Competency #8: Perform in-depth analysis to determine if adverse health effects are likely.

Courses and Training Videos

Modules

• Online Public Health Assessment Training (PHAT) - In this series of online and interactive modules, you will learn the fundamentals of the public health assessment (PHA) process. For this competency, please review PHAT Module 7: Health Effects Evaluation. In PHAT Module 7 you will learn to conduct each step of the PHA's health effects evaluation. The health effects evaluation helps you decide whether harmful effects are possible in exposed populations.

Webinars

• Understanding How Benchmark Dose (BMD) Analysis Is Used in Health Assessments. - In this webinar you will learn basic information about the toxicology behind deriving benchmark dose analysis. You will see an example of how to use BMD results using 1,2,3-trichloropropane. Finally, you can find this webinar on PHAST's resource page under the "PHA Training" category. To request access to PHAST, send an e-mail to PHAST@CDC.gov.
• ATSDR Guidance for Calculating Benzo(a)pyrene (BaP) Equivalents for Cancer Evaluations of Polycyclic Aromatic Hydrocarbons (PAHs) - In this webinar you will learn about the ATSDR's guidance for calculating BaP equivalents for cancer evaluations of PAHs.
  

Guidance

Public Health Assessment Guidance Manual (PHAGM)

PHAGM describes methods and resources that you, as a health assessor, can use to evaluate environmental exposures associated with chemical and radiological contamination. For this competency, please, review PHAGM’s section 6 and, specifically, the subsection on toxicological effects analysis.

• In-Depth Toxicological Effects Analysis - Study this section in PHAGM to learn about the various components of a toxicological evaluation, including the basis of the minimal risk level, comparing site-specific doses and air concentrations to effect levels, and making decisions about possible health effects.
  • Identify Data from Studies Used to Develop Non-Cancer Health Guidelines - Study this PHAGM's section to learn about the process for reviewing the studies used to develop health guidelines for non-cancer health effects.
  • Evaluate the Evidence to Examine Non-Cancer Effects - Study this section to learn about the process of comparing site-specific doses and concentrations to effect levels from critical studies used to derive health guidelines as well as other studies with similar effect levels. This process will help you determine where site-specific doses and concentrations lie in relation to the observed-effect levels in the published literature.
  • Evaluate the Evidence to Examine Cancer Effects - Study this section to learn about the process for determining whether cancer effects could be possible based on your estimated site-specific cancer risks and how to evaluate cancer when cancer risk estimates are not possible.
  • Review Toxicological Data for Other Health Effects - Study this section to learn how to review toxicological data from the toxicological profile and determine if other health effects might be possible, besides those effects associated with the health guideline.
  • Review Other Contaminant-Specific Toxicological Information with Doses or Air Concentrations Similar to Those for Your Site - Study this section to learn how to examine factors that influence whether an exposure to a contaminant could produce harmful health effects. Learn as well how these factors weigh into your decision about possible health effects.
  • Sample Toxicological Profile LSE Table and Figure - Study this example of a level of significant exposure (LSE) table and figure, as presented in ATSDR's toxicological profiles.

Cancer

Cancer Classification System - Study this document to learn about the cancer classification systems used by

• National Toxicology Program in the U.S. Department of Health and Human Services
• U.S. Environmental Protection Agency
• International Agency for Research on Cancer (IARC)

Chemical Specific

Guidance for Inhalation Exposures to Particulate Matter - Study this guidance to learn about how to evaluate acute and chronic particulate matter data using the Air Quality Guidelines from the World Health Organization.

Toxic Equivalents Guidance for Dioxin and Dioxin-like Compounds - Study this guidance to learn how to calculate toxic equivalents (TEQs) for dioxin and dioxin-like compounds.

Chemical Mixtures

Framework for Assessing Health Impacts of Multiple Chemicals - Study this manual, which serves as a supplement to PHAGM, to learn about a recommended process to evaluate the potential public health impacts of exposures to multiple chemicals and other stressors.

Radiation

Basic Introduction to Dose Determination from Radioactive Materials - This ATSDR document introduces and defines the radiological terms used by ATSDR health physicists. It provides a brief discussion of risk assessment as it pertains to radiation.

Tools

• Toxic Substances Portal - The ATSDR's Toxic Substances Portal website provides detailed information about toxic substances for scientists, health care providers, and community members. Health assessors will be interested in the chemical specific toxicological profiles, interaction profiles, minimal risk levels (MRLs), ToxFAQs™, and ToxGuides™.
• Health Effects Charts - The health effect charts are available for some of the more common contaminants at waste sites. Use these charts, which are based on ATSDR's toxicological profiles, for information about harmful effects that might be expected at different doses or air concentrations. You can download the charts from the PHAST results screen.
• Checklist for the In-Depth Toxicological Effects Analysis - Use this checklist to understand the actions you need to take in order to conduct the in-depth toxicological effects analysis.
• Common data sources for the toxicological effects analysis - Refer to this table in PHAGM for a list of data sources that can be used for the analysis of toxicological effects.
• United States Cancer Statistics Data Visualizations – CDC - In this CDC website you will find documentation on the cancer incidence rate in United States.