ABSTRACT
PROBLEM: Translating research to support practice is becoming a more prominent goal in the scientific community. However, further innovation and research is needed on effective approaches to this endeavor. PURPOSE: This case study describes an approach that combines the insights of diffusion of innovation theory with the philosophy and practices of community engagement. KEY POINTS: Elements of our approach included staged dissemination, iterative active engagement, multi-pronged and tailored messaging, use of networks, contextualization of study findings, and emergent strategy. Our work proceeded in five stages, from laying the groundwork to deepened partnership. CONCLUSIONS: Our experience illustrates the challenges and confirms the benefits of a community engaged, partnered, and non-linear approach to research translation aimed at improving public health.
Subject(s)
Community Participation , Community-Based Participatory Research , Humans , Stakeholder Participation , Public HealthABSTRACT
Lipophilic persistent environmental chemicals (LPECs) have the potential to accumulate within a woman's body lipids over the course of many years prior to pregnancy, to partition into human milk, and to transfer to infants upon breastfeeding. As a result of this accumulation and partitioning, a breastfeeding infant's intake of these LPECs may be much greater than his/her mother's average daily exposure. Because the developmental period sets the stage for lifelong health, it is important to be able to accurately assess chemical exposures in early life. In many cases, current human health risk assessment methods do not account for differences between maternal and infant exposures to LPECs or for lifestage-specific effects of exposure to these chemicals. Because of their persistence and accumulation in body lipids and partitioning into breast milk, LPECs present unique challenges for each component of the human health risk assessment process, including hazard identification, dose-response assessment, and exposure assessment. Specific biological modeling approaches are available to support both dose-response and exposure assessment for lactational exposures to LPECs. Yet, lack of data limits the application of these approaches. The goal of this review is to outline the available approaches and to identify key issues that, if addressed, could improve efforts to apply these approaches to risk assessment of lactational exposure to these chemicals.
Subject(s)
Environmental Pollutants/analysis , Maternal Exposure , Milk, Human/chemistry , Risk Assessment , Animals , Dose-Response Relationship, Drug , Female , Humans , Models, Theoretical , Monte Carlo Method , Pregnancy , Rats , Research DesignABSTRACT
The Agency for Toxic Substances and Disease Registry (ATSDR) derives health-based guidance values called minimal risk levels (MRLs) to assist with assessment of risks posed by exposures to hazardous chemicals. From the total of 326 MRLs currently posted on ATSDR's web site (www.atsdr.cdc.gov), 14 and 5 MRLs are based on reproductive and endocrine endpoints, respectively. The paper also describes the ranking of effects into less serious and serious categories according to ATSDR's Guidance for Developing Toxicological Profiles, endpoints used for the MRLs derivation, and the use of uncertainty factors.
