A Critical Comparison of Exposure Factors in the Czech Republic, the Slovak Republic and the USA. A. Cullen, University of Washington, School of Public Affairs, 208 Parrington Hall, Box 353055, Seattle, WA 98195; J. Ruprich, Center for the Hygiene of Food Chains-Brno, National Institute of Public Health in Prague, Czech Republic; and F. Hruba, Specialized State Institute of Public Health, Banska Bystrica, Slovakia
Traditionally, the analysis and management of health risk in many countries was carried out using epidemiological approaches involving tallies of disease or death attributable to various causes. In recent years scientists in the US have increasingly used risk analytic techniques to address situations where contaminants occur at low levels, affect small populations or involve future changes, issues which can complicate epidemiological approaches. The exchange of information about risk analytic techniques, as well as input data and assumptions, between analysts in different regions and countries has naturally followed. Yet, the use of exposure assumptions relevant to the population or region of concern is known to be critical since enormous variability is expected. Data collected in one locale may be irrelevant to another, thus, where possible, all assumptions should be based on site specific data, or data adapted with this purpose in mind. Nevertheless, in many cases risk assessors in other countries are borrowing US exposure models and assumptions directly, especially when local information is not readily available or usable. In an effort to address the gap in locally relevant exposure factors for Central Europe we perform a three way comparison of some demographic, dietary and behavioral exposure factors. We compare exposure information from Slovakia and the Czech Republic based on the 1991 census, the World Health Organization's CINDI (Country wide Integrated Non-communicable Disease Intervention) study (1992) and local food basket studies, to exposure data published in the US by EPA, USDA, and others. Exposure factors found to vary between the three countries include the rate at which individuals consume various types of foods, the portion of their diets consisting of locally grown or produced fruits, vegetables, dairy products, meats as distinguished from the portion shipped in from out of town sources, the frequency with which individuals change residences, the proximity of their homes to their workplaces, how much they weigh, and how active their life style among others. We find that the impact of incorporating exposure assumptions based on US datasets into risk assessments whose results are intended to support decisions in Central Europe can be quite significant.