Science and decisions: advancing toxicology to advance risk assessment

In 2009, the National Research Council (NRC) released the latest in a series of advisory reports on human health risk assessment, titled Science and Decisions: Advancing Risk Assessment. This wide-ranging report made a number of recommendations related to risk assessment practice at the U.S. Environmental Protection Agency that could both influence and be influenced by evolving toxicological practice. In particular, Science and Decisions emphasized the scientific and operational necessity of a new approach for dose-response modeling; addressed the recurring challenge of defaults in risk assessment and the question of when research results can be used in place of defaults; and reinforced the value of cumulative risk assessment, which would require enhanced understanding of the joint influence of chemical and nonchemical stressors on health outcomes. The objective of this article is to summarize key messages from Science and Decisions, both as a stand-alone report and in comparison with another recent NRC report, Toxicity Testing in the 21st Century: A Vision and a Strategy. Although these reports have many conclusions in common and reinforce similar themes, there are important differences that merit careful consideration, such as the move away from apical endpoints in Toxicity Testing and the emphasis on benefit-cost analyses and related decision tools in Science and Decisions that would be strengthened by quantification of apical endpoints. Moving risk assessment forward will require toxicologists to wrestle with the implications of Science and Decisions from a toxicological perspective.