The decision tree allows the division of combined exposures into different groups, exposures where one or more individual components are a concern, exposures that are of low concern, and exposures that are a concern for combined effects but not for the effects of individual chemicals.
The decision tree divides combined exposures of humans and ecological receptors into groups where one or more components are a concern by themselves, where risks from the combined exposures are of low concern, and where there is a concern for the effects from the combined exposures but not from individual chemicals.
We judged applicability to be of low concern for all studies in the reference standard domain.
For example, stigmatization may indeed be of low concern to our patients.
Therefore, we conclude that PAH exposure through Dutch drinking water is of low concern for consumer health.
An exposure with an MOE of ≥ 10,000 is considered to be of low concern for public health and low priority for risk management action (EFSA 2005).
In the flow and timing domain, we considered 23 study centres (85%) to be of low concern for risk of bias because all patients were accounted for in the analysis and information about indeterminate results was provided.
Conclusions: The estimated margin of exposure for PAH exposure through drinking water was > 10,000 for all 120 measurement locations, which suggests that PAH exposure through drinking water is of low concern for consumer health.
The EFSA (2005) is of the view that, in general, an MOE of ≥ 10,000, if it is based on the BMDL10 from an animal study, would be of "low concern from a public health point of view and might be considered as a low priority for risk management actions".
In the flow and timing domain, we considered 16 studies (76%) to be of low concern for risk of bias because all patients were accounted for in the analysis, information about uninterpretable results was provided and all patients had the same reference tests performed.
