances were sub jected for
formal risk assessments, while 71 went through preliminary or summary
risk assessments. A listing of the activities of CAG itself, reveals
that it has prepared over 200 reports on about 110 chemicals or
classes of chemicals.
A second s tuty examined the analyses and documental ion prepared by
the agency in the regulation of three carcinogenic chemicals:
cadmium, trichloroethylene, and arsenic . For cadmium, a total of 21
agency reports were created, of which nine dealt primarily with
exposure assessments and seven with health and environmental effects.
For trichloroethylene, eight reports were involved, with fire dealing
wi th exposure and one wi th heal th and environmental consequences . For
arsenic, there were 16 reports, of which 12 analyzed exposure and
seven health and environmental ef fee ts .
If the EPA experience is typical, federal risk assessment activity
is neither uniformly rigorous or uniformly cursory. Examples of the
two extremes may be seen in EPA's pre-market notification (P~N) pro-
cedures for pesticides and FDA's new drug application (NDA) process.
EPA receives large numbers of notifications each year, and mus t make
its decisions within 90 days of receipt (although this statutory
deadline is not invariably met). A typical notification involves the
submission of very little toxicological data, and the agency is often
left to infer risk levels from a chemical 's physical structure,
chemical propertied and from the notifying corapany's estimates of
future production, vol~e, and uses. EPA rarely demands further
information. Hazard assessments are done for all substances as
notifications come in, but detailed quantitative risk assessments are
only performed when strong positive results are indicated. At FDA, on
the other hand, large stacks of toxicological information are ~ub-
mi~cted with all NDA's. Exposures for drugs are, in comparison with
PMN chemicals, easy to characterize, malcing risk assessments much
simpler. FDA generally takes about 20 months to analyze an NDA, and
in the vast majority of cases, it requests additional data from the
applicant (GAO, 1980~.
The Diverse Functions of Risk Assessment
Risk assessment plays dif ferent roles in the regulatory proces s .
These roles fall into two general categories: priority setting and
analysis of regulatory controls. The two roles imply distinct demands
on risk as sessors .
OCR for page 111
111
Priority setting. Regulatory agencies typically have potential
Jurisdiction over ~ large number of substances. Circumstances force
them to allocate their resources to a few at a tome. Common sense and
public opinion--if not their own policies--induce agencies to try to
devote their attention mainly to the largest hazards. This allocation
decision requires some sort of de facto risk assessment. Some notion
of relative hazard -implicit or explicit, internally generated or
imposed by outside groups--is necessary for this function. A part
(and, for some critics, a major part) of the general criticism of
federal regulation is that the agencies are not setting their
priorities sensibly or systematically. In general, it appears that
agency risk assessments for priority setting have been informal, and
less systematic and visible, than for assessing regulatory controls.
Agencies set priorities in two areas: regulatory screening and
testing. Regulatory screening involves decisionmaking about which
substances should be selected--ant often in what order--for serious
formal regulatory review. Virtually all programs have this problem,
although there is one important variation. Some programs cover a
finite ant known set of chemicals that must be reviewed. Here, the
order of the regulatory reviews is the key question, and the job of
the risk assessor may be to help the agency implement a 'iworst-first"
or another reasoned approach. Some such thinking, for example, is
relevant to OSHA's decisions about which occupational standards
(cotton dust, benzene5 etc.) it will review first. Similarly, EPA
pesticides program has long had lists of "suspect" pesticide in-
gredients, and it has had to decide which ones to formally consider
for cancellation or for new controls. Other programs, most promi-
nently those that must in effect grant official licenses for the
production or use of new products or substances, are forced to
categorize relative risk on a case-by case basis so they can decide
which new applications to concentrate on. Examples include FBA review
of new food additives and applications to EPA for federal registration
of new pesticides. In both variations, however, the screening
function is the same: some sort of relative rating or ranking of risk
muse be accomplished, however imprecisely.
Variations among screening efforts--even within a single regula-
tory agency-are illustrated by three EPA programs. These cases
dramas ize the range of agency control over the qual ity and quant i ty of
data available for risk assessments used in screening.
OCR for page 112
112
Case 1: Premanufact~ring Reviews: Screening Based on Sketchy
Biological Data
EPA.'s Office of Toxic Substances is charged to oversee the
manufacturing of new chemicals under Section 5 of the Toxic
Substances Control Acto Section 5 regulations require pre-
man~facturing notification (PMN) but do not require the
manufacturer to perform toxicity tests. Consequently, assessors
usually must screen in order to isolate the few chemicals needing
detailed regulatory review from scarce data. EPA has had to rely
heavily on analysis of structure activity relations (SAR) and
mutagenicity data, when available, to do this screening. The
agency reported it had considered drawing up risk assessment
criteria for screening, but found that the limited amount and
variety of information to be weighed in such decisions precluded
their developing explicit criteria. Each chemical is considered
on a case-by-case, necessarily judgmental basin.
Case 2: Pesticide Regulation: Qualitative Screening Based on
. .
Agency Da ~ a Requ i remeet s
EPA's Office of Pesticide Programs oversees the federal
registration and reregistration of pesticides. In contrast to
the PAN process, pesticide regulations require the manufacturer
to perform a number of tests dealing with acute and chronic
toxicity. In the screening process, each active pesticide
ingredient, (and its metabolites or degradation products) is
measured against a set of qualitative risk criteria, or
"triggers.'' Specific criteria are detailed for carcinogenic,
mutagenic, and teratogenic responses. If a pesticide reaches or
exceeds these risk criteria, OPP shifts to a higher regulatory
gear; it issues a "rebuttable presumption against regulation" and
undertakes a more elaborate process to weigh benefits against
risks .
Case 3: Airborne Carcinogens: Screening Based on Quantitative
-
Data
In some cases, agencies have fairly extensive quantitative
data for a list of chemicals ~ but limitations on agency resources
preclude regulating the entire liste Setting regulatory priors
Sties may require a cl~emical-by-chemical quantitative comparison
of the health risk. EPA's Carcinogen Assessment Group (CAG)
reports that it has performed such a qualitative analysis for the
Office of Air Programs to help it determine which air pollutants
should be regulated fits to OSHA' s 1980 Cancer Policy has
suggested a similar use for quantitative risk assessment to
determine which chemicals in a particular category should be
regulated first.
OCR for page 113
113
A second distinc t type of priority selecting involves the
establishment of testing priorities for substances that lack
adequate data to permit risk decisions. Risk asses~ment--formal
or informal--is an inherent e lement in decis ions about such
research/~esting priorities at such organizations as the National
Toxicology Program, the National Center for Toxicological
Research, and the research efforts of agencies themselves.
Establishing regulatory controls. The other broad category of use
for risk assessment is to help determination of what appropriate
policy measures, if any, are required to protect public health. This
application has received the most attention in public discussions of
regulation and its deficiencies, and, in general, is the use for which
the most formal versions of the art are found.
Here, too, there are wide variations in what is expected of risk
aseessors. One source of variation is the nature of the statutory
direction to the agency on 'ROW it should sleigh various factors in
reaching control decis ions. Tab le 2 summarizes the ten regulatory
statutes administered by the four ma jar federal regulators: EPA, Fl)A,
OSaA, and CPSC. Mere are shades of difference--soraetimes in
different sections of the same s tatute--in the degree of protection
required, and, more salient, in the relative weights that agencies are
instructed to place on risk, control costs, and technical feasi-
bility. This latter factor may be divided into three approaches.
First, several laws require a balanc ing of costs and benefits.
Such statutes generally call on the agency administering a regulatory
program to weigh the benefits to be achieved through an action,
including the reduction in public health risk against such coots as
the ec anomie hardship imposed on those be ing regulated. On some
instances, Congress has explicitly listed factors to be balanced in
decisions, while in others, this approach has been read into risk
legislation by courts in response to vaguer mandates specifying the
reduct ion -of "unreasonab le" r i slcs . Examp les o f expl ic i t ba lane ing
provisions are found in the pesticide law and the safe drinking water
law, while examples of implicit balanc ing are found in the toxic
substances law. (Details of these and other examples can be fount in
Table 2. ~ The role of risk assessments under these schemes Is usually
quite clear. It provides an explicit way for measuring, either
quantitatively or qualitatively, the benefits that regulatory actions
will provide.
Second, some laws call for mandatory control techniques whenever
hazard is affirmed. These include the outright ban of products under
the De laney clauses in the food law, and the parts of the c lean air
law that specify "an ample margin of safety" in emissions standards.
This type of statute provides a need for the hazard identification
phase of risk assessment, but since the control action is specified
once the hazard is affirmed, the contribution of the dose-response
information is less clear.