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Dose (RfD): Description and Use in Health Risk Assessments

Reference Dose (RfD): Description and Use in 

Health Risk Assessments

Background Document 1A 

March 15, 1993

Table of Contents 

1.1. INTRODUCTION 

1.1.1. BACKGROUND AND SUMMARY

1.1.2. OVERVIEW

1.2. TRADITIONAL APPROACH TO ASSESSING SYSTEMIC TOXICITY 

1.2.1. DESCRIPTION OF THE TRADITIONAL APPROACH

1.2.2. SOME DIFFICULTIES IN UTILIZING THE TRADITIONAL APPROACH 

1.3. EPA ASSESSMENT OF RISKS ASSOCIATED WITH SYSTEMIC TOXICITY 

1.3.1. HAZARD IDENTIFICATION 

1.3.2. DOSE-RESPONSE ASSESSMENT

1.3.3. EXPOSURE ASSESSMENT

1.3.4. RISK CHARACTERIZATION

1.4. APPLICATION IN RISK MANAGEMENT

1.5. OTHER DIRECTIONS

1.6. HYPOTHETICAL, SIMPLIFIED EXAMPLE OF DETERMINING AND USING RfD 

1.6.1. EXPERIMENTAL RESULTS

1.6.2. ANALYSIS

1.7. REFERENCES

1. REFERENCE DOSE (RfD): DESCRIPTION AND USE IN HEALTH RISK ASSESSMENTS

1.1. INTRODUCTION

This concept paper describes the U.S. Environmental Protection Agency's (U.S. 

EPA) principal approach to and rationale for assessing risk for health effects other 

than cancer and gene mutations from chronic chemical exposure. By outlining 

principles and concepts that guide EPA risk assessment for such systemic effects 

the paper complements the new risk assessment guidelines (U.S. EPA, 1987), 

which describe the Agency's approach to risk assessment in other areas, 

specifically carcinogenicity, mutagenicity, developmental toxicity, exposure, and 

chemical mixtures. (In this document the term "systemic toxicity" refers to an 

effect other than carcinogenicity or mutagenicity induced by a toxic chemical.) 

1.1.1. BACKGROUND AND SUMMARY

Chemicals that give rise to toxic endpoints other than cancer and gene mutations 

are often referred to as "systemic toxicants" because of their effects on the 

function of various organ systems. In addition, chemicals that cause cancer and 

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gene mutations also commonly evoke other toxic effects (i.e., systemic toxicity). 

Based on our understanding of homeostatic and adaptive mechanisms, systemic 

toxicity is treated as if there is an identifiable exposure threshold (both for the 

individual and for populations) below which there are no observable adverse 

effects. This characteristic distinguishes systemic endpoints from carcinogenic 

and mutagenic endpoints, which are often treated as nonthreshold processes. 

Systemic effects have traditionally been evaluated using such terms as 

"acceptable daily intake (ADI)," "safety factor (SF)," and "margin of safety 

(MOS)," concepts that are associated with certain limitations described below. 

The U.S. EPA established the Reference Dose (RfD) Work Group to address these 

concerns. 

In preparing this report, the RfD Work Group has drawn on traditional report on 

risk assessment (NRC, 1983), to more fully articulate the use of noncancer, 

nonmutagenic experimental data in reaching regulatory decisions about the 

significance of exposures to chemicals. In the process, the Work Group has 

coined less value-laden terminology -- "reference dose (RfD)," "uncertainty factor 

(UF)"; "margin of exposure (MOE)"; and "regulatory dose (RgD)" -- to clarify and 

distinguish between aspects of risk assessment and risk management. These 

concepts are currently in general use in many parts of U.S. EPA. 

1.1.2. OVERVIEW

This document consists of four parts in addition to this Introduction. In Section 

1.2., the traditional approach to assessing risks of systemic toxicity is presented, 

and issues associated with this approach are identified and discussed. In Section 

1.3., the modifications made to the traditional approach by the Work Group are 

presented. Section 1.4. examines how these new concepts can be applied in 

reaching risk management decisions, and Section 1.5. briefly discusses some of 

the additional approaches the U.S. EPA is using and exploring to address this 

issue. Section 1.6. provides a sample RfD calculation. Section 1.7. consists of 

references. 

1.2. TRADITIONAL APPROACH TO ASSESSING SYSTEMIC TOXICITY

The U.S. EPA's approach to assessing the risks associated with systemic toxicity 

is different from its approach to assessing the risks associated with 

carcinogenicity, because of the different mechanisms of action thought to be 

involved in the two cases. In the case of carcinogens, the Agency assumes that a 

small number of molecular events can evoke changes in a single cell that can 

lead to uncontrolled cellular proliferation. This mechanism for carcinogenesis is 

referred to as "nonthreshold," since there is theoretically no level of exposure for 

such a chemical that does not pose a small, but finite, probability of generating a 

carcinogenic response. In the case of systemic toxicity, however, organic 

homeostatic, compensating, and adaptive mechanisms exist that must be 

overcome before a toxic endpoint is manifested. For example, there could be a 

large number of cells performing the same or similar function whose population 

must be significantly depleted before the effect is seen. 

The threshold concept is important in the regulatory context. The individual 

threshold hypothesis holds that a range of exposures from zero to some finite 

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value can be tolerated by the organism with essentially no chance of expression 

of the toxic effect. Further, it is often prudent to focus on the most sensitive 

members of the population; therefore, regulatory efforts are generally made to 

keep exposures below the population threshold, which is defined as the lowest of 

the thresholds of the individuals within a population. 

1.2.1. DESCRIPTION OF THE TRADITIONAL APPROACH 

In many cases, risk decisions on systemic toxicity have been made by the Agency 

using the concept of the "acceptable daily intake (ADI)" derived from an 

experimentally determined "no-observed-adverse-effect level (NOAEL)." The ADI 

is commonly defined as the amount of a chemical to which a person can be 

exposed on a daily basis over an extended period of time (usually a lifetime) 

without suffering a deleterious effect. The ADI concept has often been used as a 

tool in reaching risk management decisions (e.g., establishing allowable levels of 

contaminants in foodstuffs and water.) 

A NOAEL is an experimentally determined dose at which there was no statistically 

or biologically significant indication of the toxic effect of concern. In an 

experiment with several NOAELs, the regulatory focus is normally on the highest 

one, leading to the common usage of the term NOAEL as the highest 

experimentally determined dose without a statistically or biologically significant 

adverse effect. The NOAEL for the critical toxic effect is sometimes referred to 

simply as the NOEL. This usage, however, invites ambiguity in that there may be 

observable effects that are not of toxicological significance (i.e., they are not 

"adverse"). For the sake of precision, this document uses the term NOAEL to 

mean the highest NOAEL in an experiment. In cases in which a NOAEL has not 

been demonstrated experimentally, the term "lowest-observed-adverse-effect 

level (LOAEL)" is used. 

Once the critical study demonstrating the toxic effect of concern has been 

identified, the selection of the NOAEL results from an objective examination of 

the data available on the chemical in question. The ADI is then derived by 

dividing the appropriate NOAEL by a safety factor (SF), as follows: 

ADI (human dose) = NOAEL (experimental dose)/SF. (Equation 1)

Generally, the SF consists of multiples of 10, each factor representing a specific 

area of uncertainty inherent in the available data. For example, a factor of 10 

may be introduced to account for the possible differences in responsiveness 

between humans and animals in prolonged exposure studies. A second factor of 

10 may be used to account for variation in susceptibility among individuals in the 

human population. The resultant SF of 100 has been judged to be appropriate for 

many chemicals. For other chemicals, with data bases that are less complete (for 

example, those for which only the results of subchronic studies are available), an 

additional factor of 10 (leading to a SF of 1000) might be judged to be more 

appropriate. For certain other chemicals, based on well-characterized responses 

in sensitive humans (as in the effect of fluoride on human teeth), an SF as small 

as 1 might be selected.

While the original selection of SFs appears to have been rather arbitrary (Lehman 

and Fitzhugh, 1954), subsequent analysis of data (Dourson and Stara, 1983) 

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lends theoretical (and in some instances experimental) support for their 

selection. Further, some scientists, but not all, within the EPA interpret the 

absence of widespread effects in the exposed human populations as evidence of 

the adequacy of the SFs traditionally employed. 

1.2.2. SOME DIFFICULTIES IN UTILIZING THE TRADITIONAL APPROACH

1.2.2.1. Scientific Issues 

While the traditional approach has performed well over the years and the Agency 

has sought to be consistent in its application, observers have identfied scientific 

shortcomings of the approach. Examples include the following:

a. Too narrow a focus on the NOAEL means that information on the shape of the 

dose-response curve is ignored. Such data could be important in estimating 

levels of concern for public safety.

b. As scientific knowledge increases and the correlation of precursor effects (e.g., 

enzyme induction) with toxicity becomes known, questions about the selection of 

the appropriate "adverse effect" arise.

c. Guidelines have not been developed to take into account the fact that some 

studies have used larger (smaller) numbers of animals and, hence, are generally 

more (less) reliable than other studies.

These and other "scientific issues" are not susceptible to immediate resolution, 

since the data base needed is not yet sufficiently developed or analyzed. U.S. 

EPA work groups are presently considering these issues. 

1.2.2.2. Management-related Issues 

1.2.2.2.1. The use of the term "safety factor" 

The term "safety factor" suggests, perhaps inadvertently, the notion of absolute 

safety (i.e., absence of risk). While there is a conceptual basis for believing in the 

existence of a threshold and "absolute safety" associated with certain chemicals, 

in the majority of cases a firm experimental basis for this notion does not exist. 

1.2.2.2.2. The implication that any exposure in excess of the ADI is "unacceptable" and that 

any exposure less than the ADI is "acceptable" or "safe" 

In practice, the ADI is viewed by many (including risk managers) as an 

"acceptable" level of exposure, and, by inference, any exposure greater than the 

ADI is seen as "unacceptable." This strict demarcation between what is 

"acceptable" and what is "unacceptable" is contrary to the views of most 

toxicologists, who typically interpret the ADI as a relatively crude estimate of a 

level of chronic exposure which is not likely to result in adverse effects to 

humans. The ADI is generally viewed by risk assessors as a "soft" estimate, 

whose bounds of uncertainty can span an order of magnitude. That is, within 

reasonable limits, while exposures somewhat higher than the ADI are associated 

with increased probability of adverse effects, that probability is not a certainty. 

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Similarly, while the ADI is seen as a level at which the probability of adverse 

effects is low, the absence of all risk to all people cannot be assured at this level. 

1.2.2.2.3. Possible limitations imposed on risk management decisions 

Awareness of the "softness" of the ADI estimate, as discussed above, argues for 

careful case-by-case consideration of the toxicological implications of individual 

situation, so that ADIs are not given a degree of significance that is scientifically 

unwarranted. In addition, the ADI is only one factor in a risk management 

decision and should not be used to the exclusion of other relevant factors.

1.2.2.2.4. Development of different ADIs by different programs 

In addition to occasionally selecting different critical toxic effects, Agency 

scientists have reflected their best scientific judgments in the final ADI by 

adopting factors different from the standard factors listed in Table 1. For 

example, if the toxic endpoint for a chemical in experimental animals is the same 

as that which has been established for a related chemical in humans at similar 

doses, one could argue for an SF of less than the traditional 100. On the other 

hand, if the total toxicologic data base is incomplete, one could argue that an 

additional SF should be included, both as a matter of prudent public policy and as 

an incentive to others to generate the appropriate data.

TABLE 1

Guidelines for the Use of Uncertainty Factors in Deriving Reference 

Doses and Modifying Factors

Standard Uncertainty Factors (UFs): 

Use a 10-fold factor when extrapolating from valid experimental results in studies 

using prolonged exposure to average healthy humans. This factor is intended to 

account for the variation in sensitivity among the members of the human 

population and is referenced as "10H". 

Use an additional 10-fold factor when extrapolating from valid results of longterm studies on experimental animals when results of studies of human exposure 

are not available or are inadequate. This factor is intended to account for the 

uncertainty involved in extrapolating from animal data to humans and is 

referenced as "10A". 

Use an additional 10-fold factor when extrapolating from less than chronic results 

on experimental animals when there are no useful long-term human data. This 

factor is intended to account for the uncertainty involved in extrapolat- ing from 

less than chronic NOAELs to chronic NOAELs and is referenced as "10S". 

Use an additional 10-fold factor when deriving an RfD from a LOAEL, instead of a 

NOAEL. This factor is intended to account for the uncertainty involved in 

extrapolating from LOAELs to NOAELs and is referenced as "10L". 

Modifying Factor (MF): 

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Use professional judgment to determine the MF, which is an additional 

uncertainty factor that is greater than zero and less than or equal to 10. The 

magnitude of the MF depends upon the professional assessment of scientific 

uncertainties of the study and data base not explicitly treated above; e.g., the 

completeness of the overall data base and the number of species tested. The 

default value for the MF is 1.

*Source: Adapted from Dourson and Stara, 1983

Such practices, as employed by a number of scientists in different 

programs/agencies, exercising their best scientific judgment, have in some cases 

resulted in different ADIs for the same chemical. The fact that different ADIs 

were generated (for example, by adopting different SFs) can be a source of 

considerable confusion when the ADIs are used exclusively in risk management 

decisionmaking (see Section 1.2.2.2.3). The existence of different ADIs need not 

imply that any of them is more "wrong"--or "right"--than the rest. It is more 

nearly a reflection of the honest difference in scientific judgment. 

However, on occasion, these differences in judgment of the scientific data, can be 

interpreted as differences in the management of the risk. As a result, scientists 

may be inappropriately impugned, and/or perfectly justifiable risk management 

decisions may be tainted by charges of "tampering with the science." This 

unfortunate state of affairs arises, at least in part, from treating the ADI as an 

absolute measure of safety. 

1.3. EPA ASSESSMENT OF RISKS ASSOCIATED WITH SYSTEMIC TOXICITY

The U.S. EPA approach to analyzing systemic toxicity data follow the general 

format set forth by NRC in its description of the risk assessment process (NRC, 

1983). The determination of the presence of risk and its potential magnitude is 

made during the risk assessment process, which consists of hazard identification, 

dose-response assessment, exposure assessment, and risk characterization. 

Having been apprised by the risk assessor that a potential risk exists, the risk 

manager considers control options available under existing statutes and other 

relevant non-risk factors (e.g., benefits to be gained and costs to be incurred). All 

of these considerations go into the determination of the regulatory decision 

(Figure 1).

FIGURE 1

Conceptual Framework for Risk Assessment and Risk Management*

------------------------------------------------------------------------------ 

 Risk Assessment Risk Management 

------------------------------------ ----------------------------------- 

Hazard Identification Control Options 

 | | 

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 | | 

 | Dose-Response Assessment | Non-risk Analyses 

 | (e.g., RfD) | | 

 | | | | 

 | | Exposure Assessment | | 

 | | | | | 

 | | | | | 

 v v v v v 

Risk Characterization ------------------->Regulatory Decision 

 (e.g., criterion) (e.g., RgD, Standard) 

------------------------------------------------------------------------------ 

*Source: Adapted from NRC, 1983

1.3.1. HAZARD IDENTIFICATION

1.3.1.1. Evidence

1.3.1.1.1. Type of effect

Exposure to a given chemical, depending on the dose employed, may result in a 

variety of toxic effects. These may range from gross effects, such as death, to 

more subtle biochemical, physiologic, or pathologic changes. In assessments of 

the risk posed by a chemical, the toxic endpoints from all available studies are 

considered, although primary attention usually is given to the effect (the "critical 

effect") exhibiting the lowest NOAEL. In the case of chemicals with limited data 

bases, additional toxicity testing may be necessary before an assessment can be 

made.

1.3.1.1.2. Principal studies

Principal studies are those that contribute most significantly to the qualitative 

assessment of whether or not a particular chemical is potentially a systemic 

toxicant in humans. In addition, they may be used in the quantitative doseresponse assessment phase of the risk assessment. These studies are of two 

types: studies of human populations (epidemiologic investigations) and studies 

using laboratory animals.

1.3.1.1.2.1. Epidemiologic studies 

Human data are often useful in qualitatively establishing the presence of an 

adverse effect in exposed human populations. When there is information on the 

exposure level associated with an appropriate endpoint, epidemiologic studies 

can also provide the basis for a quantitative dose-response assessment. The 

presence of such data obviates the necessity of extrapolating from animals to 

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humans; therefore, human studies, when available, are given first priority, with 

animal toxicity studies serving to complement them.

In epidemiologic studies, confounding factors that are recognized can be 

controlled and measured, within limits. Case reports and acute exposures 

resulting in severe effects provide support for the choice of critical toxic effect, 

but they are often of limited utility in establishing a quantitative relationship 

between environmental exposures and anticipated effects. Available human 

studies on ingestion are usually of this nature. Cohort studies and clinical studies 

may contain exposure-response information that can be used in estimating effect 

levels, but the method of establishing exposure must be evaluated for validity 

and applicability.

1.3.1.1.2.2. Animal studies

For most chemicals, there is a lack of appropriate information on effects in 

humans. In such cases, the principal studies are drawn from experiments 

conducted on nonhuman mammals, most often the rat, mouse, rabbit, guinea 

pig, hamster, dog, or monkey.

1.3.1.1.3. Supporting studies

These studies provide supportive, rather than definitive, information and can 

include data from a wide variety of sources. For example, metabolic and other 

pharmacokinetic studies can provide insights into the mechanism of action of a 

particular compound. By comparing the metabolism of the chemical exhibiting the 

toxic effect in the animal with the metabolism found in humans, it may be 

possible to assess the potential for toxicity in humans or to estimate the equitoxic 

dose in humans.

Similarly, in vitro studies can provide insights into the chemical's potential for 

biological activity; and under certain circumstances, considera- tion of structureactivity relationships between a chemical and other structurally related 

compounds can provide clues to the test chemical's pos- sible toxicity. More 

reliable in vitro tests are presently being developed to minimize the need for liveanimal testing. There is also increased emphasis on generating mechanism-ofaction and pharmacokinetic information as a means of increasing understanding 

of toxic processes in humans and nonhumans.

1.3.1.1.4. Route of exposure

The U.S. EPA often approaches the investigation of a chemical with a particular 

route of exposure in mind (e.g., an oral exposure for a drinking water 

contaminant or an inhalation exposure for an air contaminant). In most cases, 

the toxicologic data base does not include detailed testing on all possible routes 

of administration, with their possibly significant differences in factors such as 

mechanism-of-action and bioavailability. In general, the U.S. EPA's position is 

that the potential for toxicity manifested via one route of exposure is relevant to 

considerations of any other route of exposure, unless convincing evidence exists 

to the contrary. Consideration is given to potential differences in absorption or 

metabolism resulting from different routes of exposure, and whenever 

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appropriate data (e.g., comparative metabolism studies) are available, the 

quantitative impacts of these differences on the risk assessment are delineated.

1.3.1.1.5. Length of exposure

The U.S. EPA is concerned about the potential toxic effects in humans associated 

with all possible exposures to chemicals. The magnitude, frequency, and duration 

of exposure may vary considerably in different situations. Animal studies are 

conducted using a variety of exposure durations (e.g., acute, subchronic, and 

chronic) and schedules (e.g., single, intermittent, or continuous dosing). 

Information from all these studies is useful in the hazard identification phase of 

risk assessment. For example, overt neurological problems identified in high-dose 

acute studies tend to reinforce the observation of subtle neurological changes 

seen in low-dose chronic studies. Special attention is given to studies involving 

low-dose, chronic exposures, since such exposures can elicit effects absent in 

higher dose, shorter exposures, through mechanisms such as accumulation of 

toxicants in the organisms.

1.3.1.1.6. Quality of the study

Evaluation of individual studies in humans and animals requires the consideration 

of several factors associated with a study's hypothesis, design, execution, and 

interpretation. An ideal study addresses a clearly delineated hypothesis, follows a 

carefully prescribed protocol, and includes sufficient subsequent analysis to 

support its conclusions convincingly.

In evaluating the results from such studies, consideration is given to many other 

factors, including chemical characterization of the compound(s) under study, the 

type of test species, similarities and differences between the test species and 

humans (e.g., chemical absorption and metabolism), the number of individuals in 

the study groups, the number of study groups, the spacing and choice of dose 

levels tested, the types of observations and methods of analysis, the nature of 

pathologic changes, the alteration in metabolic responses, the sex and age of test 

animals, and the route and duration of exposure.

1.3.1.2. Weight-of-Evidence Determination 

As the culmination of the hazard identification step, a discussion of the weight-ofevidence summarizes the highlights of the information gleaned from the principal 

and supportive studies. Emphasis is given to examining the results from different 

studies to determine the extent to which a consistent, plausible picture of toxicity 

emerges. For example, the following factors add to the weight of the evidence 

that the chemical poses a hazard to humans: similar results in replicated animal 

studies by different investigators; similar effects across sex, strain, species, and 

route of exposure; clear evidence of a dose-response relationship; a plausible 

relation between data on metabolism, postulated mechanism-of-action, and the 

effect of concern; similar toxicity exhibited by structurally related compounds; 

and some link between the chemical and evidence of the effect of concern in 

humans.

1.3.2. DOSE-RESPONSE ASSESSMENT

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1.3.2.1. Concepts and Problems

Empirical observations have generally revealed that as the dosage of a toxicant is 

increased, the toxic response (in terms of severity and/or incidence of effect) also 

increases. This dose-response relationship is well-founded in the theory and 

practice of toxicology and pharmacology. Such behavior is observed in the 

following instances: in quantal responses, in which the proportion of responding 

individuals in a population increases with dose; in graded responses, in which the 

severity of the toxic response within an individual increases with dose; and in 

continuous responses, in which changes in a biological parameter (e.g., body or 

organ weight) vary with dose.

In evaluating a dose-response relationship, certain difficulties arise. For example, 

one must decide on the critical endpoint to measure as the "response." One must 

also decide on the correct measure of "dose." In addition to the interspecies 

extrapolation aspects of the question of the appropriate units for dose, the more 

fundamental question of administered dose versus absorbed dose versus target 

organ dose should be considered. These questions are the subject of much 

current research.

1.3.2.2. Selection of the Critical Data

1.3.2.2.1. Critical study

Data from experimental studies in laboratory animals are often selected as the 

governing information when performing quantitative risk assessments, since 

available human data are usually insufficient for this purpose. These animal 

studies typically reflect situations in which exposure to the toxicant has been 

carefully controlled and the problems of heterogeneity of the exposed population 

and concurrent exposures to other toxicants have been minimized. In evaluating 

animal data, a series of professional judgments are made which involve, among 

others, consideration of the scientific quality of the studies. Presented with data 

from several animal studies, the risk assessor first seeks to identify the animal 

model that is most relevant to humans, based on the most defensible biological 

rationale (e.g., for instance using comparative pharmacokinetic data). In the 

absence of a clearly most relevant species, the most sensitive species (i.e., the 

species showing a toxic effect at the lowest administered dose) is used by risk 

assessors at U.S. EPA, since there is no assurance that humans are not at least 

as innately sensitive as the most sensitive species tested. This selection process 

is more difficult when the routes of exposure in the animal tests are different 

from those involved in the human situation under investigation. In order to use 

data from controlled studies of genetically homogeneous animals, the risk 

assessor must also extrapolate from animals to humans and from high 

experimental doses to comparatively low environmental exposures, and must 

account for human heterogeneity and possible concurrent human exposures to 

other chemicals.

Although for most chemicals there is a lack of well-controlled cohort studies 

investigating noncancer endpoints, in some cases an epidemiologic study may be 

selected as the critical data (e.g., in cases of cholinesterase inhibition). Risk 

assessments based on human data have the advantage of avoiding the problems 

inherent in interspecies extrapolation. In many instances, use of such studies, as 

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is the case with animal investigations, involves extrapolation from relatively high 

doses (such as those found in occupational settings) to the low doses found in 

the environmental situations to which the general population is more likely to be 

exposed. In some cases, a well-designed and well-conducted epidemiologic study 

that shows no association between known exposures and toxicity can be used to 

directly project an RfD (as has been done in the case of fluoride).

1.3.2.2.2. Critical data

In the simplest terms, an experimental exposure level is selected from the critical 

study that represents the highest level tested in which "no adverse effect" was 

demonstrated. This "no-observed-adverse-effect-level" (NOAEL) is the key datum 

gleaned from the study of the dose-response relationship and, traditionally, is the 

primary basis for the scientific evaluation of the risk posed to humans by 

systemic toxicants. This approach is based on the assumption that if the critical 

toxic effect is prevented, then all toxic effects are prevented.

More formally, the NOAEL is defined in this discussion as the highest 

experimental dose of a chemical at which there is no statistically or biologically 

significant increase in frequency or severity of an adverse effect in individuals in 

an exposed group when compared with individuals in an appropriate control 

group. As noted above, there may be sound professional differences of opinion in 

judging whether or not a particular response is adverse. In addition, the NOAEL is 

a function of the size of the population under study. Studies with a small number 

of subjects are less likely to detect low-dose effects than studies using larger 

numbers of subjects. Also, if the interval between doses in an experiment is 

large, it is possible that the experimentally determined NOAEL is lower than that 

which would be observed in a study using intervening doses.

1.3.2.2.3. Critical endpoint

As noted in Section 1.2., a chemical may elicit more than one toxic effect 

(endpoint), even in one test animal, or in tests of the same or different duration 

(acute, subchronic, and chronic exposure studies). In general, NOAELs for these 

effects will differ. The critical endpoint used in the dose-response assessment is 

the effect exhibiting the lowest NOAEL.

1.3.2.3. Reference Dose (RfD)

The reference dose (RfD) and uncertainty factor (UF) concepts have been 

developed by the RfD Work Group in response to many of the problems 

associated with ADIs and SFs, as previously outlined in Section 1.2. The RfD is a 

benchmark dose operationally derived from the NOAEL by consistent application 

of generally order-of-magnitude uncertainty factors (UFs) that reflect various 

types of data sets used to estimate RfDs. For example, a valid chronic animal 

NOAEL is normally divided by an UF of 100. In addition, a modifying factor (MF), 

is sometimes used which is based on a professional judgment of the entire data 

base of the chemical. These factors and their rationales are presented in Table 1.

The RfD is determined by use of the following equation:

RfD = NOAEL / (UF x MF)

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which is the functional equivalent of Equation 1. In general, the RfD is an 

estimate (with uncertainty spanning perhaps an order of magnitude) of a daily 

exposure to the human population (including sensitive subgroups) that is likely to 

be without an appreciable risk of deleterious effects during a lifetime. The RfD is 

generally expressed in units of milligrams per kilogram of bodyweight per day 

(mg/kg/day).

The RfD is useful as a reference point from which to gauge the potential effects of 

the chemical at other doses. Usually, doses less than the RfD are not likely to be 

associated with adverse health risks, and are therefore less likely to be of 

regulatory concern. As the frequency and/or magnitude of the exposures 

exceeding the RfD increase, the probability of adverse effects in a human 

population increases. However, it should not be categorically concluded that all 

doses below the RfD are "acceptable" (or will be risk-free) and that all doses in 

excess of the RfD are "unacceptable" (or will result in adverse effects).

The U.S. EPA is attempting to standardize its approach to determining RfDs. The 

RfD Work Group has developed a systematic approach to summarizing its 

evaluations, conclusions, and reservations regarding RfDs in a "cover sheet" of a 

few pages in length. The cover sheet includes a statement on the confidence 

(high, medium, or low) the evaluators have in the stability of the RfD. High 

confidence indicates the judgment that the RfD is unlikely to change in the future 

because there is consistency among the toxic responses observed in different 

sexes, species, study designs, or in dose-response relationships, or that the 

reasons for existing differences are well understood. High confidence is often 

given to RfDs that are based on human data for the exposure route of concern, 

since in such cases the problems of interspecies extrapolation have been avoided. 

Low confidence indicates the judgment that the data supporting the RfD may be 

of limited quality and/or quantity and that additional information could result in a 

change in the RfD.

1.3.3. EXPOSURE ASSESSMENT

The third step in the risk assessment process focuses on exposure issues. For a 

full discussion of exposure assessment, consult U.S. EPA's guidelines on the 

subject (U.S. EPA, 1987). In brief, the exposure assessment includes 

consideration of the size and nature of the populations exposed and the 

magnitude, frequency, duration and routes of exposure, as well as evaluation of 

the nature of the exposed populations.

1.3.4. RISK CHARACTERIZATION

Risk characterization is the final step in the risk assessment process and the first 

input to the risk management (regulatory action) process. The purpose of risk 

characterization is to present the risk manager with a synopsis and synthesis of 

all the data that should contribute to a conclusion with regard to the nature and 

extent of the risk, including:

a. The qualitative ("weight-of-evidence") conclusions as to the likelihood that the 

chemical may pose a hazard to human health.

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b. A discussion of the dose-response information considered in deriving the the 

RfD, including the UFs and MFs used.

c. Data on the shapes and slopes of the dose-response curves for the various 

toxic endpoints, toxicodynamics (absorption and metabolism), structure-activity 

correlations, and the nature and severity of the observed effects.

d. Estimates of the nature and extent of the exposure and the number and types 

of people exposed.

e. Discussion of the overall uncertainty in the analysis, including the major 

assumptions made, scientific judgments employed, and an estimate of the degree 

of conservatism involved.

In the risk characterization process, a comparison is made between the RfD and 

the estimated (calculated or measured) exposure dose (EED). The EED should 

include all sources and routes of exposure involved. If the EED is less than the 

RfD, the need for regulatory concern is likely to be small.

An alternative measure that may be useful to some risk managers is the margin 

of exposure (MOE), which is the magnitude by which the NOAEL of the critical 

toxic effect exceeds the estimated exposure dose (EED), where both are 

expressed in the same units:

MOE = NOAEL (experimental dose) / EED (human dose).

When the MOE is equal to or greater than UF x MF, the need for regulatory 

concern is likely to be small.

Section 1.6. contains an example of the use of the concepts of NOAEL, UF, MF, 

RfD, EED, and MOE.

1.4. APPLICATION IN RISK MANAGEMENT

Once the risk characterization is completed, the focus turns to risk management. 

In reaching decisions, the risk manager utilizes the results of risk assessment, 

other technological factors, and legal, economic and social considerations in 

reaching a regulatory decision. These additional factors include efficiency, 

timeliness, equity, administrative simplicity, consistency, public acceptability, 

technological feasibility, and nature of the legislative mandate.

Because of the way these risk management factors may impact different cases, 

consistent -- but not necessarily identical -- risk management decisions must be 

made on a case-by-case basis. For example, the Clean Water Act calls for 

decisions with "an ample margin of safety"; the Federal Insecticide, Fungicide 

and Rodenticide Act (FIFRA) calls for "an ample margin of safety," taking benefits 

into account; and the Safe Drinking Water Act (SDWA) calls for standards which 

protect the public "to the extent feasible." Consequently, it is entirely possible 

and appropriate that a chemical with a specific RfD may be regulated under 

different statutes and situations through the use of different "regulatory doses 

(RgDs)."

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That is, after carefully considering the various risk and nonrisk factors, regulatory 

options, and statutory mandates in a given case (i), the risk manager selects the 

appropriate statutory alternative for arriving at an "ample" or "adequate" margin 

of exposure [MOE(i)]. As shown in Equation 2 below, this procedure establishes 

the regulatory dose, RgD(i) (e.g., a tolerance under FIFRA or a maximum 

contaminant level under SDWA), applicable to the case in question:

RgD(i) = NOAEL / MOE(i). (Equation 2)

Note that different RgDs are possible for a given chemical with a single RfD. Note 

also that comparing the RfD to a particular RgD(i) is equivalent to comparing the 

MOE(i) with the UF x MF:

RfD/RgD(i) = MOE(i) / (UF x MF).

In assessing the significance of a case in which the RgD is greater (or less) than 

the RfD, the risk manager should carefully consider the case-specific data 

compiled by the risk assessors, as discussed in Section 1.3.4. In some cases, 

additional explanation and interpretation may be required from the risk assessors 

in order to arrive at a responsible and clearly articulated final decision on the 

RgD.

It is generally useful to the risk manager to have information regarding the 

contribution to the RfD from various environmental media (e.g., air, water and 

food). Such information can provide insights that are helpful in choosing among 

available control options. However, in cases in which site-specific criteria are 

being considered, local exposures through various media can often be determined 

more accurately than exposure estimates based upon generic approaches. In 

such cases, the exposure assessor's role is particularly important. For instance, at 

a given site, consumption of fish may clearly dominate the local exposure routes, 

while, on a national basis, fish consumption may play a minor role compared to 

ingestion of treated crops.

Work is underway in the U.S. EPA to apportion the RfD among the various 

environmental media. For example, consider the case of a food-use pesticide 

which is a contaminant in drinking water. In selecting among risk management 

actions under the Safe Drinking Water Act, it might be prudent to assume an RfD 

for drinking water purposes which is some fraction of the total RfD. Such an 

apportionment would explicitly acknowledge the possible additional exposure 

from ingestion of treated crops. The apportionment of the RfD would, in general, 

provide additional guidance for risk managers of the various media-specific 

programs.

1.5. OTHER DIRECTIONS

In addition to the development of reference doses, the U.S. EPA is pursuing other 

lines of investigation for systemic toxicity. For example, the Office of Air Quality 

Planning and Standards is using probabilistic risk assessment procedures for 

criteria pollutants. In this procedure, the population at risk is characterized, and 

the likelihood of the occurrence of various effects is predicted through the use of 

available scientific literature and of scientific experts' rendering their judgments 

concerning dose-response relationships. This dose-response information is then 

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combined with the results of the exposure analysis to generate population risk 

estimates for alternative standards. Through the use of these procedures, 

decisionmakers are presented with ranges of risk estimates in which uncertainties 

associated with both the toxicity and exposure information are explicitly 

considered. The Office of Policy, Planning and Evaluation is investigating similar 

procedures in order to balance health risk and cost. In addition, scientists in the 

Office of Research and Development have initiated a series of studies designed to 

increase the reliability of risk assessments. They are investigating the use of 

extrapolation models as a means of estimating RfDs, taking into account the 

statistical variability of the NOAEL and underlying UFs. ORD is also exploring 

procedures for conducting health risk assessments that involve less-than-lifetime 

exposures. Finally, they are working on approaches to ranking the severity of 

different toxic effects.

1.6. HYPOTHETICAL, SIMPLIFIED EXAMPLE OF DETERMINING AND USING RfD

1.6.1. EXPERIMENTAL RESULTS

Suppose the U.S. EPA had a sound 90-day subchronic gavage study in rats with 

the data in Table 2:

TABLE 2

Hypothetical Data to Illustrate the Reference Dose Concept 

------------------------------------------------------------------------------ 

 Dose Observation Effect Level 

 mg/kg/day 

------------------------------------------------------------------------------ 

 0 Control--no adverse effects observed -- 

 1 No statistically or biologically NOEL 

 significant differences between treated 

 and control animals 

 5 2% decrease* in body weight gain (not NOAEL 

 considered to be of biological significance); 

 increased ratio of liver weight to body weight; 

 histopathology indistinguishable from controls; 

 elevated liver enzyme levels 

 25 20% decrease* in body weight gain; LOAEL 

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 increased* ratio of liver weight to body 

 weight; enlarged, fatty liver with vacuole 

 formation; increased* liver enzyme levels 

------------------------------------------------------------------------------ 

*Statistically significant compared to controls.

1.6.2. ANALYSIS

1.6.2.1. Determination of the Reference Dose (RfD)

1.6.2.2.1. Using the NOAEL

Because the study is on animals and of subchronic duration,

UF = 10H x 10A x 10S = 1000 (Table 1).

In addition, there is a subjective adjustment (MF) based on the high number of 

animals (250) per dose group:

MF = 0.8.

These factors then give UF x MF = 800, so that

RfD = NOAEL/(UF x MF) = 5/800 = 0.006 (mg/kg/day).

1.6.2.1.2. Using the LOAEL

If the NOAEL is not available, and if 25 mg/kg/day had been the lowest dose 

tested that showed adverse effects,

UF = 10H x 10A x 10S x 10L = 10,000 (Table 1).

Using again the subjective adjustment of MF = 0.8, one obtains

RfD = LOAEL/(UF x MF) = 25/8000 = 0.003 (mg/kg/day).

1.6.2.2. Risk Characterization Considerations 

Suppose the estimated exposure dose (EED) for humans exposed to the chemical 

under the proposed use pattern were 0.01 mg/kg/day (i.e., the EED is greater 

than the RfD). Viewed alternatively, the MOE is:

MOE = NOAEL/EED = 5 (mg/kg/day) / 0.01 (mg/kg/day) = 500.

Because the EED exceeds the RfD (and the MOE is less than the UF x MF), the 

risk manager will need to look carefully at the data set, the assumptions for both 

the RfD and the exposure estimates, and the comments of the risk assessors. In 

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addition, the risk manager will need to weigh the benefits associated with the 

case, and other non-risk factors, in reaching a decision on the regulatory dose 

(RgD).

1.7. REFERENCES 

Dourson, M.L. and J.F. Stara. 1983. Regulatory Toxicology and Pharmacology. 3: 

224-238.

Lehman, A.J. and O.G. Fitzhugh. 1954. Association of Food Drug Officials. USQ 

Bull. 18: 33-35.

NRC (National Research Council). 1983. Risk Assessment in the Federal 

Government: Managing the Process. NAS Press, Washington, DC.

U.S. EPA. 1987. The Risk Assessment Guidelines of 1986. Office of Health and 

Environmental Assessment, Washington, DC. EPA/600/8-87/045.

http://www.epa.gov/iris/rfd.htm

Last updated on Tuesday, July 26, 2011

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