CHEMICAL-MIXTURES FROM A PUBLIC-HEALTH PERSPECTIVE - THE IMPORTANCE OF RESEARCH FOR INFORMED DECISION-MAKING

When considered from a public health perspective, the central question regarding chemical mixtures is deceptively simple: Are current approa ches to risk assessment for chemical mixtures affording effective (ade quate) and efficient (cost-effective) protection for members of our so ciety? Answering this question realistically depends on an understandi ng of the hierarchical goals of public health (i.e. prevention, interv ention, treatment) and an accurate evaluation of the extent to which t hese goals are being achieved. To allow decision makers to make inform ed judgments about the health risks of chemical mixtures, adequate sci entific knowledge and understanding must be available to support risk assessment activities, which are an integral part of the regulatory de cision making process. Designing and implementing relevant research de pends on the existence of a feedback loop between researchers and regu lators, where the information needs of regulators influence the nature and direction of research and the information and understanding gener ated by researchers improves the scientific basis for public health de cisions. A clear, consistent, commonly accepted taxonomy for describin g important mixture-related phenomena is a key factor in creating and maintaining the necessary feedback loop. Ultimately, both researchers and regulators share a common goal with regard to chemical mixtures; i mproving the state-of-the-science so that we can make informed decisio ns about protecting public health. A survey of research issues and nee ds that are crucial to attaining this goal is presented.