Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.
National Research Centre for the Working Environment, Copenhagen, Denmark.
Arch Toxicol. 2024 Mar;98(3):617-662. doi: 10.1007/s00204-023-03642-w. Epub 2024 Jan 19.
Assessment factors (AFs) are essential in the derivation of occupational exposure limits (OELs) and indoor air quality guidelines. The factors shall accommodate differences in sensitivity between subgroups, i.e., workers, healthy and sick people, and occupational exposure versus life-long exposure for the general population. Derivation of AFs itself is based on empirical knowledge from human and animal exposure studies with immanent uncertainty in the empirical evidence due to knowledge gaps and experimental reliability. Sensory irritation in the eyes and airways constitute about 30-40% of OELs and is an abundant symptom in non-industrial buildings characterizing the indoor air quality and general health. Intraspecies differences between subgroups of the general population should be quantified for the proposal of more 'empirical' based AFs. In this review, we focus on sensitivity differences in sensory irritation about gender, age, health status, and vulnerability in people, based solely on human exposure studies. Females are more sensitive to sensory irritation than males for few volatile substances. Older people appear less sensitive than younger ones. However, impaired defense mechanisms may increase vulnerability in the long term. Empirical evidence of sensory irritation in children is rare and limited to children down to the age of six years. Studies of the nervous system in children compared to adults suggest a higher sensitivity in children; however, some defense mechanisms are more efficient in children than in adults. Usually, exposure studies are performed with healthy subjects. Exposure studies with sick people are not representative due to the deselection of subjects with moderate or severe eye or airway diseases, which likely underestimates the sensitivity of the group of people with diseases. Psychological characterization like personality factors shows that concentrations of volatile substances far below their sensory irritation thresholds may influence the sensitivity, in part biased by odor perception. Thus, the protection of people with extreme personality traits is not feasible by an AF and other mitigation strategies are required. The available empirical evidence comprising age, lifestyle, and health supports an AF of not greater than up to 2 for sensory irritation. Further, general AFs are discouraged for derivation, rather substance-specific derivation of AFs is recommended based on the risk assessment of empirical data, deposition in the airways depending on the substance's water solubility and compensating for knowledge and experimental gaps. Modeling of sensory irritation would be a better 'empirical' starting point for derivation of AFs for children, older, and sick people, as human exposure studies are not possible (due to ethical reasons) or not generalizable (due to self-selection). Dedicated AFs may be derived for environments where dry air, high room temperature, and visually demanding tasks aggravate the eyes or airways than for places in which the workload is balanced, while indoor playgrounds might need other AFs due to physical workload and affected groups of the general population.
评估因素(AFs)是制定职业接触限值(OELs)和室内空气质量指南的重要因素。这些因素应考虑到不同亚组之间的敏感性差异,例如工人、健康人和病人,以及职业暴露与一般人群的终身暴露。AFs 的推导本身是基于人类和动物暴露研究的经验知识,由于知识差距和实验可靠性,经验证据存在固有不确定性。眼睛和呼吸道的感官刺激约占 OELs 的 30-40%,是表征室内空气质量和一般健康的非工业建筑中的常见症状。一般人群中不同亚组之间的种内差异应进行量化,以便提出更多基于经验的 AFs。在这篇综述中,我们仅基于人类暴露研究,重点关注性别、年龄、健康状况和易感性方面的感官刺激敏感性差异。对于少数挥发性物质,女性比男性更敏感。老年人比年轻人敏感度较低。然而,长期来看,受损的防御机制可能会增加易感性。关于儿童感官刺激的经验证据很少且仅限于 6 岁以下的儿童。与成年人相比,儿童神经系统的研究表明儿童的敏感性更高;然而,一些防御机制在儿童中比在成年人中更有效。通常,暴露研究是在健康受试者中进行的。由于对中度或重度眼部或呼吸道疾病患者进行选择,因此对患病人群的暴露研究不具有代表性,这可能低估了该人群的敏感性。像个性因素这样的心理特征表明,远低于其感官刺激阈值的挥发性物质浓度可能会影响敏感性,部分原因是气味感知的影响。因此,通过 AF 无法保护具有极端个性特征的人,需要采取其他缓解策略。年龄、生活方式和健康方面的现有经验证据支持感官刺激的不超过 2 的 AF。此外,不鼓励一般的 AF 用于推导,而是建议基于经验数据风险评估、取决于物质水溶性的气道沉积以及弥补知识和实验差距的物质特异性 AF 推导。对于儿童、老年人和病人,由于无法进行人体暴露研究(出于伦理原因)或不具有普遍性(由于自我选择),感官刺激建模将是推导 AF 的更好的“经验”起点。对于干燥空气、高温和视觉要求高的环境,可能需要为眼睛或呼吸道制定专门的 AF,而在工作量平衡的地方则不需要;而对于室内游乐场,由于体力工作负荷和受影响的一般人群群体,可能需要其他的 AF。