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From a risk characterization standpoint, clinical observations of neurotoxicity are considered as the primary endpoint of concern from inhalation exposure.
Since the disease impact of these effects is seldom known, and a verification of relevant toxicity is normally also the subject of (sub chronic animal studies, the prediction of in vivo relevant results from in vitro genotoxicity tests is also important for aspects that may not have a direct impact on carcinogenesis as the ultimate endpoint of concern.
As a result, when a component-based approach identifies a critical endpoint of concern that was not addressed in the whole mixture toxicity study, a component-based approach should be used.
It is therefore critical to ensure that the time period is relevant to the endpoint of concern.
It should be pointed out that all of the above conclusions are based on the presumption that NPC is the endpoint of concern.
Asthma, particularly in children, is often mentioned as an endpoint of concern with respect to either being caused or exacerbated by the irritant properties of formaldehyde.
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While effect-based monitoring indicates hazards due to chemical contamination and provides information on toxicological endpoints of concern, tools are required to identify causes and elucidate links between exposure and effects.
The large database on formaldehyde has been reviewed, summarized, and relied upon by IARC, NTP, and US EPA in their recent evaluations, which have led to firm conclusions concerning the major endpoints of concern as discussed in this review.
Such decisions can be facilitated by knowledge of the structural information on the presence of chemical functionalities known to be related to the endpoints of concern (i.e., QSAR methods).
The primary therapeutic endpoints of concern to the clinical scientist may be very different from those of patients and, consequently, the value placed on gaining relief from symptoms may differ also.
In the case of LN, many would agree that the prevention of the need for renal replacement therapy is the clinical endpoint of most concern.
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