Abstract
The US EPA health risk assessment method is currently widely used to assess human health risks for many environmental constituents. It is used for risk assessment from the exposure to various contaminants exceeding tolerable or safe reference doses, determined e.g., for drinking water, soil, air and food. It accepts widely that excess contents of non-essential elements (e.g., As, Pb or Sb) in environmental compartments represent a general risk to human health. However, contrary to toxic trace elements, deficient contents of essential (biogenic) elements e.g., F, I, Se, Zn, Fe, Ca or Mg may represent even higher health risk. Therefore, we propose to extend the human health risk assessment by calculating the health risk for deficient content and intake of essential elements, and to introduce the terms Average Daily Missing Dose (ADMD), Average Daily Required Dose (ADRD) and Average Daily Accepted Dose (ADAD). We propose the following equation to calculate the Hazard Quotient (HQ) of health risk from deficient elements: HQd = ADRD/ADAD. At present, there are no reference concentrations or doses of essential elements in each environmental compartment in world databases (Integrated Risk Information System IRIS, The Risk Assessment Information System RAIS). ADRD and ADMD can be derived from different regulatory standards or guidelines (if they exist) or calculated from actual regional data on the state of population health and content of essential elements in the environment, e.g., in groundwater or soil. This methodology was elaborated and tested on inhabitants of the Slovak Republic supplied with soft drinking water with an average Mg content of 5.66 mg·L−1. The calculated ADMD of Mg for these inhabitants is 0.314 mg·kg−1·day−1 and HQd is equal to 2.94, indicating medium risk of chronic diseases. This method extending traditional health risk assessment is the first attempt to quantify deficient content of essential elements in drinking water. It still has some limitations but also has potential to be further developed and refined through its testing in other countries.
Highlights
The health risk represents the probability of damage, illness or human death as a result of the environmental risk factor effect [1]
According to the average value of HQd, the population from municipalities with soft drinking water has a medium risk of chronic diseases (HQd > 1.0, Table 5), while only a low risk of chronic diseases is calculated for the population from municipalities with hard water (HQd > 0.1, Table 5)
Most of the required daily intake of essential elements is covered by food, drinking water can make a significant contribution in some cases, which in the case of lower food intake plays a decisive role in the development of clinical signs of deficiency
Summary
The health risk represents the probability of damage, illness or human death as a result of the environmental risk factor effect [1]. The health risk assessment methodology was formulated in the 1980s by the US Environmental Protection Agency (US EPA)—so called the method of Human Health Risk Assessment [1]. The formulation of basic concepts and procedures for health risk assessment and their unification at the legislative level currently allows, in addition to a qualitative approach to the assessment of adverse effects of elements/substances on humans, the quantitative determination of risk levels in relation to these effects. Quantitative determination of health risk is expressed by the hazard quotient (HQ) for non-carcinogenic risk (threshold effect) or as individual lifetime cancer risk (ILCR), and optionally, annual population cancer risk (APCR), expressed in terms of the probability, i.e., number of cases of cancer per capita per year (non-threshold effect) Its main principles apply with some modifications to date [2,3,4,5,6] and have become the basis for the legislative elaboration of health risk assessment procedures within the European Union [7,8] and in individual countries, e.g., in the Slovak and Czech Republic [9,10].
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