BACKGROUND: Previous risk assessment studies have often utilised generic consumption or intake values when evaluating ingestion exposure pathways. If these values do not accurately reflect the country or scenario in question, the resulting risk assessment will not provide a meaningful representation of @entity5 risks in that particular country/scenario. OBJECTIVES: This study sought to determine water and food intake parameters for one region in South Asia, rural Pakistan, and assess the role population specific intake parameters play in @entity5 risk assessment. METHODS: A questionnaire was developed to collect data on sociodemographic features and 24-h water and food consumption patterns from a rural community. The impact of dietary differences on @entity5 susceptibility linked to @entity3494 exposure was evaluated by calculating @entity5 risks using the data collected in the current study against standard water and food intake levels for the USA, Europe and Asia. A probabilistic @entity5 risk was performed for each set of intake values of this study. RESULTS: Average daily total water intake based on drinking direct plain water and indirect water from food and beverages was found to be 3.5Lday(-1) (95% CI: 3.38, 3.57) exceeding the US Environmental Protection Agency's default (2.5Lday(-1)) and World Health Organization's recommended intake value (2Lday(-1)). Average daily @entity579 intake (469gday(-1)) was found to be lower than in India and Bangladesh whereas @entity3505 intake (402gday(-1)) was higher than intake reported for USA, Europe and Asian sub-regions. Consequently, @entity3494 -associated cumulative @entity5 risks determined for daily water intake was found to be 17 chances in @entity1 of 3-6years (95% CI: 0.0014, 0.0017), 14 in @entity1 of age 6-16years (95% CI: 0.001, 0.0011) and 6 in adults of 16-67years (95% CI: 0.0006, 0.0006) in a population size of 10,000. This is higher than the risks estimated using the US Environmental Protection Agency and World Health Organization's default recommended water intake levels. @entity579 intake data showed early life cumulative @entity5 risks of 15 chances in 10,000 for @entity1 of 3-6years (95% CI: 0.0012, 0.0015), 14 in @entity1 of 6-16years (95% CI: 0.0011, 0.0014) and later life risk of 8 adults (95% CI: 0.0008, 0.0008) in a population of 10,000. This is lower than the @entity5 risks in countries with higher @entity579 intake and elevated @entity3494 levels (Bangladesh and India). Cumulative @entity5 risk from @entity3494 exposure showed the relative risk contribution from total water to be 51%, from @entity579 to be 44% and 5% from @entity3505 intake. CONCLUSIONS: The study demonstrates the need to use population specific dietary information for risk assessment and risk management studies. Probabilistic risk assessment concluded the importance of dietary intake in estimating @entity5 risk, along with @entity3494 concentrations in water or food and age of exposed rural population.

Refinement of XXXX attributable health risks in rural Pakistan using population specific dietary intake values.

@entity1 :: ('9606', 'Species') :: ['children'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity3505 :: ('4565', 'Species') :: ['wheat'] @entity3494 :: ('MESH:D001151', 'Chemical') :: ['arsenic'] @entity579 :: ('4530', 'Species') :: ['Rice', 'rice']
@entity3494 :: (MESH:D001151,Chemical) :: ['arsenic']
