AUTHOR=Zuo Tian-Tian , Jin Hong-Yu , Chen An-Zhen , Zhang Lei , Kang Shuai , Li An-Ping , Gao Fei , Wei Feng , Yu Jian-Dong , Wang Qi , Yang Jian-Bo , Ma Shuang-Cheng 

TITLE=Novel Integrated Tiered Cumulative Risk Assessment of Heavy Metals in Food Homologous Traditional Chinese Medicine Based on a Real-Life-Exposure Scenario

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 13 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2022.908986

DOI=10.3389/fphar.2022.908986

ISSN=1663-9812

ABSTRACT=In order to serve population health better, the first integrated tiered decision tree for cumulative risk assessment of co-exposure of Pb, Cd, and As associated health risks in food homologous traditional Chinese medicines (TCM) was designed. Basically, our three-step decision tree involving hazard quotient (HQ), hazard index (HI), and target-organ toxicity dose (TTD) modification of HI method, was developed to evaluate the potential risks of 949 batches of 15 types of food homologous TCM. To acquire a real-life exposure scenario, the cumulative risk assessment model was established by the optimizing key parameters, such as ingestion rates, frequency, and duration of exposure to food homologous TCM based on questionnaire data. As a result, excluding the HQs of As in Angelica sinensis (Oliv.) Diels and Houttuynia cordata Thunb. used as food, other HQs of Pb, Cd, or As were lower than 1. However, after rapid screening of the co-exposure health risks of heavy metals by HI method, cumulative risk assessment results acquired by TTD modification of HI method implied that the potential health risks associated with the co-exposure of Pb, Cd, and As in Lonicera japonica Thunb. and Houttuynia cordata Thunb. ingested as both TCM and food were of concern in the clinic. Additionally, the cumulative risks of Pb, Cd, and As in Mentha canadensis L., Chrysanthemum indicum L., and Black-tail Snake only used as food exceeded the human tolerance dose. Collectively, our innovation on the tiered strategy of decision tree based on a real-life exposure scenario provides a novel approach engaging in the cumulative risk assessment of heavy metals in food homologous TCM. Such effort attempts to scientifically guide the rational use of TCM in the treatment of the complex diseases and the improvement of population-health.