Strategies for health interpretation: development of HBM healthbased guidance values for individual phthalates and BPA

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Strategies for health interpretation: development of HBM healthbased guidance values for individual phthalates and BPA Workshop on policy uptake of HBM-results Brussels - Nov 2018 Eva Ougier (ANSES) & Petra Apel/Rosa Lange (UBA)

WP 5 Translation of Results into Policy Task 5.1 Results Report Task 5.2 HBM-HBGVs Development and consolidation of human biomonitoring health-based guidance values (HBM-HBGVs) WP 5 Task 5.3 RA/HIA strategies Task 5.5 Action Plan Task 5.4 HBM indicators + possibility for HBM4EU-countries experts to feed in their personal expertise 8 Nov 2018 Workshop on policy uptake of HBM-results 2

Task 5.2 Overall objectives Task 5.2 HBM- HBGVs A) Establishment of a methodology to derive HBM- HBGVs for the general population (HBM-HBGV GenPop ) for workers (HBM-HBGV Workers ) based on existing derivation schemes of UBA and ANSES taking into account comments of National Hub experts Publication in peer-reviewed journal B) Derivation of HBM-HBGVs for substances prioritized under HBM4EU Documentation as reports (deliverables) including fact sheets summarizing the relevant information used for the derivation of the values Taking into account comments of National Hub experts Publication in peer-reviewed journal 8 Nov 2018 Workshop on policy uptake of HBM-results 3

Task 5.2 Overall working process Strategy to derive HBM- HBGVs for the general population & for occupationaly exposed adults Proposal for derivation and calculation of values (UBA / ANSES) NHC contacts NHCPs for NH expert consultation Integration of comments / remarks from NH experts Finalisation of the HBM-HBGVs (UBA / ANSES) Deliverable: HBM-HBGVs for prioritised substances 8 Nov 2018 Workshop on policy uptake of HBM-results 4

Definition of derived HBM-HBGVs Values derived according to current knowledge HBM-HBGV GenPop Similar to the HBM-I value from the German Biomonitoring Commission concentration of a substance or its metabolites in human biological material which there is no risk of health impairment anticipated verification or control value rather a screening tool for health risk assessment on population level, should be used with reasonable care at the individual level not for non-threshold carcinogens HBM-HBGV Workers Similar to the Biological Limit Value (BLV) from ANSES concentration of a substance or its metabolites in human biological material aiming to protect workers exposed regularly and over the course of a working life from the adverse effects related to medium- and long-term exposure screening tool for occupationally exposed adults health risk assessment also possible to derive for non-threshold carcinogens, as additional life time risks (10-4, 10-5, 10-6 ) 8 Nov 2018 Workshop on policy uptake of HBM-results 5

Derivation strategy Prerequisites Reliable toxicokinetic information in humans Analytical traceability of the selected specific biomarker(s) Quality assured & relevant epidemiological and/or toxicological data on the substance of concern to select a critical dose 8 Nov 2018 Workshop on policy uptake of HBM-results 6

Preference Derivation strategy Methodology 3 options to derive HBM-HBGVs 3 2 1 Derivation from human data based on internal concentration and health effects relationship Derivation of HBM-HBGV GenPop based on a defined tolerable intake (e.g. ADI, TDI, DNEL) & Derivation of HBM-HBGV Worker based on an occupational exposure limit (e.g. 8h-OEL, MAK value) Derivation from data based on critical effect seen in animal studies (POD as NOAEL, LOAEL or BMDL) 8 Nov 2018 Workshop on policy uptake of HBM-results 7

Scheme of derivation option n 2 based on a defined tolerable intake/external exposure value (for urinary biomarkers) External Dose Animal POD Relevant Internal Dose Monitored Biomarker AF A Human Equivalent POD AF H Defined tolerable intake/external exposure value (e.g. TDI, DNEL, OEL..) Estimate metabolite output using excretion fraction data; divide by average daily creatinine excretion or urinary volume HBM-HBGV Adapted from Aylward et al. 2009 8 Nov 2018 Workshop on policy uptake of HBM-results 8

Scheme of derivation option n 3 based on a animal POD (for urinary biomarkers) External Dose Animal POD Relevant Internal Dose Monitored Biomarker AF A Human Equivalent POD Estimate metabolite output using excretion fraction data; divide by average daily creatinine excretion or urinary volume Human Internal conc. AF H Adapted from Aylward et al. 2009 HBM-HBGV 8 Nov 2018 Workshop on policy uptake of HBM-results 9

Limitations and Uncertainties Data from epidemiological and animal studies vary in quality and focus Data on metabolite excretion/tk data often coming from studies with few volunteers, sex or age-specific differences or potential dependency on exposure level often not considered Intra- and inter-individually variability of urinary daily volume or creatinine excretion rates Level of confidence is attributed to each derived HBM-HBGV: low or medium or high 8 Nov 2018 Workshop on policy uptake of HBM-results 10 Source: oncnursingnews.com

Why do we need HBM-HBGVs? Improve risk assessment of chemicals by using HBM data Perform this HBM-based risk assessment consistently within the EU Helping policy makers to prioritise action Support for policy action and risk management measures - Easy-to-use screening tools for health risk assessment (should be used with reasonable care at the individual level) - Not to be considered as a stand-alone diagnostic criteria 8 Nov 2018 Workshop on policy uptake of HBM-results 11 Source: divassoftware.com

Relation to other existing internal limit values Biomonitoring Equivalent (BE) (developed as part of a collaboration between Summit Toxicology, US EPA, Health Canada & multiple industry trade groups): concentration of a chemical in blood or urine that corresponds to an allowable exposure guidance value (such as a USEPA Reference Dose or ATSDR Minimal Risk Level or Acceptable Daily Intake) considered safe by regulatory agencies The BE derivation process includes: Compiling existing tolerable exposure reference values; Compiling and reviewing existing pharmacokinetic information; Reviewing information on the MOA; Assessing available biomarkers for specificity and relevance; Deriving BE values for the POD and the exposure reference value (BE POD, BE); Independent peer-review of the BE; Publishing the BE dossier in the peer-reviewed literature; Development of chemical-specific communications materials 8 Nov 2018 Workshop on policy uptake of HBM-results 12

Relation to other existing internal limit values If derived from a defined tolerable intake value, then HBM-HBGVs derived within HBM4EU are functionally identical to Biomonitoring Equivalents, however: the corresponding allowable exposure guidance values selected are values considered safe by an European (regulatory) agency (e.g. EFSA, ECHA, SCOEL ) as a priority If HBM-HBGVs are derived from an animal POD (and then converted to a TDI-like value or converted to a Human Equivalent POD and then to a Human Equivalent concentration): assessment factors (AFs) applied are preferably the ones recommanded by ECHA 1 (if not, choice and magnitude of the AFs will be explained) 1 (ECHA (2012). Guidance on information requirements and chemical safety assessment. Chapter R.8: Characterisation of dose [concentration]-response for human health. Version: 2.1. https://echa.europa.eu/documents/10162/13632/information_requirements_r8_en.pdf/e153243a-03f0-44c5-8808-88af66223258 8 Nov 2018 Workshop on policy uptake of HBM-results 13

Task 5.2 Output so far 2017 Methodology document for deriving HBM-HBGVs submitted for consultation with NH-experts Gathering of comments received, revision of the document and publication still ongoing August Documents on HBM-HBGVs derivation for DINCH & DEHP sent to consultation with NH-experts Revision of documents on HBM-HBGVs for DINCH & DEHP according to the comments received D5.2 1st substance-group specific derivation of HBM-HBGVs for DINCH/DEHP uploaded by coordinator https://www.hbm4eu.eu/deliverables/ 14

Task 5.2 Outlook 2018 August Dec Proposal of HBM-HBGVs for DPHP & DBP to NH-nominated experts for review, deadline for commenting on 31 Oct 2018 Proposal of HBM-HBGVs for DiBP & BBzP to NH-nominated experts for review, resubmission to UBA/ANSES expected end of January 2019 January Proposal of HBM-HBGVs for Bisphenol A and Cadmium to NHnominated experts for review, resubmission to UBA/ANSES expected end of February 2019 D5.6 (A to C): Derivation of consolidated HBM-HBGVs for selected phthalates, for Bisphenol A, for Cadmium 15

Approaches for deriving HBM-HBGVs for phthalates mixtures? Work to perform Phthalates shown to result in disturbances in androgen-mediated development of the reproductive system in males (in utero) with biological pathways leading to common effects characterized by the spectrum of effects of the rat phthalate syndrome (ECHA 2017, Danish EPA 2016) : Suppression of fœtal androgen action inhibition of foetal testosterone production reduction of male anogenital distance decrease of gene expression related to steroid biosynthesis increase permanent nipple retention in male offspring increase incidence of genital malformations (hypospadias and cryptorchidism) delay puberty onset reduction of semen quality cause testicular changes (decreased testes and epididymides weight, tubular atrophy and Leydig cell hyperplasia) Relevant for male humans 16

Approaches for deriving HBM-HBGVs for phthalates mixtures? Work to perform Evidence from the recent peer-reviewed scientific literature shows that: - phthalates produce mixture effects; - the effects are often predicted well by using the dose-addition concept Existing methods for cumulative risk assessment Toxic Unit Summation (TUS) Hazard index (HI) Point of departure index (PODI) Toxic equivalent factors (TEF)/ Relative potency factor (RPF) Similar mixtures risk indicator (SMRI) Methods to be assessed next for phthalate mixtures (linked to WP15) 17

Thanks for your attention The UBA T5.2 team Petra Apel Rosa Lange The ANSES T5.2 team Christophe Rousselle Fatoumata Sissoko Farida Lamkarkach Eva Ougier This project has received funding from the European Union s Horizon 2020 research and innovation programme under grant agreement No 733032.

Back Up slides This project has received funding from the European Union s Horizon 2020 research and innovation programme under grant agreement No 733032.

HBM-HBGVs for DEHP (Bis(2-ethylhexyl)phthalate) Published For the general population For occupationaly exposed adults Selected TK data 1) Anderson et al. (2011) for urinary excretion fractions of metabolites 20-volunteers oral single-dose study using labelled-dehp 2) Koch et al. (2005) for the excretion half-lives (DEHP + metabolites) 1-volunteer high single-doses labelled-dehp oral study Selected BM(s) Derivation method Selected external tox guidance value or POD HBM- HBGV Σ [urinary 5-oxo-MEHP + 5-OH-MEHP] or Σ [urinary 5cx-MEPP + 5-OH-MEHP] From an external toxicological guidance value + TK extrapolation (based on urinary mass balance) TDI from EFSA (2005): 0,05 mg/kg bw/d Based on multigenerational reprotox oral rat study by Wolfe and Layton (2003): NOAEL of 4,8 mg/kg bw/d for developmental impairement; AFs = [10. 10] = 100 Σ urinary [5-oxo-MEHP + 5-OH-MEHP] Children (6-13y): 340 μg/l Adults: 500 μg/l Σ urinary [5cx-MEPP + 5-OH-MEHP] Children (6-13y): 380 μg/l Urinary 5cx-MEPP From a Point of Departure (POD) + TD and TK extrapolation (based on urinary mass balance) POD: NOAEL of 5,8 mg/kg bw/d for bilateral aspermatogenesis observed in the 2-y reproductive rat study of David et al. (2000) Allometric adjustement + TK extrapolation based on urinary mass balance + AFs = [2,5. 5] = 10 Urinary [5cx-MEPP] at the end of the workshift Workers : 620 µg/l 20

HBM-HBGVs for DEHP (Bis(2-ethylhexyl)phthalate) Published For the general population For occupationaly exposed adults Selected TK data 1) Anderson et al. (2011) for urinary excretion fractions of metabolites (20-volunteers oral single-dose study using labelled-dehp) 2) Koch et al. (2005) for the excretion half-lives (DEHP + metabolites) (1-volunteer high single-doses labelled-dehp oral study) Selected BM(s) Derivatio n method Selected defined tolerable intake HBM- HBGV Σ [urinary 5-oxo-MEHP + 5-OH-MEHP] or Σ [urinary 5cx-MEPP + 5-OH-MEHP] Level of confidence attributed to the derived DEHP HBM-HBGV GenPop TK extrapolation from a defined tolerable intake, based on urinary mass balance MEDIUM TDI from EFSA 2005: 0,05 mg/kg bw/d Based on multigenerational reproductive oral rat study of Wolfe and Layton (2003): NOAEL of 4,8 mg/kg bw/d for developmental impairement, AFs=100) Σ urinary [5-oxo-MEHP + 5-OH-MEHP] Children (6-13y): 340 μg/l Adults: 500 μg/l Σ urinary [5cx-MEPP + 5-OH-MEHP] Children (6-13y): 380 μg/l Adults: 570 μg/l Level of confidence attributed to the derived DEHP HBM-HBGV Workers urinary 5cx-MEPP From a Point of Departure (POD) 2-y reproductive rat study of David et al. (2000) POD: NOAEL of 5,8 mg/kg bw/d for bilateral aspermatogenesis + reprotox Allometric adjustement + TK extrapolation based on urinary mass balance + AFs=(2,5. 5) Urinary [5cx-MEPP] at the end of the workshift Workers : 620 µg/l LOW 21

HBM-HBGVs for DINCH (Diisononylcyclohexane-1,2-dicarboxylate) Published For the general population Selected TK data Koch et al. (2013) for metabolites fractional urinary excretion ratios + excretion halflives 3-volunteers high single-dose DINCH oral study Selected BM(s) Derivation method Selected external toxicological guidance value Σ [urinary OH-MINCH + cx-minch] From an external tox guidance value + TK extrapolation (based on urinary mass balance) TDI from EFSA (2006): 1,0 mg/kg bw/d Based on 2-generation reprotox oral rat study by BASF (2003) NOAEL of 100 mg/kg bw/d for nephrotoxicity; AFs = [10. 10] = 100 HBM-HBGV Σ urinary [OH-MINCH + cx-minch] Children (6-13y): 3 mg/l Adults: 4,5 mg/l Level of confidence attributed to the derived DINCH HBM-HBGV GenPop LOW 22