vvEPA
                                                             EPA/635/R13/138a
                                                           Public Comment Draft
                                                               www.epa.gov/iris
                  Toxicological Review of Benzo[a]pyrene

                              (CASRN 50-32-8)

                In Support of Summary Information on the
                Integrated Risk Information System (IRIS)
                                  August 2013
                                    NOTICE

This document is a Public Comment draft. This information is distributed solely for the purpose
of pre-dissemination peer review under applicable information quality guidelines. It has not been
formally disseminated by EPA. It does not represent and should not be construed to represent any
Agency determination or policy. It is being circulated for review of its technical accuracy and
science policy implications.
                     National Center for Environmental Assessment
                         Office of Research and Development
                        U.S. Environmental Protection Agency
                                 Washington, DC

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                                                   Toxicological Review ofBenzo[a]pyrene
                                      DISCLAIMER
       This document is a preliminary draft for review purposes only.  This information is
distributed solely for the purpose of pre-dissemination peer review under applicable information
quality guidelines. It has not been formally disseminated by EPA. It does not represent and should
not be construed to represent any Agency determination or policy. Mention of trade names or
commercial products does not constitute endorsement of recommendation for use.
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                                                     Toxicological Review ofBenzo[a]pyrene
CONTENTS
AUTHORS | CONTRIBUTORS | REVIEWERS	viii

PREFACE	xi

PREAMBLE TO IRIS TOXICOLOGICAL REVIEW	xiv

EXECUTIVE SUM MARY	xxxii

LITERATURE SEARCH STRATEGY| STUDY SELECTION	xxxix

1.   HAZARD IDENTIFICATION	1-1

    1.1. SYNTHESIS OF EVIDENCE	1-1

       1.1.1.  Developmental Toxicity	1-1

       1.1.2.  Reproductive Toxicity	1-21

       1.1.3.  Immunotoxicity	1-36

       1.1.4.  Other Toxicity	1-43

       1.1.5.  Carcinogenicity	1-51

    1.2. SUMMARY AND EVALUATION	1-80

       1.2.1.  Weight of Evidence for Effects Other than Cancer	1-80

       1.2.2.  Weight of Evidence for Carcinogenicity	1-81

2.   DOSE-RESPONSE ANALYSIS	2-1

    2.1. ORAL REFERENCE DOSE FOR EFFECTS OTHER THAN CANCER	2-1

       2.1.1.  Identification of Studies and Effects for Dose-Response Analysis	2-1

       2.1.2.  Methods of Analysis	2-5

       2.1.3.  Derivation of Candidate Values	2-8

       2.1.4.  Derivation of Organ/System-specific Reference Doses	2-12

       2.1.5.  Selection of the Proposed Overall Reference Dose	2-14

       2.1.6.  Confidence Statement	2-14

       2.1.7.  Previous IRIS Assessment: Reference Dose	2-15

    2.2. INHALATION REFERENCE CONCENTRATION FOR EFFECTS OTHER THAN CANCER	2-15

       2.2.1.  Identification of Studies and Effects for Dose-Response Analysis	2-15

       2.2.2.  Methods of Analysis	2-17

       2.2.3.  Derivation of Candidate Values	2-19

       2.2.4.  Derivation of Organ/System-specific Reference Concentrations	2-22

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                                                      Toxicological Review ofBenzo[a]pyrene

       2.2.5. Selection of the Proposed Reference Concentration	2-23
       2.2.6. Confidence Statement	2-23
       2.2.7. Previous IRIS Assessment: Reference Concentration	2-24
       2.2.8. Uncertainties in the Derivation of the RfD and RfC	2-24
    2.3. ORAL SLOPE FACTOR FOR CANCER	2-25
       2.3.1. Analysis of Carcinogenicity Data	2-25
       2.3.2. Dose Response Analysis - Adjustments and Extrapolations Methods	2-28
       2.3.3. Derivation of the Oral Slope Factor	2-29
       2.3.4. Uncertainties in the Derivation of the Oral Slope Factor	2-30
       2.3.5. Previous IRIS Assessment: Oral Slope Factor	2-32
    2.4. INHALATION UNIT RISK FOR CANCER	2-32
       2.4.1. Analysis of Carcinogenicity Data	2-33
       2.4.2. Dose Response Analysis—Adjustments and Extrapolations Methods	2-34
       2.4.3. Inhalation Unit Risk Derivation	2-35
       2.4.4. Uncertainties in the Derivation of the Inhalation Unit Risk	2-36
       2.4.5. Previous IRIS Assessment: Inhalation Unit Risk	2-38
    2.5. DERMAL SLOPE FACTOR FOR CANCER	2-39
       2.5.1. Analysis of Carcinogenicity Data	2-39
       2.5.2. Dose Response Analysis - Adjustments and Extrapolations Methods	2-40
       2.5.3. Derivation of the Dermal Slope Factor	2-42
       2.5.4. Dermal Slope Factor Cross-Species Scaling	2-44
       2.5.5. Uncertainties in the Derivation of the Dermal Slope Factor	2-45
       2.5.6. Previous IRIS Assessment: Dermal Slope Factor	2-47
    2.6. APPLICATION OF AGE-DEPENDENT ADJUSTMENT FACTORS (ADAFS)	2-47
REFERENCES	R-l
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                                                       Toxicological Review ofBenzo[a]pyrene
TABLES
Table ES-1. Organ/system-specific RfDs and proposed overall RfD for benzo[a]pyrene	xxxiv
Table ES-2. Organ/system-specific RfCs and proposed overall RfCfor benzo[a]pyrene	xxxv
Table LS-1. Summary of the search strategy employed for benzo[a]pyrene	xxxix
Table 1-1. Evidence pertaining to developmental effects of benzo[a]pyrene in humans	1-4
Table 1-2. Evidence pertaining to developmental effects of benzo[a]pyrene in animals	1-5
Table 1-3. Evidence pertaining to the neurodevelopmental effects of benzo[a]pyrene from PAH
               mixtures	1-13
Table 1-4. Evidence pertaining to the neurodevelopmental effects of benzo[a]pyrene in animals	1-15
Table 1-5. Evidence pertaining to the male reproductive toxicity of benzo[a]pyrene in adult
               animals	1-24
Table 1-6. Evidence pertaining to the female reproductive effects of benzo[a]pyrene in humans	1-31
Table 1-7. Evidence pertaining to the female reproductive effects of benzo[a]pyrene in adult
               animals	1-31
Table 1-8. Evidence pertaining to the immune effects of benzo[a]pyrene in animals	1-40
Table 1-9. Evidence pertaining to other toxicities of benzo[a]pyrene in animals	1-48
Table 1-10. Cancer sites for PAH-related agents reviewed by IARC	1-53
Table 1-11. Summary of epidemiologic studies of benzo[a]pyrene (direct measures) in relation
               to lung cancer risk: Tier 1 studies	1-54
Table 1-12. Summary of epidemiologic studies of benzo[a]pyrene (direct measures) in relation
               to lung cancer risk: Tier 2 studies	1-55
Table 1-13. Summary of epidemiologic studies of benzo[a]pyrene (direct measures) in relation
               to bladder cancer risk	1-58
Table 1-14. Tumors observed in chronic oral animal bioassays	1-62
Table 1-15. Tumors observed in chronic inhalation animal bioassays	1-65
Table 1-16. Tumor observations in dermal animal bioassays	1-67
Table 1-17. Experimental support for the postulated key events for mutagenic mode of action	1-74
Table 1-18. Supporting evidence for the carcinogenic to humans cancer descriptor for
               benzo[a]pyrene	1-87
Table 2-1. Summary of derivation of PODs	2-7
Table 2-2. Effects and corresponding derivation of candidate values	2-10
Table 2-3. Organ/system-specific RfDs and proposed overall  RfD for benzo[a]pyrene	2-13
Table 2-4. Summary of derivation of PODs	2-19
Table 2-5. Effects and corresponding derivation of candidate values	2-21
Table 2-6. Organ/system-specific RfCs and  proposed overall  RfCfor benzo[a]pyrene	2-22
Table 2-7. Summary of the oral slope factor derivations	2-29
Table 2-8. Summary of uncertainties in the derivation of cancer risk values for  benzo[a]pyrene
               oral slope factor	2-31
Table 2-9. Summary of the Inhalation Unit  Risk Derivation	2-36
Table 2-10. Summary of uncertainties in the derivation of cancer risk values for benzo[a]pyrene
               (inhalation unit risk)	2-38
Table 2-11. Summary of dermal slope factor derivations -unadjusted for interspecies differences	2-43
Table 2-12. Summary of uncertainties in the derivation of cancer risk values for benzo[a]pyrene
               dermal slope factor	2-46
Table 2-13. Sample application of ADAFs for the estimation of benzo[a]pyrene cancer risk
               following lifetime (70-year) oral exposure	2-48

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                                                      Toxicological Review ofBenzo[a]pyrene
Table 2-14. Sample application of ADAFs for the estimation of benzo[a]pyrene cancer risk
              following lifetime (70-year) inhalation exposure	2-49
Table 2-15. Sample application of ADAFs for the estimation of benzo[a]pyrene cancer risk
              following lifetime (70-year) dermal exposure	2-49
FIGURES

Figure LS-1. Study selection strategy	xli
Figure 1-1. Exposure-response array for developmental effects following oral exposure to
              benzo[a]pyrene	1-8
Figure 1-2. Exposure-response array for neurodevelopmental effects following oral exposure	1-18
Figure 1-3. Exposure-response array for male reproductive effects following oral exposure in
              adult animals	1-27
Figure 1-4. Exposure-response array for female reproductive effects following oral exposure in
              adult animals	1-33
Figure 1-5. Exposure-response array for immune effects following oral exposure	1-41
Figure 1-6. Proposed metabolic activation pathways and key events in the carcinogenic mode of
              action for benzo[a]pyrene	1-69
Figure 2-1. Candidate values with corresponding PODs and composite UFs	2-12
Figure 2-2. Candidate values with corresponding PODs and composite UFs	2-22
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ABBREVIATIONS
                                                       Toxicological Review ofBenzo[a]pyrene
ADAF    age-dependent adjustment factor
AhR     aryl hydrocarbon receptor
BMC     benchmark concentration
BMCL    benchmark concentration lower
         confidence limit
BMD     benchmark dose
BMDL    benchmark dose lower confidence limit
BMDS    Benchmark Dose Software
BMR     benchmark response
BPDE    benzo[a]pyrene-7,8-diol-9,10-epoxide
BW      body weight
CA       chromosomal aberration
CASRN   Chemical Abstracts Service Registry
         Number
CERCLA  Comprehensive Environmental
         Response, Compensation, and Liability
         Act
CI       confidence interval
CYP450  cytochrome P450
DAF     dosimetric adjustment factor
DNA     deoxyribonucleic acid
EPA     Environmental Protection Agency
EROD    ethoxyresorufin-o-deethylase
ETS      environmental tobacco smoke
FSH      follicle stimulating hormone
GD       gestation day
HEC     human equivalent concentration
HED     human equivalent dose
HERO    Health and Environmental Research
         Online
IHD      ischemic heart disease
i.p.       intraperitoneal
IRIS     Integrated Risk Information System
LH       luteinizing hormone
LOAEL   lowest-observed-adverse-effect level
MMAD   mass median aerodynamic diameter
MN      micronuclei
MPPD    Multi-Path Particle Deposition
NCEA    National Center for Environmental
         Assessment
no-observed-adverse-effect level
National Priorities List
National Toxicology Program
odds ratio
Office of Research and Development
polycyclic aromatic hydrocarbon
physiologically based pharmacokinetic
postnatal day
point of departure
red blood cell
regional deposited dose ratio for
extrarespiratory effects
inhalation reference concentration
oral reference dose
reactive oxygen species
relative risk
subcutaneous
squamous cell carcinoma
sister chromatid exchange
sperm chromatin structure assay
standard deviation
standardized incidence ratio
standardized mortality ratio
sheep red blood cells
single strand break
terminal deoxynucleotidyl transferase
dUTP nick end labeling
time-weighted average
uncertainty factor
interspecies uncertainly factor
intraspecies uncertainly factor
LOAEL-to-NOAEL uncertainly factor
subchronic-to-chronic uncertainly
factor
database deficiencies uncertainly factor
white blood cell
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                                                        Toxicological Review ofBenzo[a]pyrene
1

2
AUTHORS  |  CONTRIBUTORS  |  REVIEWERS
    Assessment Team
            Christine Cai, MS
            Glinda Cooper, Ph.D.
            Louis D'Amico, Ph.D.
            Jason Fritz, Ph.D.
            Martin Gehlhaus, MHS
            Catherine Gibbons, Ph.D.
            Karen Hogan, MS
            Andrew Kraft, Ph.D.
            Kathleen Newhouse, MS (Assessment Manager)
            Linda Phillips, Ph.D.
            Margaret Pratt, Ph.D.
            Keith Salazar, Ph.D.
            John Schaum, MS (retired)
            Suryanarayana Vulimiri, DVM
            Gene Ching-Hung Hsu, Ph.D. (formerly with
            EPA)

            Lyle Burgoon, Ph.D.
            John Cowden, Ph.D.
            John Stanek, Ph.D.
            Chris Brinkerhoff, Ph.D.
            Emma McConnell, MS

            Scott Glaberman, Ph.D.
                                                    U.S. EPA
                                                    Office of Research and Development
                                                    National Center for Environmental
                                                    Assessment
                                                    Washington, DC
                                                    U.S. EPA
                                                    Office of Research and Development
                                                    National Center for Environmental
                                                    Assessment
                                                    Research Triangle Park, NC

                                                    Oak Ridge Institute for Science and
                                                    Education Fellow

                                                    American Association for the
                                                    Advancement of Science Fellow
4
5
6
7
     Scientific Support Team
            Lynn Flowers, Ph.D.(Team Leader)
            John Fox, Ph.D.
            Martin Gehlhaus, MHS
            Paul White, Ph.D.
            Reeder Sams, Ph.D.
            John Cowden, Ph.D.
       Connie Kang-Sickel, Ph.D.
U.S. EPA
Office of Research and Development
National Center for Environmental
Assessment
Washington, DC

U.S. EPA
Office of Research and Development
National Center for Environmental
Assessment
Research Triangle Park, NC

Oak Ridge Institute for Science and
Education Fellow
     Production Team
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                                                        Toxicological Review ofBenzo[a]pyrene
       Taukecha Cunningham
       Maureen Johnson
       Terri Konoza
       Vicki Soto
U.S. EPA
Office of Research and Development
National Center for Environmental
Assessment
Washington, DC
Contractor Support
        Heather Carlson-Lynch, S.M.
        Peter McClure, Ph.D.
        Megan Riccardi
        Kelly Salinas
        Joe Santodonato
        Julie Stickney, Ph.D.

        George Holds worth, Ph.D.
        Lutz W.Weber, Ph.D.

        Janusz Z. Byczkowski, Ph.D., D.Sc.
SRC, Inc., Syracuse, NY
Oak Ridge Institute for Science and
Education, Oak Ridge, TN

JZB Consulting, Fairborn, OH
Executive Direction
        Kenneth Olden, Ph.D., Sc.D., L.H.D.
          (Center Director)
        Lynn Flowers, Ph.D.
          (Associate Director for Health)
        Vincent Cogliano, Ph.D.
          (IRIS Program Director—acting)
        Samantha Jones, Ph.D.
          (IRIS Associate Director for Science)
        Jamie B. Strong, Ph.D.
          (Toxic Effects Branch Chief)
U.S. EPA/ORD/NCEA
Washington, DC
Internal Review Team
        Stephen Nesnow, Ph.D. (retired)
        RitaSchoeny, Ph.D.
U.S. EPA
National Health and Environmental
Effects Research Laboratory
Research Triangle Park, NC

U.S. EPA
Office of Water
Washington, DC
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                                                           Toxicological Review ofBenzo[a]pyrene
     Reviewers

1    This assessment was provided for review to scientists in EPA's Program and Region Offices.
2    Comments were submitted by:

            Office of Children's Health Protection, Washington DC

            Office of Policy, Washington, DC

            Office of Solid Waste and Emergency Response, Washington DC

            Office of Water, Washington DC

            Region 2, New York, NY

            Region 3, Philadelphia, PA

            Region 8, Denver, CO

3    This assessment was provided for review to other federal agencies and Executive Offices of the
4    President. Comments were submitted by:

            Agency for Toxic Substances and Disease Registry, Centers for Disease Control,
            Department of Health and Human Services

            Department of Defense

            National Aeronautics and Space Administration

            National Institute for Occupational Safety and Health, Centers for Disease Control,
            Department of Health and Human Services

            Office of Management and Budget, Executive Office of the President

            White House Council on Environmental Quality, Executive Office of the President
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                                                   Toxicological Review ofBenzo[a]pyrene
PREFACE
       This Toxicological Review, prepared under the auspices of EPA's Integrated Risk
Information System (IRIS) program, critically reviews the publicly available studies on
benzo[a]pyrene in order to identify potential adverse health effects and to characterize exposure-
response relationships. Benzo[a]pyrene is found in the environment and in food. Benzo[a]pyrene
occurs in conjunction with other structurally related chemical compounds known as polycyclic
aromatic hydrocarbons (PAHs).1  Benzo[a]pyrene is universally present in these mixtures and is
routinely analyzed and detected in environmental media contaminated with PAH mixtures, thus it
is often used as an indicator chemical to measure exposure to PAH mixtures [Bostrometal.. 2002].
       Benzo[a]pyrene is listed as a hazardous substance under the Comprehensive Environmental
Response, Compensation, and Liability Act of 1980 (CERCLA), is found at 524 hazardous waste sites
on the National Priorities List (NPL) and is ranked number 9 out of 275 chemicals on the Priority
List of Hazardous Substances for CERCLA [ATSDR.  2011). Benzo[a]pyrene is also listed as a
drinking water contaminant under the Safe Drinking Water Act and a Maximum Contaminant Level
Goal (MCLG) and enforceable Maximum Contaminant Level (MCL) have been established. In air,
benzo[a]pyrene is regulated as a component in a class of chemicals referred to as Polycyclic Organic
Matter, defined as a Hazardous Air Pollutant by the 1990 amendments to the Clean Air Act
       This assessment updates IRIS assessment of benzo[a]pyrene that was developed in 1987.
The previous assessment included a cancer descriptor and oral slope factor. New information has
become available, and this assessment reviews information on all health effects by all exposure
routes. Organ/system-specific reference values are calculated based on developmental,
reproductive and immune system toxicity data. These reference values may be useful  for
cumulative risk assessments that consider the combined effect of multiple agents acting on the
same biological system. In addition, in consideration of the Agency's need to estimate  the potential
for skin cancer from dermal exposure [U.S. EPA, 2004], especially in children exposed  to
contaminated soil, this assessment includes the IRIS Program's first dermal slope factor.
       This assessment was conducted in accordance with EPA guidance, which is cited and
summarized in the Preamble to Toxicological Reviews.  The findings of this assessment and related
documents produced during its development are available on the IRIS website
[http://www.epa.gov/iris].  Appendices for chemical and physical properties, toxicokinetic
xPAHs are a large class of chemical compounds formed during the incomplete combustion of organic matter.
They consist of only carbon and hydrogen arranged in two or more fused rings.

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                                                   Toxicological Review ofBenzo[a]pyrene

information, and summaries of toxicity studies are provided as Supplemental Information to this
assessment.
       For additional information about this assessment or for general questions regarding IRIS,
please contact EPA's IRIS Hotline at 202-566-1676 (phone), 202-566-1749 (fax), or
hotline.iris@epa.gov.

Chemical Properties and Uses
       Benzo[a]pyrene is a five-ring PAH. It is a pale yellow crystalline solid with a faint aromatic
odor. It is relatively insoluble in water and has low volatility.  Benzo[a]pyrene is released to the air
from both natural and anthropogenic sources and removed from the atmosphere by photochemical
oxidation; reaction with nitrogen oxides, hydroxy and hydroperoxy radicals, ozone, sulfur oxides,
and peroxyacetyl nitrate; and dry deposition to land or water. In air, benzo[a]pyrene is
predominantly adsorbed to particulates but may also exist as a vapor at high temperatures (ATSDR,
1995).
       There is no known commercial use for benzo[a]pyrene; it is only produced as a research
chemical. Benzo[a]pyrene is ubiquitous in the environment primarily as a result of incomplete
combustion emissions. It is released to the environment via both natural sources (such as forest
fires) and anthropogenic  sources including stoves/furnaces burning fossil  fuels (especially wood
and coal), motor vehicle exhaust, cigarettes, and various industrial combustion processes (ATSDR,
1995).  Benzo[a]pyrene is also found in soot and coal tars. Mahler etal. (2005) has reported that
urban run-off from asphalt-paved car parks treated with coats of coal-tar emulsion seal could
account for the majority of PAHs in many watersheds. Benzo[a]pyrene exposure can also occur to
workers involved in the production of aluminum, coke, graphite, and silicon carbide, and in coal tar
distillation. The major sources of non-occupational exposure are cigarettes and food.  Additional
information on benzo[a]pyrene exposure and chemical properties can be found in Appendix A.

Implementation of the 2011 National Research Council Recommendations

       On December 23,  2011, The Consolidated Appropriations Act, 2012, was signed into law
(U.S. Congress, 2011).  The report language included direction to EPA for the IRIS Program related
to recommendations provided by the National Research Council (NRC) in their review of EPA's
draft IRIS assessment of formaldehyde (NRC. 2011).  The report language  included the following:

       The Agency shall incorporate, as appropriate, based on chemical-specific datasets
       and biological effects, the recommendations of Chapter 7 of the National Research
       Council's Review of the Environmental Protection Agency's Draft IRIS Assessment of
       Formaldehyde into the IRIS process...For draft assessments released in fiscal year
       2012, the Agency shall include documentation describing how the Chapter 7
       recommendations of the National Academy of Sciences (NAS) have been
       implemented or addressed, including an explanation for why certain
       recommendations were not incorporated.

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                                                   Toxicological Review ofBenzo[a]pyrene

       The NRC's recommendations, provided in Chapter 7 of their review report, offered
suggestions to EPA for improving the development of IRIS assessments. Consistent with the
direction provided by Congress, documentation of how the recommendations from Chapter 7 of the
NRC report have been implemented in this assessment is provided in the table below. Where
necessary, the documentation includes an explanation for why certain recommendations were not
incorporated.
       The IRIS Program's implementation of the NRC recommendations is following a phased
approach that is consistent with the NRC's "Roadmap for Revision" as described in Chapter 7 of the
formaldehyde review report. The NRC stated that "the committee recognizes that the changes
suggested would involve a multi-year process and extensive effort by the staff at the National
Center for Environmental Assessment and input and review by the EPA Science Advisory Board and
others."
       Phase 1 of implementation has focused on a subset of the short-term recommendations,
such as editing and streamlining documents, increasing transparency and clarity, and using more
tables, figures, and appendices to present information and data in assessments. Phase 1 also
focused on assessments near the end of the development process and close to final posting. The
IRIS benzo[a]pyrene assessment is in Phase 2 and represents a significant advancement in
implementing the NRC recommendations shown in Table F-l in Appendix F. The Program is
implementing all of these recommendations but  recognizes that achieving full and robust
implementation of certain recommendations will be an evolving process with input and feedback
from the public, stakeholders, and external peer  review committees. Phase 3 of implementation
will incorporate the longer-term recommendations made by the NRC as outlined below in Table F-2
in Appendix F, including the development of a standardized approach to describe the strength of
evidence for noncancer effects . On May 16, 2012, EPA announced [U.S. EPA. 2012c] that as a part
of a review of the IRIS Program's assessment development process, the NRC will also review
current methods for weight-of-evidence analyses and recommend approaches for weighing
scientific evidence for chemical hazard identification. This effort is included in Phase 3 of EPA's
implementation plan.
Assessments by Other National and International Health Agencies
       Toxicity information on benzo[a]pyrene has been evaluated by California EPA (CalEPA), the
World Health Organization, Health Canada, the International Agency for Research on Cancer, and
the European Union. The results of these assessments are presented in Appendix B. It is important
to recognize that these assessments were prepared at different times, for different purposes, using
different guidelines and methods, and that newer studies have been included in the IRIS
assessment
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                                                      Toxicological Review ofBenzo[a]pyrene
    PREAMBLE TO IRIS TOXICOLOGICAL REVIEWS
 1  1. Scope of the IRIS Program

 2     Soon  after  the EPA was established in
 3  1970, it was at the forefront of developing
 4  risk assessment as a science and applying it
 5  in decisions to protect human health and the
 6  environment The Clean Air Act, for example,
 7  mandates that the EPA provide "an  ample
 8  margin of safety to  protect public health";
 9  the   Safe   Drinking  Water  Act,  that  "no
10  adverse effects on the health of persons may
11  reasonably be anticipated to occur, allowing
12  an adequate margin  of safety." Accordingly,
13  the  EPA  uses  information on the adverse
14  effects of chemicals and on exposure levels
15  below  which  these  effects   are  not
16  anticipated to occur.
17     IRIS assessments critically review the
18  publicly available studies to identify adverse
19  health  effects from  exposure  to  chemicals
20  and   to  characterize  exposure-response
21  relationships.  In terms  set  forth by  the
22  National Research Council fNRC. 19831 IRIS
23  assessments cover the  hazard  identification
24  and dose-response assessment steps of risk
25  assessment, not the exposure assessment or
26  risk   characterization   steps  that  are
27  conducted  by  the  EPA's  program  and
28  regional offices and  by other federal, state,
29  and local health agencies that evaluate  risk
30  in  specific   populations  and  exposure
31  scenarios. IRIS assessments are distinct from
32  and do not address political, economic,  and
33  technical  considerations that influence the
34  design and selection of risk  management
35  alternatives.
36     An IRIS assessment may cover a single
37  chemical,  a   group  of  structurally   or
38  toxicologically  related  chemicals,  or  a
39  complex mixture. These agents  may be found
40  in air, water, soil, or sediment. Exceptions
41  are chemicals currently used exclusively as
42  pesticides,   ionizing   and   non-ionizing
43  radiation, and  criteria air pollutants listed
44  under section  108  of the  Clean Air Act
45  (carbon  monoxide,  lead,  nitrogen  oxides,
46  ozone, particulate matter, and sulfur oxides).
47     Periodically, the IRIS Program asks other
48  EPA  programs and  regions, other  federal
49  agencies, state health agencies, and the
50  general  public  to  nominate chemicals and
51  mixtures   for   future   assessment   or
52  reassessment. Agents may be considered for
53  reassessment as significant new studies are
54  published. Selection is based on program
55  and  regional  office  priorities  and  on
56  availability   of adequate  information  to
57  evaluate the potential for adverse  effects.
58  Other agents  may  also  be  assessed in
59  response to an urgent public health need.

60  2. Process for developing and peer-
61     reviewing IRIS assessments

62     The   process   for  developing  IRIS
63  assessments (revised in  May  2009  and
64  enhanced  in July 2013)  involves  critical
65  analysis    of   the    pertinent   studies,
66  opportunities for public input, and multiple
67  levels of scientific review. The EPA revises
68  draft assessments after  each review,  and
69  external drafts  and comments become part
70  of the public record (U.S. EPA. 2009).
71     Before beginning an assessment, the IRIS
72  Program discusses the scope with other EPA
73  programs and  regions to ensure that the
74  assessment will meet their  needs.  Then a
75  public  meeting on  problem formulation
76  invites discussion of the key issues and the
77  studies and analytical approaches that might
78  contribute to their resolution.
79  Step 1.    Development    of   a   draft
80     Toxicological    Review.  The    draft
81     assessment considers  all   pertinent
82     publicly  available  studies and  applies
83     consistent  criteria  to  evaluate  study
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                                                      Toxicological Review ofBenzo[a]pyrene
 1     quality, identify  health effects, identify
 2     mechanistic  events  and  pathways,
 3     integrate the evidence of causation  for
 4     each effect, and derive toxicity values. A
 5     public meeting prior to the integration of
 6     evidence  and  derivation  of  toxicity
 7     values promotes public discussion of the
 8     literature  search,  evidence,  and  key
 9     issues.
10  Step 2. Internal review by scientists in
11     EPA programs and regions. The draft
12     assessment  is revised  to  address the
13     comments from within the EPA.
14  Step 3. Interagency science consultation
15     with  other federal agencies and the
16     Executive  Offices  of  the President.
17     The  draft assessment  is  revised  to
18     address the interagency comments. The
19     science consultation draft,  interagency
20     comments, and  the EPA's response to
21     major comments become  part of the
22     public record.
23  Step 4.  Public  review  and comment,
24     followed by external peer review. The
25     EPA releases the draft assessment  for
26     public review and  comment.  A  public
27     meeting  provides an  opportunity  to
28     discuss the assessment prior  to peer
29     review. Then the EPA releases a draft for
30     external peer review. The peer reviewers
31     also  receive  written  and  oral  public
32     comments, and the peer review meeting
33     is open to the public. The peer reviewers
34     assess whether the evidence has been
35     assembled  and evaluated  according to
36     guidelines and whether the conclusions
37     are justified by the evidence. The peer
38     review draft, written public comments,
39     and peer review report become part of
40     the public record.
41  Step 5. Revision of  draft Toxicological
42     Review and development of draft IRIS
43     summary.  The   draft  assessment  is
44     revised to  reflect the  peer  review
45     comments, public comments, and newly
46     published  studies that are critical to the
47     conclusions of  the assessment.  The
48     disposition of peer review  comments
49     and public comments becomes  part of
50     the public record.
51  Step 6. Final EPA review and interagency
52     science discussion with other  federal
53     agencies and the  Executive Offices of
54     the President The draft assessment and
55     summary are revised to address the EPA
56     and interagency comments. The  science
57     discussion  draft,   written  interagency
58     comments, and  EPA's response to major
59     comments become  part of the  public
60     record.
61  Step 7.   Completion  and posting.  The
62     Toxicological Review and IRIS summary
63     are posted on the IRIS website [http://
64     www. ep a. go v/ir is].
65     The   remainder   of   this   Preamble
66  addresses step 1, the development of a draft
67  Toxicological  Review.  IRIS   assessments
68  follow  standard   practices   of  evidence
69  evaluation and peer review, many of which
70  are discussed in EPA guidelines [U.S. EPA.
71  2005a. b. 2000. 1998. 1996. 1991. 1986a. b]
72  and other methods [U.S. EPA. 2012a. b. 2011.
73  2006a.  b,   2002.   1994b).   Transparent
74  application  of  scientific  judgment is  of
75  paramount   importance.   To   provide   a
76  harmonized    approach    across    IRIS
77  assessments,  this  Preamble   summarizes
78  concepts   from   these    guidelines   and
79  emphasizes    principles     of    general
80  applicability.

si  3. Identifying and selecting
82     pertinent studies

83  3.1.  Identifying studies

84     Before beginning an assessment, the EPA
85  conducts  a comprehensive search  of the
86  primary scientific  literature. The  literature
87  search follows  standard  practices  and
88  includes the PubMed and ToxNet databases
89  of the National Library of Medicine,  Web of
90  Science,  and other databases  listed in the
91  EPA's   HERO   system    (Health   and
92  Environmental  Research  Online,  http://
93  hero.epa.gov/]. Searches for information on
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                                                        Toxicological Review ofBenzo[a]pyrene
 1  mechanisms  of  toxicity  are  inherently
 2  specialized and may include studies on other
 3  agents that act through related mechanisms.
 4     Each assessment  specifies the  search
 5  strategies, keywords, and cut-off dates of its
 6  literature  searches.  The  EPA  posts   the
 7  results of the literature search on the  IRIS
 8  web  site and requests information from the
 9  public on additional  studies  and ongoing
10  research.
11     The EPA also considers studies received
12  through  the IRIS  Submission  Desk  and
13  studies  (typically  unpublished) submitted
14  under the Toxic Substances Control  Act or
15  the  Federal  Insecticide,  Fungicide,  and
16  Rodenticide  Act.  Material submitted as
17  Confidential   Business   Information   is
18  considered only if it includes health  and
19  safety data that can be publicly released. If a
20  study that may be critical to the conclusions
21  of the  assessment  has  not  been  peer-
22  reviewed,  the  EPA  will  have   it  peer-
23  reviewed.
24     The EPA also examines the toxicokinetics
25  of the agent to identify other chemicals (for
26  example, major metabolites of the agent) to
27  include  in  the  assessment  if  adequate
28  information  is available, in order to more
29  fully explain the toxicity of the agent  and to
30  suggest  dose   metrics  for   subsequent
31  modeling.
32     In assessments of  chemical  mixtures,
33  mixture  studies  are  preferred  for their
34  ability  to  reflect   interactions   among
35  components. The literature search seeks, in
36  decreasing order of preference (U.S. EPA,
37  2000, §2.1,1986b, §2.2):
38  -  Studies of the mixture being assessed.
39  -  Studies of a sufficiently similar mixture.
40     In evaluating similarity, the assessment
41     considers the alteration of mixtures in
42     the  environment  through  partitioning
43     and transformation.
44  -  Studies    of    individual    chemical
45     components of the mixture, if there are
46     not  adequate  studies of sufficiently
47     similar mixtures.
48  3.2. Selecting pertinent epidemiologic
49       studies
50      Study design is the key consideration for
51  selecting pertinent  epidemiologic  studies
52  from the results of the literature search.
53  -   Cohort studies, case-control studies, and
54      some  population-based  surveys  (for
55      example, NHANES) provide the strongest
56      epidemiologic evidence, especially if they
57      collect  information  about  individual
58      exposures and effects.
59  -   Ecological      studies     (geographic
60      correlation studies) relate exposures and
61      effects  by geographic area.  They can
62      provide  strong evidence  if  there are
63      large   exposure   contrasts   between
64      geographic    areas,   relatively   little
65      exposure  variation within study areas,
66      and population migration is limited.
67  -   Case reports  of  high  or  accidental
68      exposure    lack   definition   of  the
69      population  at risk and  the expected
70      number of  cases.  They  can  provide
71      information about a rare effect or about
72      the  relevance  of analogous  results  in
73      animals.
74      The   assessment    briefly    reviews
75  ecological  studies  and  case  reports  but
76  reports details  only if they  suggest  effects
77  not identified by other studies.

78  3.3. Selecting pertinent experimental
79       studies
80     Exposure  route
81  consideration   for
82  experimental  animal
83  clinical studies.
 is  a   key  design
selecting   pertinent
 studies  or  human
84  -   Studies of oral,  inhalation,  or  dermal
85      exposure  involve passage through an
86      absorption barrier and are  considered
87      most pertinent to human environmental
88      exposure.
89  -   Injection  or implantation studies are
90      often considered less pertinent but may
91      provide   valuable   toxicokinetic   or
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                                                        Toxicological Review ofBenzo[a]pyrene
 1     mechanistic information. They also may
 2     be  useful  for  identifying  effects   in
 3     animals  if deposition  or absorption is
 4     problematic (for example, for particles
 5     and fibers).
 6     Exposure duration is also  a key design
 7  consideration   for   selecting   pertinent
 8  experimental animal studies.
 9  -  Studies of effects from chronic exposure
10     are most pertinent to lifetime  human
11     exposure.
12  -  Studies of effects from less-than-chronic
13     exposure  are   pertinent  but   less
14     preferred for identifying  effects  from
15     lifetime  human  exposure.  Such  studies
16     may be  indicative  of effects from less-
17     than-lifetime human exposure.
18     Short-duration studies  involving animals
19  or humans  may  provide  toxicokinetic  or
20  mechanistic information.
21     For    developmental    toxicity    and
22  reproductive toxicity, irreversible  effects
23  may result from a brief exposure during a
24  critical period of development Accordingly,
25  specialized study designs are used for  these
26  effects [U.S. EPA. 2006b. 1998. 1996. 19911.

27  4. Evaluating the quality of
28     individual studies

29     After   the    subsets    of   pertinent
30  epidemiologic   and  experimental  studies
31  have  been  selected  from the  literature
32  searches,  the  assessment evaluates  the
33  quality  of  each  individual  study.  This
34  evaluation  considers  the  design, methods,
35  conduct, and documentation of each study,
36  but not whether the  results  are positive,
37  negative, or null. The objective is to identify
38  the stronger, more informative studies based
39  on   a   uniform   evaluation   of  quality
40  characteristics  across studies  of  similar
41  design.
42  4.1. Evaluating the quality of
43       epidemiologic studies
44      The assessment evaluates  design  and
45  methodological aspects that can increase or
46  decrease  the   weight  given   to   each
47  epidemiologic study in the overall evaluation
48  [U.S. EPA. 2005a. 1998. 1996. 1994b. 19911:
49  -   Documentation   of    study    design,
50      methods, population characteristics, and
51      results.
52
53
54
55
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
   Definition  and  selection  of the study
   group and comparison group.
   Ascertainment  of  exposure
   chemical or mixture.
             to  the
56  -  Ascertainment of disease or health effect.
57  -  Duration of exposure and follow-up and
58     adequacy for assessing the occurrence of
59     effects.
   Characterization
   critical periods.
of  exposure  during
   Sample size and statistical power to
   detect anticipated effects.

-  Participation  rates  and  potential  for
   selection bias as a result of the achieved
   participation rates.

-  Measurement  error   (can  lead  to
   misclassification  of  exposure,   health
   outcomes, and other factors) and other
   types of information bias.

-  Potential confounding and other sources
   of bias addressed in the study design or
   in the analysis of results. The basis for
   consideration  of  confounding   is  a
   reasonable    expectation   that    the
   confounder  is related to both exposure
   and outcome and is sufficiently prevalent
   to result in bias.

   For developmental toxicity, reproductive
toxicity, neurotoxicity, and cancer there is
further  guidance  on  the   nuances  of
evaluating epidemiologic  studies of  these
effects fU.S. EPA. 2005a. 1998.1996.19911.
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                                                        Toxicological Review ofBenzo[a]pyrene
 1  4.2. Evaluating the quality of
 2       experimental studies
 3      The assessment evaluates  design and
 4  methodological aspects that can increase or
 5  decrease  the   weight   given   to  each
 6  experimental animal study, in-vitro study, or
 7  human clinical study [U.S. EPA. 2005a. 1998.
 8  1996,  1991]. Research  involving  human
 9  subjects  is  considered  only if conducted
10  according to ethical principles.
11  -   Documentation of study design,  animals
12      or study population, methods, basic data,
13      and results.
14  -   Nature of the assay and validity for its
15      intended purpose.
16  -   Characterization of the nature and extent
17      of impurities and contaminants of the
18      administered chemical or mixture.
19  -   Characterization of  dose  and   dosing
20      regimen (including age at exposure) and
21      their adequacy to elicit adverse effects,
22      including latent effects.
23  -   Sample  sizes and statistical  power to
24      detect dose-related differences or trends.
25  -   Ascertainment of survival,  vital  signs,
26      disease or effects, and cause of death.
27  -   Control  of  other variables  that  could
28      influence the occurrence of effects.
29      The assessment uses statistical  tests to
30  evaluate  whether the observations  may be
31  due to chance. The standard for determining
32  statistical significance  of a response is a
33  trend test or comparison of outcomes in the
34  exposed groups against those of concurrent
35  controls. In  some situations, examination of
36  historical  control  data  from  the  same
37  laboratory within a few years of the  study
38  may improve the analysis. For an uncommon
39  effect that  is  not  statistically  significant
40  compared    with    concurrent   controls,
41  historical controls may show that the effect
42  is  unlikely  to  be  due  to  chance.  For a
43  response that appears significant against a
44  concurrent control response that is unusual,
45  historical  controls  may offer  a  different
46  interpretation [U.S. EPA. 2005a. §2.2.2.1.3).
47     For developmental toxicity, reproductive
48  toxicity, neurotoxicity,  and cancer there is
49  further   guidance  on   the   nuances   of
50  evaluating  experimental studies  of  these
51  effects [U.S. EPA. 2005a. 1998. 1996. 1991).
52  In multi-generation studies,  agents  that
53  produce developmental effects at doses that
54  are not toxic to the maternal animal are of
55  special concern. Effects  that occur at doses
56  associated with mild maternal toxicity  are
57  not assumed to result only from  maternal
58  toxicity. Moreover, maternal effects may be
59  reversible, while effects on the offspring may
60  be permanent  [U.S. EPA.  1998.  §3.1.1.4,
61  1991 §3.1.2.4.5.4).

62  4.3.  Reporting study results

63     The assessment uses evidence  tables to
64  present  the  design and  key  results  of
65  pertinent studies.  There may be  separate
66  tables for each site of toxicity  or type of
67  study.
68     If a large  number of studies observe  the
69  same effect,  the assessment  considers  the
70  study quality characteristics in this section
71  to identify the strongest studies  or types of
72  study. The tables present details from these
73  studies, and  the  assessment  explains  the
74  reasons for  not reporting  details  of other
75  studies or groups  of studies that do not add
76  new  information.  Supplemental information
77  provides    references    to   all   studies
78  considered, including those  not summarized
79  in the tables.
80     The assessment discusses strengths and
81  limitations that affect the interpretation of
82  each study. If the interpretation of a study in
83  the assessment differs from  that of the study
84  authors, the assessment discusses  the basis
85  for the difference.
86     As a check   on  the   selection  and
87  evaluation of pertinent studies, the  EPA asks
88  peer reviewers to identify studies that were
89  not adequately considered.
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                                                        Toxicological Review ofBenzo[a]pyrene
 1  5. Evaluating the overall evidence
 2     of each effect

 3  5.1.  Concepts of causal inference
 4     For each  health  effect,  the  assessment
 5  evaluates  the  evidence  as  a  whole  to
 6  determine whether it is reasonable to infer a
 7  causal association between  exposure to the
 8  agent and the occurrence of the effect. This
 9  inference  is  based  on  information  from
10  pertinent human studies, animal studies, and
11  mechanistic  studies  of  adequate quality.
12  Positive, negative, and null results are given
13  weight according to study quality.
14
Causal
                inference  involves  scientific
15  judgment,  and   the   considerations  are
16  nuanced  and  complex.   Several   health
17  agencies have developed frameworks for
18  causal   inference,  among  them  the  U.S.
19  Surgeon General  [CDC. 2004: HEW.  1964).
20  the International  Agency  for Research on
21  Cancer  [2006] ,  the Institute of Medicine
22  (2008),  and the EPA fU.S. EPA. 2010. §1.6,
23  2005a.   §2.5).  Although   developed  for
24  different  purposes,  the   frameworks  are
25  similar in nature and provide an established
26  structure and language for causal inference.
27  Each considers aspects of an association that
28  suggest causation, discussed by Hill [1965]
29  and elaborated by Rothman and Greenland
30  [1998]  [U.S.  EPA. 2005a. §2.2.1.7,  1994b.
31  app. C).
32  Strength of association:  The finding  of a
33     large   relative   risk  with   narrow
34     confidence intervals  strongly suggests
35     that an association is not due to chance,
36     bias, or other factors. Modest relative
37     risks, however, may reflect a small range
38     of exposures, an agent of low potency, an
39     increase in an effect  that is  common,
40     exposure   misclassification,  or  other
41     sources of bias.
42  Consistency of association: An inference of
43     causation is   strengthened  if elevated
44     risks  are observed  in   independent
45     studies of  different   populations  and
46     exposure  scenarios. Reproducibility of
47     findings constitutes one of the strongest
48     arguments  for  causation.  Discordant
49     results sometimes reflect differences in
50     study design, exposure, or confounding
51     factors.
52  Specificity of  association:  As  originally
53     intended,   this  refers  to  one  cause
54     associated  with  one  effect.  Current
55     understanding that many agents cause
56     multiple  effects  and many effects have
57     multiple   causes  make  this   a  less
58     informative aspect of causation,  unless
59     the  effect is rare or unlikely to have
60     multiple causes.
61  Temporal    relationship:    A    causal
62     interpretation requires  that  exposure
63     precede development of the effect.
64  Biologic  gradient  (exposure-response
65     relationship):       Exposure-response
66     relationships strongly suggest causation.
67     A monotonic increase is not the only
68     pattern consistent with  causation.  The
69     presence   of   an   exposure-response
70     gradient also  weighs against bias  and
71     confounding as  the  source  of  an
72     association.
73  Biologic  plausibility:  An  inference  of
74     causation  is  strengthened   by  data
75     demonstrating     plausible    biologic
76     mechanisms, if  available.  Plausibility
77     may reflect subjective  prior  beliefs  if
78     there is insufficient understanding of the
79     biologic process involved.
80  Coherence:  An inference  of causation is
81     strengthened by supportive results from
82     animal    experiments,    toxicokinetic
83     studies, and short-term tests. Coherence
84     may also be  found  in  other  lines of
85     evidence,   such   as   changing  disease
86     patterns in the population.
87  "Natural  experiments":  A  change  in
88     exposure  that brings  about a change in
89     disease   frequency   provides   strong
90     evidence,  as it tests  the  hypothesis of
91     causation.  An  example  would be  an
92     intervention to  reduce exposure  in the
93     workplace  or  environment  that is
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                                                        Toxicological Review ofBenzo[a]pyrene
 1     followed by a  reduction of an adverse
 2     effect
 3  Analogy:    Information    on   structural
 4     analogues or on chemicals  that induce
 5     similar mechanistic events can provide
 6     insight into causation.
 7     These considerations are consistent with
 8  guidelines  for  systematic  reviews   that
 9  evaluate the quality and weight of evidence.
10  Confidence is increased if the magnitude of
11  effect is  large,  if  there is  evidence of an
12  exposure-response  relationship, or  if an
13  association was observed and the plausible
14  biases would tend to decrease the magnitude
15  of  the  reported  effect.  Confidence is
16  decreased    for     study    limitations,
17  inconsistency  of  results,  indirectness of
18  evidence,  imprecision,  or  reporting  bias
19  (Guyattetal..2008a: Guyattetal.. 2008b).

20  5.2.  Evaluating evidence in humans

21     For each effect, the assessment evaluates
22  the evidence from the epidemiologic studies
23  as a whole. The objective  is to determine
24  whether  a credible  association has  been
25  observed and, if so, whether that association
26  is  consistent with  causation. In doing this,
27  the   assessment    explores    alternative
28  explanations  (such  as  chance, bias,  and
29  confounding) and draws a conclusion about
30  whether these alternatives can satisfactorily
31  explain any observed association.
32     To    make   clear   how   much   the
33  epidemiologic  evidence  contributes to the
34  overall   weight   of  the  evidence,  the
35  assessment may select a standard descriptor
36  to characterize the epidemiologic evidence
37  of association between exposure to the agent
38  and occurrence of a health effect.
39  Sufficient epidemiologic  evidence of an
40     association consistent with causation:
41     The  evidence  establishes  a  causal
42     association   for   which    alternative
43     explanations  such as chance, bias, and
44     confounding  can  be  ruled out  with
45     reasonable confidence.
46  Suggestive epidemiologic  evidence of an
47     association consistent  with causation:
48     The   evidence   suggests   a   causal
49     association   but   chance,   bias,   or
50     confounding cannot  be  ruled  out as
51     explaining the association.
52  Inadequate  epidemiologic  evidence  to
53     infer a causal association: The available
54     studies do   not  permit  a conclusion
55     regarding the presence or absence of an
56     association.
57  Epidemiologic evidence consistent with no
58     causal association:  Several  adequate
59     studies covering the full range of human
60     exposures and considering susceptible
61     populations, and for which alternative
62     explanations   such   as   bias   and
63     confounding can   be  ruled  out,  are
64     mutually  consistent in  not finding an
65     association.

66  5.3.  Evaluating evidence in animals
67     For each effect, the assessment evaluates
68  the evidence from the animal experiments as
69  a whole to determine  the  extent to which
70  they  indicate  a potential  for  effects in
71  humans.  Consistent results across  various
72  species and strains increase confidence  that
73  similar  results  would  occur in humans.
74  Several concepts discussed by  Hill  [1965]
75  are pertinent to the weight of experimental
76  results:  consistency  of response,  dose-
77  response relationships,  strength of response,
78  biologic plausibility, and  coherence [U.S.
79  EPA. 2005a. §2.2.1.7.1994. app. C).
80     In  weighing  evidence   from multiple
81  experiments,    U.S.   EPA  f2005a.  §2.5)
82  distinguishes
83  Conflicting evidence (that is, mixed positive
84     and negative results in the same  sex and
85     strain  using a similar  study  protocol)
86     from
87  Differing  results (that is,  positive  results
88     and negative results are in different
89     sexes  or strains or use different study
90     protocols).
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                                                        Toxicological Review ofBenzo[a]pyrene
 1     Negative or null results do not invalidate
 2  positive results in a different experimental
 3  system.  The  EPA  regards  all  as  valid
 4  observations  and looks to explain  differing
 5  results using mechanistic information (for
 6  example,    physiologic    or    metabolic
 7  differences   across   test   systems)   or
 8  methodological  differences  (for  example,
 9  relative sensitivity of the tests, differences in
10  dose  levels,  insufficient sample  size, or
11  timing of dosing or data collection).
12     It  is  well established  that there are
13  critical periods for some developmental and
14  reproductive   effects  (U.S.   EPA.   2006b.
15  2005a. b, 1998. 1996. 1991). Accordingly,
16  the assessment determines  whether critical
17  periods have been adequately investigated.
18  Similarly,   the   assessment   determines
19  whether   the database  is  adequate  to
20  evaluate other critical sites and effects.
21     In  evaluating   evidence   of   genetic
22  toxicity:
23  -  Demonstration   of   gene   mutations,
24     chromosome aberrations, or aneuploidy
25     in  humans or experimental mammals
26     [in vivo] provides the strongest evidence.
27  -  This  is followed by positive results in
28     lower organisms  or  in cultured cells
29     [in vitro] or for other genetic events.
30  -  Negative results carry less weight, partly
31     because  they   cannot   exclude  the
32     possibility of  effects in  other tissues
33     (IARC. 2006).
34     For germ-cell mutagenicity, The EPA has
35  defined categories of evidence, ranging from
36  positive   results   of   human   germ-cell
37  mutagenicity to  negative  results  for  all
38  effects of concern (U.S. EPA. 1986a. 52.3).

39  5.4.  Evaluating mechanistic data

40     Mechanistic  data  can  be  useful  in
41  answering several questions.
42  -  The  biologic  plausibility  of  a  causal
43     interpretation of human studies.
44  -  The generalizability of animal studies to
45     humans.
46  -  The    susceptibility    of   particular
47     populations or lifestages.
48     The focus of the analysis is to describe, if
49  possible, mechanistic pathways that lead to a
50  health effect. These pathways encompass:
51  -  Toxicokinetic  processes  of absorption,
52     distribution,     metabolism,      and
53     elimination that lead to the formation of
54     an active agent and its presence at the
55     site of initial biologic interaction.
56  -  Toxicodynamic  processes that lead to a
57     health effect at this or another site (also
58     known as a mode of action].
59     For each effect, the assessment discusses
60  the available  information on its modes of
61  action and  associated key events [key events
62  being  empirically  observable,  necessary
63  precursor steps or biologic markers of such
64  steps; mode of action being a series of key
65  events  involving  interaction  with  cells,
66  operational  and   anatomic  changes,  and
67  resulting in disease). Pertinent information
68  may also come from studies  of metabolites
69  or of compounds that are structurally similar
70  or that act  through similar mechanisms.
71  Information  on mode   of  action  is  not
72  required  for  a conclusion that the agent is
73  causally related to an effect (U.S. EPA. 2005a.
74  §2.5).
75     The  assessment  addresses   several
76  questions about each hypothesized mode of
77  action fU.S. EPA. 2005a. 52.4.3.41
78  Is the hypothesized   mode  of action
79     sufficiently supported in test animals?
80     Strong  support for a key event being
81     necessary to a  mode of action can come
82     from  experimental   challenge   to  the
83     hypothesized mode of action, in which
84     studies   that   suppress   a key event
85     observe  suppression  of  the  effect
86     Support  for   a  mode   of  action   is
87     meaningfully strengthened by consistent
88     results in different experimental models,
89     much   more   so  than  by  replicate
90     experiments in the  same  model.  The
91     assessment  may   consider   various
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                                                        Toxicological Review ofBenzo[a]pyrene
 1     aspects of causation in addressing this
 2     question.
 3  Is the  hypothesized  mode  of  action
 4     relevant  to  humans? The  assessment
 5     reviews the key events to identify critical
 6     similarities and differences between the
 7     test   animals   and   humans.    Site
 8     concordance  is  not assumed between
 9     animals and humans, though it may hold
10     for certain effects or modes of action.
11     Information   suggesting  quantitative
12     differences in doses where effects would
13     occur   in  animals  or  humans   is
14     considered   in   the   dose-response
15     analysis.  Current  levels   of  human
16     exposure are not used to rule out human
17     relevance, as IRIS assessments may be
18     used in evaluating new or unforeseen
19     circumstances that may entail higher
20     exposures.
21  Which populations  or lifestages can be
22     particularly   susceptible    to   the
23     hypothesized  mode  of action?  The
24     assessment reviews the  key events to
25     identify populations and lifestages that
26     might be susceptible to their occurrence.
27     Quantitative  differences  may  result in
28     separate toxicity  values  for susceptible
29     populations or lifestages.
30     The assessment discusses the likelihood
31  that  an agent  operates  through  multiple
32  modes of action.  An uneven level of support
33  for  different  modes  of action  can reflect
34  disproportionate      resources      spent
35  investigating   them   [U.S.  EPA.   2005a.
36  §2.4.3.3). It should be noted that in clinical
37  reviews, the credibility of a series of studies
38  is reduced if evidence is  limited to studies
39  funded by one interested sector [Guyatt et
40  al.. 2008b1.
41     For  cancer,  the  assessment  evaluates
42  evidence of a mutagenic mode of action to
43  guide extrapolation  to lower  doses  and
44  consideration of susceptible lifestages. Key
45  data include  the  ability of the agent or a
46  metabolite to  react with or bind  to  DNA,
47  positive results in multiple test systems, or
48  similar  properties  and  structure-activity
49  relationships to mutagenic carcinogens [U.S.
50  EPA. 2005a. 32.3.51.

51  5.5. Characterizing the overall weight
52       of the evidence

53      After evaluating the human, animal, and
54  mechanistic  evidence pertinent to an effect,
55  the assessment answers the question: Does
56  the agent cause the adverse effect? [NRG.
57  2009. 19831 In doing this, the assessment
58  develops a  narrative that  integrates the
59  evidence pertinent to  causation. To provide
60  clarity  and   consistency,   the   narrative
61  includes  a standard hazard  descriptor. For
62  example, the following standard descriptors
63  combine  epidemiologic,  experimental,  and
64  mechanistic evidence of carcinogenicity [U.S.
65  EPA. 2005a. 32.51.
66  Carcinogenic   to  humans:   There   is
67      convincing epidemiologic evidence of a
68      causal association (that  is,  there  is
69      reasonable    confidence   that   the
70      association cannot be fully explained by
71      chance, bias, or confounding); or there is
72      strong human evidence of cancer or its
73      precursors, extensive  animal evidence,
74      identification of key precursor events in
75      animals,  and strong  evidence that they
76      are anticipated to occur in humans.
77  Likely to be carcinogenic to humans: The
78      evidence   demonstrates   a  potential
79      hazard to humans but does not meet the
80      criteria for carcinogenic. There may be a
81      plausible    association   in   humans,
82      multiple  positive results in animals, or a
83      combination of human, animal, or other
84      experimental evidence.
85  Suggestive   evidence   of  carcinogenic
86      potential:  The evidence raises concern
87      for effects in humans but is not sufficient
88      for   a   stronger  conclusion.   This
89      descriptor covers  a  range of evidence,
90      from  a  positive  result in  the  only
91      available study to a single positive result
92      in an extensive database that includes
93      negative  results in other species.
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                                                        Toxicological Review ofBenzo[a]pyrene
 1  Inadequate   information    to   assess
 2     carcinogenic   potential:   No   other
 3     descriptors apply.  Conflicting  evidence
 4     can   be   classified  as    inadequate
 5     information if all positive  results are
 6     opposed by  negative  studies of equal
 7     quality  in the  same  sex  and strain.
 8     Differing   results,  however,   can  be
 9     classified  as  suggestive evidence or as
10     likely to be carcinogenic.
11  Not likely to be carcinogenic to humans:
12     There is robust evidence for concluding
13     that there is no basis for concern. There
14     may be no effects in both sexes of at least
15     two  appropriate animal species; positive
16     animal  results and strong,  consistent
17     evidence that each  mode  of action in
18     animals does not operate in humans; or
19     convincing evidence that effects are not
20     likely by a particular exposure route or
21     below a defined dose.
22     Multiple descriptors may be used if there
23  is evidence that carcinogenic effects differ by
24  dose  range  or exposure  route  [U.S.  EPA.
25  2005a. 32.51.
26     Another example  of standard descriptors
27  comes from the  EPA's Integrated  Science
28  Assessments,  which  evaluate causation for
29  the effects  of the  criteria  pollutants in
30  ambient air [U.S. EPA. 2010. 31.61.
31  Causal relationship: Sufficient evidence to
32     conclude   that  there  is  a  causal
33     relationship.    Observational   studies
34     cannot   be   explained  by  plausible
35     alternatives,  or they are  supported by
36     other lines of evidence, for example,
37     animal     studies   or    mechanistic
38     information.
39  Likely  to   be   a  causal  relationship:
40     Sufficient  evidence   that  a  causal
41     relationship  is   likely, but  important
42     uncertainties   remain.   For  example,
43     observational    studies     show    an
44     association but co-exposures are difficult
45     to address or other lines of evidence are
46     limited  or  inconsistent;  or  multiple
47     animal     studies    from    different
48     laboratories  demonstrate  effects  and
49     there are limited or no human data.
50  Suggestive of a causal  relationship: At
51     least  one  high-quality epidemiologic
52     study  shows an association but other
53     studies are inconsistent
54  Inadequate to infer a causal relationship:
55     The studies do not permit a conclusion
56     regarding the presence or absence of an
57     association.
58  Not  likely to be  a  causal relationship:
59     Several adequate  studies,  covering the
60     full  range  of  human  exposure  and
61     considering susceptible populations, are
62     mutually consistent in  not showing an
63     effect at any level of exposure.
64     The EPA is investigating and may on a
65  trial  basis use  these  or  other standard
66  descriptors  to  characterize  the  overall
67  weight of the evidence for effects other than
68  cancer.

69  6. Selecting studies for derivation
70     of toxicity values

71     For  each effect where there  is credible
72  evidence of an association with the agent,
73  the assessment  derives toxicity values  if
74  there   are   suitable   epidemiologic   or
75  experimental  data. The decision to  derive
76  toxicity values may be linked to the hazard
77  descriptor.
78     Dose-response     analysis     requires
79  quantitative measures of dose and response.
80  Then, other factors being equal:
81  -  Epidemiologic studies are preferred over
82     animal studies, if quantitative measures
83     of exposure are available and effects can
84     be attributed to the agent
85  -  Among experimental   animal  models,
86     those that respond most like humans are
87     preferred,   if  the  comparability  of
88     response can be determined.
89  -  Studies   by   a   route   of   human
90     environmental  exposure are preferred,
91     although a validated toxicokinetic model
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                                                        Toxicological Review ofBenzo[a]pyrene
 1     can  be   used  to  extrapolate  across
 2     exposure routes.
 3  -  Studies of longer exposure duration and
 4     follow-up  are  preferred,  to  minimize
 5     uncertainty about  whether effects are
 6     representative of lifetime exposure.
 7  -  Studies with multiple exposure levels are
 8     preferred  for their ability to provide
 9     information  about the  shape  of the
10     exposure-response curve.
11  -  Studies with adequate power to detect
12     effects  at lower  exposure  levels are
13     preferred,  to minimize  the  extent  of
14     extrapolation to levels  found in the
15     environment
16     Studies with non-monotonic  exposure-
17  response relationships are not necessarily
18  excluded from the  analysis.  A diminished
19  effect  at higher  exposure levels may be
20  satisfactorily explained by factors such  as
21  competing toxicity, saturation of absorption
22  or metabolism,  exposure misclassification,
23  or selection bias.
24     If a large number of studies are suitable
25  for dose-response analysis, the assessment
26  considers the study characteristics in this
27  section to  focus on the  most informative
28  data. The assessment explains the reasons
29  for not analyzing other groups of studies. As
30  a check on the selection of studies for dose-
31  response  analysis,   the   EPA asks  peer
32  reviewers to identify studies that were not
33  adequately considered.

34  7. Deriving toxicity values

35  7.1.  General framework for dose-
36       response analysis

37     The EPA uses a two-step approach that
38  distinguishes analysis of the  observed dose-
39  response data from inferences about lower
40  doses [U.S. EPA. 2005a.  S3).
41     Within the observed range, the preferred
42  approach is to use modeling to incorporate a
43  wide range  of data  into the  analysis. The
44  modeling yields a point  of departure (an
45  exposure level near the  lower end  of the
46  observed    range,    without   significant
47  extrapolation to lower doses) (sections 7.2-
48  7.3).
49      Extrapolation  to lower doses considers
50  what is known about the modes of action for
51  each effect  (Sections  7.4-7.5). If response
52  estimates at lower doses are not required, an
53  alternative is to  derive  reference values,
54  which are calculated by applying factors to
55  the point  of departure in order  to account
56  for sources of uncertainty  and  variability
57  (section 7.6).
58      For  a  group  of agents that  induce an
59  effect through a common mode of action, the
60  dose-response analysis may derive a relative
61  potency factor for each agent A full dose-
62  response analysis is conducted for one well-
63  studied index chemical in the group, then the
64  potencies of other members are expressed in
65  relative terms based on relative toxic effects,
66  relative   absorption  or   metabolic  rates,
67  quantitative structure-activity relationships,
68  or receptor binding characteristics (U.S. EPA.
69  2005a. 33.2.6. 2000. 34.41.
70      Increasingly, the EPA  is basing toxicity
71  values  on  combined  analyses of multiple
72  data sets  or multiple responses. The  EPA
73  also  considers   multiple  dose-response
74  approaches  if they can  be  supported by
75  robust data.

76  7.2. Modeling dose to sites of biologic
77       effects

78      The  preferred approach for  analysis of
79  dose is toxicokinetic modeling because of its
80  ability to incorporate  a wide range of data.
81  The preferred dose metric would  refer to the
82  active agent at the site of its biologic effect or
83  to a close, reliable surrogate measure. The
84  active  agent  may be  the  administered
85  chemical or a metabolite. Confidence in the
86  use of a toxicokinetic model depends on the
87  robustness of its validation process and on
88  the results of sensitivity analyses (U.S. EPA.
89  2006a. 2005a. §3.1.1994b. §4.3).
90      Because  toxicokinetic  modeling  can
91  require  many parameters and  more  data
92  than are  typically available, the EPA has
93  developed standard approaches that can be
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                                                        Toxicological Review ofBenzo[a]pyrene
 1  applied to typical data sets. These standard
 2  approaches also facilitate comparison across
 3  exposure patterns and species.
 4  -  Intermittent   study   exposures   are
 5     standardized to a daily average over the
 6     duration of exposure. For chronic effects,
 7     daily exposures are averaged over the
 8     lifespan.  Exposures during a  critical
 9     period, however, are not averaged over a
10     longer durationfU.S. EPA. 2005a.  §3.1.1,
11     1991. §3.2).
12  -  Doses are standardized to  equivalent
13     human terms to facilitate comparison of
14     results from different species.
15     -   Oral  doses are scaled allometrically
16         using mg/kg3/4-d as  the equivalent
17         dose   metric   across   species.
18         Allometric   scaling   pertains   to
19         equivalence   across   species,  not
20         across lifestages, and is not used  to
21         scale  doses  from adult humans  or
22         mature animals to infants or children
23         [U.S. EPA. 2011. 2005a. §3.1.3).
24     -   Inhalation  exposures   are   scaled
25         using dosimetry models that  apply
26         species-specific  physiologic   and
27         anatomic   factors    and   consider
28         whether the effect occurs at the site
29         of first  contact or  after  systemic
30         circulation [U.S. EPA. 2012a. 1994b.
31         §3).
32     It can be informative to convert  doses
33  across exposure  routes. If this is  done, the
34  assessment  describes the  underlying data,
35  algorithms,  and  assumptions  [U.S.  EPA.
36  2005a. 33.1.41.
37     In the absence of study-specific data on,
38  for example, intake rates or body weight, the
39  EPA has developed recommended values for
40  use in  dose-response analysis  [U.S. EPA,
41  19881.

42  7.3.  Modeling response in the range
43       of observation
44     Toxicodynamic  ("biologically  based")
45  modeling  can incorporate  data on biologic
46  processes leading to an effect  Such models
47  require sufficient data to ascertain a mode of
48  action and to quantitatively support model
49  parameters associated  with its key events.
50  Because   different  models  may  provide
51  equivalent fits  to the observed data but
52  diverge substantially at lower doses, critical
53  biologic  parameters should  be measured
54  from laboratory studies, not by model fitting.
55  Confidence in the use of a toxicodynamic
56  model  depends  on  the  robustness  of its
57  validation process  and on the results  of
58  sensitivity analyses. Peer review  of the
59  scientific basis and performance of a model
60  is essential [U.S. EPA. 2005a. §3.2.2).
61     Because toxicodynamic modeling can
62  require    many   parameters   and   more
63  knowledge and  data  than  are typically
64  available, the EPA has developed a standard
65  set of  empirical  ("curve-fitting")  models
66  (http://www.epa.gov/ncea/bmds/) that can
67  be applied to typical  data sets, including
68  those that are nonlinear. The EPA has also
69  developed guidance  on  modeling   dose-
70  response data, assessing model  fit, selecting
71  suitable  models,  and  reporting modeling
72  results   (U.S.   EPA.   2012b).   Additional
73  judgment or alternative analyses are used if
74  the procedure fails to yield reliable  results,
75  for example, if the fit is poor, modeling may
76  be restricted to the lower doses, especially if
77  there is competing toxicity at higher  doses
78  fU.S.  EPA. 2005a. 33.2.31.
79
80
81
    Modeling is used to derive  a point  of
departure (U.S. EPA. 2012b. 2005a. §3.2.4).
(See section 7.6 for alternatives if a point of
82  departure cannot be derived by modeling.)
83  -  If linear extrapolation is used, selection
84     of a response level corresponding to the
85     point   of   departure   is   not   highly
86     influential, so standard values near the
87     low end of the observable range are
88     generally used (for example, 10% extra
89     risk for cancer bioassay data,  1% for
90     epidemiologic  data,   lower  for   rare
91     cancers).
92  -  For   nonlinear   approaches,    both
93     statistical  and  biologic  considerations
94     are taken into account.
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                                                        Toxicological Review ofBenzo[a]pyrene
 1
 2
 3
 4
 5
 6
 7
 8
 9
10
11
12
13
For dichotomous data,  a response
level of 10% extra risk  is generally
used for minimally adverse effects,
5% or lower for more severe effects.
For continuous data, a response level
is  ideally based on  an established
definition of biologic significance. In
the absence of such definition, one
control standard deviation from  the
control  mean  is  often used  for
minimally adverse effects,  one-half
standard deviation for more severe
effects.
14     The point of departure is the 95% lower
15  bound on  the dose  associated  with the
16  selected response level.

17  7.4.  Extrapolating to lower doses and
18       response levels

19     The purpose of extrapolating to lower
20  doses is to  estimate responses at exposures
21  below  the   observed   data.   Low-dose
22  extrapolation, typically used for cancer data,
23  considers what is  known about  modes of
24  action fU.S.  EPA. 2005a. §3.3.1. §3.3.21
25  1) If a biologically based model  has been
26     developed and validated for the agent,
27     extrapolation may use the fitted model
28     below the observed range if significant
29     model uncertainty can be ruled out with
30     reasonable confidence.
31  2) Linear extrapolation is used if the dose-
32     response  curve is  expected to  have a
33     linear  component  below the point of
34     departure. This includes:
35     -   Agents or their metabolites that are
36         DN A-re active   and   have   direct
37         mutagenic activity.
38     -   Agents or their metabolites for which
39         human exposures or body burdens
40         are  near doses associated with key
41         events leading to an effect
42     Linear extrapolation is also used when
43     data are insufficient to establish mode of
44     action and when scientifically plausible.
45     The result of linear extrapolation  is
46     described by an oral slope factor or an
47     inhalation unit risk, which is the slope of
48     the dose-response curve at lower doses
49     or concentrations, respectively.
50  3) Nonlinear   models   are   used    for
51     extrapolation if there are sufficient data
52     to ascertain the mode of action and to
53     conclude that it is not linear at lower
54     doses,  and  the   agent  does   not
55     demonstrate mutagenic or other activity
56     consistent with linearity at lower doses.
57     Nonlinear approaches generally should
58     not  be used in cases where mode  of
59     action has  not ascertained.  If nonlinear
60     extrapolation  is   appropriate  but  no
61     model is developed, an alternative is to
62     calculate reference values.
63  4) Both linear and  nonlinear  approaches
64     may be used if there a multiple modes of
65     action.  For example, modeling to a low
66     response   level  can  be   useful   for
67     estimating the response at doses where a
68     high-dose mode of action would be less
69     important.
70     If linear   extrapolation is  used,  the
71  assessment  develops  a  candidate slope
72  factor or unit risk for each suitable data set
73  These results  are  arrayed,  using common
74  dose metrics,  to  show  the  distribution  of
75  relative potency across  various effects and
76  experimental systems. The assessment then
77  derives or selects an overall slope factor and
78  an overall unit risk for the agent, considering
79  the  various  dose-response analyses,  the
80  study preferences discussed in section 6, and
81  the possibility of basing a more robust result
82  on multiple data sets.

83  7.5.  Considering susceptible
84       populations and lifestages

85     The assessment analyzes the available
86  information  on populations and lifestages
87  that  may be particularly susceptible  to each
88  effect A tiered approach is used [U.S. EPA.
89  2005a. 33.51.
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                                                         Toxicological Review ofBenzo[a]pyrene
    2)
 1
 2
 3
 4
 5
 6
 7
 8
 9
10
11
12
13  3)
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
If  an  epidemiologic  or  experimental
study reports quantitative results for a
susceptible population or lifestage, these
data are  analyzed to derive  separate
toxicity    values     for    susceptible
individuals.
If data on risk-related parameters allow
comparison of the general population
and  susceptible individuals, these data
are used to adjust the general-population
toxicity  values   for  application  to
susceptible individuals.
In the absence of chemical-specific data,
the EPA has  developed  age-dependent
adjustment factors for early-life exposure
to potential  carcinogens that  have a
mutagenic  mode  of  action.  There  is
evidence of  early-life susceptibility to
various carcinogenic  agents, but most
epidemiologic   studies   and    cancer
bioassays  do  not   include  early-life
exposure. To address the potential  for
early-life   susceptibility,   the   EPA
recommends  (U.S. EPA. 2005b. §5):
   10-fold adjustment  for  exposures
   before age 2 years.
   3-fold  adjustment for  exposures
   between ages 2 and 16 years.
29  7.6. Reference values and uncertainty
30       factors
31      An oral reference dose or  an inhalation
32  reference concentration is an estimate of an
33  exposure    (including    in    susceptible
34  subgroups)  that is  likely to be  without an
35  appreciable risk of adverse health effects
36  over  a lifetime [U.S.  EPA.  2002.  §4.2).
37  Reference values are typically  calculated for
38  effects other than cancer and  for suspected
39  carcinogens if a well characterized mode of
40  action indicates that a necessary key event
41  does  not  occur below  a specific  dose.
42  Reference  values  provide no information
43  about risks at higher exposure levels.
44      The  assessment  characterizes  effects
45  that form the  basis for reference values as
46  adverse,  considered  to  be adverse, or  a
47  precursor  to   an  adverse   effect   For
48  developmental     toxicity,    reproductive
49  toxicity, and neurotoxicity there is guidance
50  on adverse effects and their biologic markers
51  fU.S. EPA. 1998.1996. 19911
52      To   account   for   uncertainty   and
53  variability  in the  derivation  of  a lifetime
54  human exposure where adverse effects are
55  not anticipated to occur, reference values are
56  calculated by applying a series  of uncertainty
57  factors to the point of departure. If a point of
58  departure cannot be derived by modeling, a
59  no-observed-adverse-effect  level   or   a
60  lowest-observed-adverse-effect level is used
61  instead. The assessment discusses scientific
62  considerations  involving  several  areas of
63  variability or uncertainty.
64  Human variation. The assessment accounts
65      for variation in susceptibility  across the
66      human population and the  possibility
67      that  the  available  data  may  not  be
68      representative  of individuals  who are
69      most susceptible to the effect. A factor of
70      10 is generally used to account for this
71      variation. This factor is reduced only if
72      the  point  of departure is derived or
73      adjusted  specifically   for susceptible
74      individuals (not for a general population
75      that includes both susceptible and non-
76      susceptible individuals) (U.S. EPA. 2002.
77      §4.4.5,  1998.  §4.2, 1996. §4,  1994b.
78      §4.3.9.1,1991, §3.4).
79  Animal-to-human extrapolation. If animal
80      results  are  used to  make  inferences
81      about humans, the  assessment  adjusts
82      for cross-species differences. These may
83      arise from differences  in  toxicokinetics
84      or toxicodynamics. Accordingly, if the
85      point of departure  is  standardized to
86      equivalent human terms or is based on
87      toxicokinetic or  dosimetry modeling, a
88      factor of 101/2  (rounded to 3) is applied
89      to account for the remaining uncertainty
90      involving       toxicokinetic        and
91      toxicodynamic     differences.    If    a
92      biologically based model adjusts fully for
93      toxicokinetic     and    toxicodynamic
94      differences across species, this factor is
95      not used. In most other cases,  a factor of
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                                                        Toxicological Review ofBenzo[a]pyrene
 1      10  is  applied  [U.S. EPA.  2011. 2002.
 2      §4.4.5,  1998. §4.2, 1996.  §4,  1994b.
 3      §4.3.9.1,1991 §3.4).
 4  Adverse-effect  level  to  no-observed-
 5      adverse-effect  level.  If  a  point of
 6      departure   is  based   on  a   lowest-
 7      observed-adverse-effect    level,   the
 8      assessment must infer  a  dose where
 9      such effects are not expected. This can be
10      a matter of great uncertainty, especially
11      if there is no evidence available at lower
12      doses.  A factor  of 10  is applied to
13      account for the uncertainty in  making
14      this inference.  A factor  other  than 10
15      may   be  used,   depending   on  the
16      magnitude and nature of the  response
17      and the  shape  of  the  dose-response
18      curve [U.S. EPA. 2002. §4.4.5, 1998. §4.2,
19      1996, §4,1994b, §4.3.9.1,1991 §3.4).
20  Subchronic-to-chronic exposure. If a point
21      of  departure  is  based  on subchronic
22      studies,   the   assessment  considers
23      whether lifetime exposure could  have
24      effects  at lower  levels of exposure.  A
25      factor of 10 is applied to  account for the
26      uncertainty in using subchronic studies
27      to  make  inferences   about   lifetime
28      exposure.  This   factor  may   also  be
29      applied    for    developmental    or
30      reproductive effects if exposure covered
31      less than the full critical period. A factor
32      other than 10 may be used, depending
33      on  the  duration of the studies and the
34      nature of the response [U.S. EPA. 2002.
35      §4.4.5,1998, §4.2,1994b, §4.3.9.1).
36  Incomplete  database. If  an incomplete
37      database  raises  concern  that  further
38      studies might identify  a  more sensitive
39      effect, organ  system,  or lifestage, the
40      assessment  may  apply  a  database
41      uncertainty    factor     [U.S.     EPA.
42      2002334.4.5.  1998.  §4.2,  1996.  §4,
43      1994b. §4.3.9.1,  1991.  §3.4). The size of
44      the factor depends  on  the nature of the
45      database  deficiency. For example, the
46      EPA typically follows the  suggestion that
47      a  factor  of  10 be  applied  if  both  a
48      prenatal  toxicity  study  and   a  two-
49     generation   reproduction   study  are
50     missing and a factor of 101/2 if either is
51     missing [U.S. EPA. 2002. §4.4.5).
52     In  this  way, the  assessment  derives
53  candidate values for each suitable data set
54  and effect that is credibly associated with the
55  agent  These  results  are arrayed, using
56  common dose metrics, to show where effects
57  occur across a range of exposures [U.S. EPA.
58  1994b. 34.3.91.
59     The assessment derives  or  selects an
60  organ- or system-specific reference value for
61  each organ or system affected by the agent
62  The  assessment  explains  the rationale for
63  each organ/system-specific reference value
64  (based on,  for example, the highest quality
65  studies, the most sensitive outcome, or a
66  clustering of values).  By  providing these
67  organ/system-specific reference values,  IRIS
68  assessments     facilitate     subsequent
69  cumulative risk  assessments  that consider
70  the combined effect  of multiple agents acting
71  at a  common  site or  through  common
72  mechanisms fNRC. 20091.
73     The assessment then selects an overall
74  reference dose  and  an  overall  reference
75  concentration for the agent to  represent
76  lifetime  human  exposure levels where
77  effects are  not anticipated to  occur. This  is
78  generally the most  sensitive organ/system-
79  specific    reference    value,     though
80  consideration   of   study   quality   and
81  confidence in each  value may  lead  to  a
82  different selection.

83  7.7.  Confidence and uncertainty in the
84       reference values
85     The  assessment  selects  a  standard
86  descriptor  to characterize  the  level  of
87  confidence in each reference value, based on
88  the likelihood that the value would change
89  with further testing. Confidence in reference
90  values is based on quality of the studies used
91  and completeness of the database, with more
92  weight  given to  the latter.  The  level  of
93  confidence  is increased for reference values
94  based on human data supported by animal
95  data fU.S. EPA. 1994b. §4.3.9.21
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                                                       Toxicological Review ofBenzo[a]pyrene
 1  High confidence: The reference value is not
 2     likely to  change with further testing,
 3     except for mechanistic studies that might
 4     affect the  interpretation of prior test
 5     results.
 6  Medium confidence: This is  a matter of
 7     judgment,  between   high  and  low
 8     confidence.
 9  Low confidence: The reference  value is
10     especially  vulnerable  to  change  with
11     further testing.
12     These   criteria   are   consistent   with
13  guidelines  for  systematic  reviews  that
14  evaluate the quality of evidence. These also
15  focus on whether further research would be
16  likely to change confidence in the estimate of
17  effect fGuyatt et al.. 2008a).
18     All  assessments discuss the significant
19  uncertainties  encountered in the  analysis.
20  The    EPA   provides    guidance    on
21  characterization  of  uncertainty [U.S.  EPA.
22  2005a,  §3.6). For example, the discussion
23  distinguishes  model uncertainty  (lack  of
24  knowledge  about  the  most  appropriate
25  experimental   or  analytic  model)   and
26  parameter uncertainty  (lack of knowledge
27  about  the   parameters  of  a   model).
28  Assessments also discuss  human  variation
29  (interpersonal   differences   in   biologic
30  susceptibility or  in  exposures  that modify
31  the effects of the agent).
32
References
33  CDC.  (Centers  for Disease  Control  and
34     Prevention).    (2004).   The   health
35     consequences of smoking: A report of the
36     Surgeon General. Washington, DC: U.S.
37     Department  of  Health  and  Human
38     Services.
39     http://www.surgeongeneral.gov/library
40     /smokingconsequences/
41  Guyatt. GH:  Oxman. AD: Vist. GE: Kunz. R:
42     Falck-Ytter.    Y:    Alonso-Coello.    P:
43     Schiinemann. HI. (2008a).  GRADE: An
44     emerging consensus on rating quality of
45     evidence     and     strength      of
46     recommendations.  BMJ  336:  924-926.
47     http://dx.doi.0rg/10.1136/bmj.39489.4
48     70347.AD
49  Guyatt. GH: Oxman. AD: Kunz. R: Vist.  GE:
50     Falck-Ytter. Y: Schiinemann. HI. (2008b).
51     GRADE: What is "quality of evidence"
52     and why  is it important to  clinicians?
53     [Review].     BMJ     336:     995-998.
54     http://dx.doi.0rg/10.1136/bmj.39490.5
55     51019.BE

56  HEW. (U.S. Department of Health, Education
57     and Welfare).   (1964).  Smoking  and
58     health: Report of the advisory committee
59     to  the surgeon  general  of the public
60     health service.  Washington,  DC:  U.S.
61     Department of Health, Education, and
62     Welfare.
63     http://profiles.nlm.nih.gov/ps/retrieve/
64     ResourceMetadata/NNBBMQ

65  Hill.  AB.  (1965).  The  environment  and
66     disease: Association or causation? Proc R
67     SocMed 58: 295-300.
68  I ARC. (International Agency for Research on
69     Cancer). (2006). Preamble to  the IARC
70     monographs.       Lyon,       France.
71     http://monographs.iarc.fr/ENG/Preamb
72     le/

73  IOM.   (Institute   of  Medicine),   (2008)
74     Improving the  presumptive  disability
75     decision-making process for veterans. In
76     JM   Samet;   CC   Bodurow   (Eds.).
77     Washington,  DC:  National  Academies
78     Press.
79  NRC.  (National Research Council). (1983).
80     Risk   assessment   in   the    federal
81     government:   Managing   the   process.
82     Washington,  DC:  National  Academies
83     Press.

84  NRC.  (National Research Council). (2009).
85     Science and  decisions: Advancing risk
86     assessment Washington,  DC: National
87     Academies Press.

88  Rothman. KT:  Greenland. S. (1998). Modern
89     epidemiology (2nd ed.). Philadelphia, PA:
90     Lippincott, Williams, & Wilkins.
              This document is a draft for review purposes only and does not constitute Agency policy.
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                                                       Toxicological Review ofBenzo[a]pyrene
 1  U.S.  EPA.  (U.S.  Environmental Protection
 2     Agency).   (1986a).    Guidelines   for
 3     mutagenicity  risk   assessment  [EPA
 4     Report].          (EPA/630/R-98/003).
 5     Washington,                       DC.
 6     http: //www. ep a. go v/ir is/backgr d. html
 7  U.S.  EPA.  (U.S.  Environmental Protection
 8     Agency).  (1986b).  Guidelines for  the
 9     health   risk  assessment  of  chemical
10     mixtures. Fed Reg 51: 34014-34025.
11  U.S.  EPA.  (U.S.  Environmental Protection
12     Agency). (1988).  Recommendations  for
13     and documentation of biological values
14     for use in risk assessment [EPA Report].
15     (EPA/600/6-87/008).  Cincinnati,   OH.
16     http://cfpub.epa.gov/ncea/cfm/recordis
17     play.cfm?deid=34855
18  U.S.  EPA.  (U.S.  Environmental Protection
19     Agency).    (1991).    Guidelines    for
20     developmental toxicity risk assessment
21     [EPA  Report].  (EPA/600/FR-91/001).
22     Washington,  DC:  U.S.  Environmental
23     Protection  Agency,  Risk  Assessment
24     Forum.
25     http://www.epa.gov/iris/backgrd.html
26  U.S.  EPA.  (U.S.  Environmental Protection
27     Agency).    (1994b).    Methods    for
28     derivation  of   inhalation   reference
29     concentrations   and  application   of
30     inhalation   dosimetry   [EPA  Report].
31     (EPA/600/8-90/066F).        Research
32     Triangle           Park,           NC.
33     http://cfpub.epa.gov/ncea/cfm/recordis
34     play.cfm?deid=71993
35  U.S.  EPA.  (U.S.  Environmental Protection
36     Agency).    (1996).    Guidelines    for
37     reproductive toxicity  risk  assessment
38     [EPA   Report].   (EPA/630/R-96/009).
39     Washington,                       DC.
40     http://www.epa.gOV/raf/publications/p
41     dfs/REPR051.PDF
42  U.S.  EPA.  (U.S.  Environmental Protection
43     Agency).    (1998).    Guidelines    for
44     neurotoxicity  risk  assessment  [EPA
45     Report].         (EPA/630/R-95/001F).
46     Washington,                       DC.
47     http://www.epa.gOV/raf/publications/p
48     dfs/NEUROTOX.PDF
49  U.S.  EPA.  (U.S.  Environmental Protection
50     Agency).    (2000).     Supplementary
51     guidance  for  conducting  health  risk
52     assessment of chemical mixtures [EPA
53     Report].          (EPA/630/R-00/002).
54     Washington,                      DC.
55     http://cfpub.epa.gov/ncea/cfm/recordis
56     play.cfm?deid=20533
57  U.S.  EPA.  (U.S.  Environmental Protection
58     Agency).  (2002).  A  review  of  the
59     reference     dose    and    reference
60     concentration  processes  [EPA Report].
61     (EPA/630/P-02/002F). Washington, DC.
62     http://cfpub.epa.gov/ncea/cfm/recordis
63     play.cfm?deid=51717
64  U.S.  EPA.  (U.S.  Environmental Protection
65     Agency).   (2 005 a).    Guidelines   for
66     carcinogen   risk   assessment   [EPA
67     Report].         (EPA/630/P-03/001F).
68     Washington,                      DC.
69     http://www.epa.gov/cancerguidelines/
70  U.S.  EPA.  (U.S.  Environmental Protection
71     Agency).    (2005b).    Supplemental
72     guidance  for assessing susceptibility
73     from early-life exposure to  carcinogens
74     [EPA  Report]  (Vol. 113). (EPA/630/R-
75     03/003F).       Washington,      DC.
76     http://www.epa.gOV/cancerguidelines/g
77     uidelines-carcinogen-supplementhtm
78  U.S.  EPA.  (U.S.  Environmental Protection
79     Agency). (2006a). Approaches  for the
80     application  of  physiologically  based
81     pharmacokinetic  (PBPK)  models  and
82     supporting data in risk assessment (Final
83     Report)  [EPA   Report].  (EPA/600/R-
84     05/043F).       Washington,      DC.
85     http://cfpub.epa.gov/ncea/cfm/recordis
86     play.cfm?deid=157668
87  U.S.  EPA.  (U.S.  Environmental Protection
88     Agency).  (2006b).  A  framework  for
89     assessing  health risk of environmental
90     exposures  to  children [EPA Report].
91     (EPA/600/R-05/093F). Washington, DC.
92     http://cfpub.epa.gov/ncea/cfm/recordis
93     play.cfm?deid=158363
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                                                       Toxicological Review ofBenzo[a]pyrene
 1  U.S.  EPA.  (U.S.  Environmental Protection
 2     Agency).  (2009).  EPAs Integrated  Risk
 3     Information    System:    Assessment
 4     development  process   [EPA  Report].
 5     Washington,                      DC.
 6     http://epa.gov/iris/process.htm

 7  U.S.  EPA.  (U.S.  Environmental Protection
 8     Agency).   (2010).   Integrated  science
 9     assessment for carbon monoxide [EPA
10     Report].         (EPA/600/R-09/019F).
11     Research     Triangle    Park,    NC.
12     http://cfpub.epa.gov/ncea/cfm/recordis
13     play.cfm?deid=218686
14  U.S.  EPA.  (U.S.  Environmental Protection
15     Agency).  (2011). Recommended  use  of
       body weight  3/4 as the default method
       in derivation of the oral reference dose
       [EPA  Report].  (EPA/100/R11/0001).
16
17
18
36
37

38
       August 2013
19     Washington,                      DC.
20     http://www.epa.gOV/raf/publications/i
21     nterspecies-extrapolation.htm
22  U.S.  EPA.  (U.S.  Environmental Protection
23     Agency). (2012a). Advances in inhalation
24     gas  dosimetry  for  derivation  of  a
25     reference concentration (rfc) and use in
26     risk   assessment    [EPA    Report].
27     (EPA/600/R-12/044). Washington, DC.
28     http://cfpub.epa.gov/ncea/cfm/recordis
29     play.cfm?deid=244650
30  U.S.  EPA.  (U.S.  Environmental Protection
31     Agency).   (2012b).   Benchmark  dose
32     technical    guidance.     (EPA/100/R-
33     12/001).       Washington,       DC.
34     http://www.epa.gOV/raf/publications/p
35     dfs/benchmark_dose_guidance.pdf
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                                                        Toxicological Review ofBenzo[a]pyrene
 1
 2    EXECUTIVE SUMMARY
 3                                 Occurren ce an d Health Effects

 4                 Benzo[a]pyrene is  a  five-ring polycyclic aromatic hydrocarbon (PAH).
 5          Benzo[a]pyrene (along with other PAHs) is released into the  atmosphere as a
 6          component  of smoke  from forest  fires, industrial processes, vehicle  exhaust,
 7          cigarettes, and through the burning of fuel (such as wood, coal,  and petroleum
 8          products).   Oral exposure to benzo[a]pyrene can  occur by eating certain food
 9          products,  such  as  charred  meats,  where benzo[a]pyrene is  formed during the
10          cooking  process   or  by  eating  foods  grown  in  areas  contaminated  with
11          benzo[a]pyrene (from the air and soil). Dermal exposure may occur from contact
12          with soils or materials that contain soot, tar, or crude petroleum  products or by
13          using certain pharmaceutical products containing coal tars, such as those used to
14          treat the skin conditions, eczema and psoriasis. The  magnitude of human exposure
15          to benzo[a]pyrene  and other PAHs depends on factors such as lifestyle (e.g., diet,
16          tobacco smoking), occupation,  and living conditions (e.g., urban versus rural setting,
17          domestic heating, and cooking methods).
18                 Animal studies demonstrate that exposure to  benzo[a]pyrene  may  be
19          associated  with  developmental,  reproductive, and immunological effects.   In
20          addition, epidemiology studies involving exposure to PAH mixtures have  reported
21          associations  between  internal  biomarkers  of  exposure  to  benzo[a]pyrene
22          (benzo[a]pyrene diol epoxide-DNA adducts) and adverse birth outcomes (including
23          reduced birth weight, postnatal  body  weight,  and  head  circumference)  and
24          decreased fertility.
25                 Studies in  multiple  animal species  demonstrate that benzo[a]pyrene is
26          carcinogenic at multiple tumor sites (alimentary tract,  liver, kidney, respiratory
27          tract,  pharynx, and skin) by all routes of exposure. In addition,  there is strong
28          evidence of carcinogenicity in occupations  involving exposure  to  PAH  mixtures
29          containing benzo[a]pyrene, such as aluminum production, chimney sweeping, coal
30          gasification, coal-tar distillation, coke  production,  iron  and steel  founding,  and
31          paving and  roofing with coal tar  pitch.   An increasing number of occupational
32          studies  demonstrate a positive  exposure-response  relationship with cumulative
33          benzo[a]pyrene exposure and lung cancer.
34

35    Effects Other Than Cancer Observed Following Oral Exposure
36          In animals, oral exposure to benzo[a]pyrene has been shown to result in developmental
37    toxicity, reproductive toxicity, and immunotoxicity. Developmental effects in rats and mice include
38    neurobehavioral changes and cardiovascular effects following gestational exposures. Reproductive
39    and immune effects include decreased  sperm counts, ovary weight and follicle numbers, and
40    decreased immunoglobulin and B-cell numbers and thymus weight following oral exposures in
41    adult animals. In humans, benzo[a]pyrene exposure occurs in conjunction with other PAHs and, as

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                                                         Toxicological Review ofBenzo[a]pyrene

 1    such, attributing the observed effects to benzo[a]pyrene is complicated. However, human studies
 2    report associations between particular health endpoints and internal measures of exposure, such as
 3    benzo[a]pyrene-DNA adducts, or external measures of benzo[a]pyrene exposure. Overall, the
 4    human studies report developmental and reproductive effects that are generally analogous to those
 5    observed in animals, and provide qualitative, supportive evidence for hazards associated with
 6    benzo[a]pyrene exposure.

 7    Oral Reference Dose (RfD) for Effects Other Than Cancer
 8          Organ or system-specific RfDs were derived for hazards associated with benzo[a]pyrene
 9    exposure where data were amenable (see Table ES-1). These organ or system-specific reference
10    values may be useful for subsequent cumulative risk assessments that consider the combined effect
11    of multiple agents acting at a common site.
12          Developmental toxicity, represented by neurobehavioral changes, was chosen as the basis
13    for the proposed overall oral reference dose (RfD) as the available data indicate that
14    neurobehavioral changes representthe most sensitive hazard of benzo[a]pyrene exposure. The
15    neurodevelopmental study by Chenetal.  (2012) and the observed neurobehavioral changes were
16    used to derive the RfD. The endpoint of altered anxiety-like behavior, as measured in the elevated
17    plus maze, was selected  as the critical effect due to the sensitivity of this endpoint and the observed
18    dose-response relationship of effects across dose groups. Benchmark dose (BMD) modeling was
19    utilized to derive the BMDLiso of 0.09 mg/kg-day that was used as the point of departure (POD) for
20    RfD derivation.
21          The proposed overall RfD was calculated by dividing the POD for altered anxiety-like
22    behavior as measured in the elevated plus maze by a composite uncertainty factor (UF) of 300 to
23    account for the extrapolation from animals to humans (10), for inter individual differences in
24    human susceptibility (10), and for deficiencies in the toxicity database (3).
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                                                         Toxicological Review ofBenzo[a]pyrene
 1
 2
       Table ES-1. Organ/system-specific RfDs and proposed overall RfD for
       benzo[a]pyrene
Effect
Developmental
Reproductive
Immunological
Proposed Overall
RfD
Basis
Neurobehavioral changes
Gavage neurodevelopmental study in rats (PND 5-11)
Chen etal. (2012)

Decreased ovary weight
Gavage subchronic (60 d) reproductive toxicity study in rats
Xu etal. (2010)

Decreased thymus weight and serum IgM
Gavage subchronic (35 d) study in rats 9
De Jong etal. (1999)

Developmental toxicity
RfD
(mg/kg-d)
3 x 10'4
4 x 10"4
2 x 10"3
3 x 10'4
Confidence
MEDIUM
MEDIUM
LOW
MEDIUM
 3
 4
 5
 6
 7
 8
 9
10
11

12
13
14
15
16
17
18

19
20
21
22
23
Confidence in the Overall Oral RfD
       The overall confidence in the RfD is medium. Confidence in the principal study [Chen etal..
2012] is medium-to-high. The design, conduct, and reporting of this neurodevelopmental study
was good and a wide variety of neurotoxicity endpoints were measured.  Some informative
experimental details were, however, omitted including the sensitivity of some assays at the
indicated developmental ages and lack of reporting gender-specific data for all outcomes. Several
subchronic and developmental studies covering a wide variety of endpoints are also available;
however, the lack of a multigeneration toxicity study with exposure throughout development is not
available. Therefore, confidence in the database is medium.

Effects Other Than Cancer Observed Following Inhalation Exposure
       In animals, inhalation exposure to benzo[a]pyrene has been shown to result in
developmental and reproductive toxicity. Studies in rats following inhalation exposure show
decreased fetal survival and brain effects in offspring, and decreased testes weight and sperm
counts in adult animals. Overall, the available human PAH mixtures studies report developmental
and reproductive effects that are generally analogous to those observed in animals, and provide
qualitative, supportive evidence for the hazards associated with benzo[a]pyrene exposure.

Inhalation Reference Concentration (RfC) for Effects Other Than Cancer
       An attempt was made to derive organ or system-specific RfCs for hazards associated with
benzo[a]pyrene exposure where data were amenable (see Table ES-2). These organ or system-
specific reference values may be useful for subsequent cumulative risk assessments that consider
the combined effect of multiple agents acting at a common site.
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                                                         Toxicological Review ofBenzo[a]pyrene
 1
 2
 3
 4
 5
 6
 7
 8
 9
10
11
12
13
14
15
16

17
18
19
20

21
22
23
24
25
26
27
       Developmental toxicity, represented by decreased fetal survival, was chosen as the basis for
the proposed inhalation reference concentration (RfC) as the available data indicate that
developmental effects represent a sensitive hazard of benzo[a]pyrene exposure.  The
developmental inhalation study in rats by Archibong et al. [2002] and the observed decreased fetal
survival following exposure to benzo[a]pyrene on gestation days (CDs) 11-20 were used to derive
the overall RfC. The lowest-observed-adverse-effect level (LOAEL) of 25  [ig/m3 based on decreased
fetal survival was selected as the POD.  The LOAEL was adjusted to account for the discontinuous
daily exposure to derive the PODADj and the human equivalent concentration (HEC) was calculated
from the PODADj by multiplying by the regional deposited dose ratio (RDDRER) for extrarespiratory
(i.e., systemic) effects, as described in Methods for Derivation of Inhalation Reference Concentrations
and Application of Inhalation Dosimetry [U.S. EPA, 1994]. These adjustments resulted in a PODHEc of
4.6 [ig/m3, which was used as the POD for RfC derivation.
       The RfC was calculated by dividing the POD by a composite UF of 3,000 to account for
toxicodynamic differences between animals and humans (3], interindividual differences in human
susceptibility (10], LOAEL-to-no-observed-adverse-effect level (NOAEL]  extrapolation (10], and
deficiencies in the toxicity database (10].

       Table ES-2. Organ/system-specific RfCs and proposed overall RfC for
       benzo[a]pyrene
Effect
Developmental
Reproductive
Proposed
Overall RfC
Basis
Decreased fetal survival
Developmental toxicity study in rats (GD 11-20)
Archibongetal. (2002)

Reductions in testes weight and sperm parameters
Subchronic (60 d) reproductive toxicity study in rats
Archibong et al. (2008); Ramesh et al. (2008)

Developmental toxicity
RfC
(mg/m3)
2 x 10"6
Not
calculated3
2 x 10'6
Confidence
LOW-
MEDIUM
NA
LOW-
MEDIUM
aNot calculated due to UF >3,000

Confidence in the Overall Inhalation RfC
       The overall confidence in the RfC is low-to-medium. Confidence in the principal study
(Archibong et al., 2002] is medium. The conduct and reporting of this developmental inhalation
study were adequate; however, a NOAEL was not identified.  Confidence in the database is low due
to the lack of a multigeneration toxicity study and the lack of information on varied toxicity
endpoints following subchronic and chronic inhalation exposure. However, confidence in the RfC is
bolstered by consistent systemic effects observed by the oral route (including reproductive and
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                                                         Toxicological Review ofBenzo[a]pyrene

 1    developmental effects) and similar effects observed in human populations exposed to PAH
 2    mixtures.

 3    Evidence for Human Carcinogenicity
 4          Under EPA's Guidelines for Carcinogen Risk Assessment [U.S. EPA, 2005a], benzo[a]pyrene is
 5    "carcinogenic to humans" based on strong and consistent evidence in animals and humans. The
 6    evidence includes an extensive number of studies demonstrating carcinogenicity in multiple animal
 7    species exposed via all routes of administration and increased cancer risks, particularly in the lung
 8    and skin, in humans exposed to different PAH mixtures containing benzo[a]pyrene. Mechanistic
 9    studies provide strong supporting evidence that links the metabolism of benzo[a]pyrene to DNA-
10    reactive agents with key mutational events in genes that can lead to tumor development. These
11    events include formation of specific DNA adducts and characteristic mutations in oncogenes and
12    tumor suppressor genes that have been observed in humans exposed to PAH mixtures. This
13    combination of human, animal, and mechanistic evidence provides the basis for characterizing
14    benzo[a]pyrene as "carcinogenic to humans."

15    Quantitative Estimate of Carcinogenic Risk From Oral Exposure
16          Lifetime oral exposure to benzo[a]pyrene has been associated with forestomach, liver, oral
17    cavity, jejunum or duodenum, and auditory canal tumors in male and female Wistar rats,
18    forestomach tumors in male and female Sprague-Dawley rats, and forestomach, esophagus, tongue,
19    and larynx tumors in female B6C3Fi mice (male mice were not tested). Less-than-lifetime oral
20    exposure to  benzo[a]pyrene has also been associated with forestomach tumors in more than
21    10 additional bioassays with several strains of mice. The Kroese etal. [2001) and Beland and Gulp
22    [1998) studies were selected as the best available studies for dose-response analysis and
23    extrapolation to lifetime cancer risk following oral exposure to benzo[a]pyrene. These studies
24    included histological examinations for tumors in many different tissues, contained three exposure
25    levels and controls, contained adequate numbers of animals per dose group (~50/sex/group),
26    treated animals for up to 2 years, and included detailed reporting methods and results (including
27    individual animal data).
28          Time-weighted, average daily doses were converted to human equivalent doses on the basis
29    of (body weight)3/4 scaling [U.S. EPA. 1992). EPA then used the multistage-Weibull model for the
30    derivation of the oral slope factor. This model was used because it incorporates the time at which
31    death-with-tumor occurred and can account for differences in mortality observed between the
32    exposure groups. Using linear extrapolation from the BMDLio, human equivalent oral slope factors
33    were derived for each gender/tumor site combination (slope factor = 0.1/BMDLio) reported by
34    Kroese etal. (2001) and Beland and Gulp (1998).  The oral slope factor of 1 per mg/kg-day based
35    on the tumor response in the alimentary tract (forestomach, esophagus, tongue, and larynx) of
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                                                         Toxicological Review ofBenzo[a]pyrene

 1    female B6C3Fi mice [Beland and Gulp, 1998] was selected as the factor with the highest value
 2    (most sensitive) among a range of slope factors derived.

 3    Quantitative Estimate of Carcinogenic Risk From Inhalation Exposure
 4          Inhalation exposure to benzo[a]pyrene has been associated with squamous cell neoplasia in
 5    the larynx, pharynx, trachea, esophagus, and forestomach of male Syrian golden hamsters exposed
 6    to benzo[a]pyrene condensed onto NaCl particles [Thyssenetal., 1981].  Supportive evidence for
 7    the carcinogenicity of inhaled benzo[a]pyrene comes from additional studies with hamsters
 8    exposed to benzo[a]pyrene via intratracheal instillation. The Thyssen et al. [1981] bioassay
 9    represents the only available data that exhibit a dose-response relationship for cancer from inhaled
10    benzo[a]pyrene.
11          A time-to-tumor dose-response model was fit to the time-weighted average (TWA]
12    continuous exposure concentrations and the individual animal incidence data for tumors in the
13    larynx, pharynx, trachea, esophagus, and forestomach. The inhalation unit risk of 5 x 10-* per
14    Hg/m3 was calculated by linear extrapolation (slope factor = 0.1/BMCLio] from a BMCLio of 0.20
15    mg/m3 for the occurrence of upper respiratory and upper digestive tract tumors in male hamsters
16    chronically exposed by inhalation to benzo[a]pyrene (Thyssen et al., 1981].

17    Quantitative Estimate of Carcinogenic Risk From Dermal Exposure
18          Skin cancer in humans has been documented to result from occupational exposure to
19    complex mixtures of PAHs including benzo[a]pyrene, such as coal tar, coal tar pitches, unrefined
20    mineral oils, shale oils, and soot In animal models, numerous dermal bioassays have demonstrated
21    an increased incidence of skin tumors with increasing dermal  exposure of benzo[a]pyrene in all
22    species tested (mice, rabbits, rats, and guinea pigs], although mostbenzo[a]pyrene bioassays have
23    been conducted in mice. Due to the evidence supporting a hazard from exposure to
24    benzo[a]pyrene by the dermal route (see Section 1.1.5] and the availability of quantitative
25    information, a cancer slope factor for the dermal route was developed. The analysis in this
26    assessment focuses on chronic carcinogenicity bioassays in several strains of mice demonstrating
27    increasing incidence of benign and malignant skin tumors following repeated dermal exposure to
28    benzo[a]pyrene for the animals' lifetime.
29          The Poel (1959] and Sivaketal. (1997] studies were selected as the best available studies
30    for dose-response analysis and extrapolation to lifetime cancer risk following dermal exposure to
31    benzo[a]pyrene. Both studies included at least three exposure levels (including several low doses],
32    group sizes of 30-50 mice, and reporting of intercurrent mortality.
33          Both mouse skin tumor incidence data sets were modeled using the multistage-cancer
34    model.  Following the modeling, the BMDLio was adjusted for interspecies differences by
35    allometric scaling. The dermal slope factor of 0.005 per u.g/day was calculated by linear
36    extrapolation (slope factor = 0.1/BMDLio-HEo] from the human equivalent POD for the occurrence of
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                                                         Toxicological Review ofBenzo[a]pyrene

 1    skin tumors in male mice chronically exposed dermally to benzo[a]pyrene. As this slope factor has
 2    been developed for a local effect, it is not intended to estimate systemic risk of cancer following
 3    dermal absorption of benzo[a]pyrene into the systemic circulation.

 4    Susceptible Populations and Lifestages
 5          Benzo[a]pyrene has been determined to be carcinogenic by a mutagenic mode of action in
 6    this assessment. According to the Supplemental Guidance for Assessing Susceptibility from Early Life
 7    Exposure to Carcinogens [U.S. EPA, 2005b], individuals exposed during early life to carcinogens with
 8    a mutagenic mode of action are assumed to have an increased risk for cancer. The oral slope factor
 9    of 1 per mg/kg-day, inhalation unit risk of 0.0005 per ug/m3, and dermal slope factor of 0.005 per
10    ug/day for benzo[a]pyrene, calculated from data applicable to adult exposures, do not reflect
11    presumed early life susceptibility to this chemical. Although some chemical-specific data exist for
12    benzo[a]pyrene that demonstrate increased early life susceptibility to cancer, these data were not
13    considered sufficient to develop separate risk estimates for childhood exposure. In the absence of
14    adequate chemical-specific data to evaluate differences in age-specific susceptibility, the
15    Supplemental Guidance [U.S. EPA. 2005b) recommends that age-dependent adjustment factors
16    (ADAFs) be applied in estimating cancer risk.  The ADAFs are 10- and 3-fold adjustments that are
17    combined with age specific exposure estimates when estimating cancer risks from early life
18    (<16 years of age) exposures to benzo[a]pyrene.
19          Regarding effects other than cancer, there are epidemiological studies that report
20    associations between developmental effects (decreased postnatal growth, decreased head
21    circumference, and neurodevelopmental delays), reproductive effects and internal biomarkers of
22    exposure to benzo[a]pyrene. Studies in animals also indicate alterations in neurological
23    development and heightened susceptibility to reproductive effects following gestational or early
24    postnatal exposure to benzo[a]pyrene.

25    Key Issues Addressed in Assessment
26          The dermal slope factor was developed based on data in animals. Because there is no
27    established methodology for extrapolating dermal toxicity from animals to humans, several
28    alternative approaches were evaluated (See Appendix D in Supplemental Information).  Allometric
29    scaling using body weight to the % power was selected based on known species differences in
30    dermal metabolism and penetration of benzo[a]pyrene.
31
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                                                         Toxicological Review ofBenzo[a]pyrene
      LITERATURE SEARCH STRATEGY | STUDY SELECTION
 3
 4
 5
 6
 7
       The literature search strategy used to identify primary, peer-reviewed literature pertaining
to benzo[a]pyrene was conducted using the databases listed in Table LS-1 (see Appendix C for the
complete list of keywords used).  References from previous assessments by EPA and other national
and international health organizations were also examined. A comprehensive literature search was
last conducted in February 2012.

       Table LS-1. Summary of the search strategy employed for benzo[a]pyrene
       Database
                                              Keywords
      Pubmed
      Toxcenter
      Toxline
           Chemical name (CASRN): benzo[a]pyrene (50-32-8)a
           Synonyms: benzo[d,e,f]chrysene, benzo[def]chrysene, 3,4-benzopyrene, 1,2-benzpyrene, 3,4-bp,
           benz(a)pyrene, 3,4-benzpyren, 3,4-benzpyrene, 4,5-benzpyrene, 6,7-benzopyrene, benzopirene,
           benzo(alpha)pyrene

           Standard toxicology search keywords
           Toxicity (including duration, effects to children and occupational exposure); development;
           reproduction; teratogenicity; exposure routes; pharmacokinetics; toxicokinetics; metabolism; body
           fluids; endocrinology; carcinogenicity; genotoxicity; antagonists; inhibitors
     TSCATS
     ChemID
     Chemfinder
     CCRIS
     HSDB
     GENETOX
     RTECS
           Searched by CASRNs and chemical names (including synonyms)
 9
10
11
12
13
14
15
16
17
 Primary and secondary keywords used for the Pubmed, Toxcenter, and Toxline databases can be found in the
 Supplemental Information.

       Figure LS-1 depicts the literature search, study selection strategy, and number of references
obtained at each stage of literature screening. Approximately 20,700 references were identified
with the initial keyword search. Based on a secondary keyword search followed by a preliminary
manual screen of titles or abstracts by a toxicologist, approximately 1,190 references were
identified that provided information potentially relevant to characterizing the health effects or
physical and chemical properties of benzo[a]pyrene. A more detailed manual review of titles,
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                                                         Toxicological Review ofBenzo[a]pyrene

1    abstracts, and/or papers was then conducted.  Notable exclusions from the Toxicological Review
2    are large numbers of animal in vivo or in vitro studies designed to identify potential therapeutic
3    agents that would prevent the carcinogenicity or genotoxicity of benzo[a]pyrene and toxicity
4    studies of benzo[a]pyrene in nonmammalian species (e.g., aquatic species, plants).
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                                                                     Toxicological Review ofBenzo[a]pyrene
                   References identified based on initial keyword search (see Table LS-1): ~21,000 references
                                                                      Secondary keyword searching (see Table
                                                                      LS-1): ~14,600 references excluded
                                 References identified based on
                                 secondary keyword search (see Table
                                 LS-1): ~6,100 references
        30 references submitted by American
        Petroleum Institute
                                                         Manual screen of titles/abstracts:
                                                         ~4,900 references excluded
                                                         • Not relevant toBaP toxicity in mammals
                                                         (e.g., toxicity in aquatic species, plants)
                                                         •Site-specific risk assessments
                                                         • Chemical analytical methods
                                                         • Cancer chemotherapy studies
              Considered for inclusion in the Toxicological Review:- 1,000
              references; references subsequently evaluated based on
              Preamble Section 3
                                                            Manual screen of manuscripts excluded: ~ 600 references
                                                             • Not relevant to BaP toxicity in mammals
                                                             • Inadequate basis to infer exposure
                                                             • Inadequate reporting of study methods or results
                                                             • Animal toxicity studies with mixtures of chemicals
                                                             * Abstracts
                                                             • Not available in English
               Approximately 700 references cited in the August 2012 Draft Toxicological Review
               • Developmental toxicity: 37 references
               • Reproductive toxicity: 70 references
               • Immunotoxicity: 58 references
               • OtherToxicological Effects: 27 references
                   • Forestomach toxicity: 5 references
                   • Hematological toxicity: 3 references
                   • Livertoxicity: 3 references
                   • Kidney toxicity: 3 references
                   • Cardiovasculartoxicity: 11 references
                   • Neurological toxicity: 12 references
               • Carcinogenicity: 171 references
               •Toxicokinetic: 115 references
               •Genotoxicity: 196 references
2
3
Figure LS-1.  Study selection strategy.
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                                                          Toxicological Review ofBenzo[a]pyrene

 1           Selection of studies for inclusion in the Toxicological Review was based on consideration of
 2    the extent to which the study was informative and relevant to the assessment and general study
 3    quality considerations. In general, the relevance of health effect studies was evaluated as outlined
 4    in the Preamble and EPA guidance (A Review of the Reference Dose and Reference Concentration
 5    Processes [U.S. EPA, 2002] and Methods for Derivation of Inhalation Reference Concentrations and
 6    Application of Inhaled Dosimetry [U.S. EPA, 1994]]. The reasons for excluding epidemiological and
 7    animal studies from the references identified by the keyword search are provided in Figure LS-1.
 8           The available studies examining the health effects of benzo[a]pyrene exposure in humans
 9    are discussed and evaluated in the hazard identification sections of the assessment (Section 1], with
10    specific limitations of individual studies and of the collection of studies noted. The common major
11    limitation of the human epidemiological studies (with respect to identifying potential adverse
12    health outcomes specifically from benzo[a]pyrene] is that they all involve exposures to complex
13    mixtures containing other PAHs and other compounds. The evaluation of the epidemiological
14    literature focuses on studies in which possible associations between external measures of exposure
15    to benzo[a]pyrene or biomarkers of exposure to benzo[a]pyrene (e.g., benzo[a]pyrene-DNA
16    adducts or urinary biomarkers] and potential adverse health outcomes were evaluated.  Pertinent
17    mechanistic studies in humans (e.g., identification of benzo[a]pyrene-DNA adducts and
18    characteristics of mutations in human tumors] were also considered in assessing the weight of
19    evidence for the carcinogenicity of benzo[a]pyrene.
20           The health effects literature for benzo[a]pyrene is extensive. All animal studies of
21    benzo[a]pyrene involving repeated oral, inhalation, or dermal exposure that were considered to be
22    of acceptable quality, whether yielding positive, negative, or null results, were considered in
23    assessing the evidence for health effects associated with chronic exposure to benzo[a]pyrene. In
24    addition, animal toxicity studies involving short-term duration and other routes of exposure were
25    evaluated to  inform conclusions about health hazards.
26           The references considered and cited in this document, including bibliographic information
27    and abstracts, can be found on the Health and Environmental Research Online (HERO] website2
28    (http://hero.epa.gov/benzoapyrene].
29
      2HERO (Health and Environmental Research On-line] is a database of scientific studies and other references
      used to develop EPA's risk assessments aimed at understanding the health and environmental effects of
      pollutants and chemicals. It is developed and managed in EPA's Office of Research and Development (ORD]
      by the National Center for Environmental Assessment (NCEA]. The database includes more than
      300,000 scientific articles from the peer-reviewed literature. New studies are added continuously to HERO.

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                                                       Toxicological Review ofBenzo[a]pyrene
 1
 2    1.   HAZARD  IDENTIFICATION
 3    1.1.  SYNTHESIS OF EVIDENCE
 4          NOTE: In the environment, benzo[a]pyrene occurs in conjunction with other structurally
 5    related chemical compounds known as polycyclic aromatic hydrocarbons (PAHs).3 Accordingly,
 6    there are no epidemiologic studies designed to solely investigate the effects of benzo[a]pyrene.
 7    There are, however, many epidemiologic studies that have investigated the effects of exposure to
 8    PAH mixtures.  Benzo[a]pyrene is universally present in these mixtures and is routinely analyzed
 9    and detected in environmental media contaminated with PAH mixtures, thus it is often used as an
10    indicator chemical to measure exposure to PAH mixtures [Bostrometal., 2002].

11    1.1.1.  Developmental Toxicity
12          Human and animal studies provide evidence for PAH- and benzo[a]pyrene-induced
13    developmental effects.  Effects on fetal survival, postnatal growth, and development have been
14    demonstrated in human populations exposed to PAH mixtures during gestation. Animal studies
15    demonstrate various effects including changes in fetal survival, pup weight, blood pressure, fertility,
16    reproductive organ weight and histology, and neurological function in gestationally or early
17    postnatally treated animals.

18    Altered Birth Outcomes
19          Human and animal studies provide evidence that benzo[a]pyrene exposure may lead to
20    altered outcomes reflecting growth and development in utero or in early childhood. Two? cohort
21    studies in pregnant women in China and the United States examined cord blood levels of
22    benzo[a]pyrene-7,8-diol-9,10 epoxide (BPDE)-DNA adducts in relation to measures of child growth
23    following exposure to PAH mixtures [Tangetal.. 2006: Pereraetal.. 2005b: Perera etal.. 2004]
24    (Table 1-1]. In the Chinese cohort, high benzo[a]pyrene-adduct levels were associated with
25    reduced weight at 18, 24, and 30 months of age, but not at birth [Tangetal., 2006]. In the U.S.
26    cohort, an independent effect on birth weight was not observed with either benzo[a]pyrene-
27    adducts or environmental tobacco smoke (ETS] exposure; however, a doubling of cord blood
28    adducts in combination with ETS exposure in utero was seen, corresponding to an 8% reduction in
29    birth weight [Perera et al., 2005b]. ETS, also called secondhand smoke, is the smoke given off by a
30    burning tobacco product and the smoke exhaled by a smoker that contains over 7,000 chemicals
     3PAHs are a large class of chemical compounds formed during the incomplete combustion of organic matter.

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                                                         Toxicological Review ofBenzo[a]pyrene

 1    including benzo[a]pyrene.  No associations were seen with birth length (or height at later ages) in
 2    either of these cohort studies.
 3          A Chinese case-control study indicated that PAH exposure may be associated with increased
 4    risk of fetal death [Wu etal., 2010].  A strong association was seen between maternal blood
 5    benzo[a]pyrene-DNA adduct levels and risk of delayed miscarriage (fetal death before 14 weeks of
 6    gestation), with a fourfold increased risk for levels above compared with below the median.
 7    However, no significant difference in adduct levels was detected between fetal tissue from cases
 8    compared to controls.
 9          Decreased fetal survival has also been noted in gestationally treated animals at relatively
10    high doses by the oral and inhalation routes. An approximate 40% decrease in fetal survival was
11    noted in mouse dams treated by gavage on CDs 7-16 at doses of 160 mg/kg-day, but no decreases
12    were observed at 10 or 40 mg/kg-day (Mackenzie and Angevine, 1981). Several lower dose studies
13    of rats treated on CDs 14-17 with doses of up to 1.2 mg/kg-day benzo[a]pyrene did not observe
14    any difference in fetal survival (Tules etal.. 2012: McCallister etal.. 2008: Brown etal.. 2007).  By
15    the inhalation route, fetal survival was decreased by 19% following exposure to 25 |J.g/m3
16    benzo[a]pyrene on CDs 11-20 in F344 rats (Archibongetal.. 2002). Another study from the same
17    group of collaborators Wu etal. (2003a) evaluated fetal survival as part of a study analyzing
18    metabolites of benzo[a]pyrene and activation of the aryl hydrocarbon receptor (AhR) and
19    cytochrome P450 (CYP450) 1A1 (Wuetal.. 2003a).  This study did not report the number of dams
20    or litters, and no numerical data were reported. The study authors reported statistically significant
21    decreases in fetal survival at 75 and 100 |ig/m3 benzo[a]pyrene on CDs 11-20. An apparent
22    decrease in fetal survival was also seen at 2 5 |ig/m3, but it was unclear whether this change was
23    statistically significant.
24          In animals (Table 1-2), reduced bodyweight in offspring has also been noted in some
25    developmental studies. Decreases in body weight (up to 13%) were observed in mice following
26    prenatal gavage exposure (gestation days [CDs] 7-16), and as time from exposure increased
27    (postnatal days [PNDs] 20-42) the  dose at which effects were observed decreased (from 40 to
28    10 mg/kg-day, respectively) (Mackenzie and Angevine, 1981). In addition, decreases in body
29    weight (approximately 10-15%) were observed in rats on PNDs 36 and 71 following gavage
30    exposure at only 2 mg/kg-day on PNDs 5-11 (Chen etal.. 2012). At doses up to 1.2 mg/kg-day and
31    follow-up to PND 30, two developmental studies in rats did not observe decrements in pup body
32    weight following treatment from GD 14 to 17 (Tules etal.. 2012: McCallister etal.. 2008). Maternal
33    toxicity was not observed in mouse or rat dams exposed to up to 160 mg/kg-day benzo[a]pyrene
34    (Tules etal.. 2012: McCallister etal.. 2008: Brown etal.. 2007: Kristensen etal.. 1995: Mackenzie and
35    Angevine. 1981).

36    Fertility in Offspring
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 1           Several studies suggest that gestational exposure to maternal tobacco smoke decreases the
 2    future fertility of female offspring [Ye etal.. 2010: Tensen etal.. 1998: Weinbergetal.. 1989] (Table
 3    1-1). In animal models, marked effects on the development of male and female reproductive organs
 4    and the fertility of animals exposed gestationally has also been demonstrated [Kris tensen etal.,
 5    1995: Mackenzie and Angevine, 1981] (Table 1-2]. In two studies examining reproductive effects in
 6    mice, decreased  fertility and fecundity in Fl animals was observed following exposure to doses
 7    >10 mg/kg-day during gestation [Kristensenetal., 1995: Mackenzie and Angevine, 1981]. When Fl
 8    females were mated with untreated males, a dose-related decrease in fertility of >30% was
 9    observed, in addition to a 20% decrease in litter size starting at the lowest dose tested of 10 mg/kg-
10    day [Mackenzie and Angevine. 1981]. A dose-related decrease in fertility was also observed in male
11    mice treated gestationally with benzo[a]pyrene. At the lowest dose tested (10 mg/kg-day], a 35%
12    decrease in fertility was observed when gestationally exposed animals were mated with untreated
13    females [Mackenzie and Angevine, 1981]. Similar effects on fertility were observed in another
14    developmental study in mice [Kristensen et al., 1995]. Fl females (bred continuously for 6 months]
15    in this study had 63% fewer litters, and litters were 30% smaller as compared to control animals.
16    The fertility of male offspring was not assessed in this study.

17    Reproductive Organ Effects in Offspring
18           The above mentioned studies also demonstrated dose-related effects on male and female
19    reproductive organs in animals exposed gestationally to benzo[a]pyrene (Table 1-2]. Testicular
20    weight was decreased and atrophic seminiferous tubules and vacuolization were increased at
21    >10 mg/kg-day in male mice exposed to benzo[a]pyrene gestationally from GD 7 to 16; severe
22    atrophic seminiferous tubules were observed at 40 mg/kg-day [Mackenzie and Angevine. 1981].
23           In female mice treated with doses >10 mg/kg-day during gestation, ovarian effects were
24    observed including decreases in ovary weight, numbers of follicles, and corpora lutea [Kristensen et
25    al., 1995: Mackenzie and Angevine, 1981]. Specifically, ovary weight in Fl offspring was reduced
26    31% following exposure to 10 mg/kg-day benzo[a]pyrene [Kristensen et al., 1995] while in another
27    gestational study at the same dose level, ovaries were so drastically reduced in size (or absent] that
28    they were not weighed [Mackenzie and Angevine. 1981]. Hypoplastic ovaries with few or no
29    follicles and corpora lutea (numerical data not reported], and ovaries with few or no small,
30    medium, or large follicles and corpora lutea (numerical data not reported] have also been observed
31    in mouse offspring exposed gestationally to benzo[a]pyrene [Kristensenetal.. 1995: Mackenzie and
32    Angevine. 1981].

3 3    Cardiovascular Effects in  Offspring
34           Increased systolic and diastolic blood pressure was observed in adult animals following
35    gestational treatment with benzo[a]pyrene [Tules etal., 2012] (Table 1-2]. Approximate elevations
36    in systolic and diastolic blood pressure of 20-30% and 50-80% were noted in the 0.6 and
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                                                        Toxicological Review ofBenzo[a]pyrene
1
2
3

4
5
6
7
1.2 mg/kg-day dose groups, respectively. Heart rate was decreased at 0.6 mg/kg-day, but was
increased at 1.2 mg/kg-day.


Immune Effects in Offspring
       Several injection studies in laboratory animals suggest that immune effects may occur
following gestational or early postnatal exposure to benzo[a]pyrene. These studies are discussed in
Section 1.1.3.
8
9
       Table 1-1. Evidence pertaining to developmental effects of benzo[a]pyrene in
       humans
Study Design and Reference
Tang et al. (2006)
Tongliang, China
Birth cohort
150 non-smoking women who delivered
babies between March 2002 and June 2002
Exposure: mean hours per day exposed to
ETS 0.42 (SD 1.19); lived within 2.5 km of
power plant that operated from December
2001 to May 2002; benzo[a]pyrene-DNA
adducts from maternal and cord blood
samples; cord blood mean 0.33 (SD 0.14)
(median 0.36) adducts/10 8 nucleotides;
maternal blood mean 0.29 (SD 0.13)
adducts/10 8 nucleotides
Perera et al. (2005b); Perera et al. (2004)
New York, United States
Results
Relation between cord blood benzo[a]pyrene-DNA adducts and log-
transformed weight and height

Birth
18 mo
24 mo
30 mo
Weight
Beta (p-value)
-0.007 (0.73)
-0.048 (0.03)
-0.041 (0.027)
-0.040 (0.049)
Length (Height)
Beta (p-value)
-0.001 (0.89)
-0.005 (0.48)
-0.007 (0.28)
-0.006 (0.44)
Adjusted for ETS, sex of child, maternal height, maternal weight, and
gestational age (for measures at birth)
Relation between cord blood benzo[a]pyrene-DNA adducts and log-
transformed weight and length
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                                                       Toxicological Review ofBenzo[a]pyrene
Study Design and Reference

Wu et al. (2010)
Tianjin, China
Case control study: 81 cases (96%
participation rate)— fetal death confirmed
by ultrasound before 14 wks gestation; 81
controls (91% participation rate)— elective
abortions; matched by age, gestational age,
and gravidity; excluded smokers and
occupational PAH exposure
Exposure: benzo[a]pyrene in aborted tissue
and maternal blood samples (51 cases and
controls, 2 of 4 hospitals)
Results

Interaction
term
Benzo[a]-
pyrene-DNA
adducts
ETS in home
Weight
Beta (p-value)
-0.088 (0.05)
-0.020 (0.49)
-0.003 (0.90)
Length
Beta (p-value)
-0.014 (0.39)
-0.005 (0.64)
-0.007 (0.32)
Adjusted for ethnicity, sex of newborns, maternal body mass index,
dietary PAHs, and gestational age
Benzo[a]pyrene adduct levels (/l(f nucleotides), mean (±SD)
Cases Controls (p-value)
Maternal blood 6.0 (±4.7) 2.7 (± 2.2) (<0.001)
Aborted tissue 4.8 (± 6.0) 6.0 (± 7.4) (0.29)
Low correlation between blood and tissue levels (r = -0.02 in cases,
r = -0.21 in controls)
Association between benzo[a]pyrene adducts and miscarriage3
OR (95% Cl)
Per unit increase in adducts 1.37 (1.12,1.67)
Dichotomized at median 4.56 (1.46, 14.3)
Conditional logistic regression, adjusted for maternal education,
household income, and gestational age; age also considered as
potential confounder
1
2
Table 1-2. Evidence pertaining to developmental effects of benzo[a]pyrene in
animals
Study Design and Reference
Results
Birth outcomes and postnatal growth
Mackenzie and Angevine (1981)
CD-I mice, 30 or 60 FO females/
dose
0, 10, 40, or 160 mg/kg-d by gavage
CDs 7-16
Kristensen et al. (1995)
NMRI mice, 9 FO females/dose
0 or 10 mg/kg-d by gavage
CDs 7-16
4, number of FO females with viable litters: 46/60, 21/30, 44/60, and 13/30*
^ Fl body weight at PND 20
% change from control: 0, 4, -7*, and -13*
4, Fl body weight at PND 42
% change from control: 0, -6*, -6*, and -10*
(no difference in pup weight at PND 4)
Exposed FO females showed no gross signs of toxicity and no effects on
fertility (data not reported)
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                                                          Toxicological Review ofBenzo[a]pyrene
  Study Design and Reference
                              Results
Jules etal. (2012)
Long-Evans rats, 6-17 FO
females/dose
0, 0.15, 0.3, 0.6, or 1.2 mg/kg-d by
gavage
CDs 14-17
No overt signs of toxicity in dams or offspring, differences in pup body
weight, or number of pups/litter
McCallister et al. (2008)
Long-Evans Hooded rats, 5-
6/group
0 or 0.3 mg/kg-d by gavage
CDs 14-17
No difference in number of pups/litter

No overt maternal or pup toxicity

No difference in liverbody weight

Increased brain:body weight ratio at PNDs 15 and 30 (data not shown)
Brown et al. (2007)
Long-Evans Hooded rats, 6/group
0, 0.025, or 0.15 mg/kg-d by gavage
CDs 14-17
No difference in number of pups/litter or overt maternal or pup toxicity
Chen etal. (2012)
Sprague-Dawley rats, 20 pups
(10 male and 10 female)/group
0, 0.02, 0.2, or 2 mg/kg-d by gavage
PNDs 5-11
Statistically significant decrease in pup body weight (approximate 10-15%
decrease) at 2 mg/kg-d measured on PND 36 and 71 (no significant alteration
of pup weight during treatment period)

No differences among treatment groups in developmental milestones: incisor
eruption, eye opening, development of fur, testis decent, or vaginal opening
Archibongetal. (2002)
F344 rats, 10 females/group
0, 25, 75, or 100 u.g/m3 nose-only
inhalation for 4 hrs/d
CDs 11-20
  fetal survival ([pups/litter]/[implantation sites/litter] x 100)
% fetal survival: 97, 78*, 38*, and 34*%
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                                                                Toxicological Review ofBenzo[a]pyrene
       Study Design and Reference
                                                               Results
     Reproductive effects in offspring
      Mackenzie and Angevine (1981)
      CD-I mice, 30 or 60 FO females/
      dose
      0,10, 40, or 160 mg/kg-d by gavage
      CDs 7-16
                                 ^ number of Fl females with viable litters: 35/35, 23/35*, 0/55*, and 0/20*

                                 4/F1 female fertility index (females pregnant/females exposed to males x
                                 100): 100,66*, 0*, and 0*

                                 4, Fl male fertility index (females pregnant/females exposed to males x 100):
                                 80, 52*, 5*, and 0*

                                 4, F2 litter size from Fl dams (20%) at 10 mg/kg-d (no litters were produced
                                 at high doses)

                                 4, size or absence of Fl ovaries (weights not collected)
                                 hypoplastic ovaries with few or no follicles and corpora  lutea  (numerical data
                                 not reported)

                                 4, testicular weight in  Fl offspring
                                 % change from control: 0, -42, -82, and ND (statistical significance not
                                 reported)

                                 1" atrophic seminiferous tubules and vacuolization at >10 mg/kg-d; severe
                                 atrophic seminiferous tubules at 40 mg/kg-d (numerical data  not reported)
      Kristensen et al. (1995)
      NMRI mice, 9 FO females/dose
      0 or 10 mg/kg-d by gavage
      CDs 7-16
                                 4, number of F2 litters (-63%)

                                 4, F2 litter size (-30%)

                                 4/ ovary weight (-31%) in Fl females

                                 Few or no small, medium, or large follicles and corpora lutea
     Cardiovascular effects in offspring
     Jules etal. (2012)
     Long-Evans rats, 6-17 FO
     females/dose
     0, 0.15, 0.3, 0.6, or 1.2 mg/kg-d by
     gavage
     CDs 14-17
                                   systolic blood pressure (measured at PND 53)
                                        15%* increase at 0.6 mg/kg-d
                                        52%* increase at 1.2 mg/kg-d
                                        (other dose groups not reported)

                                   diastolic blood pressure (measured at PND 53)
                                        33%* increase at 0.6 mg/kg-d
                                        83% * increase at 1.2 mg/kg-d
                                        (other dose groups not reported)

                                Altered heart rate
                                        10% * increase at 0.6 mg/kg-day
                                        8%* decrease at 1.2 mg/kg-day
1
2
3
*Statistically significantly different from the control (p < 0.05).
a % change from control calculated as: (treated value - control value)/control value x 100.
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                                                         Toxicological Review ofBenzo[a]pyrene




































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2 Figure 1-1. Exposure-response array for developmental effects following oral
3 exposure to benzo[a]pyrene.

 4   Neurodevelopmental Effects
 5          There is evidence in humans and animals that benzo[a]pyrene induces developmental
 6   neurotoxicity.  In addition to the persistent reductions in cognitive ability observed in epidemiology
 1   studies of prenatal PAH exposure, the two epidemiology studies that examined benzo[a]pyrene-
 8   specific measures observed effects on neurodevelopment and behavior in young children. Altered
 9   learning and memory, motor activity, anxiety-like behavior, and electrophysiological changes have
10   also been observed in animals following oral and inhalation exposure to benzo[a]pyrene.
11          The mammalian brain undergoes a period of rapid brain growth during the last 3 months of
12   pregnancy through the first 2 years of life in humans [Dobbingand Sands. 1979.1973] and the first
13   1-2 weeks of life in the rat and mouse neonate [Chen etal.. 2011). This period is characterized by
14   the maturation of axonal and dendritic outgrowth and the establishment of neuronal connections.
15   Also during this critical period, animals acquire many new motor and sensory abilities [Kolb and
16   Whishaw, 1989].  There is a growing literature of animal studies that shows subtle changes in

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                                                         Toxicological Review ofBenzo[a]pyrene

 1    motor and cognitive function following acute or repeated perinatal or lactational exposure to
 2    benzo[a]pyrene [Bouayed et al.. 2009a: McCallister et al.. 2008: Wormley etal.. 2004). These effects
 3    are described below.

 4    Cognitive function
 5          Head circumference at birth is associated with measures of intelligence in children, even
 6    among term infants [Broekman etal., 2009: Gale etal., 2006]. The two birth cohort studies that
 7    examined maternal or cord blood levels of benzo[a]pyrene-DNA adducts in relation to head
 8    circumference provide some evidence of an association, most strongly within the context of an
 9    interaction with ETS [Tang etal.. 2006: Pereraetal.. 2005b: Perera etal.. 2004] (Table 1-3]. The
10    cohort in Tongliang, China also examined intelligence quotient scores at age 5 years [Pereraetal..
11    2012a]. An interaction with ETS was seen in this analysis, with larger decrements seen on the full
12    scale and verbal scales with increased benzo[a]pyrene-DNA adduct levels in the presence of
13    prenatal exposure to environmental tobacco smoke compared to the effects seen in the absence of
14    prenatal exposure to environmental tobacco smoke.
15          Animal studies have also provided evidence of altered learning and memory behaviors
16    following lactational or direct postnatal exposure to benzo[a]pyrene [Chen etal., 2012: Bouayed et
17    al.. 2009a] (Table 1-4]. In mice, spatial working memory was measured using the Y-maze
18    spontaneous alternation test [Bouayed et al.,  2009a]. This test records alternations between arm
19    entries in a Y-shaped maze as a measure of memory, as rodents typically prefer to investigate a new
20    arm of the maze. To a lesser extent, this test can also reflect changes in sensory processing, novelty
21    preference, and anxiety-related responses in  rodents.  An improvement in working memory was
22    evident in mice, as exhibited by significant increases in spontaneous alternations in the Y-maze test
23    in mice on PND 40 following lactational exposure to 2 mg/kg-day benzo[a]pyrene (but not 20
24    mg/kg-day] from PND 0 to 14 [Bouayed etal.. 2009a]. The total number of arm entries in the
25    Y-maze was unaffected by lactational exposure, suggesting that changes in motor function were not
26    driving this response.  In rats, spatial learning and memory was measured using the Morris water
27    maze, which measures the ability of a rat to navigate to a target platform using external spatial cues
28    [Chen  etal.. 2012]. Increased escape latency(time to find the hidden platform], as well as
29    decreased time in the target quadrant and decreased number of platform crossings during a probe
30    trial with the platform removed were observed in PND 39-40 rats following postnatal exposure to
31    2 mg/kg-day benzo[a]pyrene [Chen etal.. 2012]. These effects were more pronounced in animals
32    tested at PNDs 74-75. No difference in swim speed was observed between treatment groups,
33    suggesting the observed changes are not attributable to general motor impairment These
34    observations may indicate primary effects of benzo[a]pyrene on learning and/ or  memory
35    processes; however, the presented data were insufficient to attribute these findings to learning and
36    memory processes alone. Specifically, visual  examinations of the improvements in escape latency
37    (slopes] over the four learning trial days were not noticeably affected by treatment dose, suggesting

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                                                         Toxicological Review ofBenzo[a]pyrene

 1    that all groups learned at a similar rate. As 4 trials/ day were averaged for each animal at each trial
 2    day, it is unclear whether the dose-related increases in escape latency already observable at trial
 3    day 1 reflect effects on learning or other effects (e.g., altered anxiety or vision responses).
 4    Additionally, as it is not clear that the groups learned to a comparable extent in hidden platform
 5    tests, the results of the probe trial cannot be conclusively attributed to memory retention and likely
 6    involve other contributing factors.

 7    Neuromuscular function, coordination, and sensorimotor development
 8          Motor behavior and coordination, assessed by locomotion, reaching, balance,
 9    comprehension, drawing, and hand control was one of the specific domains assessed in the Chinese
10    birth cohort evaluated by Tangetal. [2008].  In children aged 2 years, decreased scores were seen
11    in relation to increasing benzo[a]pyrene-DNA adducts measured in cord blood, with a Beta per unit
12    increase in adducts of-16 (p = 0.04), and an approximate twofold increased risk of development
13    delay per unit increase in adducts (Table 1-3).
14          In laboratory animals (Table 1-4), impaired performance in neuromuscular and
15    sensorimotor tests have been consistently observed in mice lactationally exposed to >2 mg/kg-day
16    benzo[a]pyrene  from PND 0 to 14 (Bouayed et al., 2009a] and in rat pups postnatally exposed to
17    >0.02 mg/kg-day benzo[a]pyrene from PND 5 to 11 (Chenetal.. 2012). In the righting reflex test,
18    significant increases in righting time were observed in PNDs 3-5 mice and in PNDs 12-16 rats.
19    These decrements did not show a monotonic dose response. In another test of sensorimotor
20    function and coordination, dose-dependent increases in latency in the negative geotaxis test were
21    observed in PNDs 5-9 mice and in PNDs 12-14 rats. The forelimb grip strength test of
22    neuromuscular strength was also evaluated in both mice and rats, but alterations were only
23    observed in mice. In mice, a dose-dependent increase in duration of forelimb grip was observed on
24    PNDs 9 and 11 during lactational exposure to benzo[a]pyrene. The Water Escape Pole Climbing
25    test was also used to evaluate neuromuscular function and coordination in mice (Bouayed etal.,
26    2009a). No effect on climbing time was observed, suggesting no change in muscle strength.
27    However, increased latency in pole grasping and pole escape in PND 20 male pups was observed,
28    highlighting potential decrements in visuomotor integration and/or coordination, although anxiety-
29    related responses cannot be ruled out Treatment-dependant increases in pup body weight around
30    the testing period complicate the interpretation of these results.
31          Negative geotaxis and surface righting are discrete endpoints routinely used as part of a
32    neurobehavioral test battery to assess acquisition of developmental milestones. In typical
33    protocols, animals are tested on successive days (e.g. PNDs 3-12) and successful acquisition of
34    these phenotypes is indicated when righting occurs. In rats, both phenotypes are nearly always
35    established before PND 12. Chenetal. (2012) performed these tests as quantitative measures of
36    sensorimotor function at PND 12 and beyond, with control animals already able to right within
37    0.8-1.8 seconds and orient 180° within 5-9 seconds. Although informative  in terms of possible

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                                                         Toxicological Review ofBenzo[a]pyrene

 1    delays in sensory motor development, the sensitivity of these measures at these later postnatal ages
 2    is difficult to interpret  Specifically, statistically significant differences observed by Chenetal.
 3    [2012] in the surface righting test were on the order of ~0.2-0.3 seconds and in the negative
 4    geotaxis test, ~3-4 seconds, with no automated recording of latency (such as use of video
 5    recordings). Additionally, male and female rats (which sometimes exhibit differences in the
 6    maturation of these developmental landmarks following challenge) were pooled for these
 7    measures.

 8    Anxiety and activity
 9          Anxiety, attention, and hyperactivity in children ages 6-7 years were examined in relation
10    to benzo[a]pyrene-DNA adducts measured at birth in a follow-up of a birth cohort study conducted
11    in New York City (Pereraetal., 2012b). The associations were stronger using the measures in cord
12    blood compared with maternal samples, with indications of a fourfold increased risk (p  = 0.051) of
13    attention problems associated with cord blood adduct levels above the median compared with 2-
14    fold increased risk associated with maternal blood adduct levels (Table 1-3). Exposure was treated
15    as a dichotomy (i.e., detectable compared with non-detectable levels) in these analyses.
16          Decreased anxiety-like behavior was reported in both rat and mice following postnatal oral
17    exposure to benzo[a]pyrene (Chenetal.. 2012: Bouayedetal.. 2009a] (Table 1-4). Anxiety-like
18    behaviors were measured in both species using an elevated plus maze, where an increase in the
19    time spent in the closed arms of the maze is considered evidence of anxious behavior. In mice,
20    significant increases in the entries and time spent in open arms of the maze, as well as significantly
21    decreased entries into closed arms of the maze (in the 2 mg/kg-day group), were observed on PND
22    32 followinglactational exposure to >2 mg/kg-day benzo[a]pyrene (Bouayedetal.. 2009a). The
23    mice also exhibited decreased latency of the first entry into an open arm following lactational
24    exposure to 20 mg/kg-day benzo[a]pyrene. There was no exposure-related effect on the total
25    number of times the mice entered arms of the maze, indicating the lack of an effect on general
26    locomotor  activity. Decreased anxiety-like behavior was also reported in rats following oral
27    benzo[a]pyrene exposure from PND 5 to 11, although sex-specific differences were observed (Chen
28    etal.. 2012). In females, postnatal exposure to >0.2 mg/kg-day benzo[a]pyrene was associated with
29    a significant increase in the number of open arm entries and significant decreases in the number of
30    closed arm entries on PND 70. Significantly increased time in open arms of the maze was reported
31    in PND 70 female rats following postnatal exposure to >0.02 mg/kg-day.  Male rats also  showed
32    decreased anxiety-like behavior on PND 70, although the  doses needed to detect these responses
33    were higher than females (i.e., increases at >2 mg/kg-day for open arm entries and >0.2 mg/kg-day
34    for time spent in open arms). A significant decrease in latency to enter an open arm of the maze
35    was observed in both male and female rat pups exposed to 2 mg/kg-day benzo[a]pyrene.
36          In contrast to results from the elevated plus maze, no altered reactions were observed in
37    cliff aversion test paradigms (testing stress responses and integration of sensorimotor processes)

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                                                         Toxicological Review ofBenzo[a]pyrene

 1    following postnatal oral exposure to benzo[a]pyrene [Chenetal.. 2012: Bouayedetal.. 2009a].
 2    Increased spontaneous locomotor activity in the open field on PND 69 has been reported in rats
 3    postnatally exposed to >0.2 mg/kg-day [Chenetal.. 2012). Elevated activity in an open field is
 4    attributable primarily to either increased motor activity or decreased anxiety-like behavior,
 5    although the relative contributions of these two components could not be separated.
 6          Increased locomotor activity on PND 69, measured using the open field test, has been
 7    reported in rats postnatally exposed to >0.2 mg/kg-day benzo[a]pyrene on PNDs 5-11 [Chenetal.,
 8    2012], but not in mice exposed lactationally to doses up 20 mg/kg-day and tested on PND 15
 9    fBouayedetal..2009a).

10    Electrophysiological changes
11          Electrophysiological effects of gestational exposure to benzo[a]pyrene have been examined
12    in two studies (by the same research group) through implanted electrodes in the rat cortex and
13    hippocampus (Table 1-4).  Maternal inhalation exposure to 0.1 mg/m3 resulted in reduced long-
14    term potentiation in the dentate gyrus of male offspring between PND 60 and 70 (Wormley etal..
15    2004). Oral exposure of dams to 0.3 mg/kg-day for four days during late gestation resulted in
16    decreased evoked neuronal activity in male offspring following mechanical whisker stimulation
17    between PND 90 and 120 fMcCallister etal.. 20081 Specifically,  the authors noted reduced spike
18    numbers in both short and long latency responses following whisker stimulation. These effects
19    were observed several months post-exposure, suggesting that gestational benzo[a]pyrene exposure
20    has long-lasting functional effects on neuronal activity elicited by sensory stimuli.
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                                                               Toxicological Review ofBenzo[a]pyrene
1
2
Table 1-3.  Evidence pertaining to the neurodevelopmental effects of
benzo[a]pyrene from PAH mixtures
          Reference and Study Design
                                                         Results
     Tang et al. (2008); Tang et al. (2006)
     Tongliang, China
     Birth cohort
     150 non-smoking women, delivered
     March 2002-June 2002; lived within 2.5
     km of power plant that operated from
     December 2001 to May 2002
     Outcomes: head circumference at birth;
     Gesell Developmental Schedule,
     administered by physicians at 2 years of
     age (4 domains: motor, adaptive,
     language, and social); standardized mean
     score = 100 ± SD 15 (score < 85 =
     developmental delay)
     Exposure:  mean hours per day exposed to
     ETS 0.42 (SD  1.19); lived within 2.5 km of
     power plant that operated from
     December 2001 to May 2002;
     benzo[a]pyrene-DNA adducts from
     maternal and cord blood samples; cord
     blood mean 0.33 (SD 0.14) (median 0.36)
     adducts/108 nucleotides; maternal blood
     mean 0.29 (SD 0.13) adducts/10"8
     nucleotides
                              Relation between cord blood benzo[a]pyrene-DNA adducts and
                              log-transformed head circumference
                                                                      Beta (p-value)
                                           Birth                       -0.011 (0.057)
                                          18 mo                       -0.012 (0.085)
                                          24 mo                       -0.006(0.19)
                                          30 mo                       -0.005 (0.31)
                              High versus low, dichotomized at median, adjusted for ETS, sex
                              of child, maternal height, maternal weight, Cesarean section
                              delivery, maternal head circumference, and gestational age (for
                              measures at birth)
     Tang et al. (2008); Tang et al. (2006)
     (See above for population and exposure
     details); n = 110 for Developmental
     Quotient analysis.  No differences
     between the 110 participants in this
     analysis and the nonparticipants with
     respect to maternal age, gestational age,
     birth weight, birth length, or birth head
     circumference. Higher maternal
     education (direction not reported, p =
     0.056)
     Outcomes: Gesell Developmental
     Schedule, administered by physicians at 2
     years of age (4 domains: motor, adaptive,
     language, and social); standardized mean
     score = 100 ± SD 15 (score < 85 =
     developmental delay)
                              Association between benzo[a]pyrene adducts and development
                                                      Beta (95% Cl)a
                        OR (95% Cl)
                                     Motor
                                    Adaptive
                                    Language
                                     Social
                                    Average
-16.0 (-31.3, -0.72)*

 -15.5 (-35.6, 4.61)

 -16.6 (-33.7, 0.46)

 -9.29 (-25.3, 6.70)

-14.6 (-28.8, -0.37)*
1.91  (1.22,2.97)*

1.16  (0.76, 1.76)

1.31  (0.84,2.05)

1.52  (0.93,2.50)

1.67 0.93,3.00)
                              aLinear regression of change in Developmental Quotient per unit
                               increase in benzo[a]pyrene adducts
                              bLogistic regression of risk of developmental delay (defined as
                               normalized score < 85) per 1 unit (0.1 adducts/10"8 nucleotides)
                               increase in adducts
                              Both analyses adjusted for sex, gestational age, maternal education,
                               ETS, and cord lead levels
                              Cl = confidence level; OR = odds ratio
     Pereraetal. (2012a); Tang et al. (2008);
     Tangetal. (2006)
     (See above for population and exposure
     details); 132 (83%) followed through age
     5; 100 of these had complete data for
                              Environmental tobacco smoke (ETS) measure not correlated with
                              benzo[a]pyrene adduct measures (i.e., absolute value of Spearman r <
                              0.10)
                              Relation between cord blood benzo[a]pyrene-DNA adducts, ETS
                              exposure, and IQ measures
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                                                               Toxicological Review ofBenzo[a]pyrene
          Reference and Study Design
                                                                 Results
     analysis.  No differences between the 100
     participants in this analysis and the
     nonparticipants with respect to adduct
     levels, environmental tobacco smoke
     exposure, IQ measures, maternal age,
     gestational  age, or infant gender. Higher
     maternal education (60% and 35% with >
     high school, respectively, in participants
     and non-participants, p < 0.05)
     Outcomes: Wechsler Preschool and
     Primary Intelligence Quotient scale
     (Shanghai version)
                                                               Beta (95% Cl)
                                                           Main Effect
                   With ETS Interaction term
                                          Full scale
                                           Verbal
                                        Performance
-2.42 (-7.96, 3.13)

-1.79 (-7.61, 4.03)

-2.57 (-8.92, 3.79)
-10.10 (-18.90,-1.29)

-10.35 (-19.61, -1.10)

 -7.78 (-18.03,2.48)
                                      Beta per 1 unit increase in log-transformed cord adducts, adjusted for
                                      ETS exposure, gestational age, maternal education, cord lead, maternal
                                      age, and gender
     Perera et al. (2012b); Perera et al.
     (2005b); Perera et al. (2004)
     United States, New York
     Birth cohort
     265 pregnant women : African-American
     and Dominican non-smoking women that
     delivered babies between April 1998-
     October 2002 (253 and 207 for behavior
     and head circumference analysis,
     respectively); approximately 40% with
     smoker in the home
     Outcomes:  head circumference at birth
     Exposure: benzo[a]pyrene-DNA adducts
     from maternal and cord blood samples;
     mean 0.22 (SD 0.14) adducts/10"8
     nucleotides; median of detectable values
     0.36 adducts/10"8 nucleotides
                                      Relation between cord blood benzo[a]pyrene-DNA adducts,
                                      environmental tobacco smoke exposure (ETS), and log-
                                      transformed head circumference
                                                                              Beta (p-value)
                                              Interaction term
                                        benzo[a]pyrene-DNA adducts
                                                ETS in home
                      -0.032 (0.01)

                      -0.007 (0.39)

                      -0.005 (0.43)
                                      High versus low, dichotomized at 0.36 adducts/10"8 nucleotides,
                                      adjusted for ethnicity, sex of newborns, maternal body mass
                                      index, dietary PAHs, and gestational age
     Perera et al. (2012b);
     n = 215 with outcome data and no missing
     covariate data). No differences between
     the participants in this analysis and the
     nonparticipants with respect to adduct
     levels, environmental tobacco smoke
     exposure, maternal age, gestational age,
     and socioeconomic variables; participants
     more likely to be female and African-
     American
     Outcomes:  Child Behavior Checklist (118
     items), completed by mothers for children
     ages 6-7 yrs.  Two domains: anxious/
     depression, attention problems
     (normalized T-score <65 = borderline or
     clinical syndrome); also used for scales of
     anxiety problems and attention deficit
     hyperactivity problems based on DSM
     classification
                                      Logistic regression of risk of borderline or clinical status in
                                      relation to detectable levels of benzo[a]pyrene adducts
                                                                        Maternal       Cord blood
                                                          Prevalence    OR (95% Cl)      OR (95% Cl)
                                      Anxious/depressed      6.32 %    1.4 (0.38, 5.4)    2.6 (0.69, 9.4)
                                      Attention problems     6.72%    2.2(0.74,6.8)   4.1(0.99,16.6)
                                      Anxiety (DSM)          9.48%    2.2(0.79,6.1)    2.5(0.84,7.7)

                                      Attention deficit-                1.8(0.66,5.1)   2.6(0.68,10.3)
                                      hyperactivity (DSM)
                                      Exposure dichotomized as detectable (n = 87 maternal, 56 cord
                                      blood samples) versus non-detectable; adjusted for sex,
                                      gestational age, maternal education, maternal IQ, prenatal ETS,
                                      ethnicity, age, heating season, prenatal demoralization, and
                                      HOME inventory
1
2
*Statistically significantly different from the control (p < 0.05).
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                                                               Toxicological Review ofBenzo[a]pyrene
1
2
Table 1-4. Evidence pertaining to the neurodevelopmental effects of
benzo[a]pyrene in animals
        Reference and Study Design
                                                       Results3
     Cognitive function
     Chen etal. (2012)
     Sprague-Dawley rats, 20 pups
     (10 male and 10 female)/group
     0, 0.02, 0.2, or 2 mg/kg-d by gavage
     PNDs 5-11
                         Hidden Platform test in Morris water maze (day 4 of testing):
                                 PND 39: significant increase in escape latency at 2 mg/kg-d only
                                 PND 74: significant increase in escape latency at >0.2 mg/kg-d
                                 Increases in latency were observed in trials 1-3 ( PND 36-38 or PND
                                 71-73): ~30+% greater than controls at 2 mg/kg-day (note: all
                                 experimental groups exhibited similar decreases in escape latency-
                                 slopes were visually equivalent, across the four trial days)

                         Probe test in the Morris water maze (day 5):
                                 Time spent in the target quadrant:
                                 PND 40: significant decrease at 2 mg/kg-d only
                                 PND 75: significant decrease at >0.2 mg/kg-d

                                 Number of platform crossings:
                                 PND 40: significant decrease at 2 mg/kg-d only
                                 PND 75: significant decrease at >0.2 mg/kg-d (in females) and
                                 2 mg/kg-d (in males)
     Bouayed etal. (2009a)
     Female Swiss albino mice, 5/group
     0, 2, or 20 mg/kg-d maternal gavage
     PNDs 0-14 (lactational exposure)
                         Significant increase in the percent of spontaneous alternations in the Y-maze
                         alternation test at 2 mg/kg-d but not at 20 mg/kg-d

                         No effect on the total number of arm entries in the Y-maze alternation test
     Neuromuscularfunction,  coordination, and sensorimotor development
     Chen etal. (2012)
     Sprague-Dawley rats, 20 pups
     (10 male and 10 female)/group
     0, 0.02, 0.2, or 2 mg/kg-d by gavage
     PNDs 5-11
                         Latency in the surface righting reflex test
                                 PND 12: significant increase at 0.2 mg/kg-d only
                                 PND 14: significant increase at 0.02 and 2 mg/kg-d only
                                 PND 16: significant difference at 2 mg/kg-d only
                                 PND 18: no significant difference

                         Latency in the negative geotaxis test
                                 PND 12: significant increase at all doses
                                 PND 14: significant increase at 2 mg/kg-d only
                                 PNDs 16 and 18: no significant difference

                         No effect on duration of forelimb grip in forelimb grip strength test
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                                          Toxicological Review ofBenzo[a]pyrene
Reference and Study Design
Bouaved etal. (2009a)
Female Swiss albino mice, 5/group
0, 2, or 20 mg/kg-d maternal gavage
PNDs 0-14 (lactational exposure)




Results3
Significant increase in righting time in the surface righting reflex test at both
doses on PNDs 3 and 5 (but not PNDs 7 and 9)
Significant increase in latency in the negative geotaxis time for 20 mg/kg-d
dose group at PNDs 5, 7, and 9 (no significant difference at PND 11)
Significant increase in duration of forelimb grip in forelimb grip strength test
at both dose groups on PND 9 (statistically significant at PND 11 only at high
dose)
Significant increase in pole grasping latency in male pups in the water escape
pole climbing test at 20 mg/kg-d
No effect on climbing time in the water escape pole climbing test
Significant increase in pole escape latency in the water escape pole climbing
test in male rats at 20 mg/kg-d
Anxiety and/or motor activity
Chen etal. (2012)
Sprague-Dawley rats, 20 pups
(10 male and 10 female)/group
0, 0.02, 0.2, or 2 mg/kg-d by gavage
PNDs 5-11







Bouaved etal. (2009a)
Female Swiss albino mice, 5/group
0, 2, or 20 mg/kg-d maternal gavage
PNDs 0-14 (lactational exposure)

Elevated plus maze
Significant increase in the number of entries into open arms at PND 70 at
>0.2 mg/kg-d (in females) and 2 mg/kg-d (in males) (no difference at PND
35)
Significant decrease in the number of entries into closed arms at PND 70 at
>0.2 mg/kg-d (in females) and 2 mg/kg-d (in males) (no difference at PND
35)
Significant increase in the time spent in open arms at PND 35 at 2 mg/kg-d in
females and at PND 70 at doses >0.02 mg/kg-d in females and >0.2 mg/kg-d
in males
Significant decrease in latency time to first enter an open arm on PND 70 at
>0.2 mg/kg-d (no difference at PND 35)
Open field test
Significant increase in the number of squares: PND 34- significant increase at
2 mg/kg-d; PND 69; significant increase at >0.02 mg/kg-d (no difference at
PNDs 18 and 20)
Significant increase in rearing activity at 0.2 mg/kg-d on PND 69 (no
difference at PNDs 18, 20, and 34)
Cliff aversion test
No effect on the latency to retract from the edge
Elevated plus maze
Significantly increased time in open arms at >2 mg/kg-d
Significantly increased percentage of entries into open arms at >2 mg/kg-d
Significantly decreased entries into closed at 2 mg/kg-d, but not at 20
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                                                      Toxicological Review ofBenzo[a]pyrene
Reference and Study Design

Results3
mg/kg-d
Significantly decreased latency time to enter an open arm at 20 mg/kg-d
No effect on the total number of arm entries
Open field test
No significant change in activity on PND 15
Electrophysiological changes
McCallister et al. (2008)
Long-Evans Hooded rats, 5-6/group
0 or 0.3 mg/kg-d by gavage
CDs 14-17
Wormlev et al. (2004)
F344 rats, 10 females/group
0 or 100 u.g/m3 nose-only inhalation
for 4 hrs/d
CDs 11-21
Statistically significant decreases in stimulus-evoked cortical
activity on PNDs 90-120
Reduction in the number of spikes in both the short and long
on PNDs 90-120 (numerical data not presented)
Electrophysiological changes in the hippocampus:
Consistently lower long term potentiation following
exposure (statistical analysis not reported)
% change relative to control: -26%
neuronal
; latency periods
gestational
% change from control calculated as: (treated value - control value)/control value x 100.
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                                                         Toxicological Review ofBenzo[a]pyrene
       100
        10 =
         1 =
       o
       Q
        0.1 -.
       0.01
                                                    > Doses > LOACL O Doses < NOACL
                                                                                 1" motor
 2          Figure 1-2. Exposure-response array for neurodevelopmental effects
 3          following oral exposure.
 4

 5    Mode of Action Analysis- Developmental Toxicity
 6          Data regarding the potential mode of action for the various manifestations of developmental
 7    toxicity associated with benzo[a]pyrene exposure are limited, and the mode of action for
 8    developmental toxicity is not known. General hypothesized modes of action for the various
 9    observed developmental effects include, but are not limited to altered cell signaling, genotoxicity,
10    cytotoxicity, and oxidative stress.
11          It is plausible that developmental effects of benzo[a]pyrene may be mediated by altered cell
12    signaling through the Ah receptor (AhR). Benzo[a]pyrene is a ligand for the AhR and activation of
13    this receptor regulates downstream gene expression including the induction of GYP enzymes
14    important in the conversion of benzo[a]pyrene into reactive metabolites. Studies in AhR knock-out
15    mice indicate that AhR signaling during embryogenesis is essential for normal liver, kidney,
16    vascular, hematopoietic, and immune development [Schmidt etal., 1996: Fernandez-Salguero etal.,
17    1995]. In experiments in AhR responsive and less-responsive mice, the mice with the less
18    responsive AhR were protected from renal injury as adults following gavage treatment with  0.1 or
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                                                         Toxicological Review ofBenzo[a]pyrene

 1    0.5 mg/kg-day benzo[a]pyrene from GD 10-13. Renal injury was indicated by an increase in
 2    urinary albumin and a decrease in glomerular number [Nanez etal.. 2011).
 3          Low birth weight has been associated with prenatal exposure to PAHs in human
 4    populations [Pereraetal., 2005b]. Several epidemiology studies have revealed an inverse
 5    association between low birth weight and increased blood pressure, hypertension, and measures of
 6    decreased renal function as adults [Zandi-Nejadetal., 2006]. It has been hypothesized that this
 7    may be attributable to a congenital nephron deficit associated with intrauterine growth restriction
 8    fZandi-Neiadetal.. 20061.
 9          No clear mode(s) of action for the observed neurodevelopmental and neurobehavioral
10    changes following benzo[a]pyrene exposure have been demonstrated. General hypothesized
11    mechanisms with limited evidentiary support are related to  altered CNS neurotransmission. These
12    mechanisms involve altered neurotransmitter gene expression, and neurotransmitter levels, in
13    regions associated with spatial learning, anxiety, and aggression, such as the hippocampus,
14    striatum, and hypothalamus [Li etal.. 2012: Oiu etal.. 2011:  Tang etal.. 2011: Xia etal.. 2011:
15    Bouayedetal.. 2009a: Grovaetal.. 2008: Brown etal.. 2007:  Grovaetal.. 2007: Stephanouetal..
16    1998). Specifically, benzo[a]pyrene exposure caused changes associated with potential
17    modifications to the dopaminergic andserotonergic systems [Bouayedetal.. 2009a: Stephanou et
18    al., 1998], as well as NMDA receptor signaling [Qiuetal., 2011]. Increased oxidative stress in these
19    same regions has also been proposed as a mechanism [Saunders etal., 2006].

20    Summary of Developmental Effects
21          Developmental effects  following in utero exposure to PAH mixtures or benzo[a]pyrene
22    alone have been reported in humans and in animal models.  In human populations, decreased head
23    circumference, decreased birth weight, and decreased postnatal weight have been reported.
24    Analogous effects in laboratory animals, including decreased pup weight and decreased fetal
25    survival, have been noted following gestational or early postnatal exposure to benzo[a]pyrene by
26    the oral or inhalation route [Chen etal., 2012: Archibongetal., 2002:  Mackenzie and Angevine,
27    1981]. Reproductive function is also altered in mice treated gestationally with benzo[a]pyrene
28    [Kristensenetal.. 1995: Mackenzie and Angevine. 1981]. These effects include impaired
29    reproductive performance in Fl offspring (male and female] and alterations of the weight and
30    histology of reproductive organs (ovaries and testes].
31          The available human and animal data also support the conclusion thatbenzo[a]pyrene is a
32    developmental neurotoxicant  Human studies of environmental PAH  exposure in two cohorts have
33    observed neurotoxic effects, including suggestions of reduced head circumference (Tang etal.,
34    2006: Pereraetal.. 2005b: Pereraetal.. 2004], impaired cognitive ability (Pereraetal.. 2009: Tang
35    etal.. 2008]. impaired neuromuscular function (Tang etal.. 2008]. and increased attention
36    problems and anxious/depressed behavior following prenatal exposure (Pereraetal.. 2012b].
37    These effects were seen in birth cohort studies in different populations (New York City and China],

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                                                        Toxicological Review ofBenzo[a]pyrene

 1    in studies using specific benzo[a]pyrene measures (i.e., adduct levels measured in cord blood
 2    samples) [Pereraetal.. 2012b: Tang etal.. 2008: Tangetal.. 2006: Pereraetal.. 2005b: Pereraetal..
 3    2004). This type of measure covers a relevant time window of exposure with respect to gestational
 4    development The analytical method was the same in the two studies (with a common set of
 5    investigators). The coefficient of variation of the exposure measures was relatively small (12%),
 6    but a high proportion of samples were below the detection limit; thus, these studies were limited in
 7    terms of ability to examine a broad range of exposure. The available evidence from mice and rats
 8    also demonstrates significant and persistent developmental impairments following exposure to
 9    benzo[a]pyrene. Impaired learning and memory behaviors and impaired neuromuscular function
10    were consistently observed in multiple neurobehavioral tests in two separate species at
11    comparable doses in the absence of maternal or neonatal toxicity (Chen etal., 2012: Bouayedetal.,
12    2009a).
13          In conclusion, the available human and animal data suggest that developmental toxicity and
14    developmental neurotoxicity are hazards of benzo[a]pyrene exposure.

15    Suscep tible Pop illations an d Lifestages
16          Childhood susceptibility to benzo[a]pyrene toxicity is indicated by epidemiological studies
17    reporting associations between adverse birth outcomes and developmental effects and internal
18    biomarkers of exposure to benzo[a]pyrene, presumably via exposure to complex PAH mixtures
19    (Pereraetal.. 2012b: Pereraetal.. 2009: Tangetal.. 2008: Tangetal.. 2006: Pereraetal.. 2005b:
20    Pereraetal., 2005a: Perera etal., 2004). The occurrence of benzo[a]pyrene-specific DNAadducts in
21    maternal and umbilical cord blood in conjunction with exposure to ETS was associated with
22    reduced birth weight and head circumference in offspring of pregnant women living in New York
23    City (Pereraetal., 2005b). In other studies, elevated levels of BPDE-DNA adducts in umbilical cord
24    blood were associated with:  (1) reduced birth weights or reduced head circumference (Perera et
25    al.. 2005a: Pereraetal.. 2004): and (2) decreased body weight at 18, 24, and 30 months (Tangetal..
26    2008: Tangetal.. 2006).
27          Studies in humans and experimental animals indicate that exposure to PAHs in general, and
28    benzo[a]pyrene in particular, may impact neurological development.  Observational studies in
29    humans have suggested associations between gestational exposure to PAHs and later measures of
30    neurodevelopment (Perera etal.. 2009: Tangetal.. 2008). In the Perera etal. (2009) study, the
31    exposure measures are based on a composite of 8 PAHs measured in air.  In Tangetal.. (2008).
32    increased levels of benzo[a]pyrene-DNA adducts in cord blood were associated with decreased
33    developmental quotients in offspring  (Tangetal., 2008).
34          Evidence in animals of the effects of benzo[a]pyrene on neurological development includes:
35    (1) decreased electrophysiological response to electrical stimulation of the dentate gyrus of the
36    hippocampus and increased brain concentrations of benzo[a]pyrene metabolites in offspring of
37    F344 rats exposed by inhalation to benzo[a]pyrene:carbon black aerosols on CDs 11-21 (Wormley

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                                                         Toxicological Review ofBenzo[a]pyrene

 1    etal.. 2004: Wu etal.. 2003a]: (2) decreased evoked response in the field cortex and decreased
 2    cerebrocortical levels of messenger RNA for the N-methyl-D-aspartate receptor subunit in offspring
 3    of Long-Evans rats exposed to 300  [J.g/kg on CDs 14-17 [McCallister et al.. 2008): and (3) decreased
 4    righting reflex and altered anxiety-like behavior in offspring of lactating rats exposed to oral doses
 5    of 2 or 20 mg/kg-day on PNDs 1-14 (Bouayed etal.. 2009a).

 6    1.1.2.  Reproductive Toxicity
 7           Human and animal studies provide evidence for benzo[a]pyrene-induced male and female
 8    reproductive toxicity.  Effects on sperm quality and male fertility have been demonstrated in human
 9    populations highly exposed to PAH mixtures [Spares and Melo, 2008: Hsu etal., 2006]. The use of
10    internal biomarkers of exposure in humans (e.g., BPDE-DNA adducts) support associations between
11    benzo[a]pyrene exposure and these effects. In females, numerous epidemiological studies indicate
12    that cigarette smoking reduces fertility; however, few studies have specifically examined levels of
13    benzo[a]pyrene exposure and female reproductive outcomes.  Animal studies demonstrate
14    decrements in sperm quality, changes in testicular histology, and hormone alterations following
15    benzo[a]pyrene exposure in adult male animals, and decreased fertility and ovotoxic effects in adult
16    females following exposure to benzo[a]pyrene.

17    Male Reproductive Effects
18    Fertility
19           Effects on male fertility have been demonstrated in populations exposed to mixtures of
20    PAHs. Spermatozoa from smokers  have reduced fertilizing capacity, and embryos display lower
21    implantation rates [Spares and Melo. 2008). Occupational PAH exposure has been associated with
22    higher levels of PAH-DNA adducts in sperm and male infertility [Gaspari et al.. 2003). In addition,
23    men with higher urinary levels of PAH metabolites have been shown to be more likely to be infertile
24    [Xiaetal., 2009].  Studies were not identified that directly examined the reproductive capacity of
25    adult animals following benzo[a]pyrene exposure.  However, a dose-related decrease in fertility
26    was observed in male mice treated in utero with benzo[a]pyrene, as discussed in Section 1.1.1.

27    Sperm parameters
28           Effects on semen quality have been demonstrated in populations exposed to mixtures of
29    PAHs including coke oven workers  and smokers [Spares and Melo, 2008: Hsu etal., 2006]. Coke
30    oven workers had higher frequency of oligospermia (19 versus 0% in controls] and twice the
31    number of morphologically abnormal sperm (Hsu etal., 2006]. Elevated levels of BPDE-DNA
32    adducts have been measured in the sperm of populations exposed to PAHs occupationally (Gaspari
33    etal.. 2003] and through cigarette smoke (Phillips. 2002: Zenzes etal.. 1999]. A higher
34    concentration of BPDE-DNA adducts was observed in sperm not selected for intrauterine
35    insemination or in vitro fertilization based on motility and morphology in patients of fertility clinics

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                                                        Toxicological Review ofBenzo[a]pyrene

 1    [Perrinetal.. 2011b: Perrinetal.. 2011a]. An association between benzo[a]pyrene exposure levels
 2    and increased sperm DNA fragmentation using the sperm chromatin structure assay was observed
 3    by Rubes etal. [2010]. However, it is currently unclear whether the sperm chromatin structure
 4    assay, which measures sperm fragmentation following denaturation, is predictive of fertility
 5    [Sakkas and Alvarez. 2010: ASRM. 20081.
 6          In several studies in rats and mice, a decrease in sperm count, motility, and production and
 7    an increase in morphologically abnormal sperm have been reported (Table 1-5). Alterations in
 8    these sperm parameters have been observed in different strains of rats and mice and across
 9    different study designs and routes of exposure.
10          Decreases in epididymal sperm counts (25-50% compared to controls) have been reported
11    in Sprague-Dawley rats and C57BL6  mice treated with 1-5 mg/kg-day benzo[a]pyrene by oral
12    exposure for 42 or 90 days (Chen etal., 2011: Mohamedetal., 2010). Additionally, a 15% decrease
13    in epididymal sperm count was observed at a dose 100-fold lower in Sprague-Dawley rats exposed
14    to benzo[a]pyrene for 90 days (Chung etal., 2011). However, confidence in this study is limited
15    because the authors dosed the animals with 0.001, 0.01, and 0.1  mg/kg-day benzo[a]pyrene, but
16    only reported on sperm parameters at the mid-dose, and no other available studies demonstrated
17    findings in the range of the mid- and high-dose. In rats, an oral short-term study and a subchronic
18    inhalation study lend support for the endpoint of decreased sperm count (Arafaetal., 2009:
19    Archibong et al., 2008: Rameshetal., 2008). Significantly decreased sperm count and daily sperm
20    production (~40% decrease from control in each parameter) were observed following 10 days of
21    gavage exposure to 50 mg/kg-day benzo[a]pyrene in rats (Arafaetal., 2009). In addition, a 69%
22    decrease from controls in sperm count was observed in rats following inhalation exposure to 75
23    Mg/m3benzo[a]pyrene for 60 days (Archibongetal..  2008: Rameshetal.. 2008).
24          Both oral and inhalation exposure of rodents to benzo[a]pyrene have been shown to lead to
25    decreased epididymal sperm motility and altered morphology. Decreased motility of 20-30%
26    compared to controls was observed in C57BL6 mice  (>1 mg/kg-day) and Sprague-Dawley rats
27    (0.01 mg/kg-day) (Chung etal., 2011: Mohamed etal., 2010).  The effective doses spanned two
28    orders of magnitude; however, as noted above, reporting is limited in the study that observed
29    effects at 0.01 mg/kg-day benzo[a]pyrene (Chung etal., 2011). A short-term oral study in rats also
30    reported a significantly decreased number of motile sperm (~40% decrease) following 10 days of
31    gavage exposure to 50 mg/kg-day benzo[a]pyrene (Arafa et al.. 2009). In addition, decreased
32    sperm motility was observed following inhalation exposure to 75 |ig/m3 benzo[a]pyrene in rats for
33    60 days (Archibong etal.. 2008: Rameshetal.. 2008) and to >75  [ig/m3 for 10 days (Inyangetal..
34    2003). Abnormal sperm morphology was observed in Sprague-Dawley rats treated with 5 mg/kg-
35    day benzo[a]pyrene by gavage for 84 days (Chen etal., 2011] and in rats exposed to 75  |ig/m3
36    benzo[a]pyrene by inhalation for 60  days (Archibong etal., 2008: Rameshetal., 2008).
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                                                         Toxicological Review ofBenzo[a]pyrene

 1    Testicular changes
 2           Several studies have demonstrated dose-related effects on male reproductive organs in
 3    adult animals exposed subchronically to benzo[a]pyrene (Table 1-5).  Decreases in testicular
 4    weight of approximately 35% have been observed in a 10-day gavage study in adult Swiss albino
 5    rats exposed to 50 mg/kg-day benzo[a]pyrene [Arafa etal., 2009] and following subchronic
 6    inhalational exposure of adult F344 rats to 75 |J.g/m3 [Archibongetal., 2008: Rameshetal., 2008].
 7    No effects on testes weight were observed in Wistar rats exposed for 35 days to gavage doses up to
 8    50 mg/kg-day [Kroese etal., 2001] F344 rats exposed for 90 days to dietary doses up to 100
 9    mg/kg-day [Knuckles etal.. 2001]: or Sprague-Dawley rats exposed for 90 days to gavage doses up
10    to 0.1 mg/kg-day [Chung etal.. 2011]. Strain differences may have contributed to differences in
11    response, however, F344 rats exposed to benzo[a]pyrene via inhalation showed effects on
12    testicular weight [Archibong et al., 2008: Ramesh et al., 2008].  In addition, decreased testicular
13    weight has also been observed in offspring following in utero exposure to benzo[a]pyrene as
14    discussed in Section 1.1.1.
15           Histological changes in the testis have often been reported to accompany decreases in
16    testicular weight Apoptosis, as evident by increases in terminal deoxynucleotidyl transferase dUTP
17    nick end labeling (TUNEL] positive germ cells and increases in caspase-3 staining, was evident in
18    seminiferous tubules of Sprague-Dawley rats following 90 days of exposure to >0.001 and
19    0.01 mg/kg-day, respectively, benzo[a]pyrene by gavage [Chung etal., 2011]. However, the study
20    authors did not observe testicular atrophy or azospermia in any dose group. Seminiferous tubules
21    were reported to look qualitatively similar between controls and animals exposed to
22    benzo[a]pyrene by inhalation doses of 75 |ig/m3 for 60 days  [Archibong et al., 2008: Ramesh etal.,
23    2008].  However, when histologically examined, statistically significantly reduced tubular lumen
24    size and length were observed in treated animals.  Seminiferous tubule diameters also appeared to
25    be reduced in exposed animals, although this difference did not reach statistical significance
26    [Archibongetal., 2008: Rameshetal., 2008]. In addition, histological changes in the seminiferous
27    tubules have also been observed in offspring following in utero exposure to benzo[a]pyrene as
28    discussed in Section 1.1.1.

29    Epididymal changes
30           In addition to testicular effects, histological effects in the epididymis have been observed
31    following 90-day gavage exposure to benzo[a]pyrene [Chung etal., 2011] (Table 1-5]. Specifically,
32    statistically significant decreased epididymal tubule diameter (for caput and cauda] was observed
33    at doses >0.001 mg/kg-day. Atthe highest dose tested (0.1 mg/kg-day], diameters were reduced
34    approximately 25%.  No  changes in epididymis weights were observed following an 84-day
35    treatment in Sprague-Dawley rats of 5 mg/kg-day benzo[a]pyrene (Chen etal.. 2011].
                This document is a draft for review purposes only and does not constitute Agency policy.
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                                                            Toxicological Review ofBenzo[a]pyrene


 1    Hormone changes
 2           Several animal models have reported decreases in testosterone following both oral and
 3    inhalation exposure to benzo[a]pyrene (Table 1-5). In male Sprague-Dawley rats, decreases in
 4    testosterone have been observed following 90-day oral exposures [Chung etal., 2011: Zheng etal.,
 5    2010]. Statistically significant decreases of 15% in intratesticular testosterone were observed at
 6    5 mg/kg-day in one study [Zheng etal., 2010], while a second study in the same strain of rats
 7    reported statistically significant decreases of approximately 40% in intratesticular testosterone and
 8    70% in serum testosterone at 0.1 mg/kg-day [Chung et al., 2011 ].  Statistically significant decreases
 9    in intratesticular testosterone (80%] and serum testosterone (60%] were also observed following
10    inhalation exposure to 75 |J.g/m3 benzo[a]pyrene in F344 rats for 60 days (Archibongetal.. 2008:
11    Ramesh et al., 2008]. Statistically significant increases in serum luteinizing hormone (LH] have also
12    been observed in Sprague-Dawley rats following gavage exposure to benzo[a]pyrene at doses of
13    >0.01 mg/kg-day (Chung etal., 2011] and in F344 rats following inhalation exposure to 75 |ig/m3
14    benzo[a]pyrene for 60 days (Archibongetal.. 2008: Ramesh etal.. 20081
15
16
Table 1-5. Evidence pertaining to the male reproductive toxicity of
benzo[a]pyrene in adult animals
           Reference and Study Design
                                                      Results
      Sperm quality
      Mohamed et al. (2010)
      C57BL/6 mice, 10 males/dose
      (treated before mating with unexposed
      females)
      0,1, or 10 mg/kg-d, daily gavage (FO males
      only)
      42 d
                               epididymal sperm count in FO mice
                             Approximate % change from control:
                                    0, -50*, and -70*
                             (data reported graphically)

                             i, epididymal sperm motility in FO mice
                             Approximate % change from control:
                                    0, -20*, and -50*
                             (data reported graphically)

                             •^ epididymal sperm count in untreated Fl and F2 generations
                             (data reported graphically)

                             No effects were observed in the F3 generation
      Chen etal. (2011)
      Sprague-Dawley rats, 10 males/dose
      0 or 5 mg/kg-d by gavage
      84 d
                               epididymal sperm count (% change from control)
                                    0 and-29*

                               % abnormal epididymal sperm
                                    5 and 8*
      Chung etal. (2011)
      Sprague-Dawley rats, 20-25 males/dose
      0, 0.001, 0.01, or 0.1 mg/kg-d by gavage
      90 d
                               epididymal sperm motility (% change relative to control; reported
                             only for 0.01 mg/kg-d)
                                    0 and-30*

                             No statistically significant decrease in epididymal sperm count
                This document is a draft for review purposes only and does not constitute Agency policy,
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                                          Toxicological Review ofBenzo[a]pyrene
Reference and Study Design
Archibong et al. (2008); Ramesh et al.
(2008)
F344 rats, 10 males/group
0 or 75 u.g/m3, 4 hrs/d by inhalation
60 d
Results
•i, epididymal sperm motility (% change from control)
0 and -73*
•^ epididymal sperm count (% change from control)
0 and -69*
/T" % abnormal epididymal sperm
33 and 87*
•i, spermatids/g testis (approximate % change from control; numerical
data not reported)
0 and -45*
Testicular changes (weight, histology)
Mohamed et al. (2010)
C57BL/6 mice, 10 males/dose
(treated before mating with unexposed
females)
0, 1, or 10 mg/kg-d, daily gavage (FO males
only)
42 d
Chung etal. (2011)
Sprague-Dawley rats, 20-25 males/dose
0, 0.001, 0.01, or 0.1 mg/kg-d by gavage
90 d
Chen etal. (2011)
Sprague-Dawley rats, 10/dose
0 or 5 mg/kg-d by gavage
84 d
Archibong et al. (2008); Ramesh et al.
(2008)
F344 rats, 10 adult males/group
0 or 75 u.g/m3, 4 hrs/d by inhalation
60 d
Kroese et al. (2001)
Wistar rats, 10/sex/dose
0, 1.5, 5, 15, or 50 mg/kg-d by gavage,
5d/wk
35 d
Knuckles etal. (2001)
F344 rats, 20/sex/dose
0, 5, 50, or 100 mg/kg-d in diet
90 d
•i, seminiferous tubules with elongated spermatids (approximate %
change from control; numerical data not reported)
0, -20*, and -35*
No statistically significant change in area of seminiferous epithelium
of testis (approximate % change from control; numerical data not
reported)
0, 5, and 20
1" number of apoptotic germ cells per tubule (TUNEL or caspase 3
positive)
No change in testis weight or histology
/T" testicular lesions characterized as irregular arrangement of germ
cells and absence of spermatocytes (numerical data not reported)
No change in testis weight
•i, decreased testis weight (% change from control)
0 and 34*
•^ size of seminiferous tubule lumens and reduced tubular length
No change in % of tubules with elongated spermatids
No change in testis weight
No change in testis weight
This document is a draft for review purposes only and does not constitute Agency policy,
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                                                              Toxicological Review ofBenzo[a]pyrene
Reference and Study Design
Epididymal changes (weight, histology)
Chung etal. (2011)
Sprague-Dawley rats, 20-25 males/dose
0, 0.001, 0.01, or 0.1 mg/kg-d by gavage
90 d
Chen etal. (2011)
Sprague-Dawley rats, 10/dose
0 or 5 mg/kg-d by gavage
84 d
Hormone changes
Chung etal. (2011)
Sprague-Dawley rats, 20-25 males/dose
0, 0.001, 0.01, 0.1 mg/kg-d by gavage
90 d
Zheng etal. (2010)
Sprague-Dawley rats, 8 males/dose
0, 1, or 5 mg/kg-d by gavage
90 d
Archibong et al. (2008); Ramesh et al.
(2008)
F344 rats, 10 adult males/group
0 or 75 u.g/m3, 4 hrs/d by inhalation
60 d
Results

•^ diameter of caput epididymal tubule (n = 5; numerical data not
reported)
•^ diameter of cauda epididymal tubule (n = 5; numerical data not
reported)
No change in epididymis weight


•i, Intratesticular testosterone (approximate % change from control;
data reported graphically)
0, -12, -25, and -40*
•i, Serum testosterone (approximate % change from control ;
numerical data not reported)
0, 0, -35, and -70*
1" serum LH (approximate % change from control; numerical data not
reported)
0, 33, 67*, and 87*
•i, hCG or dbcAMP-stimulated testosterone production in Leydig cells
•^ Intratesticular testosterone (approximate % change from control;
numerical data not reported)
0, -15, and -15*
•^ intratesticular testosterone (approximate % change from control;
numerical data not reported)
0 and -80*
•i, serum testosterone (approximate % change from control)
0 and -60*
1" serum LH (approximate % change from control)
0 and 50*
1
2
3
*Statistically significantly different from the control (p < 0.05).
a % change from control calculated as: (treated value - control value)/control value x 100.
                This document is a draft for review purposes only and does not constitute Agency policy,
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                                                           Toxicological Review ofBenzo[a]pyrene
        1000 3
         100 ~;
          10 .
           1
       o
       Q
         0.1 :
        0.01 ;
       0.001
                  o  y
                  Osl  'r-
                   ^  c
\b cpididymal

sperm count

and motility
    o >.

    o "9

    l—1 00






4, cpididymal

 sperm count

T*in abnormal

   sperm



Sperm Quality
                                          5 "9
                                          Jz o
                                          u en
-i- opididymal

sperm motility
  Irregular

 germ cell

organization




 Testicular

  Effects
                                                   = T3

                                                   .E: o
                                                   u en
 4/ TT (serum

    and

intratesticular)
                                        5 "9
                                       Jz o
                                       u en
                                                                             t LH
                                                                                         o
                                                                                         r-t

                                                                                         O
    xb TT

(intratesticular)
                                                                        Hormone Changes
2           Figure 1-3. Exposure-response array for male reproductive effects following

3           oral exposure in adult animals.



4    Mode of action analysis—male reproductive effects


5           Exposure to benzo[a]pyrene in laboratory animals induces male reproductive effects


6    including decreased levels of testosterone and increased levels of LH, decreased sperm quality, and


7    histological changes in the testis. Decrements in sperm quality and decreased fertility have also

8    been demonstrated in populations highly exposed to PAH mixtures [Spares and Melo, 2008: Hsuet


9    al.. 20061
               This document is a draft for review purposes only and does not constitute Agency policy,

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                                                         Toxicological Review ofBenzo[a]pyrene

 1           Numerous studies have indicated that benzo[a]pyrene reduces testosterone levels following
 2    oral or inhalation exposure [Chung etal.. 2011: Zheng etal.. 2010: Archibongetal.. 2008: Ramesh et
 3    al.. 2008). It is plausible that the effects on sperm quality and histological changes of the
 4    reproductive organs are secondary to an insufficiency of testosterone [Inyangetal., 2003]. One
 5    study has hypothesized that benzo[a]pyrene perturbs the production of testosterone by Leydig
 6    cells [Chung etal., 2011]. This study found a statistically significant reduction in testicular
 7    testosterone in rats treated with 0.1 mg/kg-day benzo[a]pyrene for 90 days and found that
 8    testosterone production in isolated Leydig cells was also inhibited approximately 50%, even in
 9    cultures stimulated with human chorionic gonadotropin and dibutryl cyclic adenosine
10    monophosphate.
11           Leydig cell function is thought to be regulated by testicular macrophages [Hales, 2002].
12    When testicular macrophages are activated and produce inflammatory mediators, Leydig cell
13    testosterone production is inhibited [Hales, 2002].  Zheng etal. [2010] treated rats with 5 mg/kg-
14    day benzo[a]pyrene for 90 days and reported a statistically significant increase in ED-1 type
15    testicular macrophages and a statistically significant decrease in intratesticular testosterone.
16           Arafaetal. [2009] reported that male reproductive effects observed following
17    benzo[a]pyrene exposure could be ameliorated by antioxidant pre-treatment This study reported
18    decreased sperm count, motility, and production, in addition to decreased testis weight following a
19    10 day oral administration in rats of 50 mg/kg-day benzo[a]pyrene. Pretreatment with the citris
20    flavonoid hesperidin protected rats from all of these effects except the decrease in sperm motility.
21           A study in tobacco smokers suggests that direct DNA damage from the reactive metabolite
22    BPDE may decrease sperm motility [Perrinetal., 201 la]. In this study, motile sperm were
23    separated from non-motile sperm using a "swim-up" self-migration technique. The investigators
24    found that the motile sperm selected by this method had significantly fewer BPDE-adducts than
25    non-selected sperm.
26           Other hypothesized modes of action of the observed male reproductive effects include
27    benzo[a]pyrene-mediated DNA damage to male germ cells leading to genotoxicity, cytotoxicity, and
28    apoptosis [Chungetal.. 2011: Perrinetal.. 2011b: Perrinetal.. 2011a: Olsenetal.. 2010: Revel et
29    al., 2001], compromised function of Sertoli cells [Raychoudhury and Kubinski, 2003], and
30    decreased embryo viability post-fertilization associated with sperm DNA damage  [Borini etal..
31    2006: Seli etal.. 20041

32    Female Reproductive Effects

33    Fertility
34           In women, exposure to cigarette smoke has been shown to affect fertility, including effects
35    related to pregnancy, ovulatory disorders, and spontaneous abortion (as reviewed in Waylenetal..
36    2009: Cooper and Moley, 2008: Spares and Melo, 2008]. In addition, several studies suggest that in
37    utero exposure to maternal tobacco smoke also decreases the future fertility of female offspring  [Ye

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                                                         Toxicological Review ofBenzo[a]pyrene

 1    etal.. 2010: Jensen etal.. 1998: Weinbergetal.. 1989]. Benzo[a]pyrene levels in follicular fluid and
 2    benzo[a]pyrene-DNA adducts in granulosa-lutein cells and oocytes and in human cervical cells have
 3    been associated with smoking status and with amount smoked [Neal etal.. 2008:  Mancini etal..
 4    1999: Melikian etal.. 1999: Zenzes etal.. 1998: Shamsuddin and Can. 1988].
 5          Few epidemiological studies have examined the specific influence of components of PAH
 6    mixtures on fertility or other reproductive outcomes; EPA identified only two studies with specific
 7    data on benzo[a]pyrene (Table 1-6]. One of these studies addressed the probability of conception
 8    among women undergoing in vitro fertilization [Neal etal., 2008]. Follicular fluid benzo[a]pyrene
 9    levels were significantly higher among the women who did not conceive compared with women
10    who did get pregnant  No association was seen between conception and serum levels of
11    benzo[a]pyrene. The other study examined risk of delayed miscarriage (fetal death before 14 weeks
12    of gestation], using a case-control design with controls selected from women undergoing elective
13    abortion (Wu etal., 2010]. A strong association was seen between maternal blood benzo[a]pyrene-
14    DNA adduct levels and risk of miscarriage, with a fourfold increased risk for levels above compared
15    with below the median. Benzo[a]pyrene-DNA adduct levels were similar in the aborted tissue of
16    cases compared with controls.
17          Experimental studies in mice also provide evidence that benzo[a]pyrene exposure affects
18    fertility (Table 1-7). Decreased fertility and fecundity (decreased number of FO females producing
19    viable litters at parturition) was statistically significantly reduced by about 35% in adult females
20    exposed to 160 mg/kg-day of benzo[a]pyrene (Mackenzie and Angevine, 1981].  In another study,
21    FO females showed no signs of general toxicity or effects on fertility following gavage exposure to
22    10 mg/kg-day on CDs  7-16 (Kristensenetal., 1995]. Decrements in fertility were more striking in
23    the offspring from these studies, as described in Section 1.1.1.

24    Ovarian effects
25          Human epidemiological studies that directly relate ovotoxicity and benzo[a]pyrene
26    exposure are not available; however, smoking, especially during the time of the peri-menopausal
27    transition, has been shown to accelerate ovarian senescence (Midgette and Baron, 1990].
28    Benzo[a]pyrene-induced ovarian toxicity has been demonstrated in animal studies. In adult female
29    rats treated by gavage, statistically significant, dose-related decreases in ovary weight has been
30    observed in female rats treated for 60  days at doses >5 mg/kg (2.5 mg/kg-day adjusted) (Xu etal.,
31    2010). At 10 mg/kg in adult rats (5 mg/kg-day adjusted), ovary weight was decreased 15% (Xuet
32    al., 2010). Changes in  ovary weight were not observed in two subchronic studies in rats.
33    Specifically, no changes in ovary weight were seen in Wistar rats exposed for 35 days to gavage
34    doses up to 50 mg/kg-day (Kroese etal., 2001] or in F344 rats exposed for 90 days to dietary doses
35    up to 100 mg/kg-day (Knuckles etal.. 2001).
36          In adult female rats treated by gavage, dose-related decreases in the number of primordial
37    follicles have been observed in female rats treated for 60  days at doses >2.5 mg/kg-day, with a

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                                                          Toxicological Review ofBenzo[a]pyrene

 1    statistically significant decrease of approximately 20% at the high dose [Xu etal.. 2010] (Table 1-7).
 2    No notable differences in other follicle populations and corpora lutea were observed. However, in
 3    utero studies exposing dams to the same doses produced offspring with few or no follicles or
 4    corpora lutea [Kristensenetal., 1995: Mackenzie and Angevine, 1981].  Additional support for the
 5    alteration of female reproductive endpoints comes from intraperitoneal (i.p.] experiments in
 6    animals and in vitro experiments. Several studies have observed ovarian effects (decreased
 7    numbers of ovarian follicles and corpora lutea, absence of folliculogenesis, oocyte degeneration,
 8    and decreased fertility] in rats and mice exposed via i.p. injection (Bormanetal., 2000: Miller etal.,
 9    1992: Swartz and Mattison. 1985: Mattison et al.. 1980]. Further evidence is available from in vitro
10    studies showing inhibition of antral follicle development and survival, as well as decreased
11    production of estradiol, in mouse ovarian follicles cultured with benzo[a]pyrene for 13 days (Sadeu
12    and Foster, 2011]. Likewise, follicle stimulating hormone (FSH]-stimulated growth of cultured rat
13    ovarian follicles was inhibited by exposure to benzo[a]pyrene (Neal etal., 2007].

14    Hormone levels
15           Alteration of hormone levels has been observed in female rats following oral or inhalation
16    exposure to benzo[a]pyrene (Table 1-7].  Inhalation exposure to benzo[a]pyrene:carbon black
17    particles during gestation resulted in decreases in plasma progesterone, estradiol, and prolactin in
18    pregnant rats (Archibongetal., 2002]. In addition, statistically significant, dose-related decreases
19    in estradiol along with altered estrus cyclicity was observed in female rats treated for 60 days at
20    doses >2.5 mg/kg-day by gavage (Xu etal., 2010]. Mechanistic experiments have also noted
21    decreased estradiol output in murine ovarian follicles cultured with benzo[a]pyrene in vitro for
22    13 days, but did not find any decrease in progesterone (Sadeu and Foster. 2011].

23    Cervical effects
24           One subchronic animal study is available that investigated effects in the cervix following
25    oral exposure to benzo[a]pyrene (Table 1-7].  Statistically-significant dose-related increases in the
26    incidence of cervical inflammatory cells were observed in mice exposed twice a week for 98 days to
27    benzo[a]pyrene via gavage at doses >2.5 mg/kg (Gao etal.. 2011a: Gao etal.. 2010]. Cervical effects
28    of increasing severity, including epithelial hyperplasia, atypical hyperplasia, apoptosis, and
29    necrosis, were observed at higher doses.  There are no data on cervical effects in other species or in
30    other mouse strains.  Gao etal. (2011a] considered the hyperplasia responses to be preneoplastic
31    lesions. Cervical  neoplasia was not reported in the available chronic bioassays, but this tissue was
32    not subjected to histopathology examination in either bioassay (Kroese etal., 2001: Beland and
33    Culp, 1998].  Thus, the relationship of the cervical lesions to potential development of neoplasia is
34    uncertain.
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                                                      Toxicological Review ofBenzo[a]pyrene
1
2
Table 1-6. Evidence pertaining to the female reproductive effects of
benzo[a]pyrene in humans
Reference and Study Design
Probability of conception
Neal et al. (2008)
36 women undergoing in vitro fertilization
(19 smokers, 7 passive smokers, and 10 non-
smokers)
Exposure: benzo[a]pyrene in serum and follicular
fluid

Fetal death
Wu et al. (2010)
Tianjin, China
Case control study: 81 cases (96% participation
rate) — fetal death confirmed by ultrasound before
14 wks gestation; 81 controls (91% participation
rate)— elective abortions; matched by age,
gestational age, and gravidity; excluded smokers
and occupational PAH exposure
Exposure: benzo[a]pyrene in aborted tissue and
maternal blood samples (51 cases and controls,
2 of 4 hospitals)


Results

Benzo[a]pyrene levels (ng/mL)
Did not
Conceived Conceive (p-value)
Follicular fluid 0.1 1.7 (<0.001)
Serum 0.01 0.05 (not reported)


Benzo[a]pyrene adduct levels (/10s nucleotides), mean
(±SD)
Cases Controls (p-value)
Maternal blood 6.0 (±4.7) 2.7 (± 2.2) (<0.001)
Aborted tissue 4.8 (± 6.0) 6.0 (± 7.4) (0.29)
Low correlation between blood and tissue levels (r = -0.02 in
cases, r = -0.21 in controls)
Association between benzo[a]pyrene adducts and
miscarriage3
OR (95% Cl)
Per unit increase in adducts 1.37 (1.12,1.67)
Dichotomized at median 4.56 (1.46, 14.3)
Conditional logistic regression, adjusted for maternal
education, household income, and gestational age; age also
considered as potential confounder
3
4
Table 1-7. Evidence pertaining to the female reproductive effects of
benzo[a]pyrene in adult animals
Reference and Study Design
Results3
Fertility
Mackenzie and Angevine (1981)
CD-I mice, 30 or 60 FO females/dose
0, 10, 40, or 160 mg/kg-d by gavage
•i, number of FO females with viable litters
46/60, 21/30, 44/60, and 13/30*
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                                          Toxicological Review ofBenzo[a]pyrene
Reference and Study Design
CDs 7-16
Kristensen et al. (1995)
NMRI mice, 9 females/dose
0 or 10 mg/kg-d by gavage
CDs 7-16
Results3

No changes in fertility of FO females
Ovarian effects (weight, histology, follicle numbers)
Xu et al. (2010)
Sprague-Dawley rats, 6 females/
dose
0, 5 or 10 mg/kg by gavage every
other day (2.5 and 5 mg/kg-d,
adjusted)
60 d
Knuckles etal. (2001)
F344 rats, 20/sex/dose
0, 5, 50, or 100 mg/kg-d in diet
90 d
Kroese et al. (2001)
Wistar rats, 10/sex/dose
0, 1.5, 5, 15, or 50 mg/kg-d by gavage
5d/wk
35 d
•i, ovary weight (% change from control)
0, -11*, and -15*
•^ number of primordial follicles (20%* decrease at high dose)
/T" increased apoptosis of ovarian granulosa cells (approximate %
apoptosis)
2, 24*, and 14*
No changes in ovary weight
No changes in ovary weight
Hormone levels
Xu et al. (2010)
Sprague-Dawley rats, 6 females/
dose
0, 5, or 10 mg/kg by gavage every
other day (2.5 and 5 mg/kg-d,
adjusted)
60 d
Archibongetal. (2002)
F344 rats, 10 females/group
0, 25, 75, or 100 u.g/m3by inhalation
4 hrs/d
GDs 11-20 (serum hormones tested
at GD 15 and 17 in 0, 25, and
75 ug/m3dose groups)
•i, serum estradiol (approximate % change from control)
0, -16, and -25*
Altered estrous cyclicity
4> FO estradiol, approximately 50% decrease at 75 u.g/m3at GD 17
4> FO prolactin, approximately 70% decrease at 75 u.g/m3at GD 17
/T" FO plasma progesterone approximately 17% decrease at 75 u.g/m3 at
GD17
Cervical effects
Gaoetal. (2011a)
ICR mice, 26 females/dose
0, 2.5, 5, or 10 mg/kg by gavage
2d/wk
98 d
-t cervical epithelial hyperplasia: 0/26, 4/26, 6/25*, and 7/24*
T* cervical atypical hyperplasia: 0/26, 0/26, 2/25, and 4/24*
T* inflammatory cells in cervical epithelium: 3/26, 10/26, 12/25*, and
18/24*
This document is a draft for review purposes only and does not constitute Agency policy,
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                                                           Toxicological Review ofBenzo[a]pyrene
 1
 2
 3
*Statistically significantly different from the control (p < 0.05).
a % change from control calculated as: (treated value - control value)/control value x 100.
1000 -,
-

re 100 -
-
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T ft
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• o o A A •
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Ovarian Effects

O ?3
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™ -D
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sb serum
Estradiol

Hormone
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o
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1s cervical
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Cervical
Effects

















 5           Figure 1-4. Exposure-response array for female reproductive effects following
 6           oral exposure in adult animals.

 7    Mode-of-action analysis—female reproductive effects
 8           Although the mechanisms underlying female reproductive effects following benzo[a]pyrene
 9    exposure are not fully established, associations with stimulation of apoptosis, impairment of
10    steroidogenesis, and cytotoxicity have been made. Ovarian lesions in benzo[a]pyrene-exposed rats

                This document is a draft for review purposes only and does not constitute Agency policy.
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                                                         Toxicological Review ofBenzo[a]pyrene

 1    have been associated with increased apoptosis in ovarian granulosa cells and alteration in
 2    hormone-mediated regulation of folliculogenesis [Xu etal.. 2010). and results from in vitro
 3    experiments provide support for an association between benzo[a]pyrene exposure and impaired
 4    folliculogenesis, steroidogenesis, and oocyte maturation [Sadeu and Foster, 2011: Neal etal., 2007].
 5    A growing body of research suggests that benzo[a]pyrene triggers the induction of apoptosis in
 6    oocytes through AhR-driven expression of pro-apoptotic genes, including Bax [Kee etal., 2010: Neal
 7    etal.. 2010: Pru etal.. 2009: Matikainen etal.. 2002: Matikainen etal.. 2001: Robles etal.. 20001.
 8    Other proposed mechanisms include the impairment of folliculogenesis from reactive metabolites
 9    [Takizawaetal.. 1984: Mattison and Thorgeirsson. 1979.1977] or by a decreased sensitivity to
10    FSH-stimulated follicle growth [Neal etal.. 2007]. Based on findings that an ERa antagonist
11    counteracted effects of subcutaneously administered benzo[a]pyrene on uterine weight (decreased
12    in neonatal rats and increased in immature rats], interactions with ERa have been proposed,
13    possibly via occupation of ERa binding sites or via AhR-ER-crosstalk [Kummer et al., 2 00 8: Kummer
14    etal., 2007]. However, several in vitro studies have demonstrated low affinity binding of
15    benzo[a]pyrene to the estrogen receptor and alteration of estrogen-dependent gene expression
16    [Liu etal.. 2006: van Lipzigetal.. 2005: Vondraceketal.. 2002: Fertucketal.. 2001: Charles etal..
17    2000]. so the role of the ER in benzo[a]pyrene-induced reproductive toxicity is unclear.

18    Summary of Reproductive Effects
19    Male reproductive effects
20          Exposure to benzo[a]pyrene in laboratory animals induces male reproductive effects
21    including decreased levels of testosterone and increased levels of LH, decreased sperm count and
22    motility, histological changes in the testis, and decreased reproductive success.  These findings in
23    animals are supported by decrements in sperm quality and decreased fertility in human
24    populations exposed to PAH mixtures [Spares and Melo, 2008: Hsu etal., 2006]. In laboratory
25    animals, male reproductive toxicity has been observed after oral and inhalation exposure to rats or
26    mice. Effects seen after oral exposures include impaired fertility, effects on sperm parameters,
27    decreased reproductive organ weight, testicular lesions, and hormone alterations [Chen etal.. 2011:
28    Chung etal.. 2011: MohamedetaL 2010: Zheng etal.. 2010: Mackenzie andAngevine. 19811  In
29    addition to oral exposure, male reproductive effects of benzo[a]pyrene have also been observed
30    following inhalation exposure in rats [Archibongetal.. 2008: Rameshetal.. 2008:  Inyangetal..
31    2003]. The male reproductive effects associated with benzo[a]pyrene exposure are considered to
32    be biologically plausible and adverse.  The evidence for male reproductive toxicity seen across
33    multiple human and animal studies identifies the male reproductive system effects as a potential
34    hazard associated with exposure to benzo[a]pyrene.
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                                                          Toxicological Review ofBenzo[a]pyrene

 1    Female reproductive effects
 2           A large body of mechanistic data, both in vivo and in vitro, suggests that benzo [a]pyrene
 3    impacts fertility through the disruption of folliculogenensis. This finding is supported, albeit
 4    indirectly, by observations of premature ovarian senescence in women exposed to cigarette smoke
 5    [Midgette and Baron. 1990].  Evidence for female reproductive toxicity of benzo[a]pyrene comes
 6    from studies of human populations exposed to PAH mixtures as well as laboratory animal and in
 7    vitro studies. In addition, two human studies observed associations specifically between
 8    benzo[a]pyrene measures and two fertility-related endpoints:  decreased ability to conceive [Neal et
 9    al.. 2008: Neal etal.. 2007] and increased risk of early fetal death (i.e., before 14 weeks gestation]
10    [Wu etal.. 2010].  Studies in multiple strains of rats and mice indicate fertility-related effects
11    including decreases in ovarian follicle populations and decreased fecundity. Decreased serum
12    estradiol has also been noted in two different strains of rats exposed by oral or inhalation exposure.
13    The reproductive effects associated with benzo[a]pyrene exposure are biologically supported and
14    relevant to humans. In consideration of the evidence from human, animal, and mechanistic studies,
15    female reproductive effects are identified as a potential hazard associated with exposure to
16    benzo[a]pyrene.

17    Suscep tible Pop illations an d Lifestages
18           Epidemiological studies indicate that exposure to complex mixtures of PAHs, such as
19    through cigarette smoke, is associated with measures of decreased fertility in humans [Neal etal.,
20    2008: El-Nemr etal., 1998] and that prenatal exposure to cigarette smoking is associated with
21    reduced fertility of women later in life [Weinbergetal.. 1989].  A case-control study in a Chinese
22    population has also indicated that women with elevated levels of benzo [a]pyrene-DNA adducts in
23    maternal blood were 4 times more likely to have experienced a miscarriage [Wuetal., 2010].
24           Inhalation exposure of pregnant female rats to benzo[a]pyrene:carbon black aerosols on
25    CDs 11-20 caused decreased fetal survival and number of pups per litter associated with decreased
26    levels of plasma progesterone, estradiol, and prolactin [Archibongetal., 2002].  Decreased numbers
27    of live pups were  also seen in pregnant mice following i.p. exposure to benzo[a]pyrene [Mattison et
28    al.. 1980]. These results indicate that benzo [ajpyrene exposure can decrease the ability of females
29    to maintain pregnancy.
30           Oral multigenerational studies of benzo [ajpyrene exposure in mice demonstrated effects on
31    fertility and the development of reproductive organs (decreased ovary and testes weight] in both
32    male and female offspring of pregnant mice exposed to 10-160 mg/kg-dayon CDs 7-16
33    (Kristensenetal.. 1995: Mackenzie and Angevine, 1981].
34           Reductions in female fertility associated with decreased ovary weight and follicle number
35    following gestational exposure (as discussed in Section 1.1.1] are supported by observations of:
36    (1] destruction of primordial follicles (Bormanetal.. 2000: Mattison etal.. 1980] and decreased
37    corpora lutea (Miller etal., 1992: Swartz and Mattison, 1985] in adult female mice following i.p.

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                                                         Toxicological Review ofBenzo[a]pyrene

 1    exposure; (2) decreased ovary weight in adult female rats following oral exposure [Xuetal.. 2010]:
 2    and (3) stimulation of oocyte apoptosis [Matikainenetal.. 2002: Matikainen etal.. 2001] or by a
 3    decreased sensitivity to FSH-stimulated follicle growth [Neal etal.. 2007].
 4           Reductions in male fertility associated with decreased testes weight following gestational
 5    exposure (as discussed in Section 1.1.1] are supported by observations of: (1] decreased sperm
 6    count, altered serum testosterone levels, testicular lesions, and/or increased numbers of apoptotic
 7    germ cells in adult rats following repeated oral exposure to benzo[a]pyrene [Chung etal., 2011:
 8    Chen etal.. 2010: Zheng etal.. 2010: Arafa etal.. 2009]: (2] decreased epididymal sperm counts in
 9    adult FO and Fl generations of male mice following 6 weeks of oral exposure of the FO animals  to
10    benzo[a]pyrene [Mohamedetal.. 2010]: and (3] decreased testis weight, decreased testicular or
11    plasma testosterone levels, and/or decreased sperm production, motility, and density in adult male
12    rats following repeated inhalation exposure to aerosols of benzo[a]pyrene:carbon black [Archibong
13    etal.. 2008: Ramesh etal.. 2008: Inyangetal.. 2003].

14    1.1.3.  Immunotoxicity
15           Human studies evaluating immune effects following exposure to benzo[a]pyrene alone  are
16    not available for any route of exposure. However, a limited number of occupational human studies,
17    particularly in coke oven workers [Zhang etal.. 2012: Wuetal.. 2003b: Winker etal.. 1997:
18    Szczekliketal., 1994], show effects on immune parameters associated with exposure to PAH
19    mixtures. These studies are of limited utility because effects associated specifically with
20    benzo[a]pyrene cannot be distinguished from other constituents of the PAH mixture. Subchronic
21    and short-term animal studies have reported immunotoxic effects of benzo[a]pyrene by multiple
22    routes of exposure (Table 1-8]. Effects  include changes in thymus weight and histology, decreased
23    B cell percentages and other alterations in the spleen, and immune suppression. Data obtained
24    from subchronic oral gavage studies are supported by short-term, i.p., intratracheal, and
25    subcutaneous (s.c.] studies.  Additionally, there is evidence in animals for effects of benzo[a]pyrene
26    on the developing immune system. No  studies were located that examined immune system
27    endpoints following inhalation exposure of animals to benzo[a]pyrene.

28    Thymus Effects
29           Decreased thymus weights (up to 62% compared to controls] were observed in male and
30    female Wistar rats exposed by gavage to 10-90 mg/kg-day benzo[a]pyrene for 35 or 90 days
31    (Kroese etal.. 2001: De long etal., 1999]. This effect may be due to thymic atrophy. The incidence
32    of slight thymic atrophy was increased in males (6/10] and females (3/10] at a dose of 30 mg/kg-
33    day in a 90-day study, although there was no evidence of atrophy at any lower dose (Kroese etal.,
34    2001]. Additionally, at the highest dose tested (90 mg/kg-day] in one of the 35-day studies, the
35    relative cortex surface area of the thymus and thymic medullar weight were significantly reduced
36    (De long etal.. 1999]. Other histopathological changes in the thymus (increased incidence of brown
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                                                         Toxicological Review ofBenzo[a]pyrene

 1    pigmentation of red pulp; hemosiderin) were observed in Wistar rats of both sexes at 5 0 mg/kg-
 2    day in a 35-day study; however, this tissue was not examined in intermediate-dose groups [Kroese
 3    etal.. 2001). Consistent with the effects observed in these studies, decreased thymus weights and
 4    reduced thymic cellularity were observed in i.p. injection studies that exposed mice to doses
 5    ranging from 50 to 150 mg/kg in utero [Holladay and Smith, 1995,1994: Urso and Tohnson, 1988].

 6    Spleen Effects
 7          Reduced splenic cellularity indicated by decreased relative and absolute number of B cells
 8    in the spleen (decreased up to 41 and 61% compared to controls, respectively) and decreased
 9    absolute number of splenic cells (31% decrease at the highest dose) was observed in a subchronic
10    study in male Wistar rats administered 3-90 mg/kg-day benzo[a]pyrene by gavage for 35 days (De
11    long etal., 1999).  While the effect on the relative number of B cells was dose-related, the lower
12    doses did not affect the number of B cells or the absolute splenic cell number. The reduced splenic
13    cell count at the highest dose was attributed by the study authors to the decreased B cells, and
14    suggests a possible selective toxicity of benzo[a]pyrene to B cell precursors in the bone marrow.
15    The spleen effects observed in De long etal. (1999).
16          are supported by observations of reduced spleen cellularity and decreased spleen weights
17    following i.p. injection or in utero benzo[a]pyrene exposure to doses ranging from 50 to 150 mg/kg
18    (Holladay and Smith. 1995: Urso etal.. 1988).
19          In addition to physical effects on the spleen, several studies have demonstrated functional
20    suppression of the spleen following benzo[a]pyrene exposure.  Dose-related decreases in sheep red
21    blood cell (SRBC) specific serum IgM levels after SRBC challenge were reported in rats (10 or
22    40 mg/kg-day) and mice (5, 20,or 40 mg/kg-day) following s.c.  injection of benzo[a]pyrene for
23    14 days (Temple etal., 1993). Similarly, reduced spleen cell responses, including decreased
24    numbers of plaque forming cells and reduced splenic phagocytosis to SRBC and lipopolysaccharide
25    challenge, were observed in B6C3Fi mice exposed to doses >40 mg/kg-day benzo[a]pyrene by i.p.
26    or s.c. injection for 4-14 days (Lyte and Bick. 1985: Dean etal.. 1983: Munson and White. 1983] or
27    by intratracheal instillation for 7 days (Schnizleinetal., 1987).

28    Immun oglob ulin Alterations
29          Alterations in immunoglobulin levels have been associated with exposure to PAH mixtures
30    in a limited number of human studies. Some occupational studies have reported evidence of
31    immunosuppression following PAH exposure. For example, reductions in serum IgM and/or IgA
32    titers were reported in coke oven workers (Wu et al., 2003b: Szczeklik et al., 1994]. Conversely,
33    immunostimulation of immunoglobulin levels has also been observed in humans, specifically
34    elevated IgG fKarakaya etal.. 19991 and elevated IgE fWuetal.. 2003bl following occupational PAH
35    exposure.
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                                                         Toxicological Review ofBenzo[a]pyrene

 1          Decreases in serum IgM (13-33% compared to controls) and IgA levels (22-61% compared
 2    to controls) were observed in male Wistar rats exposed to 3-90 mg/kg-day benzo[a]pyrene by
 3    gavage for 35 days (De long et al.. 1999): however, these reductions were not dose-dependent.
 4    Similarly, reductions in IgA (9-38% compared to controls) were also observed in male and female
 5    B6C3Fimice exposed to doses of 5-40 mg/kgbenzo[a]pyreneby s.c. injection for 14 days (Munson
 6    and White, 1983). Reductions in serum IgG levels of 18-24%, although not statistically significant,
 7    were observed in female B6C3Fi mice exposed to doses >50 mg/kg benzo[a]pyrene by i.p. injection
 8    for 14 days (Dean etal.. 1983).

 9    Immune Suppression and Sensitization
10          Some occupational studies of coke oven emissions have reported evidence of
11    immunosuppression following PAH exposure. Reduced mitogenic responses in T cells (Winker et
12    al., 1997) and reduced T-lymphocyte proliferative responses (Karakaya et al., 2004) have been
13    observed following occupational exposure to PAH. Increased levels of apoptosis were observed in
14    the peripheral blood mono nuclear cells (a population of lymphocytes and monocytes) of
15    occupationally exposed coke oven workers, which is a response that may contribute to
16    immunodeficiency in this population (Zhang etal., 2012).  However, a limitation of this study is that
17    it does not attribute the proportion of apoptotic activity to a specific class of cells and does not
18    include assessment of other potential markers of immunotoxicity in peripheral blood.
19          Results of functional immune assays in laboratory animals following short-term i.p. and s.c.
20    exposures add to the evidence for benzo[a]pyrene immunotoxicity. Resistance to Streptococcus
21    pneumonia or Herpes simplex type 2 was dose dependently reduced in B6C3Fi mice following s.c.
22    injection of >5 mg/kg-day benzo[a]pyrene for 14 days (Munson etal.. 1985). Reduced cell
23    proliferation, IFN-y release, and IL-4 release were observed in male and female C56BL/6 mice
24    following short-term exposure to a gavage dose of 13 mg/kg benzo[a]pyrene as measured in a
25    modified local lymph node assay (van den Berg et al., 2005). A statistically significant decrease in
26    natural killer cell activity was observed in male Wistar rats (Effector:Target cell ratio  was 40.9 ±
27    28.4% that of controls) exposed to  90 mg/kg-day by gavage for 35 days (De long etal., 1999):
28    however, splenic natural killer cell  activity was not affected in B6C3Fi mice after s.c. injection of
29    40mg/kg-day benzo[a]pyrene for 14 days (Munson etal.. 1985). The magnitude of the dose and
30    duration of the exposure may account for the discrepancy between these two studies. Single i.p.
31    injections of 50 mg/kg benzo[a]pyrene decreased pro- and/or pre-B-lymphocytes and neutrophils
32    in the bone marrow of C57BL/6J mice without affecting the numbers of immature and mature B-
33    lymphocytes or GR-1+ myeloid cells (Galvanetal., 2006).
34          In contrast to studies that have shown immunosuppression, benzo[a]pyrene may also
35    induce sensitization responses.  Epicutaneous abdominal application of 100 [igbenzo[a]pyrene to
36    C3H/HeN mice, followed by ear challenge with 20 [ig benzo[a]pyrene 5 days later, produced a
37    contact hypersensitivity (a significant ear swelling) response (Klemme etal., 1987).

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                                                         Toxicological Review ofBenzo[a]pyrene

 1   Developmental Immunotoxicity
 2          As noted above, several i.p. injection studies suggest that cell-mediated and humoral
 3   immunity may be altered by exposure to high doses of benzo[a]pyrene during gestation.
 4   Suppression of the mixed lymphocyte response, the graft-versus-host response, and suppression of
 5   the plaque-forming cell response to SRBCs was observed in mice exposed in utero to 150 mg/kg
 6   during mid (CDs 11-13), late (CDs 16-18), or both (CDs 11-17) stages of gestation; these effects
 7   persisted until 18 months of age  [Urso and Gengozian, 1984,1982,1980). Fetal thymic atrophy, as
 8   assessed by reductions in cellularity (74-95%, compared to controls), was observed in mice
 9   exposed to 50-150 mg/kg benzo[a]pyrene from GD 13 to 17, when examined on GD 18 [Holladay
10   and Smith.  1994). Analysis of cell surface  markers (e.g., CD4, CD8) from the same study indicate
11   that benzo[a]pyrene may inhibit and/or delay thymocyte maturation, possibly contributing to the
12   observed thymic atrophy (Holladay and Smith, 1994). Consistent  with these findings, several other
13   studies have noted decreased thymocyte numbers and disrupted T cell maturation after in utero
14   exposure to benzo[a]pyrene (Rodriguez etal.. 1999: Holladay and Smith. 1995: Lummus and
15   Henningsen. 1995: Urso etal.. 1992: Urso  andTohnson. 1987).
16          The fetal liver is the primary hematopoietic organ during gestation and a major source of
17   thymocyte precursors beginning around GD 10 or 11 in mice (Landreth and Dodson. 2005:  Penit
18   andVasseur, 1989).  Statistically significant reductions in total cellularity in the fetal liver of 54 and
19   67% were reported in offspring after i.p. exposures of 50 or 100 mg/kg benzo[a]pyrene,
20   respectively, to the dams on CDs 13-17 (Holladay and Smith, 1994). The decreased fetal liver
21   cellularity was accompanied by decreased expression of terminal deoxynucleotidyl transferase and
22   CD45R cellular markers, which are known to be present in cortical thymocyte progenitors in the
23   fetal liver (Holladay and Smith. 1994: Fine etal.. 1990: Silverstone etal.. 1976). These data also
24   suggest that benzo[a]pyrene disrupts liver hematopoiesis during gestation and may interfere with
25   prolymphoid seeding of the thymus, possibly contributing to thymic atrophy and cell-mediated
26   immunosuppression. Decreased numbers of CD4+ T-cells have been reported in the spleen  of
27   1-week-old mice following in utero benzo[a]pyrene exposure by i.p. injection to the dams,
28   demonstrating the potential for downstream effects on T-cell development (Rodriguez etal.. 1999).
29   The decreased numbers of CD4+ T-cells correspond with  observations of decreased proliferation in
30   the presence of ConA and a weak response compared to controls in an allegeneic mixed lymphocyte
31   reaction assay (Urso and Kramer. 2008).
32          Postnatal exposure to benzo[a]pyrene has also been suggested to cause immune effects.
33   Dose-dependent decreases in erythrocytes (attributed to reduced  bone marrow erythropoiesis), as
34   well as reduced expression of IL-4 and IFN-y were observed in the pups of Wistar rats exposed to
35   0.1-10 mg/kg-day benzo[a]pyrene by subcutaneous injection for 14 days (Matiasovic etal.. 2008).
36   This finding suggests that benzo[a]pyrene may alter the immune response to infection or
37   vaccination in developing animals.
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                                                            Toxicological Review ofBenzo[a]pyrene
1
2
       Table 1-8. Evidence pertaining to the immune effects of benzo[a]pyrene in
       animals
Reference and Study Design
Results3
Thy m us effects
Kroese et al. (2001)
Wistar rats, 10/sex/dose
0, 3, 10, or 30 mg/kg-d by gavage 5 d/wk
90 d
De Jong etal. (1999)
Wistar rats, 8 males/dose
0, 3, 10, 30, or 90 mg/kg-d by gavage 5 d/wk
35 d
Kroese et al. (2001)
Wistar rats, 10/sex/dose
0, 1.5, 5, 15, or 50 mg/kg-d by gavage 5 d/wk
35 d
4, thymus weight
Females (% change from control):
Males (% change from control):
1" slight thymic atrophy
Females (incidence):
Males (incidence):
4> thymus weight
% change from control:
4> thymus weight
Females (% change from control):
Males (% change from control):
0, -3, -6, and -28*
0, 0, -13, and -29*
0/10, 0/10, 0/10, and 3/10
0/10, 2/10, 1/10, and 6/10*
0, -9, -15*, -25*, and -62*
0, 13, 8, -3, and -17*
0, -8, -11, -27*, and -33*
Spleen effects
De Jong etal. (1999)
Wistar rats, 8 males/dose
0, 3, 10, 30, or 90 mg/kg-d by gavage 5 d/wk
35 d
4, relative number (%) of B cells in spleen
% change from control: 0, -8, -13*, -18*, and -41*
•^ total number of B cells in spleen
% change from control: 0, 13, -13, -13, and -61*
Change in total cell number in the spleen
% change from control: 0, 20, 0, +7, and -31*
Immunoglobulin alterations
De Jong etal. (1999)
Wistar rats, 8 males/dose
0, 3, 10, 30, or 90 mg/kg-d by gavage 5 d/wk
35 d
4, serum IgM
% change from control:
4, serum IgA
% change from control:
0, -13, -14, -33*, and -19
0, -27, -22, -28, and -61*
3
4
5
*Statistically significantly different from the control (p < 0.05).
a % change from control calculated as: (treated value - control value)/control value x 100.
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                                                        Toxicological Review ofBenzo[a]pyrene
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 2          Figure 1-5. Exposure-response array for immune effects following oral
 3          exposure.
 4   Mode-of-Action Analysis—Immune Effects
 5          Exposure to benzo[a]pyrene induces immunosuppressive effects such as decreased
 6   numbers of B cells in the spleen and decreased thymus weight and cellularity following oral, i.p.,
 7   s.c., or intratracheal exposure in experimental animals. However, the key events underlying
 8   benzo[a]pyrene immunotoxicity have not been identified.
 9          Benzo[a]pyrene is a well-known ligand for the AhR [Okey etal., 1994: Nebertetal., 1993:
10   Postlindetal., 1993].  Ligands of the AhR have been shown to have a role in regulating
11   hematopoietic stem cells in the bone marrow, a major site of B-cell proliferation and antibody
12   production [Esser, 2009].  Benzo[a]pyrene reduced B-cell lymphopoiesis at concentrations as low
13   as 10-8M [Hardinetal., 1992]. Furthermore, Ah-responsive (C57BL/6] mice showed greater dose-
14   dependent reductions in B-cell lymphopoiesis than those observed in Ah-nonresponsive (DBA/2]
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                                                         Toxicological Review ofBenzo[a]pyrene

 1    mice [Hardinetal.. 1992].  Addition of the AhR antagonist and CYP450 inhibitor, a-napthaflavone,
 2    inhibited the benzo[a]pyrene-induced suppression of B-cell lymphopoiesis in a concentration-
 3    dependent fashion.  Similarly, the CYP1A1 inhibitor, l-(l-propynyl) pyrene, blocked
 4    benzo[a]pyrene-induced B-cell growth inhibition but not growth inhibition caused by the
 5    benzo[a]pyrene metabolite, BPDE; these data suggest that a GYP 1A1-dependent metabolite of
 6    benzo[a]pyrene is responsible for the B-cell growth suppressive effects observed after
 7    benzo[a]pyrene exposure [Allan etal.. 2006]. Altogether, these data suggest that benzo[a]pyrene
 8    may regulate B-cell proliferation and antibody production in the bone marrow via the AhR.

 9    Summary of Immune Effects
10          Evidence for immunotoxic effects of benzo[a]pyrene exposure comes from animal studies
11    that vary in route and duration of exposure. There are no human epidemiological studies that
12    provide specific support for benzo[a]pyrene immunotoxicity; however, immunosuppression has
13    been observed in studies following occupational exposure to PAH mixtures.  However, these
14    findings  are limited by co-exposures to other constituents of PAH mixtures.
15          Effects such as altered thymus weight and histology, spleen effects, and altered
16    immunoglobulin levels observed by the oral route reported in animal bioassays provide some
17    evidence of immunotoxicity following benzo[a]pyrene exposure; however, in vivo functional assays
18    provide stronger support for immunotoxicity [WHO,  2012]. The immunological changes observed
19    in the available subchronic oral gavage studies are supported by a larger database of in vivo studies
20    of benzo[a]pyrene (by parenteral exposure] indicating functional immunosuppression such as
21    decreased proliferative responses to antigens and decreased resistance to pathogens or tumor cells
22    [Kong etal.. 1994: Blantonetal.. 1986: Munson etal.. 1985: White etal.. 1985: Dean etal.. 1983:
23    Munson  and White,  1983]. Although the key events underlying the mode of action of
24    benzo[a]pyrene immunotoxicity are not firmly established, there is evidence of physical alterations
25    to tissues/organs of the immune system, as well as decreases in immune function. Evidence of
26    benzo[a]pyrene-associated immunotoxicity is supported by consistent thymic effects observed in
27    two oral studies, as well as splenic effects, and varying immunosuppressive responses observed in
28    short-term or in vitro tests. Overall, the weight of evidence in animals indicates that
29    immunotoxicity may be a hazard associated with benzo[a]pyrene exposure.
                This document is a draft for review purposes only and does not constitute Agency policy.
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                                                         Toxicological Review ofBenzo[a]pyrene

 1    Suscep tible Pop ulations an d Lifestages
 2          The severity and persistence of immune effects observed during in utero studies suggests
 3    that immunotoxicity may be greater during gestation than adulthood [Dietert and Piepenbrink.
 4    2006: Holladay and Smialowicz, 2000: Urso and Gengozian, 1982]. Urso and Gengozian [1982]
 5    provide experimental support demonstrating that immunosuppression from benzo[a]pyrene
 6    exposure during gestation was greater than for mice exposed after birth to a 2 5-fold higher dose.
 7    There is also substantial literature indicating that disruption of the immune system during certain
 8    critical periods of development (e.g., initiation of hematopoiesis, migration of stem cells, expansion
 9    of progenitor cells] may have significant and lasting impacts on lifetime immune function (e.g.,
10    Burns-Naasetal.,2008: Dietert. 2008: Landreth. 2002: Dietert etal.. 2000]. In addition, chemical-
11    specific studies show increased dose sensitivity and disease persistence from developmental versus
12    adult chemical exposure (reviewed in Luebke etal., 2006].
13          Thymus toxicity is a sensitive and specific effect of benzo[a]pyrene and has been observed
14    in both prenatal and adult exposure studies. The thymus serves as a major site of thymocyte
15    proliferation and selection for maturation,  and impairment can lead to cell-mediated immune
16    suppression fKuper etal.. 2002: De Waal etal.. 1997: Kuper etal.. 19921 The thymus is believed to
17    be critical for T lymphocyte production during early life and not in adulthood (Hakim etal.. 2005:
18    Schonlandetal., 2003: Petrie, 2002: Mackalletal., 1995]. Therefore, the decreases in thymus
19    weight observed in studies of adult animals exposed to benzo[a]pyrene suggest that
20    immunosuppression may be a heightened concern for individuals developmentally exposed to
21    benzo[a]pyrene.

22    1.1.4.  Other Toxicity
23          There is some evidence thatbenzo[a]pyrene can produce effects in the forestomach, liver,
24    kidney, and cardiovascular system, as well as alter hematological parameters. However, there is
25    less evidence for these effects compared to organ systems described earlier in Section 1.1.1 to 1.1.3.

26    Forestomach Toxicity
27          Lesions have been observed in the forestomach following subchronic and chronic oral
28    exposure to benzo[a]pyrene (Table 1-10).  Increases in the incidence of forestomach hyperplasia
29    have been observed in Wistar rats following shorter-term, subchronic, and chronic gavage exposure
30    (Kroese etal.. 2001: De long et al., 1999] and in B6C3Fi mice following chronic dietary exposure
31    (Beland and Gulp. 1998: Gulp etal.. 1998].
32          Following chronic gavage exposure, increased incidences of forestomach hyperplasia were
33    observed in male and female rats at 3 and 10 mg/kg-day; at the highest dose, a lower incidence of
34    hyperplasia was reported (Kroese etal.. 2001). However, only the highest-level lesion (hyperplasia,
35    papilloma, or carcinoma) observed in each organ was scored, such that hyperplasia observed in the
36    forestomach, in which tumors were also  observed, was not scored. The majority of animals in the
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 1    high-dose group exhibited forestomach tumors; therefore, the hyperplasia was not scored and the
 2    incidence of forestomach hyperplasia in the study is more uncertain at the highest dose.  Shorter-
 3    term studies [Kroese etal.. 2001: De long et al.. 1999] showed dose-related increases in
 4    forestomach hyperplasia at doses >10 mg/kg-day in Wistar rats. In addition, following chronic
 5    dietary exposure, a dose-dependent increase in the incidence of forestomach hyperplasia and
 6    hyperkeratosis was observed in female mice at >0.7 mg/kg-day [Beland and Gulp, 1998:  Gulp etal.,
 7    1998]. Forestomach tumors were also observed at >0.7 mg/kg-day by Beland and Gulp [1998] and
 8    Gulp etal. [1998].
 9          Although humans do not have a forestomach, forestomach effects observed in rodents are
10    believed to be supportive of a human hazard as humans have similar squamous epithelial tissue in
11    their oral cavity [IARC, 2003: Wester and Kroes, 1988]. Mechanistic investigations suggest that
12    bioactivation of benzo[a]pyrene leads to reactive intermediates that can lead to mutagenic events,
13    as well as to cytotoxic and apoptotic events. The available human, animal, and in vitro evidence
14    best supports a mutagenic mode of action as the primary mode by which benzo[a]pyrene induces
15    carcinogenesis. Available data indicate that forestomach hyperplasia may be a histological
16    precursor to neoplasia observed at this site after chronic exposure to benzo[a]pyrene [Kroese etal..
17    2001: De long et al.. 1999]. Dose-response data show that forestomach hyperplasia occurs at
18    shorter durations and at lower doses than tumors in rats and mice exposed to benzo[a]pyrene for
19    up to 2 years [Kroese etal.. 2001: Beland and Gulp. 1998]. Kroese etal. [2001] reported  that the
20    forestomach lesions demonstrated a progression over the course of intercurrent sacrifices; the
21    authors described early lesions as focal or confluent basal hyperplasia, followed by more advanced
22    hyperplasia with squamous cell papilloma, culminating in squamous cell carcinoma. The
23    description of the progression of forestomach lesions provided by Kroese  et al. [2001]. coupled
24    with the  observation that hyperplasia occurs before tumors and at lower doses than tumors,
25    suggests that forestomach hyperplasia induced by benzo[a]pyrene is likely a preneoplastic lesion.

26    Hematological Toxicity
27          Altered hematological parameters, including decreases in red blood cell [RBC] count,
28    hemoglobin, and hematocrit have been observed in laboratory animals following benzo[a]pyrene
29    exposure (Table 1-9. Statistically significant decreases in RBC count, hemoglobin, and hematocrit
30    were observed in male Wistar rats at doses >10 mg/kg-day for 35 days  [De long etal., 1999]. A
31    minimal, but statistically significant increase in mean cell volume and a decrease in mean cell
32    hemoglobin were observed at the highest dose (90 mg/kg-day], which may indicate dose-related
33    toxicity for the RBCs and/or RBC precursors in the bone marrow [De long etal., 1999]. Similarly,
34    male and female F344 rats also showed maximal decreases in RBC counts, hematocrit, and
35    hemoglobin levels between 10-12% in a 90-day dietary study [Knuckles etal..  2001]. Findings
36    were significant for RBC counts and hematocrit in males at > 50 mg/kg-day, while decreased RBC
37    counts and hematocrit in females and hemoglobin levels in both sexes were only significant in the

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 1    100 mg/kg-day group [Knuckles etal.. 2001]. Small, but not statistically significant, decreases in
 2    RBC counts and hemoglobin were observed in both 35- and 90-day studies in Wistar rats [Kroese et
 3    al.. 2001). It should be noted that when observed, the magnitudes of the decreases in RBCs,
 4    hemoglobin, and hematocrit were generally small; about 18% at 90 mg/kg-day and <10% at lower
 5    doses [Belong etal., 1999] and about 10% in F344 rats [Knuckles etal., 2001]. A decrease in white
 6    blood cells (WBCs], attributed to reduced numbers of lymphocytes and eosinophils, was also
 7    observed at 90 mg/kg-day following gavage exposure for 35 days [De long etal., 1999]. The mode
 8    of action by which benzo[a]pyrene exposure may lead to altered hematological parameters is
 9    undetermined.

10    Liver Toxicity
11          Liver effects other than cancer associated with benzo[a]pyrene exposure primarily include
12    changes in liver weight and abnormal histopathology (Table 1-10]. Increased liver weight was
13    reported in a 90-day study in both male and female Wistar rats given benzo[a]pyrene by gavage
14    [Kroese etal.. 2001]. Both females (17% increase] and males (29% increase] demonstrated
15    statistically significant increased liver weights at the highest dose tested (30 mg/kg-day]; a
16    statistically significant increase (15%] was also reported in males  at 10 mg/kg-day. Similar to the
17    findings in the 90-day study by Kroese etal. (2001]. increased liver:body weight ratios were
18    observed at the highest dose in a 90-day dietary study in male F344 rats, although there was no
19    change observed in female liver weights (Knuckles etal., 2001]. Increased liver:body weight ratios
20    were also observed in both sexes at high doses (600 and 1,000 mg/kg] in an accompanying acute
21    study (Knuckles etal.. 2001]. A statistically significant increase in liver weight was also observed in
22    male Wistar rats given 90 mg/kg-day benzo[a]pyrene by gavage for 35 days (De long et al.. 1999].
23    Consistent with the findings by De long et al. (1999], a statistically significant increased liver weight
24    (about 18%] was also observed in both male and female Wistar rats at the highest dose (50 mg/kg-
25    day] given by gavage in a 35-day study (Kroese etal., 2001].
26          Limited exposure-related differences in clinical chemistry parameters associated with liver
27    toxicity were observed; no differences in alanine aminotransferase or serum aspartate
28    transaminase levels were observed, and a small dose-related decrease in y-glutamyl transferase
29    was observed in males only exposed to benzo[a]pyrene for 90 days (Kroese etal.. 2001].
30          Treatment-related lesions in the liver (oval cell hyperplasia] were identified as statistically
31    significantly increased following exposure to 90 mg/kg-day benzo[a]pyrene for 35 days; however,
32    incidence data were not reported (De Jong etal., 1999]. A 2-year carcinogenicity study (Kroese et
33    al., 2001] observed some histopathological changes in the liver; however, organs with tumors were
34    not evaluated. Since many of the animals in the highest two doses developed liver tumors, the dose
35    responsiveness of the histological changes is unclear.
36          A dose-dependent increase in liver microsomal ethoxyresorufin-o-deethylase (EROD]
37    activity, indicative of CYP1A1 induction, was observed in both sexes at doses >1.5 mg/kg-day in a

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                                                          Toxicological Review ofBenzo[a]pyrene

 1    3 5-day study [Kroese etal.. 2001]. However, at the highest dose tested, with the greatest fold
 2    induction in EROD activity, there was no evidence of associated adverse histopathologic findings.
 3    The finding of increased liver weight across multiple studies of varying exposure durations, as well
 4    as histopathological changes in the liver provide evidence of the liver as a target of benzo[a]pyrene-
 5    induced toxicity. The mode of action by which benzo[a]pyrene induces these effects is unknown.

 6    Kidney Toxicity
 7          There is minimal evidence of kidney toxicity following exposure to benzo[a]pyrene
 8    (Table 1-9). Statistically significant decreases in kidney weight were observed at doses of 3, 30,
 9    and 90 mg/kg-day, but not at 10 mg/kg-day, in a 35-day gavage study in male Wistar rats [De long
10    etal.. 1999).  In a 35-day gavage study with a similar dose range in male and female Wistar rats, no
11    statistically significant changes in kidney weights were observed at any dose. [Kroese etal., 2001].
12    Histopathological analysis of kidney lesions revealed an apparent dose-responsive increase in the
13    incidence of abnormal tubular casts in the kidney in male F344 rats exposed by diet for 90 days
14    [Knuckles etal.. 2001]. The casts were described as molds of distal nephrons lumen and were
15    considered by the study authors to be indicative of renal dysfunction. However, the statistical
16    significance of the kidney lesions is unclear. Several gaps and inconsistencies in the reporting make
17    interpretation of the kidney effects difficult, including: (1] no reporting of numerical data; (2] no
18    indication of statistical significance in the accompanying figure for kidney lesions;  (3] discrepancies
19    between the apparent incidences and sample sizes per dose group; and (4] uncertainty in how
20    statistical analysis of histopathological data was applied. As such, the significance of the abnormal
21    tubular casts is unclear. While there are some findings to suggest that the kidneys may be affected
22    by benzo[a]pyrene exposure, the results are inconsistent, and there are insufficient data to suggest
23    that the kidneys may be a primary target of benzo[a]pyrene-induced toxicity.

24    Cardiovascular Toxicity
25          Atherosclerotic vascular disease and increased risk of cardiovascular mortality have been
26    associated with cigarette smoking [Ramos and Moorthy, 2005: Miller and Ramos, 2001: Thirman et
27    al.. 1994] and, to a more limited degree, occupational exposure to PAH mixtures [Friesenetal..
28    2010: Friesenetal.. 2009: Burstynetal.. 2005: Chauetal.. 1993].  Elevated mortality due to
29    cardiovascular disease was observed in a PAH-exposed occupational population (coke oven plant
30    workers], but elevated cardiovascular mortality was also observed in the non-exposed or slightly
31    exposed populations (Chau etal., 1993]. Elevated risks of ischemic heart disease (IHD] were
32    associated with past cumulative benzo[a]pyrene exposure  among aluminum smelter workers (with
33    a 5-year lag], although the trend was not statistically significant; there was no observed association
34    with more recent benzo[a]pyrene exposure (Friesenetal..  2010]. Elevated risk of mortality from
35    IHD was also associated with cumulative benzo[a]pyrene exposure in a cohort of male asphalt
36    workers (although not statistically significant]; the trend in average benzo[a]pyrene exposure and
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                                                         Toxicological Review ofBenzo[a]pyrene

 1    association with IHD was statistically significant, with an approximately 60% increase in risk
 2    between the lowest and highest exposure groups [Burstyn et al.. 2005). The two studies that
 3    associate benzo[a]pyrene exposure with cardiovascular effects [Friesenetal.. 2010: Burstyn etal..
 4    2005] rely on statistical models to create exposure groups rather than direct measurement of the
 5    cohort under examination. Additionally, while these studies used benzo[a]pyrene exposure
 6    groupings for analysis, they cannot address co-exposures that may have occurred in the
 7    occupational setting (asphalt or aluminum smelters) or exposures that occurred outside the
 8    workplace.
 9          Increased systolic and diastolic blood pressure has been observed in the offspring of dams
10    exposed to increasing concentrations of benzo[a]pyrene (Tules etal.. 2012] (Table 1-1].  At the
11    highest dose tested (1.2 mg/kg body weight by gavage to the dams], systolic pressures were
12    elevated approximately 50% and diastolic pressures were elevated approximately 80% above
13    controls. An intranasal exposure of 0.01 mg/kg-day benzo[a]pyrene in adult male rats also
14    produced an increase in blood pressure following a 7 day exposure  (Centner and Weber, 2011].
15          Reduced endothelial integrity and increased smooth muscle cell mass, both related to
16    atherosclerosis, have been observed in Sprague-Dawley rats exposed to 10 mg/kg benzo[a]pyrene
17    by i.p. injection (once/week for 8 weeks] (Zhang and Ramos. 1997]. The molecular mechanisms
18    underlying PAH-induced vascular injury and the development of atherosclerosis are not well
19    established, but current hypotheses include cell proliferative responses to injury of endothelial cells
20    from reactive metabolites (including reactive oxygen species [ROS]] and genomic alterations in
21    smooth muscle cells from reactive metabolites leading to transformed vasculature cells and
22    eventual plaque formation (Ramos and Moorthy, 2005]. However, while the link between PAHs
23    and atherosclerotic disease has been studied, experiments specifically looking at the relationship
24    between levels of exposure to benzo[a]pyrene (via environmentally relevant routes] and the
25    development of aortic wall lesions related to atherosclerosis have not generally been performed.
26          One exception to this observation comes from  a series of experiments on Apolipoprotein E
27    knock-out (ApoE -/-] mice exposed orally to benzo[a]pyrene. ApoE -/- mice develop spontaneous
28    atherosclerosis, which is thought to be due to enhanced oxidative stress from the lack of ApoE
29    (Godschalk et al., 2003]. Overall, these studies suggest that benzo[a]pyrene exposure in ApoE-/-
30    mice enhances the progression of atherosclerosis through a general local inflammatory process.

31    Neurological Toxicity
32          Impaired learning and memory, as well as neurochemical alterations, have been observed in
33    humans following occupational exposure to PAH mixtures (Niuetal., 2010]. Male coke oven
34    workers were analyzed for alterations in neurobehavioral function using the World Health
35    Organization Neurobehavioral Core Test Battery (WHO-NCTB], as well as changes in
36    neurotransmitter concentrations in blood. Urinary levels of the PAH metabolite, 1-hydroxypyrene,
37    were used as markers of PAH exposure.  In the WHO-NCTB, coke workers had lower scores in the

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                                                           Toxicological Review ofBenzo[a]pyrene
 1    digit span and forward digit span tests than matched control subjects, suggesting that short-term
 2    memory was impaired. The authors also reported that the digit span and forward digit span scores
 3    significantly decreased with increasing 1-hydroxypyrene levels in urine. PAH exposure also altered
 4    the blood levels of several neurotransmitters. As in the functional assays, the authors reported that
 5    alterations in neurochemical measures were associated with urinary levels of 1-hydroxypyrene.
 6           Alterations in neuromuscular, autonomic, sensorimotor, aggression, and
 7    electrophysiological endpoints have been reported in rats and mice following acute or short-term
 8    exposure to benzo[a]pyrene [Bouayed et al., 2009b: Grovaetal., 2008: Grovaetal., 2007: Saunders
 9    etal.. 2006: LiuetaL 2002: Saunders etal.. 2002:  Saunders etal..  20011 Impaired Morris water
10    maze performance was observed following subchronic oral gavage in adult rats [Chen etal.. 2011:
11    Chengzhietal., 2011]  and following short-term i.p. exposure in adult mice [Grovaetal., 2007]:
12    however, the former study was conducted with only a single  dose group, while the latter did not
13    evaluate possible changes in locomotion and reported unexplained decreases in escape latency on
14    trial day 1 following benzo[a]pyrene exposure. Decreased anxiety-like behavior in hole board and
15    elevated plus maze tests has been observed following short-term i.p. exposure [Grova etal., 2008].
16    In addition, a 28-day gavage study in male mice observed an  increase in aggressive behavior (as
17    measured by the resident intruder test] and an increase in consummatory sexual behavior in mice
18    treated with 0.02 mg/kg-day [Bouayed etal., 2009b]. These  data suggest that benzo[a]pyrene
19    exposure could be neurotoxic in adults; however,  only limited data are available to inform the
20    neurotoxic potential of repeated subchronic or chronic exposure to benzo[a]pyrene via the oral
21    route (Table 1-9].
22
23
Table 1-9. Evidence pertaining to other toxicities of benzo[a]pyrene in
animals
               Reference and Study Design
                                                         Results3
      Forestomach toxicity
       Kroese et al. (2001)
       Wistar (Riv:TOX) rats: male and female (52/sex/dose
       group)
       0, 3,10, or 30 mg/kg-d by gavage 5 d/wk
       104 wks (chronic)

       Wistar (Riv:TOX) rats: male and female
       (10/sex/dose group)
       0, 3,10, or 30 mg/kg-d by gavage 5 d/wk
       90 d (subchronic)

       Wistar (specific pathogen-free Riv:TOX) rats
       (10/sex/dose group)
       0,1.5, 5,15, or 50 mg/kg bw by gavage 5 d/wk
       5 wks (shorter-term)
                                     Forestomach hyperplasia (basal cell hyperplasia)
                                     Incidences'5:
                                     M: 2/50; 8/52; 8/52; and 0/52
                                     F: 1/52; 8/51; 13/51; and 2/52

                                     Forestomach hyperplasia (slight basal cell hyperplasia)
                                     Incidences:
                                     M: 2/10; 0/10; 6/10; and 7/10
                                     F: 0/10; 2/10; 3/10; and 7/10

                                     Forestomach hyperplasia (basal cell hyperplasia)
                                     Incidences:
                                     M: 1/10; 1/10; 4/10; 3/10; and 7/10
                                     F: 0/10; 1/10; 1/10; 3/10; and 7/10*
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          Reference and Study Design
                      Results3
Beland and Gulp (1998); Gulp et al. (1998)
BSCSFi mice: female (48/dose group)
0, 5, 25, or 100 ppm in the diet (average daily
doses": 0, 0.7, 3.3, and 16.5 mg/kg-d)
2 years
Forestomach hyperplasia
Incidences: 13/48; 23/47; 33/46*; and 38/47*

Forestomach hyperkeratosis
Incidences: 13/48, 22/47, 33/46*, 38/47*
De Jong etal. (1999)
Wistar rats: male (8/ dose group)
0, 3,10, 30, or 90 mg/kg-d by gavage 5 d/wk
5 wks
Forestomach hyperplasia (basal cell hyperplasia)
statistically significantly increased incidences at 30 and 90
mg/kg-d were reported, but incidence data were not
provided
Hematological toxicity
Kroese et al. (2001)
Wistar rats, 10/sex/dose
0, 3,10, or 30 mg/kg-d by gavage 5 d/wk
90 d

Wistar rats, 10/sex/dose
0,1.5, 5,15, or 50 mg/kg-d by gavage 5 d/wk for35 d
RBC count and hemoglobin changes not statistically
significant in males or females at any dose (numerical data
not reported)
                                                RBC count: changes not statistically significant (numerical
                                                data not reported)

                                                Hemoglobin:  changes not statistically significant
                                                (numerical data not reported)
Knuckles etal. (2001)
F344 rats, 20/sex/dose
0, 5, 50, or 100 mg/kg-d by diet
90 d
4, RBC count
Females (% change from control): statistically significant at
100 mg/kg-d (numerical data not reported)

Males (% change from control): statistically significant at
50 and 100 mg/kg-d (numerical data not reported)

4, hematocrit
Females (% change from control): statistically significant at
100 mg/kg-d (numerical data not reported)

Males (% change from control): statistically significant at
50 and 100 mg/kg-d (numerical data not reported)

4, hemoglobin
Females: statistically significant at 100 mg/kg-d (numerical
data not reported)
Males: statistically significant at 100 mg/kg-d (numerical
data not reported)
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                                          Toxicological Review ofBenzo[a]pyrene
Reference and Study Design
De Jong etal. (1999)
Wistar rats, 8 males/dose
0, 3, 10, 30, or 90 mg/kg-d by gavage 5 d/wk
35 d
Results3
4, RBC count
% change from control: 0, -1,- 5*, -10*, and -18*
•^ hemoglobin
% change from control: 0, -1, -7*, -10*, and -18*
•i, hematocrit
% change from control: 0, 0, -6*, -8*, and -14*
4> WBC count
% change from control: 0, -8, -9, -9, and -43*
1" mean cell volume
% change from control: 0, 0, -3, 0, and 3*
•i, mean corpuscular hemoglobin concentration
% change from control: 0, -1, -1, -1, and -3*
Liver toxicity
Kroese et al. (2001)
Wistar rats, 10/sex/dose
0, 3, 10, or 30 mg/kg-d by gavage 5 d/wk
90 d
Wistar rats, 10/sex/dose
0, 1.5, 5, 15, or 50 mg/kg-d by gavage 5 d/wk for 35
d
Knuckles etal. (2001)
F344 rats, 20/sex/dose
0, 5, 50, or 100 mg/kg-d by diet
90 d
De Jong etal. (1999)
Wistar rats, 8 males/dose
0, 3, 10, 30, or 90 mg/kg-d by gavage 5 d/wk
35 d
1" liver weight
Females (% change from control): 0, -2, 4, and 17*
Males (% change from control): 0, 7, 15*, and 29*
Liver histopathology: no effects reported
/T" liver weight
Females (% change from control): 0, 3, 2, 9, and 18*
Males (% change from control): 0, 2, 1, 3, and 18*
Liver histopathology: no effects reported
/T" liverbody weight ratio
Females: no change (numerical data not reported)
Males (% change from control): 23% change reported at
100 mg/kg-d (numerical data not reported)
1" liver weight
% change from control: 0, -9, 7, 5, and 15*
/T" liver oval cell hyperplasia (numerical data not reported)
reported as significant at 90 mg/kg-d;
Kidney effects
Knuckles etal. (2001)
F344 rats, 20/sex/dose
0, 5, 50, or 100 mg/kg-d by diet
90 d
De Jong etal. (1999)
Wistar rats, 8 males/dose
/T" abnormal tubular casts
Females: not statistically significant (numerical data not
reported)
Males: apparent dose-dependent increase (numerical data
not reported)
•^ kidney weight
% change from control: 0, -11*, -4, -10*, and -18*
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                                                            Toxicological Review ofBenzo[a]pyrene
Reference and Study Design
0, 3, 10, 30, or 90 mg/kg-d by gavage 5 d/wk
35 d
Kroese et al. (2001)
Wistar rats, 10/sex/dose
0, 1.5, 5, 15, or 50 mg/kg-d by gavage 5 d/wk
35 d
Results3

kidney weight: no change (data not reported)
Neurological toxicity
Chengzhietal. (2011)
Sprague-Dawley rats, male, 32/dose
0 or 2 mg/kg-d by gavage
90 d
Bouayedetal. (2009b)
Swiss albino mice, male, 9/group
0, 0.02, or 0.2 mg/kg by gavage
28 d
1" time required for treated rats to locate platform in
water maze (data reported graphically)
Significant decrease in latency to attack and increase in the
number of attacks in the resident-intruder test at 0.02
mg/kg-d (but not at high dose)
Significant increase in mount number in the copulatory
behavior test at 0.02 and 0.2 mg/kg-d
 1
 2    *Statistically significantly different from the control (p < 0.05).
 3    a % change from control calculated as: (treated value - control value)/control value x 100.
 4    bReported incidences may not fully account for the occurrence of hyperplasias due to the scoring of only the
 5     highest -level lesion in an individual animal (e.g., animals with forestomach tumors that also showed hyperplasia
 6     would not have the observation of hyperplasia recorded).
 7    °Based on the assumption that daily  benzo[a]pyrene intake at 5 ppm was one-fifth of the 25-ppm intake (about
 8     21 u.g/d) and using TWA body weights of 0.032 kg for the control, 5- and 25-ppm groups and 0.026 kg for the
 9     100-ppm group.

10    1.1.5.  Carcinogenicity

11    Evidence in Humans

12           There are many epidemiologic studies involving exposure to PAH mixtures that contain
13    benzo[a]pyrene (e.g., studies of coke oven workers, asphalt workers). This discussion primarily
14    focuses on epidemiologic studies that included a direct measure of benzo[a]pyrene exposure. All
15    identified studies have co-exposures to other PAHs.  The identified studies were separated into
16    tiers according  to the extent and quality of the exposure analysis and other study design features:

17           Tier 1:  Detailed exposure assessment conducted (using a benzo(a)pyrene metric), large
18           sample  size (>~50 exposed cases), and adequate follow-up period to account for expected
19           latency  (e.g., >20 years for lung cancer).

20           Tier 2: Exposure assessment, sample size,  or follow-up period did not meet the criteria for
21           Tier 1, or only a single-estimate exposure analysis was conducted.

22           For lung cancer, each of the Tier 1 studies  observed increasing risks of lung cancer with
23    increasing cumulative exposure to benzo[a]pyrene (measured in |ig/m3-years), and each of these

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                                                         Toxicological Review ofBenzo[a]pyrene

 1    studies addressed in the analysis the potential for confounding by smoking [Armstrong and Gibbs,
 2    2009: Spinellietal..20Q6: Xuetal.. 1996] (Table 1-11). These three studies represent different
 3    geographic locations and two different industries. The pattern of results in the Tier 2 studies was
 4    mixed, as would be expected for studies with less precise exposure assessments or smaller sample
 5    sizes: one of the standardized mortality ratio (SMR) estimates was <1.0, with the other eight
 6    estimates ranging from 1.2 to 2.9 (Table 1-12).  In considering all of the available studies,
 7    particularly those with the strongest methodology, there is considerable support for an association
 8    between benzo[a]pyrene exposure and lung cancer, although the relative contributions of
 9    benzo[a]pyrene and of other PAHs cannot be established.
10           For bladder cancer, the cohort and nested case-control studies observed a much smaller
11    number of cases compared with lung cancer; this limits their ability to examine exposure-response
12    relationships. Three cohort studies with detailed exposure data, however, identified 48 - 90 cases
13    (Burstynetal.. 2007: Gibbs and Sevigny. 2007a: Gibbs etal.. 2007: Gibbs and Sevigny. 2007b]
14    (Spinelli etal., 2006] (Tier 1 studies, Table 1-13). Although cumulative exposure (up to
15    approximately 2 [ig/m3-years) was not related to increasing risk in the study of asphalt workers by
16    Burstynetal. (2007). an exposure-response was seen with the wider exposure range (i.e., >80
17    [ig/m3-years) examined in two studies of aluminum smelter workers by Gibbs and Sevigny (2007a):
18    Gibbs etal. (2007): Gibbs and Sevigny (2007b) and (Spinelli etal.. 2006). This difference in
19    response is not surprising, given that the highest exposure group in the asphalt worker studies
20    corresponded to the exposures seen in the lowest exposure categories in the studies of aluminum
21    smelter workers.  The five studies with more limited exposure information or analyses each
22    included between 2 and 16 bladder cancer cases, with relative risk estimates ranging from  0.6 to
23    2.9. None of these individual effect estimates was statistically significant (Table 1-13).
24           Two of the identified studies contained information on risk of mortality from melanoma.
25    Neither of these studies observed increased risks of this type  of cancer, with an SMR of 0.91 (95%
26    confidence interval  [CI] 0.26, 2.48) [22 cases) in (Spinelli etal.. 2006) and 0.58 (95% CI 0.12,1.7) in
27    Gibbs et al. (2007][3 cases]. Of additional interest is non-melanoma skin cancer, particularly with
28    respect to dermal exposures. The literature pertaining to this kind of cancer and PAH exposure
29    goes back to the 18th century work of Sir Percival Pott describing scrotal cancer, a squamous cell
30    skin cancer, in chimney sweeps (Brown and Thornton.  1957). One of the identified studies
31    reported an increased risk of mortality from non-melanoma skin cancer among asphalt workers
32    (roofers), with an SMR of 4.0 (95% CI: 1.0,10.9) among workers with >20 years (Hammond etal..
33    1976}.  In addition to this study, three studies in Scandinavian countries examined non-melanoma
34    skin cancer risk in relation to occupations with likely dermal exposure to creosote (i.e., timber
35    workers, brickmakers, and power linesmen) using incidence data from population registries
36    (Pukkala. 1995: Karlehagenetal.. 1992: Tornqvist etal.. 1986).
37           The standardized incidence ratio (SIR) estimates were 1.5 (95% CI: 0.7, 2.6) based on five
38    exposed cases, 2.37 (95% CI: 1.08, 4.50) based on nine  cases,  and 4.64 (95% CI: 1.51,10.8)  based

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                                                         Toxicological Review ofBenzo[a]pyrene
 1    on five cases, respectively, in Tornqvist et al. [1986]. Karlehagen et al. [1992]. and Pukkala [1995].
 2    These studies provide support for the association between dermal PAH exposure, including
 3    benzo[a]pyrene exposure, and skin cancer.
 4          In addition to cohorts of workers occupationally exposed to PAH mixtures, populations
 5    exposed to benzo[a]pyrene through topical coal tar formulations for the treatment of psoriasis,
 6    eczema, and dermatitis have also been studied.  In the majority of studies with greater than 20
 7    years of follow-up, coal tar treatment was not significantly associated with skin cancer [Roelofzen
 8    etal., 2010: Pittelkowetal.,  1981: Maughanetal., 1980].  However, in populations of patients with
 9    co-exposure to psoralen and ultraviolet-A light therapy (later determined to be carcinogenic], high
10    exposure to coal tar treatments was associated with an increased risk of non-melanoma skin cancer
11    [Stern etal.. 1998: Stern etal.. 1980].
12          Lung, bladder, and skin cancers are the cancers that have been observed in occupational
13    studies of PAH mixtures [Benbrahim-Tallaaetal.. 2012: Baan etal.. 2009: Secretan etal.. 2009]..
14    The reproducibility of lung, bladder, and skin cancers in different populations and exposure
15    settings after occupational exposure to PAH mixtures (see Table 1-10] adds plausibility to the
16    hypothesis that common etiologic factors may be operating.  The potential role that benzo[a]pyrene
17    may play as a causal agent is further supported by the observation that these same sites are also
18    increased in the studies that included a direct measure of benzo[a]pyrene.

19          Table 1-10. Cancer sites for PAH-related agents reviewed by IARC
PAH-Related Mixture or
Occupation
Aluminum production
Carbon electrode manufacture
Coal gasification
Coal tar distillation
Coal tar pitch (paving and roofing)
Coke production
Creosotes
Diesel exhaust
Indoor emissions from household
combustion of biomass fuel (primarily
wood)
Indoor emissions from household
combustion of coal
Sites with Sufficient
Evidence in Humans
Lung
Urinary bladder

Lung
Skin
Lung
Lung

Lung

Lung
Sites with Limited
Evidence in Humans

Lung


Urinary bladder

Skin
Urinary bladder
Lung

Reference
Baan etal. (2009)

IARC (2010)

Baan etal. (2009)

Baan etal. (2009)

Baan etal. (2009)

Baan etal. (2009)

IARC (2010)

Benbrahim-Tallaa et al.
(2012)
Secretan et al. (2009)

Secretan et al. (2009)

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                                                              Toxicological Review ofBenzo[a]pyrene
PAH-Related Mixture or
Occupation
Mineral oils, untreated or mildly
treated
Shale oils
Soot (chimney sweeping)
Sites with Sufficient
Evidence in Humans
Skin
Skin
Lung
Skin
Sites with Limited
Evidence in Humans


Urinary bladder
Reference
Baanetal. (2009)

Baanetal. (2009)

Baanetal. (2009)

1
2

3
4
Adapted from IARC (2010).

        Table 1-11. Summary of epidemiologic studies of benzo[a]pyrene (direct
        measures) in relation to lung cancer risk: Tier 1 studies
               Reference and Study Design
                                                                    Results
      Armstrong and Gibbs (2009) (Quebec, Canada)
      Cohort, aluminum smelter workers, seven plants
      16,431 (15,703 men; 728 women)
      Duration: minimum 1 yr, began work 1966-1990
      Follow-up: through 1999 (mean ~30 yrs)
      Smoking information collected from medical
      records
      Exposure:  Job exposure matrix ~5,000 personal
      benzo[a]pyrene measures from the 1970s to 1999
      Related references: Lavoue et al. (2007) (exposure
      data); Gibbs and Sevigny (2007a); Gibbs etal.
      (2007); Gibbs and Sevigny (2007b); Armstrong et al.
      (1994)
                                              SMR 1.32 (1.22, 1.42) [677 cases]
                                              Lung cancer risk by cumulative benzo[a]pyrene exposure
                                                 Median
                                                benzo[a]-
                                                 pyrene      n
                                               Hg/m3-years  cases   SMR (95% Cl)
                   RR (95% Cl)
                                                   0        35    0.62(0.44,0.87)     1.0 (referent)

                                                   10       266   1.09 (0.96, 1.23)   1.75 (1.23,2.48)
                                                   30       70    1.88(1.47,2.38)   3.02(2.01,4.52)
                                                   60       53    1.21(0.91,1.59)   1.94(1.27,2.97)
                                                   120       114   1.93(1.59,2.32)   3.09(2.12,4.51)
                                                   240       116   1.79(1.48,2.15)   2.86(1.96,4.18)
                                                   480       23    2.36(1.49,3.54)   3.77(2.23,6.38)
                                                   RR = relative risk
                                                   No evidence of confounding by smoking
                                                   Additional  modeling as continuous variable: RR 1.35
                                                   (95% Cl 1.22, 1.51) at 100 u.g/m3-years (0.0035 per
                                                   u.g/m3-years increase); other shapes of exposure-
                                                   response curve examined.
      Spinelli et al. (2006) (British Columbia, Canada)
      Cohort, aluminum smelter workers
      6,423 (all men)
      Duration: minimum >3 yrs; began work 1954-1997
      Follow-up: through 1999 (14% loss to follow-up;
      mean ~24yrs)
      Smoking information from self-administered
      questionnaire
      Exposure: Job exposure matrix using 1,275 personal
                                              SMR 1.07 (0.89, 1.28) [120 cases]
                                              SIR  1.10 (0.93, 1.30) [147 cases]
                                              Lung cancer risk by cumulative benzo[a]pyrene exposure
                                               Benzo[a]-pyrene
                                                 ug/m3-years
n cases
  RR (95% Cl)a
                                                    0-0.5

                                                   0.5-20
  25

  42
 1.0  (referent)

1.23  (0.74,2.03)
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                                                       Toxicological Review ofBenzo[a]pyrene
benzo[a]pyrene measures from 1977 to 2000 (69%
for compliance monitoring)
Related references: Friesen et al. (2006) (exposure
data); Spinellietal. (1991)

Xuetal. (1996) (China)
Nested case-control in iron-steel worker cohort
610 incident cases (96% participation); 959 controls
(94% participation) (all men)
Duration: data not reported
Smoking information collected from interviews;
next-of-kin interviews with 30% of lung cancer cases
and 5% of controls
Exposure: Job exposure matrix 82,867 historical
monitoring records, 1956-1992
20-40 23 1.35 (0.76,2.40)
40-80 25 1.36 (0.78,2.39)
>80 32 1.79 (1.04,3.01)
a Adjusting for smoking category; trend p < 0.001
Lung cancer risk by cumulative benzo[a]pyrene exposure
Benzo[a]-pyrene
(u.g/m3-years) n cases RR (95% Cl)a
<0.84 72 1.1(0.8,1.7)
0.85-1.96 117 1.6 (1.2, 2.3)
1.97-3.2 96 1.6 (1.1, 2.3)
>3.2b 105 1.8 (1.2, 2.5)
Adjusting for birth year and smoking category; trend
p < 0.004. Referent group is "nonexposed" (employed in
administrative or low-exposure occupations)
bStudy table IV unclear; could be >3.0 for this category
1
2
Table 1-12. Summary of epidemiologic studies of benzo[a]pyrene (direct
measures) in relation to lung cancer risk: Tier 2 studies
Reference and Study Design
Results
Limited follow-up period (<20 yrs)
Friesen et al. (2009) (Australia)
Cohort, aluminum smelter workers
4,316 (all men)
Duration: minimum 90 d; began work after 1962
Follow-up: through 2002, mean 16 yrs (maximum
20 yrs)
Smoking information from company records if
employed before 1995 and study interviews if
employed after 1994
Exposure: Job/task exposure matrix using TWA
benzo[a]pyrene measures (n=655), 1977-2004 (79%
from 1990 to 2004)
RR 1.2 (0.7, 2.3) [19 cases in exposed; 20 in unexposed]
Lung cancer risk by cumulative benzo[a]pyrene exposure
Benzo[a]-pyrene
u.g/m3-yrs
0
>0-0.41
0.41-10.9
>10.9
aPoisson regression
n cases RR
20 1.0
6 0.7
6 1.4
7 1.7
, adjusting for smoking; trend
(95% Cl)a
(referent)
(0.3, 1.8)
(0.6, 3.5)
(0.7, 4.2)
p = 0.22.
Proxy measure
Olsson etal. (2010) (Denmark, Norway, Finland,
Israel)
Nested case-control, asphalt workers
433 lung cancer cases (65% participation); 1,253
controls (58% participation), matched by year of
birth, country (all men)
Duration: minimum >2 seasons, median 8 seasons;
Lung cancer risk by
Coal tar
unit-yrsa
0.39-4.29
4.30-9.42
9.43-16.88
cumulative coal tar exposure3
n
cases RR
43 1.31
32 0.98
30 0.97
(95% Cl)
(0.87, 2.0)
(0.62, 1.6)
(0.61, 1.6)
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                                                           Toxicological Review ofBenzo[a]pyrene
          Reference and Study Design
                                                                       Results
began work 1913-1999
Follow-up: from 1980 to 2002-2005 (varied by
country)
Smoking information from interviews
Exposure:  compilation of coal tar exposure
measures, production characteristics, and repeat
measures in asphalt industry in each country used to
develop exposure matrix
Related references: Boffetta et al. (2003); Burstyn et
al. (2000)
                                                 16.89-196.48

                                                 (trend p-value)
    54
  1.60
(1.09, 2.4)

 (0.07)
                                                Adjusting for set, age, country, tobacco pack-years.
Costantino et al. (1995) (United States, Pennsylvania)
Cohort, coke oven workers
5,321 and 10,497 unexposed controls (non-oven
steel workers; matched by age, race, date of first
employment) (all men)
Duration: data not reported; worked in 1953
Follow-up through 1982 (length data not reported)
Exposure: average daily exposure coal tar pitch
volatiles: 3.15 mg/m3 top-side full-time jobs, 0.88
mg/m3 side jobs; used to calculate weighted
cumulative exposure index
Related reference: Dong et al. (1988) (exposure data)
                                                SMR 1.95 (1.59, 2.33) [255 cases]

                                                Lung cancer risk by cumulative exposure
                                                   Coal tar pitch
                                                     volatiles
                                                    (mg/m3-mo)
           n
         cases
          RR  (95%CI)a
                                                          0

                                                        1-49

                                                       50-199

                                                       200-349

                                                       350-499

                                                       500-649

                                                        >650
          203

          34

          43

          59

          39

          27

          56
          1.0 (referent)

          1.2 (0.85, 1.8)

          1.6 (1.1,2.3)

          2.0 (1.5,2.8)

          2.0 (1.6,3.2)

          2.7 (2.0,4.6)

          3.1 (2.4,4.6)
                                                Adjusting for age, race, coke plant, period of follow-up;
                                                trend p< 0.001.
Limited exposure information
 Liuetal. (1997)(China)

Cohort, various carbon plants and aluminum smelter
workers
6,635 (all men)
Duration: minimum 15 yrs; began work before 1971
Follow-up: through 1985 (mean ~14 yrs)
Smoking information from questionnaire
Exposure: Area samples from one carbon plant,
1986-1987
                                                SMR 2.2 (1.1, 2.8) [50 cases]

                                                Lung cancer risk by exposure category
                                                  Exposure
                                                  category
  Mean
benzo[a]-
 pyrene
  Mg/m3
n cases   SMR  (95% Cl)a
                                                    None           -           13
                                                     Low           -           6
                                                   Moderate       0.30         5
                                                     High          1.19         26
                                                'Calculated by EPA from data in paper
                       1.49 (0.83,2.5)

                       1.19 (0.48,2.5)

                       1.52 (0.55,3.4)

                        4.30  (2.9,6.2)
Bergerand Manz (1992) (Germany)
                                                SMR 2.88 (2.28, 3.59) [78 cases]
Cohort, coke oven workers
789 (all men)
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                                                          Toxicological Review ofBenzo[a]pyrene
          Reference and Study Design
                       Results
Duration: minimum 10 yrs (mean 27 yrs); began work
1900-1989
Follow-up through 1989 (length data not reported)
Smoking information from plant records and
interviews
Exposure: mean benzo[a]pyrene: 28 (range 0.9-89)
u.g/m3
Hansen (1991); (Hansen, 1989) (Denmark)
SMR 2.90 (1.88, 4.3) [25 cases] (ages 40 to 89)
SMR 2.46 (1.59, 3.6) [25 cases] (with smoking adjustment)
Cohort, asphalt workers
679 workers (applicators) (all men)
Duration: data not reported; employed 1959 to 1980
Follow-up to 1986 (mean ~11 yrs)
Smoking information from 1982 surveys of industry
and general population
Exposure: asphalt fume condensate, 35 personal
samples during flooring:  median 19.7 (range 0.5-
260) mg/m3
Gustavsson etal. (1990) (Sweden)
Cohort, gas production (coke oven) workers
295 (all men)
Duration: minimum 1 yr, median 15 yrs; employed
1965-1972
Follow-up: 1966-1986 (mortality); 1966-1983
(incidence; mean ~15 yrs)
Smoking information from interviews with older
workers
Exposure: area sampling - top of ovens.
Benzo[a]pyrene, 1,964 mean 4.3 (range 0.007-33);
1,965 mean 0.52, (0.021-1.29) |jg/m3
SMR 0.82 (0.22, 2.1) [4 cases] (referent group = employed
men)
SIR 1.35(0.36,3.5) [4 cases]
Moulin et al. (1989) (France)
Cohort and nested case-control, two carbon
electrode plants
1,302 in  Plant A (all men), employed in 1975; follow-
up 1975-1985 (incidence); smoking information from
plant records
1,115 in  Plant B (all men); employed in 1957; follow-
up 1957-1984 (mortality)
Duration of employment and follow-up: data not
reported
Exposure: benzo[a]pyrene, 19 area samples and 16
personal samples in Plant A (personal sample mean
2.7; range 0.59-6.2 u.g/m3); 10 area samples and
7 personal samples in Plant B; personal sample mean
0.17, range 0.02-0.57 u.g/m3
Plant A: SMR 0.79 (0.32,1.6) [7 cases]
Plant B: SMR 1.18 (0.63, 2.0) [13 cases]

Internal Comparison (case-control), >1 yr duration:
Plant A: OR 3.42 (0.35, 33.7) [7 cases, 21 controls]
Plant B: OR 0.49 (0.12. 2.0) [13 cases, 33 controls]
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                                                               Toxicological Review ofBenzo[a]pyrene
               Reference and Study Design
                                                               Results
     Hammond et al. (1976) (United States)
                                        SMR 1.6 (1.3,1.9) [99 cases] (>20 yrs since joining union)
                                        (CIs calculated by EPA from data in paper)
     Cohort, asphalt- roofers
     5,939 (all men)
     Duration: minimum 9 yrs, began before 1960
     Follow-up: through 1971
     Exposure: 52 personal samples (masks with filters)
     during specific jobs and tasks; mean benzo[a]pyrene
     16.7 u.g per 7-hr d
1
2
Table 1-13. Summary of epidemiologic studies of benzo[a]pyrene (direct
measures) in relation to bladder cancer risk
              Reference and Study Design
                                                              Results
     Tier 1 studies
     Burstyn et al. (2007) (Denmark, Norway, Finland,
     Israel)

     Cohort, asphalt workers
     7,298 all men)
     Duration: minimum >2 seasons, median 8 seasons;
     began work 1913-1999
     Follow-up: began around 1960, ended around 2000
     (years varied by country); median 21 yrs
     Smoking information not collected
     Exposure: compilation of benzo[a]pyrene measures,
     production characteristics, and repeat measures in
     asphalt industry in each country used to develop
     exposure matrix
     Related references: (Boffetta eta I., 2003); Burstyn
     et al. (2000)
                                       48 incident bladder cancer cases (39 cases in analyses with
                                       15-yr lag)
                                       Bladder cancer risk by cumulative benzo[a]pyrene exposure3
                                         Benzo[a]-
                                          pyrene
                                        u.g/m3-yrsa     n cases
         RR (95% Cl)
           (no lag)b
RR (95% Cl)
(15 yr lag)0
                                         0-0.253        12       1.0 (referent)   1.0 (referent)

                                       0.253-0.895      12      0.69 (0.29, 1.6)  1.1 (0.44, 2.9)

                                       0.895-1.665      12      1.21(0.45,3.3)  1.7(0.62,4.5)

                                          >1.665        12      0.84(0.24,2.9)  1.1(0.30,4.0)

                                       Adjusting for age, calendar period, total duration of
                                       employment, country.
                                       bTrend p = 0.9
                                       'Trend p = 0.63
                                       Stronger pattern seen with average exposure in 15-yr lag
                                       (RR 1.5, 2.7,1.9 in second through fourth quartile; trend p =
                                       0.15)
     Gibbs and Sevigny (2007a); Gibbsetal. (2007);
     Gibbs and Sevigny (2007b) (Quebec, Canada)
                                       Hired before 1950: SMR 2.24 (1.77, 2.79) [78 cases]
                                       Bladder cancer risk by cumulative benzo[a]pyrene exposure
     Cohort, aluminum smelter workers, 7 plants
     16,431 (15,703 men; 728 women)
     Duration: minimum 1 yr, began work 1966-1990
     Follow-up: through 1999 (mean ~30 yrs)
     Smoking information collected from medical
     records
     Exposure: Job exposure matrix using ~5,000
     personal benzo[a]pyrene measures from the 1970s
     to 1999
     Related references: Lavoue et al. (2007) (exposure
                                         Benzo[a]-
                                          pyrene
                                        u.g/m3-yrsa     n cases    SMR (95% Cl)
                         Smoking-
                         adjusted
                           RRb
                                            0

                                            10

                                            30

                                            60

                                           120
3       0.73(0.15,2.1)  1.0 (referent)

14      0.93 (0.45, 1.4)      1.11

3       1.37 (0.28,4.0)      1.97

1       0.35 (0.9, 1.9)       0.49

15       4.2 (2.4,6.9)       8.49
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                                          Toxicological Review ofBenzo[a]pyrene
Reference and Study Design
data); Armstrong et al. (1994); Gibbs (1985); Gibbs
and Horowitz (1979)

Spinelli et al. (2006) (British Columbia, Canada)
See Table 1-11 for study details; this study is
considered a "Tier 2") study for bladder cancer
because of the smaller number of bladder cancer
cases (n = 12) compared with lung cancer cases (n =
120)
Results
240 30 6.4 (4.3, 9.2)
480 12 23.9 (12.2, 41.7)
aCategory midpoint
bCls not reported; highest category is >80 u.g/m3-yrs
n observed = 57).
Mortality risk reduced in cohort hired in 1950-1959,
SMR=1.23.
Similar patterns seen in analysis of bladder cancer
incidence.
SMR 1.39 (0.72, 2.43) [12 cases]
SIR 1.80; Cl 1.45-2.21 [90 cases, including in situ]
Bladder cancer risk by cumulative benzo[a]pyrene exposure
Benzo[a]-
pyrene
|jg/m3-years n cases RR (95% Cl)a
0-0.5 17 1.0 (referent)
0.5-20 20 0.83 (0.43, 1.59)
20-40 13 1.16 (0.56,2.39)
40-80 18 1.50 (0.77,2.94)
>80 22 1.92 (1.02,3.65)
Adjusting for smoking category; trend p < 0.001
Tier 2 studies
Friesen et al. (2009) (Australia)
See Table 1-12 for study details
Costantino et al. (1995) (United States,
Pennsylvania)
See Table 1-12 for study details
Hammond et al. (1976) (United States)

RR 0.6 (0.2, 2.0) [five cases in exposed; eight in unexposed]
Bladder cancer risk by cumulative benzo[a]pyrene exposure
Benzo[a]-
pyrene
u.g/m3-yrs n cases RR (95% Cl)a
0 8 1.0 (referent)
>0-0.41 1 0.2 (0.03, 1.9)
0.41-10.9 2 0.7 (0.2,3.7)
>10.9 2 1.2 (0.2,5.6)
aPoisson regression, adjusting for smoking category; trend
p = 0.22
SMR 1.14 (0.61, 2.12) (16 cases)
SMR 1.7 (0.94, 2.8) (13 cases) (>20 yrs since joining union)
(CIs calculated by EPA from data in paper)
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                                                        Toxicological Review ofBenzo[a]pyrene
Reference and Study Design
See Table 1-12 for study details
Moulin etal. (1989) (France)
See Table 1-12 for study details
Gustavsson et al. (1990) (Sweden)
See Table 1-12 for study details
Results

Plant A: 0 observed cases;
Plant B:SMR 1.94 (0.40, 5
expected <1.0
0) (3 cases)
SMR 2.85 (0.30, 10.3) (2 cases) (referent group
men)

= employed

 2   Evidence in Animals

 3   Oral exposure
 4          Evidence of tumorigenicity following oral exposure to benzo[a]pyrene has been
 5   demonstrated in rats and mice.  As summarized in Table 1-14, oral exposure to benzo[a]pyrene has
 6   resulted in an increased incidence of tumors in the alimentary tract in male and female rats [Kroese
 7   etal.. 2001: Brune etal.. 19811 and female mice fBeland and Gulp. 1998: Gulp etal.. 19981 liver
 8   carcinomas in male and female rats,  kidney adenomas in male rats [Kroese etal., 2001], and
 9   auditory canal tumors in both sexes  [Kroese etal.. 2001).
10          Forestomach tumors have been observed in several lifetime cancer bioassays in rats and
11   mice following both gavage and dietary exposure to benzo[a]pyrene at doses ranging from
12   0.016 mg/kg-day in Sprague-Dawley rats to 3.3 and 10 mg/kg-day in B6C3Fi mice and Wistar rats,
13   respectively [Kroese etal.. 2001: Belandand Gulp. 1998: Gulp etal.. 1998: Brune etal.. 1981].  In
14   addition, multiple less-than-lifetime  oral exposure cancer bioassays in mice provide supporting
15   evidence that oral exposure to benzo[a]pyrene is associated with an increased incidence of
16   forestomach tumors [Weyandetal..  1995: Benjamin etal.. 1988: Robinson etal.. 1987: El-Bayoumy.
17   1985: Triolo etal.. 1977:  Wattenberg. 1974: Roe etal.. 1970: Biancifiori etal.. 1967: Chouroulinkov
18   etal.. 1967: Fedorenko and Yansheva. 1967: Neal and Rigdon. 1967: Berenblum and Haran. 1955].
19   Although humans do not have a forestomach, similar squamous epithelial tissue is present in the
20   oral cavity [IARC. 2003: Wester and  Kroes. 1988]: therefore, EPA concluded that forestomach
21   tumors observed in rodents following benzo[a]pyrene exposure are relevant in the assessment of
22   carcinogenity. For further discussion, see Sections 1.2 and 2.3.4.
23          Elsewhere in the  alimentary  tract, dose-related increases of benign and malignant tumors
24   were observed. In rats, oral cavity tumors were induced in both sexes and adenocarcinomas of the
25   jejunum were induced in males  [Kroese etal., 2001]. In mice, tumors were induced in the tongue,
26   esophagus, and larynx of females (males were not tested] [Beland and Gulp, 1998: Gulp etal., 1998].
27          Chronic oral exposure to benzo[a]pyrene resulted in a dose-dependent increased incidence
28   of liver carcinomas in both sexes of Wistar rats, with the first liver tumors detected in week 35 in
29   high-dose male rats; liver tumors were described as complex, with a considerable proportion
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                                                        Toxicological Review ofBenzo[a]pyrene

 1    (59/150 tumors) metastasizing to the lungs [Kroese etal.. 2001]. Treatment-related hepatocellular
 2    tumors were not observed in mice [Beland and Gulp. 1998: Gulp etal.. 1998).
 3          A statistically significantly increased incidence of kidney tumors (cortical adenomas) was
 4    observed in male Wistar rats following chronic gavage exposure (Kroese etal., 2001] (Table 1-14).
 5    The kidney tumors were observed at the mid- and high-dose groups. Treatment-related kidney
 6    tumors were not observed in two other studies (Brune etal., 1981).
 7          Lung tumors were also observed following almost nine months of dietary exposure to
 8    approximately 10 mg/kg-day in female AJ mice (Weyandetal., 1995). Other lifetime exposure
 9    studies did not report treatment-related increases in lung tumors (Kroese etal.. 2001: Beland and
10    Gulp. 1998: Gulp etal.. 19981
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                                                        Toxicological Review ofBenzo[a]pyrene
      Table 1-14. Tumors observed in chronic oral animal bioassays
    Study Design and Reference
                           Results
Kroese et al. (2001)
Wistar (Riv:TOX) rats (52/sex/dose
group)
0, 3,10, or 30 mg/kg-d by gavage 5 d/wk
2 yrs
Forestomach
        incidences:
        M: 0/52; 7/52*; 18/52*; and 17/52* (papilloma)
        M: 0/52; 1/52; 25/52*; and 35/52* (squamous cell carcinoma)
        F: 1/52; 3/51; 20/51*; and 25/52* (papilloma)
        F: 0/52; 3/51; 10/51*; and 25/52* (squamous cell carcinoma)

Oral cavity
        incidences:
        M: 0/24; 0/24; 2/37; and 10/38* (papilloma)
        M: 1/24; 0/24; 5/37; and 11/38* (squamous cell carcinoma)
        F: 0/19; 0/21; 0/9; and 9/31*(papilloma)
        F: 1/19; 0/21; 0/9; and 9/31* (squamous cell carcinoma)

Jejunum (adenocarcinomas)
        incidences:
        M: 0/51; 0/50; 1/51; and 8/49*
        F: 0/50; 0/48; 0/50; and 2/51

Duodenum (adenocarcinomas)
        incidences:
        M: 0/51; 0/50; 0/51; and 1/49
        F: 0/49; 0/48; 0/50; and 2/51

Liver (adenomas and carcinomas)
        incidences:
        M: 0/52; 3/52; 15/52*; and 4/52 (adenoma)
        M: 0/52; 1/52; 23/52*; and 45/52* (carcinoma)
        F: 0/52; 2/52; 7/52*; and 1/52 (adenoma)
        F: 0/52; 0/52; 32/52*; and 50/52* (carcinoma)

Kidney (cortical adenoma)
        incidences:
        M: 0/52; 0/52; 7/52*;  and 8/52*
        F: increase not observed

Auditory canalb (Zymbal gland) (carcinomas)
        incidences:
        M: 0/1; 0/0; 2/7; and 19/33*
        F: 0/0; 0/1; 0/0; and 13/20*
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                                                             Toxicological Review ofBenzo[a]pyrene
       Beland and Gulp (1998); Gulp et al.
       (1998)
       BSCSFi mice: female (48/dose group)
       0, 5, 25, or 100 ppm (average daily
       doses3: 0, 0.7, 3.3, and 16.5 mg/kg-d) in
       the diet
       2 yrs
Forestomach (papillomas and squamous cell carcinomas)
       incidences: 1/48; 3/47; 36/46*; and 46/47*

Esophagus (papillomas and carcinomas)
       incidences: 0/48; 0/48; 2/45; and 27/46*

Tongue (papillomas and carcinomas)
       incidences: 0/49; 0/48; 2/46; and 23/48*

Larynx (papillomas and carcinomas)
       incidences: 0/35; 0/35; 3/34; and 5/38
       Bruneetal. (1981)
       Sprague-Dawley rats: male and female
       (32/sex/dose)
       Gavage: 0, 6,18, 39 mg/kg-yr (0, 0.016,
       0.049, 0.107 mg/kg-d)
       Diet: 0, 6, 39 mg/kg-yr (0, 0.016, 0.107
       mg/kg-d)
       Treated until moribund or dead
       2 yrs
Forestomach (papillomas and carcinomas0); gavage
       incidences: 3/64; 12/64*; 26/64*; and 14/64*

Forestomach (papillomas); diet
       incidences: 2/64; 1/64; and 9/64*

Larynx and esophagus (papillomas); gavage
       incidences: 3/64; 1/64; 0/64; and 0/64

Larynx and esophagus (papillomas); diet
       incidences: 1/64; 2/64; and 1/64
 1
 2    Indicates statistical significance as identified in study.
 3    aBased on the assumption that daily benzo[a]pyrene intake at 5 ppm was one-fifth of the 25-ppm intake (about
 4     21 u.g/day) and using TWA body weights of 0.032 kg for the control, 5- and 25-ppm groups and 0.026 kg for the
 5     100-ppm group.
 6    blncidences are for number of rats with tumors compared with number of tissues examined histologically.
 7     Auditory canal tissue was examined histologically when abnormalities were observed on macroscopic
 8     examination.
 9    °Two malignant forestomach tumors were observed (one each in the mid- and high-dose groups).

10    Inhalation exposure
11           The inhalation database of benzo[a]pyrene carcinogenicity studies consists of one lifetime
12    inhalation bioassay in male hamsters [Thyssenetal., 1981].  Intratracheal instillation studies in
13    hamsters are also available [Feron and Kruysse. 1978: Ketkar etal.. 1978: Feronetal.. 1973: Henry
14    etal.. 1973: Saffiottietal.. 19721
15           Several long term intratracheal installation studies in hamsters evaluated the
16    carcinogenicity of benzo[a]pyrene [Feron and Kruysse, 1978: Feronetal., 1973: Henry etal., 1973:
17    Saffiotti et al., 1972].  These studies treated animals with benzo[a]pyrene once a week in a saline
18    solution (0.5-0.9%] for > 8 months and observed animals for one to two years following cessation
19    of exposure. Tumors in the larynx, trachea, bronchi, bronchioles, and alveoli were observed.
20    Individual studies also reported tumors  in the nasal cavity and forestomach.  These intratracheal
21    instillation studies support the carcinogenicity of benzo[a]pyrene in the respiratory tract; however,
22    direct extrapolation from a dose delivered by intratracheal instillation to an inhalation
23    concentration expected to result in similar responses is not recommended [Driscoll etal., 2000].
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                                                         Toxicological Review ofBenzo[a]pyrene

 1          Chronic inhalation exposure to benzo[a]pyrene resulted in the development of tumors in
 2    the respiratory tract and pharynx in Syrian golden hamsters (Table 1-15). Concentration-
 3    dependent increased incidences of tumors in the upper respiratory tract, including the larynx and
 4    trachea, were reported by Thyssen et al. [1981] at measured exposure concentrations of >9.5
 5    mg/m3. In addition, a decrease in tumor latency was observed in the larynx and trachea, and nasal
 6    cavity tumors were observed at the mid- and high-concentration, but the incidences were not dose-
 7    dependently increased. A concentration-related increase in tumors in the upper digestive tract
 8    (pharynx and esophagus) was also reported. In addition, a single forestomach tumor was observed
 9    in each of the mid- and high-concentration groups, in animals with a tumor in either the larynx or
10    pharynx; forestomach tumors were not observed in control animals. The study authors presumed
11    that the pharyngeal and esophageal tumors were a consequence of mucociliary particle  clearance.
12    The authors stated that the rates of tumors of other organs generally corresponded to the rates in
13    controls.
14          Under contract to the U.S. EPA, Clement and Associates U.S. EPA (1990b) obtained the
15    individual animal data (including individual animal pathology reports, time-to-death data, and
16    exposure chamber monitoring data) collected by Thyssen etal. (1981). A re-analysis of the
17    individual animal pathology reports from  the original study supports the concentration-dependent
18    increased incidence of tumors in the larynx and pharynx (U.S. EPA, 1990a, b). The exposure
19    measurements and individual animal data from Thyssen etal. (1981) were used to calculate
20    average continuous lifetime exposures for each individual hamster. Group averages of individual
21    average continuous lifetime exposure concentrations were 0, 0.25,1.01, and 4.29 mg/m3 for the
22    control through high-exposure groups, as  described in U.S. EPA (1990b).
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                                                                Toxicological Review ofBenzo[a]pyrene
              Table 1-15. Tumors observed in chronic inhalation animal bioassays
                 Reference and Study Design
                     Results'3
      Thyssenetal. (1981)
      Syrian golden hamsters: male
      (20-30 animals/group)
       0, 2.2, 9.5, or 46.5 mg/m3 on NaCI particles by nose
      only inhalation for 3-4.5 hrs/5-7 d/wk
      (TWA exposure concentrations3: 0, 0.25,1.01, and
      4.29 mg/m3)
      Treated until moribund or dead (up to 130 wks)
      MMAD: not reported
Larynx
        incidences: 0/27; 0/27; 8/26; and 13/25
        earliest observation of tumor0:107 and 68 wks
Pharynx
        incidences: 0/27; 0/27; 6/26; and 14/25
        earliest observation of tumor: 97 and 68 wks
Trachea
        incidences: 0/27; 0/27; 1/26; and 3/25
        earliest observation of tumor: 115 and 63 wks

Nasal cavity
        incidences: 0/27; 0/27; 3/26; and 1/25
        earliest observation of tumor: 116 and 79 wks

Esophagus
        incidences: 0/27; 0/27; 0/27; and 2/25
        earliest observation of tumor: 71 wks

Forestomach
        incidences: 0/27; 0/27; 1/26; and 1/25
        earliest observation of tumor: 119 and 72 wks
                                                        Revised tumor incidence data

                                                        Larynx
                                                               incidences: 0/27; 0/27; 11/26; and 12/34
                                                        Pharynx
                                                               incidences: 0/27; 0/27; 9/26; and 18/34

                                                        Larynx and pharynx (combined)6
                                                               incidences: 0/27; 0/27; 16/26; and 18/34
 2
 3    aDuration adjusted inhalation concentrations calculated from exposure chamber monitoring data and exposure
 4     treatment times obtained by Clement Associates and reported in U.S. EPA (1990b). Daily exposure times:
 5     4.5 hours/day, 5 days/week on weeks 1-12; 3 hours/day, 5 days/week on weeks 13-29; 3.7 hours/day,
 6     5 days/week on week 30; 3 hours/day, 5 days/week on weeks 31^41; and 3 hours/day, 7 days/week for reminder
 7     of the experiment.
 8    Statistical significance not reported by study authors.
 9    °Earliest observation of tumor provided for 9.5 and 46.5 mg/m3 concentration groups.
10    dRevised tumor incidence data based on original study pathology reports obtained by Clement Associates and
11     reported in U.S. EPA(1990b).
12    eNasal, forestomach, esophageal, and tracheal tumors occurred in hamsters that also had tumors in the larynx or
13     pharynx, except for two animals in the mid-concentration group that displayed nasal tumors (one malignant and
14     one benign) without displaying tumors in the pharynx or larynx.
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                                                         Toxicological Review ofBenzo[a]pyrene

 1    Dermal exposure
 2           Repeated application of benzo[a]pyrene to skin (in the absence of exogenous promoters)
 3    has been demonstrated to induce skin tumors in mice, rats, rabbits, and guinea pigs. These studies
 4    have been reviewed by multiple national and international health agencies [IARC, 2010: IPCS, 1998:
 5    ATSDR, 1995: IARC, 1983,1973]. Mice have been the most extensively studied species in dermal
 6    carcinogenesis studies ofbenzo[a]pyrene because of evidence that they may be more sensitive than
 7    other animal species; however, comprehensive comparisons of species differences in sensitivity to
 8    lifetime dermal exposure are not available. Systemic tumors in benzo[a]pyrene-treated mice were
 9    not increased compared to controls in lifetime dermal bioassays in which macroscopic examination
10    of internal organs was included [Higginbotham etal.. 1993: Habs etal.. 1980: Schmahletal..  1977:
11    Schmidt etal.. 1973: Roe etal.. 1970: Poel. 19591.
12           The analysis in this document focuses on chronic carcinogenicity bioassays in several
13    strains of mice following repeated dermal exposure to benzo[a]pyrene for the animals' lifetime
14    (Table 1-16). These studies  involved 2- or 3-times/week exposure protocols, at least two exposure
15    levels plus controls, and histopathological examinations of the skin and other tissues (Sivaketal.,
16    1997: Grimmer etal.. 1984: Habs etal.. 1984: Grimmer etal.. 1983: Habs etal.. 1980: Schmahletal..
17    1977: Schmidt etal.. 1973: Roe etal.. 1970: Poel. 1960.19591
18           Numerous studies in mice observed skin tumors following benzo[a]pyrene exposure, but
19    were not considered further in this assessment because of the availability of the chronic studies
20    identified above. These studies included several "skin painting" studies in mouse skin that did not
21    report the doses applied (e.g., Wynder and Hoffmann. 1959: Wynderetal.. 1957): several shorter-
22    term studies (Albertetal.. 1991:  Nesnowetal.. 1983: Emmettetal.. 1981: Levin etal.. 1977):
23    initiation-promotion studies utilizing acute dosing of benzo[a]pyrene followed by repeated
24    exposure to  a potent tumor promoter; and studies involving vehicles expected to interact with or
25    enhance benzo[a]pyrene carcinogenicity (e.g., Bingham and Falk, 1969).
26           One study applied benzo[a]pyrene (topically once a week for 6 months) to
27    immunocompromised mice with human skin xenografts (n=10) and did not observe tumors,
28    whereas all three  control mice (mice with no xenografts) developed skin tumors (Urano etal..
29    1995).  The authors concluded this result indicates that human skin is much less susceptible to
30    benzo[a]pyrene than mouse skin. However, it is unclear that this human skin xenograft model
31    preserves the physiological and morphological properties of human skin in vivo (Kappes etal..
32    2004).
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                                                         Toxicological Review ofBenzo[a]pyrene
       Table 1-16.  Tumor observations in dermal animal bioassays
         Reference and Study Design
                       Results3
Poel (1959)
C57L mice: male (13-56/dose)
0, 0.15, 0.38, 0.75, 3.8, 19, 94, 188, 376, or 752 u.g
Dermal; 3 times/wk for up to 103 wks or until the
appearance of a tumor by gross examination
Skin tumors (gross skin tumors and epidermoid carcinoma);
dose-dependent decreased time of tumor appearance
        Incidences:
        Gross skin tumors: 0/33; 5/55; 11/55; 7/56; 41/49;
        38/38; 35/35; 12/14; 14/14; and 13/13
        Epidermoid carcinoma: 0/33; 0/55; 2/55; 4/56;
        32/49; 37/38; 35/35; 10/14; 12/14; and 13/13
Poel (1960)
SWR, CSHeB, or A/He mice: male (14-25/dose)
0, 0.15, 0.38, 0.75, 3.8, 19.0, 94.0, or 470 u.g
Dermal; 3 times/wk until mice died or a skin tumor
was observed
Skin tumors and dose-dependent decreased time of first
tumor appearance
        Incidences:
        SWR: 0/20; 0/25; 2/22; 15/18; 12/17; 16/16; 16/17;
        and 14/14
        CSHeB: 0/17; 0/19; 3/17; 4/17; 11/18;/ 17/17; 18/18;
        and 17/17
        A/He mice: 0/17; 0/18; 0/19; 0/17; 0/17; 21/23;
        11/16; and 17/17
Roe etal. (1970)
Swiss mice: female (50/dose)
0, vehicle, 0.1, 0.3,1, 3, or 9 u.g
Dermal; 3 times/wk for up to 93 wks
Skin tumors; malignant skin tumors were observed in 4/41 and
31/40 mice in the two high dose groups, respectively
        incidences:
        0/43; 0/47; 1/42; 0/42; 1/43; 8/41; and 34/46
Schmidt etal. (1973)
NMRI mice: female (100/group)
Swiss mice: female (100/group)
0, 0.05, 0.2, 0.8, or 2 u.g
Dermal; 2 times/wk until spontaneous death
occurred or until an advanced carcinoma was
observed
Skin tumors (carcinomas)
        incidences:
        NMRI:
        2/100 at 2 u.g (papillomas);
        2/100 at 0.8 u.g and 30/100 at 2 u.g (carcinomas)
        Swiss:
        3/80 at 2 u.g (papillomas);
        5/80 at 0.8 u.g and 45/80 at 2 u.g (carcinomas)
Schmahl etal. (1977)
NMRI mice: female (100/group)
0, 1,1.7, or 3 u.g
Dermal; 2 times/wk until natural death or until they
developed a carcinoma at the site of application
Skin tumors (papillomas and carcinomas)
        incidences:
        0/81; 1/77; 0/88; and 2/81 (papillomas)
        0/81; 10/77; 25/88; and 43/81 (carcinomas)
Habs etal. (1980)
NMRI mice: female (40/group)
0,1.7, 2.8, or 4.6 ug
Dermal; 2 times/wk until natural death or gross
observation of infiltrative tumor growth
Skin tumors and dose-dependent increase in age-standardized
tumor incidence
        incidences:
        0/35; 8/34; 24/35; and 22/36
        age-standardized tumor incidence:
        0, 24.8, 89.3, and 91.7%
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                                                           Toxicological Review ofBenzo[a]pyrene
               Reference and Study Design
                                                                Results3
       Grimmer et al. (1984); Grimmer et al. (1983)
       CFLP mice: female (65-80/group)
       0, 3.9, 7.7, or 15.4 u.g (1983 study)
       0, 3.4, 6.7, or 13.5 u.g (1984 study)
       Dermal; 2 times/wk for 104 wks
                                           Skin tumors (papillomas and carcinomas) with a decrease in
                                           tumor latency
                                                  incidences:
                                                  1983: 0/80; 7/65; 5/64; and 2/64 (papillomas)
                                                       0/80; 15/65; 34/64; and 54/64 (carcinomas)
                                                  1984: 0/65; 6/64; 8/65; and 4/65 (papillomas)
                                                       0/65; 37/64; 45/65; and 53/65 (carcinomas)
       Habsetal. (1984)
       NMRI mice: female (20/group)
       0, 2, or 4 u.g
       Dermal; 2 times/wk for life
                                           Skin tumors (papillomas and carcinomas) with a decrease in
                                           mean survival time
                                                  incidences:
                                                  0/20; 2/20; and 0/20 (papillomas)
                                                  0/20; 7/20; and 17/20 (carcinomas)
       Sivaketal. (1997)
       C3H/HeJ mice: male (30/group)
       0, 0.05, 0.5, or 5 u.g
       Dermal; 2 times/wk for 104 wks
                                           Skin tumors (papillomas and carcinomas)
                                                  incidences:
                                                  0/30; 0/30; 5/30 (2 papillomas, 3 carcinomas); and
                                                  27/30 (1 papilloma, 28 carcinomas)
 1
 2
Statistical significance not reported by study authors.
 3    Mode of Action Analysis—Carcinogenicity
 4           The carcinogenicity of benzo[a]pyrene, the most studied PAH, is well documented [IARC,
 5    2010: Xuetal.. 2009: Tiangetal.. 2007: Tiangetal.. 2005: Xue and Warshawsky. 2005: Rameshetal..
 6    2004: Bostrometal.. 2002: Penning etal.. 1999: IPCS. 1998: Harvey. 1996: ATSDR. 1995: Cavalieri
 7    andRogan. 1995: U.S. EPA. 1991b).  The primary mode of action by which benzo[a]pyrene induces
 8    carcinogenicity is via a mutagenic mode of action. This mode of action is presumed to apply to all
 9    tumor types and is relevant for all routes of exposure. The general sequence of key events
10    associated with a mutagenic mode of action for benzo[a]pyrene is: (1) bioactivation of
11    benzo[a]pyrene to DNA-reactive metabolites via three possible metabolic activation pathways: a
12    diol epoxide pathway, a radical cation pathway, and an o-quinone and ROS pathway; (2) direct DNA
13    damage by reactive metabolites, including the formation of DNA adducts and ROS-mediated
14    damage; (3) formation and fixation of DNA mutations, particularly in tumor suppressor genes or
15    oncogenes associated with tumor initiation; and (4) clonal expansion of mutated cells during the
16    promotion and progression phases of cancer development. These events are depicted as stages of
17    benzo[a]pyrene-induced carcinogenesis in Figure 1-6.
18           Benzo[a]pyrene is a complete  carcinogen, in that it can act as both an initiator and a
19    promoter of carcinogenesis. Initiation via direct DNA damage (key event 2) can occur via all three
20    metabolites of benzo[a]pyrene. DNA damage that is not adequately repaired leads to mutation (key
21    event 3), and these mutations can undergo clonal expansion (key event 4) enabled by multiple
22    mechanisms also induced by benzo[a]pyrene, including AhR binding leading to an upregulation of
23    genes related to biotransformation, growth, and differentiation, and regenerative cell proliferation
24    resulting from cytotoxicity and a sustained inflammatory response.  However, there is not sufficient

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                                                          Toxicological Review ofBenzo[a]pyrene

 1    evidence that these mechanisms, which contribute to the promotion and progression phases of
 2    cancer development, act independently of DNA damage and mutation to produce benzo[a]pyrene-
 3    induced tumors (please see Other possible modes of action, below).  The available human, animal,
 4    and in vitro evidence supports a mutagenic mode of action as the primary mode by which
 5    benzo[a]pyrene induces carcinogenesis.
 7
 8
10
11
12
13
14
15
16
                          Key events in the mode of action for benzofalpyrene carcinogenicity
                                                                      Promotion	Progression
                                                                   Upreguiatton of genes
                                                                       related to
                                                                    biotransformation,
                                                                      growth, and
                                                                     differentiation
                                                                      Proliferation
                                                                      of initiated
                           o-qumone
                            and ROS
             Figure 1-6. Proposed metabolic activation pathways and key events in the
             carcinogenic mode of action for benzo[a]pyrene.
Data in Support of the Mode of Action

Summary of metabolic activation pathways
       Dial epoxide pathway. Benzo[a]pyrene diol epoxide metabolites, believed to be the most
potent DNA-binding metabolites of benzo[a]pyrene, are formed through a series of Phase I
metabolic reactions (see Appendix D of the Supplemental Information).  The initial metabolism is
carried out primarily by the inducible activities of GYP enzymes including CYP1A1, CYP1B1, and
CYP1A2.  Further metabolism by epoxide hydrolase and the mixed function oxidase system yields
(+)-anti- BPDE, one of the most potent DNA-binding metabolites of benzo[a]pyrene.
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                                                         Toxicological Review ofBenzo[a]pyrene

 1    Benzo[a]pyrene diol epoxide metabolites interact preferentially with the exocyclic amino groups of
 2    deoxyguanine and deoxyadenine [Geacintovetal.. 1997: Terinaetal.. 1991). Adducts may give rise
 3    to mutations unless these adducts are removed by DNA repair processes prior to replication.  The
 4    stereochemical nature of the diol epoxide metabolite (i.e., anti- versus syn-diol epoxides) affects the
 5    number and type of adducts and mutation that occurs [Geacintovetal., 1997]. Transversion
 6    mutations (e.g., GC—>TA or AT—>TA] are the most common type of mutation found in mammalian
 7    cells following diol epoxide exposure (Bostrom etal., 2002].
 8          Radical cation pathway. Radical cation formation involves a one-electron oxidation by GYP
 9    or peroxidase enzymes (i.e., horseradish peroxidase, prostaglandin H synthetase] that produce
10    electrophilic radical cation intermediates (Cavalieri and Rogan. 1995.1992].  Radical cations can be
11    further metabolized to phenols and quinones (Cavalieri etal., 1988e: Cavalieri et al., 1988d], or they
12    can form unstable adducts with DNA that ultimately result in depurination. The predominant
13    depurinating adducts occur at the N-3 and N-7 positions of adenine and the C-8 and N-7 positions of
14    guanine (Cavalieri and Rogan, 1995].
15          o-Quinone/ROS pathway. The o-quinone metabolites of PAHs are formed by enzymatic
16    dehydrogenation of dihydrodiols (Bolton etal.. 2000: Penning etal.. 1999: Harvey. 1996: ATSDR.
17    1995] (see Appendix D of the Supplemental Information]. Dihydrodiol dehydrogenase enzymes are
18    members of the a-keto reductase gene superfamily. o-Quinone metabolites are potent cytotoxins,
19    are weakly mutagenic, and are capable of producing a broad spectrum of DNA damage. These
20    metabolites  can interact directly with DNA as well as result in the production of ROS (i.e., hydroxyl
21    and superoxide radicals] that may produce further cytotoxicity and DNA damage. The
22    o-quinone/ROS pathway also can produce depurinated DNA adducts from benzo[a]pyrene
23    metabolites. In this pathway, and in the presence of NAD(P]+, aldo-keto reductase oxidizes
24    benzo[a]pyrene-7,8-diol to a ketol, which subsequently forms benzo[a]pyrene-7,8-dione. This and
25    other PAH o-quinones react with DNA to form unstable, depurinating DNA adducts.  In the presence
26    of cellular reducing equivalents, o-quinones can also activate redox cycles, which produce ROS
27    (Penning etal.,  1996].  DNA damage in in vitro systems following exposure to benzo[a]pyrene-
28    7,8-dione or other o-quinone PAH derivatives occurs through the AKR pathway and can involve the
29    formation of stable DNA adducts (Baluetal., 2004], N-7 depurinated DNA adducts (Mccoulletal.,
30    1999]. DNA damage from ROS (8-oxo-dG] (Park etal.. 2006]. and strand scission (Flowers etal..
31    1997: Flowers etal.. 19961

32    Summary of genotoxicity and mutagenicity
33          The ability of metabolites of benzo[a]pyrene to cause mutations and other forms of DNA
34    damage in both in vivo and in vitro studies  is well documented (see genotoxicity tables in
35    Appendix D in Supplemental Information].  With metabolic activation (e.g., the inclusion of S9],
36    benzo[a]pyrene is consistently mutagenic in the prokaryotic Salmonella/Ames and Escherichia coli
37    assays. In mammalian in vitro studies, benzo[a]pyrene is consistently mutagenic and clastogenic,

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                                                         Toxicological Review ofBenzo[a]pyrene

 1    and induces cell transformation both with and without metabolic activation. Cytogenetic damage in
 2    the form of chromosomal aberrations (CAs), micronuclei (MN), sister chromatid exchanges (SCEs),
 3    and aneuploidy are commonplace following benzo[a]pyrene exposure as are DNA adduct
 4    formation, single strand breaks (SSB), and induction of DNA repair and unscheduled DNA synthesis.
 5    In vitro mammalian cell assays have been conducted in various test systems, including human cell
 6    lines.
 7           In the majority of in vivo studies, benzo[a]pyrene has tested positive in multiple species and
 8    strains and under various test conditions for cell transformation, CAs, DNA adducts, DNA strand
 9    breaks, MN formation, germline mutations, somatic mutations (H-ras, K-ras, p53, lacZ, hprt), and
10    SCEs. Human studies are available following exposures to PAH mixtures through cigarette smoke
11    or occupational exposure in which benzo[a]pyrene-specific DNA adducts have been detected, and it
12    has been demonstrated qualitatively that benzo[a]pyrene metabolites damage DNA in exposed
13    humans.

14    Experimental support for the hypothesized mode of action
15           EPA's Cancer Guidelines [Section 2.4; (2005a]J describe a procedure for evaluating mode-
16    of-action data for cancer. A framework for analysis of mode of action information is provided and
17    followed below.
18           Strength, consistency, and specificity of association. Strong evidence links the
19    benzo[a]pyrene diol epoxide metabolic activation pathway with key mutational events in genes that
20    are associated with tumor initiation (mutations in the p53 tumor suppressor gene and H-ras or
21    K-ras oncogenes) (Table 1-17). Results in support of a mutagenic mode of action via
22    benzo[a]pyrene diol epoxide include observations of frequent G^T transversion mutations in p53
23    and ras genes in lung tumors of human cancer patients exposed to coal smoke (Keohavong et al.,
24    2003: DeMarini et al.. 2001). These results are consistent with evidence thatbenzo[a]pyrene diol
25    epoxide is reactive with guanine bases in DNA; that G—>T transversions, displaying strand bias, are
26    the predominant type of mutations caused by benzo[a]pyrene in several biological systems (Liu et
27    al.. 2005: Hainautand Pfeifer. 2001: Marshall etal.. 19841: and that sites of DNA adduction at
28    guanine positions in cultured human HeLa or bronchial epithelial cells exposed to  benzo[a]pyrene
29    diol epoxide correspond to p53 mutational hotspots observed in human lung cancers (Denissenko
30    etal., 1996: Puisieuxetal., 1991].  In addition,  mice exposed to benzo[a]pyrene in  the diet (Culp et
31    al.. 20001 or by i.p. injection fNesnowetal.. 1998a:  Nesnowetal.. 1998b: Nesnowetal.. 1996.1995:
32    Mass etal., 1993] had forestomach or lung tumors, respectively, showing frequent G^T or  C
33    transversions in the K-ras gene. Supporting evidence includes observations thatbenzo[a]pyrene
34    diol epoxide (specifically (+]-anti-BPDE] is more potent than benzo[a]pyrene itself, benzo[a]pyrene
35    phenols, or benzo[a]pyrene diols in mutagenicity assays in bacterial and in vitro mammalian
36    systems (Malaveille etal.. 1977: Newbold and Brookes. 1976] and in producing lung tumors in
37    newborn mice following i.p. administration. Other supporting evidence includes observations of

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                                                        Toxicological Review ofBenzo[a]pyrene

 1    elevated BPDE-DNA adduct levels in WBCs of groups of coke oven workers and chimney sweeps,
 2    occupations with known elevated risks of cancer [Vineis etal.. 2007: Pavanello etal.. 1999). and in
 3    lung tissue from tobacco smokers with lung cancer [Rojas etal.. 2004: Godschalketal.. 2002: Rojas
 4    etal., 1998: Andreassenetal., 1996: Alexandrovetal., 1992]. Several epidemiological studies have
 5    indicated that PAH-exposed individuals who are homozygous for a CYP1A1 polymorphism, which
 6    increases the inducibility of this enzyme (thus increasing the capacity to produce benzo[a]pyrene
 7    diol epoxide), have increased levels of PAH or BPDE-DNA adducts [Aklillu etal., 2005: Alexandrov
 8    etal.. 2002: Bartsch etal.. 2000: Perera and Weinstein. 20001.
 9          Additional supporting evidence of a mutagenic mode of action for benzo[a]pyrene
10    carcinogenicity is the extensive database of in vitro and in vivo studies demonstrating the
11    genotoxicity and mutagenicity of benzo[a]pyrene following metabolic activation (Table 1-17). In
12    vitro studies overwhelmingly support the formation of DNA adducts, mutagenesis in bacteria, yeast,
13    and mammalian cells, several measures of cytogenetic damage (CA, SCE, MN), and DNA damage. In
14    vivo systems in animal models are predominantly positive for somatic mutations following
15    benzo[a]pyrene exposure.
16          Support for the radical cation  activation pathway contributing to tumor initiation through
17    mutagenic events includes observations that depurinated DNA adducts (expected products from
18    reactions of benzo[a]pyrene radical cations with DNA) accounted for 74% of identified DNA
19    adducts in mouse skin exposed to benzo[a]pyrene (Roganetal., 1993] and that 9 of 13 tumors
20    examined from mice exposed to dermal applications of benzo[a]pyrene had H-ras oncogene
21    mutations attributed to depurinated DNA adducts from benzo[a]pyrene radical cations
22    (Chakravartietal.. 1995).
23          Support for the o-quinone/ROS pathway contributing to tumor initiation via mutagenic
24    events includes in vitro demonstration that several types of DNA damage can occur from
25    o-quinones andROS (Parketal.. 2006: Balu etal.. 2004: Mccoull etal.. 1999: Flowers etal.. 1997:
26    Flowers etal., 1996]. In addition, benzo[a]pyrene-7,8-dione can induce mutations in the p53 tumor
27    suppressor gene using an in vitro yeast reporter gene assay (Park etal., 2008: Shenetal., 2006: Yu
28    etal., 2002], and dominant p53 mutations induced by benzo[a]pyrene-7,8-dione in this system
29    corresponded to p53 mutational hotspots observed in human lung cancer tissue (Park etal., 2008].
30          Dose-response concordance and temporal relationship.  Studies in humans demonstrating
31    that benzo[a]pyrene-induced mutational events in p53 or ras oncogenes precede tumor formation
32    are not available, but there is evidence linking benzo[a]pyrene exposure to signature mutational
33    events in humans. In vitro exposure of human p53 knock-in murine fibroblasts to 1 |iM
34    benzo[a]pyrene for 4-6 days induced p53 mutations with similar features to  those identified in p53
35    mutations in human lung cancer; i.e., predominance of G—>T transversions with strand bias and
36    mutational hotspots atcodons 157-158 (Liu etal.. 2005).
37          Bennett etal. (1999) demonstrated a dose-response relationship between smoking
38    history/intensity and the types of p53 mutations associated with benzo[a]pyrene (G—>T

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 1   transversions) in human lung cancer patients (Table 1-17). In lung tumors of non-smokers, 10% of
 2   p53 mutations were G^T transversions, versus 40% in lung tumors from smokers with >60 pack-
 3   years of exposure.
 4          In mice, dose-response and temporal relationships have been described between the
 5   formation of BPDE-DNA adducts and skin and forestomach tumors (Table 1-17). In a study using
 6   mice treated dermally with benzo[a]pyrene once or twice per week for up to 15 weeks (10, 25, or
 7   50 nmol benzo[a]pyrene per application), levels of benzo[a]pyrene-DNA adducts in the skin, lung,
 8   and liver increased with increasing time of exposure and increasing dose levels (Talaskaetal.,
 9   2006). Levels at the end of the exposure period were highest in the skin; levels in the lung and liver
10   at the same time were 10- and 20-fold lower, respectively. Levels of benzo[a]pyrene-DNA adducts
11   in skin and lung increased in an apparent biphasic manner showing a lower linear slope between
12   the two lowest dose levels, compared with the slope from the middle to the highest dose.
13          Another study examined the dose-response  relationship and the time course of
14   benzo[a]pyrene-induced skin damage (Table 1-17), DNA adduct formation, and tumor formation in
15   female mice. Mice were treated dermally with 0,16, 32, or 64 |ig of benzo[a]pyrene once per week
16   for 29 weeks (Albert etal.. 1991). Indices of skin damage and levels of BPDE-DNA adducts in skin
17   reached plateau levels in exposed groups by 2-4 weeks of exposure. With increasing dose level,
18   levels of BPDE-DNA adducts (fmol/ng DNA) initially increased in a linear manner and began to
19   plateau at doses >32 |ig/week. Tumors began appearing after 12-14 weeks of exposure for the
20   mid- and high-dose groups and at 18 weeks for the low-dose group. At study termination
21   (35 weeks after start of exposure), the mean number of tumors per mouse was approximately one
22   per mouse in the low- and mid-dose groups and eight per mouse in the high-dose group. The time-
23   course data indicate thatbenzo[a]pyrene-induced increases in BPDE-DNA adducts preceded the
24   appearance of skin tumors, consistent with the formation of DNA adducts as a precursor event in
25   benzo[a]pyrene-induced skin tumors.
26          (Gulp etal., 1996) compared dose-response  relationships for BPDE-DNA adducts and
27   tumors in female B6C3Fi mice exposed to benzo[a]pyrene in the diet at 0,18.5, 90, or 350 |ig/day
28   for 28 days (to examine adducts) or 2 years (to examine tumors) (Table 1-17).  The benzo[a]pyrene
29   dose-tumor response data showed a sharp increase in forestomach tumor incidence between the
30   18.5 |ig/day group (6% incidence) and the 90 |ig/day group (78% incidence). The BPDE-DNA
31   adduct levels in forestomach showed a relatively linear dose-response throughout the
32   benzo[a]pyrene dose range tested. The appearance of increased levels of BPDE-DNA adducts in the
33   targettissue at 28 days is temporally consistent with the contribution of these adducts to the
34   initiation of forestomach tumors. Furthermore, about 60% of the examined tumors had mutations
35   in the K-ras oncogene at codons 12 and 13, which were  G—>T or G—>C transversions indicative of
36   BPDE reactions with DNA (Gulp etal.. 1996).
37          Biological plausibility and coherence. The evidence for a mutagenic mode of action for
38   benzo[a]pyrene is consistent with the current understanding that mutations in p53 and ras

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 1    oncogenes are associated with increased risk of tumor initiation (Table 1-17). The benzo[a]pyrene
 2    database is internally consistent in providing evidence for BPDE-induced mutations associated with
 3    tumor initiation in cancer tissue from humans exposed to complex mixtures containing
 4    benzo[a]pyrene [Keohavongetal., 2003: Pfeifer and Hainaut, 2003: Pfeifer etal., 2002: DeMarini et
 5    al., 2001: Hainautand Pfeifer, 2001: Bennett etal., 1999], in animals exposed to benzo[a]pyrene
 6    [Gulp etal.. 2000: Nesnowetal.. 1998a: Nesnowetal.. 1998b: Nesnowetal.. 1996.1995: Mass etal..
 7    1993], and in in vitro systems [Denissenko etal.,  1996: Puisieuxetal., 1991]. Consistent
 8    supporting evidence includes: (1] elevated BPDE-DNA adduct levels in tobacco smokers with lung
 9    cancer fRoias etal.. 2004: Godschalk etal.. 2002:  Roias etal.. 1998: Andreassen etal.. 1996:
10    Alexandrovetal.. 1992]: (2] demonstration of dose-response relationships  between G—>T
11    transversions in p53 mutations in lung tumors and smoking intensity [Bennett etal., 1999]: (3] the
12    extensive database of in vitro and in vivo studies  demonstrating the genotoxicity and mutagenicity
13    of benzo[a]pyrene following metabolic activation; and (4] general concordance between temporal
14    and dose-response relationships for BPDE-DNA adduct levels and tumor incidence in studies of
15    animals exposed to benzo[a]pyrene [Gulp etal., 1996: Albert etal., 1991]. There is also supporting
16    evidence that contributions to tumor initiation through mutagenic events can be made by the
17    radical cation [Chakravarti etal.. 1995: Roganetal.. 1993] and o-quinone/ROS metabolic activation
18    pathways [Park etal.. 2008: Park etal.. 2006: Shen etal.. 2006: Balu etal.. 2004: Yu etal.. 2002:
19    Mccoull etal.. 1999: Flowers etal.. 1997: Flowers etal.. 1996].

20           Table 1-17. Experimental support for the postulated key events for mutagenic
21           mode of action
      1. Bioactivation of benzo[a]pyrene to DNA-reactive metabolites via three possible metabolic activation
         pathways: a diol epoxide pathway, a radical cation pathway, and an o-quinone and ROS pathway.
      Evidence that benzo[a]pyrene metabolites induce key events:
       •  Metabolism of benzo[a]pyrene via all three pathways has been demonstrated in multiple in vitro studies, and
          the diol epoxide and radical cation metabolic activation pathways have been demonstrated in in vivo studies
          in humans and animals (see Metabolic Activation Pathways section)
       •  Multiple in vivo studies in humans and animals have demonstrated distribution of reactive metabolites to
          target tissues
      Human evidence that key events are necessary for carcinogenesis:
       •  Humans with CYP polymorphisms or lacking a functional GSTM1 gene form higher levels of benzo[a]pyrene
          diol epoxides, leading to increased BPDE-DNA adduct formation and increased risk of cancer (Vineis et al.,
          2007; Pavanelloetal., 2005; Pavanello et al., 2004; Alexandrovetal., 2002; Perera and Weinstein, 2000)
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                                                          Toxicological Review ofBenzo[a]pyrene
2.  Direct DNA damage by the reactive metabolites, including the formation of DNA adducts and ROS-mediated
   damage.
Evidence that benzo[a]pyrene metabolites induce key events:
 •  Reactive benzo[a]pyrene metabolites have demonstrated genotoxicity in most in vivo and in vitro systems in
    which they have been tested, including the bacterial mutation assay, transgenic mouse assay, dominant
    lethal mutations in mice, BPDE-DNA adduct detection in humans and animals, and DNA damage, CAs, MN
    formation, and SCE in animals (Appendix D in Supplemental Information)
 •  Multiple in vivo benzo[a]pyrene animal exposure studies have demonstrated DNA adduct formation in target
    tissues that precede tumor formation and increase in frequency with dose (Gulp et al., 1996; Talaska et al.,
    1996; Albert et al., 1991)
 •  Benzo[a]pyrene diol epoxide metabolites interact preferentially with the exocyclic amino groups of
    deoxyguanine and deoxyadenine in DNA (Geacintov et al., 1997; Jerina et al., 1991; Koreeda et al., 1978;
    Jeffrey et al., 1976)
 •  Benzo[a]pyrene o-quinone metabolites are capable of activating redox cycles and producing ROS that cause
    oxidative base damage (Parketal., 2006; Balu et al., 2004; Mccoull etal., 1999; Flowers etal., 1997; Flowers
    etal., 1996)
Human evidence that key events are necessary for carcinogenesis:
 •  Detection of benzo[a]pyrene diol epoxide-specific DNA adducts is associated with increased cancer risk in
    humans that are occupationally exposed (see Evidence in  Humans section)
 •  These benzo[a]pyrene diol epoxides formed BPDE-DNA adducts preferentially at guanine residues that have
    been detected in tissues of humans with cancer who were exposed to PAHs (Vineis and Perera, 2007; Rojas
    et al., 2004; Godschalk et al., 2002; Li et al., 2001; Pavanello et al., 1999; Rojasetal.,  1998; Andreassen et al.,
    1996; Alexandrov et al., 1992)
3.  Formation and fixation of DNA mutations, particularly in tumor suppressor genes or oncogenes associated
   with tumor initiation.
Evidence that benzo[a]pyrene metabolites induce key events:
 •  Several in vivo exposure studies have observed benzo[a]pyrene diol epoxide-specific mutational spectra
    (e.g., G->Ttransversion mutations) in K-ras, H-ras, and p53 in forestomach or lung tumors (Gulp et al., 2000;
    Nesnowetal., 1998a; Nesnowetal.,  1998b; Nesnowetal., 1996,1995; Mass etal., 1993)
 •  Multiple animal exposure studies have identified benzo[a]pyrene-specific mutations in H-ras, K-ras, and p53
    in target tissues preceding tumor formation (Liu et al., 2005; Gulp et al., 1996);(Wei et al., 1999)
Human evidence that key events are necessary for carcinogenesis:
 •  DNA adducts formed by the benzo[a]pyrene diol epoxide reacting with guanine bases lead predominantly to
    G->Ttransversion mutations; these specific mutational spectra have been identified in PAH-associated
    tumors in humans at mutational hotspots, including oncogenes (K-ras) and tumor suppressor genes (p53)
    (Liu etal.. 2005: Keohavong et al.. 2003: Pfeiferand Hainaut. 2003: Pfeifer et a I.. 2002: DeMarini etal.. 2001:
    Hainaut and Pfeifer, 2001; Bennett et al., 1999; Denissenko et al., 1996; Puisieux et al., 1991; Marshall et al.,
    1984; Koreeda et al., 1978; Jeffrey et al., 1976)
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                                                           Toxicological Review ofBenzo[a]pyrene
      4. Clonal expansion of mutated cells during the promotion and progression phases of cancer development.
      Evidence that benzo[a]pyrene metabolites induce key events:
       •  Benzo[a]pyrene has been shown to be a complete carcinogen, in that skin tumors in mice, rats, rabbits, and
          guinea pigs have been associated with repeated application of benzo[a]pyrene to skin in the absence of
          exogenous promoters (IPCS. 1998: Sivaketal.. 1997: ATSDR. 1995: Grimmer et al.. 1984: Habsetal.. 1984:
          Grimmer etal., 1983; IARC, 1983,1973; Habsetal., 1980; Schmahl et al., 1977; Schmidt et al., 1973; Roe et
          al., 1970; Poel, 1960, 1959(IPCS, 1998; ATSDR, 1995; IARC, 1983, 1973)
       •  Mice exposed dermally to benzo[a]pyrene for 26 weeks were found to have increased frequencies of H-ras
          mutations in exposure-induced hyperplastic lesions that were further increased in tumors (Wei et al., 1999)
       •  AhR activation by PAHs (including benzo[a]pyrene) upregulates genes responsible for tumor promotion and
          increases tumor incidence in mice (Ma and Lu, 2007; Talaska et al., 2006; Shimizu et al., 2000)
 2    Other possible modes of action
 3           The carcinogenic process for benzo[a]pyrene is likely to be related to some combination of
 4    molecular events resulting from the formation of several reactive metabolites that interact with
 5    DNA to form adducts and produce DNA damage resulting in mutations in cancer-related genes, such
 6    as tumor suppressor genes or oncogenes. These events may reflect the initiation potency of
 7    benzo[a]pyrene. However, benzo[a]pyrene possesses promotional capabilities that may be related
 8    to AhR affinity, immune suppression, cytotoxicity, and the formation of ROS, as well as the
 9    inhibition of gap junctional intercellular communication.
10           The ability of certain PAHs to act as initiators and promoters may increase their
11    carcinogenic potency. The promotional effects of PAHs appear to be related to AhR affinity and the
12    upregulation of genes related to growth and differentiation [Bostrometal., 2002]. The genes
13    regulated by this receptor belong to two major functional groups (i.e., induction of metabolism or
14    regulation cell differentiation and proliferation). PAHs  bind to the cytosolic AhR in complex with
15    heat shock protein 90. The ligand-bound receptor is then transported to the nucleus in complex
16    with the AhR nuclear translocator protein. The AhR complex interacts with AhR elements of DNA
17    to increase the transcription of proteins associated with induction of metabolism and regulation of
18    cell differentiation and proliferation. Following benzo[a]pyrene exposure, disparities have been
19    observed in the tumor pattern and toxicity of Ah-responsive and Ah-nonresponsive mice, as Ah-
20    responsive mice were more susceptible to tumorigenicity in target tissues such as liver, lung, and
21    skin [Ma and Lu. 2007: Talaska etal.. 2006: Shimizu etal.. 2000).
22           Benzo[a]pyrene has both inflammatory and immunosuppressive effects that may function
23    to promote tumorigenesis. Inflammatory responses to  cytotoxicity may contribute to the tumor
24    promotion process; for example, benzo[a]pyrene quinones (1,6-, 3,6-, and 6,12-benzo[a]pyrene-
25    quinone) generated ROS and increased cell proliferation by enhancing the epidermal growth factor
26    receptor pathway in cultured breast epithelial cells [Burdick et al., 2003]. In addition, several
27    studies have demonstrated that exposure to benzo[a]pyrene increases the production of
28    inflammatory cytokines, which may contribute to cancer progression [N'Diaye etal.. 2006: Tamaki
29    etal.. 2004: Garconetal.. 2001b: Garconetal.. 2001a].  Conversely, the immunosuppressive effects
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 1    of benzo[a]pyrene exposure (see Section 1.1.3) may provide an environment where tumor cells can
 2    evade detection by immune surveillance mechanisms normally responsible for recognizing and
 3    eliminating nascent cancer cells [Hanahan and Weinberg. 2011).  In addition, the developing fetus
 4    may be even more sensitive to these effects; Urso and Gengozian [1980] found that mice exposed to
 5    benzo[a]pyrene in utero not only had a significantly increased tumor incidence as adults but also a
 6    persistently suppressed immune system.
 7          Gap junctions are channels between cells that are crucial for differentiation, proliferation,
 8    apoptosis, and cell death. Interruption of gap junctional intercellular communication is associated
 9    with a loss of cellular control of growth and differentiation, and consequently with the two
10    epigenetic steps of tumor formation, promotion and progression. Thus, the inhibition of gap
11    junctional intercellular communication by benzo[a]pyrene, observed in vitro [Sharovskaya et al.,
12    2006: Blahaetal., 2002], provides another mechanism of tumor promotion.
13          In summary, there are tumor promoting effects of PAH exposures that are not mutagenic.
14    Although these effects are observed following benzo[a]pyrene-specific exposures, the occurrence of
15    BPDE-DNA adducts and associated mutations that precede both cytotoxicity and tumor formation
16    and increase with dose provides evidence that mutagenicity is the primary event that initiates
17    tumorigenesis following benzo[a]pyrene exposures.  A biologically plausible mode of action may
18    involve a combination of effects induced by benzo[a]pyrene, with mutagenicity as the initiating
19    tumorigenic event. Subsequent AhR activation and cytotoxicity could then lead to increased ROS
20    formation, regenerative cell proliferation, and inflammatory responses, which, along with evasion
21    of immune surveillance and gap junctional intercellular communication, would provide an
22    environment where the selection for mutated cells increases the rate of mutation, allowing clonal
23    expansion and progression of these tumor cells to occur.  However, it was determined that, in
24    comparison to the large database on the mutagenicity of benzo[a]pyrene, there were insufficient
25    data to develop a separate mode of action analysis for these promotional effects.

26    Conclusions about the hypothesized mode of action
27          There is sufficient evidence to conclude that the major mode of action for benzo[a]pyrene
28    carcinogenicity involves mutagenicity mediated by DNA reactive metabolites. The evidence for a
29    mutagenic mode of action for benzo[a]pyrene is consistent with the current understanding that
30    mutations in p53 and ras oncogenes are associated with increased risk of tumor initiation. The
31    benzo[a]pyrene database provides strong and consistent evidence for BPDE-induced mutations
32    associated with tumor initiation in cancer tissue from humans exposed to complex mixtures
33    containing benzo[a]pyrene, in animals exposed to benzo[a]pyrene, and in in vitro systems.
34    Supporting evidence suggests that contributions to tumor initiation through potential mutagenic
35    events can be made by the radical cation and o-quinone/ROS metabolic activation pathways.  Other
36    processes may contribute to the carcinogenicity of benzo[a]pyrene via the promotion and
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 1    progression phases of cancer development (e.g., inflammation, cytotoxicity, sustained regenerative
 2    cell proliferation).

 3    Support for the Hypothesized Mode of Action in Test Animals
 4          Benzo[a]pyrene induces gene mutations in a variety of in vivo and in vitro systems and
 5    produces tumors in all animal species tested and by all routes of exposure (see Appendix D in
 6    Supplemental Information). Strong, consistent evidence in animal models supports the postulated
 7    key events: the metabolism of benzo[a]pyrene to DNA-reactive intermediates, the formation of
 8    DNA adducts, the subsequent occurrence of mutations in oncogenes and tumor suppressor genes,
 9    and the clonal expansion of mutated cells.

10    Relevance of the Hypothesized Mode of Action to Humans
11          A substantial database indicates that the postulated key events for a mutagenic mode of
12    action all occur in human tissues.  Evidence is available from studies of humans exposed to PAH
13    mixtures (including coal smoke and tobacco smoke) indicating a contributing role for
14    benzo[a]pyrene diol epoxide in inducing key mutational events in genes that are associated with
15    tumor initiation (mutations in the p53 tumor suppressor gene and H-ras or K-ras oncogenes). The
16    evidence includes observations of a spectrum of mutations in ras oncogenes and the p53 gene in
17    lung tumors of human patients exposed to coal smoke or tobacco smoke) that are similar to the
18    spectrum of mutations caused by benzo[a]pyrene  diol epoxide in several biological systems,
19    including tumors from mice exposed to benzo[a]pyrene. Additional supporting evidence includes
20    correspondence between hotspots of p53 mutations in human lung cancers and sites of DNA
21    adduction by benzo[a]pyrene diol epoxide in experimental systems, and elevated BPDE-DNA
22    adduct levels in respiratory tissue of lung cancer patients or tobacco smokers with lung cancer.

23    Populations or Lifestages Particularly Susceptible to the Hypothesized Mode of Action
24          A mutagenic mode of action for benzo[a]pyrene-induced carcinogenicity is considered
25    relevant to all populations and lifestages. The current understanding of biology of cancer indicates
26    that mutagenic chemicals, such as benzo[a]pyrene, are expected to exhibit a greater effect in early
27    life exposure versus later life exposure fU.S. EPA. 2005b: Vesselinovitch etal.. 19791 The EPA's
28    Supplemental Guidance for Assessing Susceptibility from Early-Life Exposure to Carcinogens (U.S. EPA.
29    2005b) recommends the application of age-dependent adjustment factors (ADAFs) for carcinogens
30    that act through a mutagenic mode of action. Given that a determination benzo [ajpyrene acts
31    through a mutagenic mode of carcinogenic action has been made, ADAFs should be applied along
32    with exposure information to estimate cancer risks for early-life exposure.
33          Toxicokinetic information suggest early lifestages may have lower levels of some GYP
34    enzymes than adults (Ginsberg etal.. 2004: Cresteil. 1998). suggesting that lower levels of
35    mutagenic metabolites may be formed in early lifestages. Though expression of bioactivating
36    enzymes is believed to be lower in the developing fetus and children, metabolism of

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                                                         Toxicological Review ofBenzo[a]pyrene

 1    benzo[a]pyrene still occurs, as indicated by the detection of benzo[a]pyrene-DNA or protein
 2    adducts or urinary metabolites [Naufal et al.. 2010: Ruchirawat et al.. 2010: Suter etal.. 2010:
 3    Mielzynskaetal.. 2006: Pereraetal.. 2005a: Tang etal.. 1999: Whyattetal.. 1998). While
 4    expression of GYP enzymes is lower in fetuses and infants, the greater liver to body mass ratio and
 5    increased blood flow to liver in fetuses and infants may compensate for the decreased expression of
 6    GYP enzymes [Ginsberg etal., 2004].  Activity of Phase II detoxifying enzymes in neonates and
 7    children is adequate for sulfation but decreased for glucuronidation and glutathione conjugation
 8    [Ginsberg et al., 2004].  The conjugation of benzo[a]pyrene-4,5-oxide with glutathione was
 9    approximately one-third less in human fetal than adult liver cytosol [Pacifici etal..1988].
10          In addition, newborn or infant mice develop liver and lung tumors more readily than young
11    adult mice following acute i.p. exposures to benzo[a]pyrene [Vesselinovitch etal., 1975]. These
12    results indicate that exposure to benzo[a]pyrene during early life stages presents additional risk for
13    cancer, compared with exposure during adulthood, despite lower metabolic activity in early
14    lifestages. Population variability in metabolism and detoxification of benzo[a]pyrene, in addition to
15    DNA repair capability, may affect cancer risk. Polymorphic variations in the human population in
16    CYP1A1, CYP1B1, and other GYP enzymes have been implicated as determinants of increased
17    individual cancer risk in some studies [Ickstadtetal.. 2008: Aklillu etal.. 2005: Alexandrov et al..
18    2002: Perera and Weinstein, 2000]. Some  evidence suggests that humans lacking a functional
19    GSTM1 gene have higher BPDE-DNA adduct levels and are thus at greater risk for cancer [Binkova
20    etal.. 2007: Vineis etal.. 2007: Pavanello etal.. 2005: Pavanello etal.. 2004: Alexandrov etal.. 2002:
21    Perera and Weinstein, 2000]. In addition, acquired deficiencies or inherited gene polymorphisms
22    that affect the efficiency or fidelity of DNA repair may also influence individual susceptibility to
23    cancer from environmental mutagens [Wang etal.. 2010: Ickstadtetal.. 2008: Binkova etal.. 2007:
24    Matullo etal.. 2003: Shen etal.. 2003: Cheng etal.. 2000: Perera and Weinstein. 2000: Wei etal..
25    2000: Amos etal., 1999]. In general, however, available support for the role of single
26    polymorphisms in significantly modulating human PAH cancer risk from benzo[a]pyrene or other
27    PAHs is relatively weak or inconsistent.  Combinations of polymorphisms, on the other hand, may
28    be critical determinants of a cumulative DNA-damaging dose, and thus indicate greater
29    susceptibility to cancer from benzo[a]pyrene exposure [Vineis etal., 2007].
30
31    Analysis of Toxicogenomics Data
32          An analysis of pathway-based transcriptomic data was conducted to help inform the cancer
33    mode of action for benzo[a]pyrene (see the Supplemental Information for details of this analysis].
34    These data support a mutagenic and cellular proliferation mode of action that follows three
35    candidate pathways: aryl hydrocarbon signaling; DNA damage regulation of the Gl/S phase
36    transition; and/or Nrf2 regulation of oxidative stress. Specifically, the analysis showed that
37    benzo[a]pyrene may activate the AhR, leading to the formation of oxidative metabolites and
38    radicals which may lead to oxidative damage and DNA damage. Subsequently, DNA damage can

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                                                         Toxicological Review ofBenzo[a]pyrene

 1    occur and activate p53 andp53 target genes, including p21 andMDM2. In addition, the data
 2    indicate that p53 signaling may be decreased under these conditions, as ubiquitin and MDM2 are
 3    both upregulated, and work together to degrade p53.  Furthermore, the transcriptional
 4    upregulation of cyclin D may result in enough cyclin D protein to overcome the p21 inhibitory
 5    competition for CDK4, allowing for Gl/S phase transition to occur. The data also supports the
 6    hypothesis that an upregulation of PCNA in combination with the upregulation of ubiquitin
 7    indicates that cells are moving towards the Gl/S phase transition. Although the alterations to the
 8    Nrf2 pathway suggest cells are preparing for a pro-apoptotic environment, there is no
 9    transcriptional evidence that the apoptotic pathways are being activated.
10           There are uncertainties associated with the available transcriptomics data. For instance,
11    the available studies only evaluate gene expression following benzo[a]pyrene exposure and do not
12    monitor changes in protein or metabolite expression, which would be more indicative of an actual
13    cellular state change. Further research is required at the molecular level to demonstrate that the
14    cellular signaling events being inferred from such data are actually operative and result in
15    phenotypic changes. In addition, this analysis relied upon two short term studies that evaluated
16    mRNA expression levels in a single tissue (liver) and species (mouse) and were conducted at
17    relatively high doses.

18    1.2. SUMMARY AND EVALUATION

19    1.2.1.   Weight of Evidence for Effects Other than Cancer
20           The weight of the evidence from  human and animal studies indicates that the strongest
21    evidence for potential hazard following benzo[a]pyrene exposure is for developmental and
22    reproductive toxicity and immunotoxicity. In humans, exposure to PAH mixtures has been shown
23    to result in developmental and reproductive toxicity and immunotoxicity.  Most of the available
24    human data on benzo[a]pyrene report associations between particular health endpoints and
25    concentrations of benzo[a]pyrene-DNA adducts, with fewer noncancer studies correlating health
26    effects with external measures of exposure. The available human studies report effects that are
27    generally analogous to the effects observed in animal toxicological studies, and provide qualitative,
28    supportive evidence for the effect-specific hazards identified in Section 1.1.1 to 1.1..4.
29           In animals, evidence of developmental and reproductive toxicity and immunotoxicity has
30    been observed across species and dosing regimens. The available evidence from mice and rats
31    treated by gavage during gestation or in  the early postnatal period demonstrate developmental
32    effects including decreased body weight, decreased fetal survival, decreased fertility, atrophy of
33    reproductive organs, and altered neurobehavioral outcomes (Chenetal., 2012: Tules etal., 2012:
34    Bouayedetal.. 2009a: Kristensenetal.. 1995: Mackenzie and Angevine. 1981). Male and female
35    reproductive toxicity, as evidenced by effects on sperm parameters, decreased reproductive organ
36    weights, histological changes, and hormone alterations, have been observed after oral exposure in
37    rats and mice (Chenetal.. 2011: Chung etal.. 2011: Mohamed etal.. 2010:  Zheng etal.. 2010:
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                                                         Toxicological Review ofBenzo[a]pyrene

 1    Mackenzie and Angevine. 1981]. Benzo[a]pyrene exposure has also been shown to lead to altered
 2    immune cell populations and histopathological changes in immune system organs [Kroese etal..
 3    2001: De long et al.. 1999). as well as thymic and splenic effects following subchronic oral exposure.
 4    Varying immunosuppressive responses are also observed in short term oral and injection studies.
 5    The weight of the evidence indicates that developmental toxicity, reproductive toxicity and
 6    immunotoxicity are hazards following oral exposure to benzo[a]pyrene.
 7           Following inhalation exposure to benzo[a]pyrene in animals, evidence of developmental
 8    and reproductive toxicity has been observed. Decreased fetal survival has been observed in rats
 9    exposed to benzo[a]pyrene via inhalation during gestation [Wormley et al.. 2004: Archibongetal..
10    2002).  Male reproductive toxicity, as evidenced by effects on sperm parameters, decreased testes
11    weight, and hormone alterations, has also been observed in rats following subchronic inhalation
12    exposure to benzo[a]pyrene [Archibong et al., 2008: Rameshetal., 2008]. Female reproductive
13    toxicity, as evidenced by modified hormone levels in dams, has been observed following inhalation
14    exposure to benzo[a]pyrene during gestation [Archibongetal., 2002]. The weight of the evidence
15    indicates that developmental toxicity and reproductive toxicity are hazards following inhalation
16    exposure to benzo[a]pyrene.
17           Forestomach hyperplasia was observed following oral and inhalation exposure; however,
18    this endpoint most likely reflects early events in the neoplastic progression of forestomach tumors
19    following benzo[a]pyrene exposure (see Section 1.1.4], and was  not considered further for dose-
20    response analysis and the derivation of reference values.

21    1.2.2.  Weight of Evidence for Carcinogenicity
22           Under EPA's Guidelines for Carcinogen Risk Assessment [U.S. EPA. 2005b]. benzo[a]pyrene is
23    "carcinogenic to humans."  EPA's Cancer Guidelines [U.S. EPA, 2005b] emphasize the importance of
24    weighing all of the evidence in reaching conclusions about human carcinogenic potential. The
25    descriptor of "carcinogenic to humans" can be used when the following conditions are met:
26    (a] there is strong evidence of an association between human exposure and either cancer or the key
27    precursor events of the agent's mode of action but not enough for a causal association, (b] there is
28    extensive evidence of carcinogenicity in animals, (c] the mode or modes of carcinogenic action and
29    associated key precursor events have been identified in animals, and (d] there is strong evidence
30    that the key precursor events that precede the cancer response in animals are anticipated to occur
31    in humans and progress to tumors, based on available biological information.  The data supporting
32    these four conditions for benzo[a]pyrene are presented below and in Table 1-18.

33    a) Strong human evidence of cancer or its precursors
34           There is a large body of evidence for human carcinogenicity for complex PAH mixtures
35    containing benzo[a]pyrene, including soot, coal tars, coal-tar pitch, mineral oils, shale oils, and
36    smoke from domestic coal burning [IARC. 2010: Baanetal.. 2009]. There is also evidence of
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                                                         Toxicological Review ofBenzo[a]pyrene

 1    carcinogenicity, primarily of the lung and skin, in occupations involving exposure to PAH mixtures
 2    containing benzo[a]pyrene, such as chimney sweeping, coal gasification, coal-tar distillation, coke
 3    production, iron and steel founding, aluminum production, and paving and roofing with coal tar
 4    pitch [IARC, 2010: Baanetal., 2009: Straif etal., 2005]. Increased cancer risks have been reported
 5    among other occupations involving exposure to PAH mixtures such as carbon black and diesel
 6    exhaust [Benbrahim-Tallaa etal., 2012: Bosettietal., 2007]. There is extensive evidence of the
 7    carcinogenicity of tobacco smoke, of which benzo[a]pyrene is a notable constituent. The
 8    methodologically strongest epidemiology studies (in terms of exposure assessment, sample size,
 9    and follow-up period] provide consistent evidence of a strong association between benzo[a]pyrene
10    exposure and lung cancer.  Three large epidemiology studies in different geographic areas,
11    representing two different industries, observed increasing risks of lung cancer with increasing
12    cumulative exposure to benzo[a]pyrene (measured in |ig/m3-years], with approximately a 2-fold
13    increased risk at the higher exposures; each of these studies addressed potential confounding by
14    smoking (Armstrong and Gibbs. 2009: Spinelli etal.. 2006: Xuetal.. 1996] (Table 1-11]. Although
15    the relative contributions of benzo[a]pyrene and of other PAHs cannot be established, the
16    exposure-response patterns seen with the benzo[a]pyrene measures make it unlikely that these
17    results represent confounding by other exposures. Similarly, for bladder cancer, two of the three
18    cohort studies with detailed exposure data observed an increasing risk with exposures above  >80
19    [ig/m3-years(Gibbs and Sevigny. 2007a: Gibbs etal.. 2007: Gibbs and Sevigny. 2007b: Spinelli etal..
20    2006] (Table 1-13].  The exposure range was much lower in the third study (Burstyn etal.. 2007:
21    Gibbs and Sevigny. 2007a: Gibbs etal.. 2007: Gibbs and Sevigny. 2007b]. such that the highest
22    exposure group only reached the level of exposure seen in the lowest exposure categories in the
23    other studies. Data pertaining to non-melanoma skin cancer is limited to studies with more indirect
24    exposure measures, e.g., based on occupations with likely dermal exposure to creosote  (i.e., timber
25    workers, brick makers, and power linesmen]; the relative risk estimates seen in the four available
26    studies that provide risk estimates for this type of cancer ranged from 1.5 to 4.6, with three of these
27    four estimates greater than 2.5  and statistically significant (Pukkala, 1995: Karlehagenetal., 1992:
28    Tornqvistetal., 1986: Hammond etal., 1976]. These four studies provide support for the
29    association between dermal PAH exposure, including benzo[a]pyrene exposure, and skin cancer.
30          Although it is likely that multiple carcinogens present in PAH mixtures contribute to the
31    carcinogenic responses, strong evidence is available from several studies of humans exposed to
32    PAH mixtures supporting a contributing role for benzo[a]pyrene diol epoxide in inducing key
33    mutagenic precursor cancer events in target tissues. Elevated BPDE-DNA adducts have been
34    reported in smokers compared to non-smokers, and the increased adduct levels in smokers are
35    typically increased twofold compared with non-smokers (Phillips, 2002]. Elevated BPDE-DNA
36    adduct levels have been observed in WBCs of groups of coke oven workers and chimney sweeps,
37    occupations with known elevated risks of cancer (Rojas etal.. 2000: Bartschetal.. 1999: Pavanello
38    etal.. 1999: Bartschetal.. 1998: Rojas etal.. 1998]. and in lung tissue from tobacco smokers with

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                                                        Toxicological Review ofBenzo[a]pyrene

 1   lung cancer (Rojas etal.. 2004: Godschalketal.. 2002: Bartsch etal.. 1999: Rojas etal.. 1998:
 2   Andreassen et al.. 1996: Alexandrovetal.. 1992).
 3          Mutation spectra distinctive to diol epoxides have been observed in the tumor suppressor
 4   gene p53 and the K-ras oncogene in tumor tissues taken from lung cancer patients who were
 5   chronically exposed to two significant sources of PAH mixtures: coal smoke and tobacco smoke.
 6   Hackmanetal. [2000] reported an increase of GC—>TA transversions and a decrease of GC—>AT
 7   transitions at the hprt locus in T-lymphocytes of humans with lung cancer who were smokers
 8   compared to non-smokers. Lung tumors from cancer patients exposed to emissions from burning
 9   smoky coal showed mutations in p53 and K-ras that were primarily G—>T transversions (76 and
10   86%, respectively) [DeMarini etal.. 2001). [Keohavongetal.. 2003] investigated the K-ras
11   mutational spectra from non-smoking women and smoking men chronically exposed to emissions
12   from burning smoky coal, and smoking men who resided in homes using natural gas; among those
13   with K-ras mutations, 67, 86, and 67%,  respectively, were G^T transversions. Lung tumors from
14   tobacco smokers showed a higher frequency of p53 mutations that were G—>T transversions
15   compared with lung tumors in non-smokers [Pfeifer and Hainaut, 2003: Pfeifer etal., 2002: Hainaut
16   and Pfeifer. 2001]. and the frequency of these types of p53 mutations in lung tumors from smokers
17   increased with increasing smoking intensity [Bennett etal.. 1999].
18          Similarly, investigations of mutagenesis following specific exposures to benzo[a]pyrene (as
19   opposed to PAH mixtures] have consistently observed that the benzo[a]pyrene diol epoxide is very
20   reactive with guanine bases in DNA, and that G^T transversions are the predominant type of
21   mutations caused by benzo[a]pyrene diol epoxide in several biological test (Pfeifer and Hainaut,
22   2003: Hainaut and Pfeifer, 2001]. Following treatment of human HeLa cells with benzo[a]pyrene
23   diol epoxide, Denissenko etal. (1996] reported that the distribution of BPDE-DNA adducts within
24   p53 corresponded to mutational hotspots observed in p53 in human lung cancers. Benzo[a]pyrene
25   exposure induced mutations in embryonic fibroblasts from human p53 "knock-in" mice that were
26   similar to those found in smoking related human cancers, with a predominance of G^T
27   transversions that displayed strand bias and were also located in the same mutational hotspots
28   found in p53 in human lung tumors (Liu etal., 2005]. These results, combined with a mechanistic
29   understanding that mutations in p53 (which encodes a key transcription factor in DNA repair and
30   regulation of cell cycle and apoptosis] may be involved in the initiation phase of many types of
31   cancer, are consistent with a common mechanism for mutagenesis following exposures to PAH
32   mixtures and provide evidence of a contributing role of benzo[a]pyrene diol epoxide in the
33   carcinogenic response of humans to coal smoke and tobacco smoke.
34          Therefore, while the epidemiological evidence alone does not establish a causal association
35   between human exposure and cancer, there is strong evidence that the key precursor events of
36   benzo[a]pyrene's mode of action are likely to be associated with tumor formation in humans.
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                                                        Toxicological Review ofBenzo[a]pyrene

 1    b) Extensive animal evidence
 2          In laboratory animals (rats, mice, and hamsters), exposures to benzo[a]pyrene via the oral,
 3    inhalation, and dermal routes have been associated with carcinogenic responses both systemically
 4    and at the site of administration. Three 2-year oral bioassays are available that associate lifetime
 5    benzo[a]pyrene exposure with carcinogenicity at multiple sites. These bioassays observed
 6    forestomach, liver, oral cavity, jejunum, kidney, auditory canal (Zymbal gland), and skin or
 7    mammary gland tumors in male and female Wistar rats [Kroese etal., 2001): forestomach tumors
 8    in male and female Sprague-Dawley rats [Brune etal., 1981): and forestomach, esophagus, tongue,
 9    and larynx tumors in female B6C3Fi mice [Beland and Gulp. 1998: Gulp etal.. 1998).  Repeated or
10    short-term oral exposure to benzo[a]pyrene was associated with forestomach tumors in additional
11    bioassays with several strains of mice [Weyandetal., 1995: Benjamin et al., 1988: Robinson etal.,
12    1987: El-Bayoumy. 1985: Triolo etal.. 1977: Wattenberg. 1974:  Roe etal.. 1970: Biancifiori  etal..
13    1967: Chouroulinkovetal.. 1967: Fedorenko andYansheva. 1967: Neal andRigdon. 1967:
14    Berenblum and Haran. 1955). EPA has considered the uncertainty associated with the relevance of
15    forestomach tumors for estimating human risk from benzo[a]pyrene exposure. While humans do
16    not have a forestomach, squamous epithelial tissue similar to that seen in the rodent forestomach
17    exists in the  oral cavity and upper two-thirds of the esophagus in humans [IARC. 2003: Wester and
18    Kroes, 1988).  Human studies, specifically associating exposure to benzo[a]pyrene with the
19    alimentary tract tumors are not currently available.  However, benzo[a]pyrene-DNA adducts have
20    been detected in oral and esophageal tissue obtained from smokers [reviewed by Phillips, 2002)
21    and several epidemiological studies have identified increased exposure to PAHs as an independent
22    risk factor for esophageal cancer [Abedi-Ardekani et al., 2010: Szymanska et al., 2010: Gustavsson
23    etal.. 1998: Liu etal.. 1997).  Thus, EPA concluded that forestomach tumors in rodents are relevant
24    for assessing the carcinogenic risk to humans.
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                                                         Toxicological Review ofBenzo[a]pyrene

 1          Chronic inhalation exposure to benzo[a]pyrene was associated primarily with tumors in the
 2    larynx and pharynx of male Syrian golden hamsters exposed to benzo[a]pyrene:NaCl aerosols
 3    [Thyssen et al.. 1981). Additionally, less-than-lifetime oral exposure cancer bioassays in mice
 4    provide supporting evidence that exposure to benzo[a]pyrene is associated with an increased
 5    incidence of lung tumors in mice [Weyandetal., 1995: Robinson etal., 1987: Wattenberg, 1974]. In
 6    additional studies with hamsters, intratracheal instillation of benzo[a]pyrene was associated with
 7    upper and lower respiratory tract tumors [Feron and Kruysse, 1978: Ketkar etal., 1978: Feron et
 8    al.. 1973: Henry etal.. 1973: Saffiotti etal.. 1972].  Chronic dermal application of benzo[a]pyrene
 9    (2-3 times/week] has been associated with mouse skin tumors  in numerous bioassays [Sivaketal..
10    1997: Grimmer etal.. 1984: HabsetaL 1984: Grimmer etal.. 1983: Habsetal.. 1980: SchmahletaL
11    1977: Schmidt etal.. 1973: Roe etal.. 1970: Poel. 1960.1959]. Skin tumors in rats, rabbits, and
12    guinea pigs have also been associated with repeated application of benzo[a]pyrene to skin in the
13    absence of exogenous promoters [IPCS. 1998: ATSDR. 1995: IARC. 1983.1973]. When followed by
14    repeated exposure to a potent tumor promoter, acute dermal exposure to benzo[a]pyrene induced
15    skin tumors in numerous studies of mice, indicating that benzo[a]pyrene is a strong tumor-
16    initiating agent in the mouse skin model [Weyandetal.. 1992: Cavalierietal.. 1991: Rice etal..
17    1985: El-Bayoumyetal.. 1982: Lavoieetal.. 1982: Ravehetal.. 1982: Cavalierietal..  1981: Slagaet
18    al.. 1980: Wood etal.. 1980: Slaga etal.. 1978: Hoffmann etal.. 1972].
19          Carcinogenic responses in animals exposed to benzo[a]pyrene by other routes of
20    administration include: (1] liver or lung tumors in newborn mice given acute postnatal i.p.
21    inj ections [Lavoieetal.. 1994: Busby etal.. 1989: Weyand and Lavoie. 1988: Lavoie etal.. 1987:
22    Wislocki etal.. 1986: Busby etal.. 1984: Buening etal.. 1978: Kapitulnik etal.. 1978]: (2] increased
23    lung tumor multiplicity in A/J adult mice given single i.p. injections [Mass etal.. 1993]: (3] injection
24    site tumors in mice following s.c. injection [Nikonova. 1977: Pfeiffer. 1977:  Homburger etal.. 1972:
25    Roe and Waters. 1967: GrantandRoe. 1963: Steiner. 1955: Rask-Nielsen. 1950: Pfeiffer  and Allen.
26    1948: Bryan and Shimkin, 1943: Barry etal., 1935]: (4] injection site sarcomas in mice following
27    intramuscular injection[Sugiyama, 1973]: (5] mammary tumors in rats with intramammilary
28    administration [Cavalierietal., 1991: Cavalieri et al., 1988c: Cavalierietal., 1988b: Cavalieri etal.,
29    1988a]: (6] cervical tumors in mice with intravaginal application [Naslundetal., 1987]: and
30    (7] tracheal tumors in rats with intratracheal implantation [Toppingetal.. 1981: Nettesheim etal..
31    19771
32          Therefore, the animal database provides extensive evidence of carcinogenicity in animals.

33    c) Identification of key precursor events have been identified in animals
34          There is sufficient evidence to conclude that benzo[a]pyrene carcinogenicity involves a
35    mutagenic mode of action mediated by DNA reactive metabolites.  The benzo[a]pyrene database
36    provides strong and consistent evidence for BPDE-induced mutations associated with tumor
37    initiation in cancer tissue from humans exposed to complex mixtures containing benzo[a]pyrene, in

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                                                         Toxicological Review ofBenzo[a]pyrene

 1    animals exposed to benzo[a]pyrene, and in in vitro systems. Other processes may contribute to the
 2    carcinogenicity of benzo[a]pyrene via the promotion and progression phases of cancer
 3    development (e.g., inflammation, cytotoxicity, sustained regenerative cell proliferation, anti-
 4    apoptotic signaling), but the available evidence best supports a mutagenic mode of action as the
 5    primary mode by which benzo [a] pyrene acts.

 6    d) Strong evidence that the key precursor events are anticipated to occur in humans
 7          Mutations in p53 and ras oncogenes have been observed in tumors from mice exposed to
 8    benzo[a]pyrene in the diet [Gulp etal.. 2000] or by i.p. injection [Nesnow et al.. 1998a: Nesnow et
 9    al., 1998b: Nesnow etal., 1996,1995: Mass etal., 1993]. Mutations in these same genes have also
10    been reported in lung tumors of human cancer patients, bearing distinctive mutation spectra (G^T
11    transversions] that correlate with exposures to coal smoke [Keohavongetal., 2003: DeMarini etal.,
12    2001] or tobacco smoke [Pfeifer and Hainaut. 2003: Pfeifer etal.. 2002: Hainautand Pfeifer. 2001:
13    Bennett etal.. 1999].
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                                                       Toxicological Review ofBenzo[a]pyrene
1
2
Table 1-18. Supporting evidence for the carcinogenic to humans cancer
descriptor for benzo[a]pyrene
Evidence
a) Strong human evidence of cancer or its precursors
• Increased risk of lung, bladder, and skin cancer in
humans exposed to complex PAH mixtures containing
benzo[a]pyrene
• Benzo[a]pyrene-specific biomarkers detected in
humans exposed to PAH mixtures associated with
increased risk of cancer

and chimney sweeps
- BPDE-DNAadducts in smokers
• Benzo[a]pyrene-specific DNA adducts have been
detected in target tissues in humans exposed to PAH
mixtures

cigarette smokers with lung cancer and in skin
eczema patients treated with coal tar


cells in vitro corresponds to mutational hotspots
at guanine residues in human lung tumors
• Benzo[a]pyrene-specific mutational spectra identified
in PAH-associated tumors in humans
- GC->TA transversions and GC->AT transitions at
hprt locus in T-lymphocytes of humans with lung
cancer
- G->T transversions in exposed human- p53
knock-in mouse fibroblasts at the same
mutational hotspot in p53 from smoking-related
lung tumors in humans
- G->T transversions at the same mutational
hotspot in p53 and K-ras in human lung tumors
associated with smoky coal exposures
- Increased percentage of G->T transversions in
p53 in smokers versus non-smokers
b) Extensive animal evidence
Reference

IARC (2010, 2004); Secretan et al. (2009); Baan et al.
(2009); Benbrahim-Tallaa etal. (2012)
Rnias pt al l~)C\r\r\\- RarKrh pt al MQQQ11 Pauanplln pt al

(1999); Bartsch etal. (1998); Rojas et al. (1998)
Phillips (2002)
Rniac pt al (1C\C\A.\m f^nrlcrhalk pt al OHO?^1 Rartcrh pt al

(1999); Godschalk et al. (1998b); Roias et al. (1998);
Andreassen et al. (1996); Alexandrov et al. (1992)
npniQQpnkn pt al MQQfi^'PiiiQipiiYPtal M QQ'M

Hackman et al. (2000)
Liu et al. (2005)
Keohavong et al. (2003); DeMarini et al. (2001)
Pfeifer and Hainaut (2003); Pfeifer et al. (2002); Hainaut
and Pfeifer (2001); Bennett et al. (1999)

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                                          Toxicological Review ofBenzo[a]pyrene
Evidence
Reference
Oral exposures
• Forestomach tumors in male and female rats and in
female mice following chronic exposure
• Forestomach tumors in mice following less-than-
lifetime exposures
• Alimentary tract and liver tumors in male and female
rats following chronic exposure
• Kidney tumors in male rats following chronic
exposure
• Auditory canal tumors in male and female rats
following chronic exposure
• Esophageal, tongue, and laryngeal tumors in female
mice following chronic exposure
• Lung tumors in mice following less-than-lifetime
exposure
Kroese et al. (2001); Beland and Gulp (1998); Gulp et al.
(1998); Bruneetal. (1981)
Wevand et al. (1995); Benjamin et al. (1988); Robinson et
al. (1987); EI-Bayoumy (1985); Triolo et al. (1977);
Wattenberg (1974); Roe et al. (1970); Biancifiori et al.
(1967); Chouroulinkov et al. (1967); Fedorenko and
Yansheva (1967); Neal and Rigdon (1967); Berenblum and
Haran (1955)
Kroese et al. (2001)
Kroese et al. (2001)
Kroese et al. (2001)
Beland and Gulp (1998); Gulp et al. (1998)
Wevand et al. (1995); Robinson et al. (1987); Wattenberg
(1974)
Inhalation exposures
• Upper respiratory tract tumors in male hamsters
following chronic exposure
Thvssenetal. (1981)

Dermal exposures
• Skin tumors in mice following chronic exposures
without a promoter or acute exposures with a
promoter
• Skin tumors in rats, rabbits, and guinea pigs
following subchronic exposures
Sivak et al. (1997); Grimmer et al. (1984); Habs et al.
(1984); Grimmer et al. (1983); Habs et al. (1980); Schmahl
et al. (1977); Schmidt et al. (1973); Roe et al. (1970); Poel
(1960, 1959)
(IPCS, 1998; ATSDR, 1995; IARC, 1983, 1973)

Other routes of exposure
• Respiratory tract tumors in hamsters following
intratracheal instillation
• Liver or lung tumors in newborn mice given acute
postnatal i.p. injections
• Lung tumor multiplicity in A/J adult mice given single
i.p. injections
(Feron and Kruysse, 1978; Ketkar et al., 1978; Feron et al..
1973; Henry et al., 1973; Saffiotti et al., 1972)
(Lavoie et al., 1994; Busby et al., 1989; Wevand and
Lavoie, 1988; Lavoie et al., 1987; Wislocki et al., 1986;
Busby et al., 1984; Buening et al., 1978; Kapitulnik et al..
1978)
Mass et al. (1993)

c) Identification of key precursor events have been identified in animals
• Bioactivation of benzo[a]pyrene to DNA-reactive
metabolites has been shown to occur in multiple
species and tissues by all routes of exposure
• Direct DNA damage by the reactive metabolites,
including the formation of DNA adducts and ROS-
mediated damage
• Formation and fixation of DNA mutations, particularly
in tumor suppressor genes or oncogenes associated
with tumor initiation
See 'Experimental Support for Hypothesized Mode of
Action' section
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                                          Toxicological Review ofBenzo[a]pyrene
Evidence
Reference
d) Strong evidence that the key precursor events are anticipated to occur in humans
• Mutations in p53 or ras oncogenes have been
observed in forestomach or lung tumors from mice
exposed to benzo[a]pyrene
- G->T transversions in ras oncogenes or the p53
gene have been observed in lung tumors of
human cancer patients exposed to coal smoke
- Higher frequency of G->T transversions in lung
tumors from smokers versus non-smokers
Gulp et al. (2000); Nesnow et al. (1998a); Nesnow et al.
(1998b); Nesnow et al. (1996, 1995); Massetal.
Keohavong et al. (2003); DeMarini et al. (2001)
Pfeifer and Hainaut (2003); Pfeifer et al. (2002);
and Pfeifer (2001); Bennett et al. (1999)
(1993)
Hainaut

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                                                       Toxicological Review ofBenzo[a]pyrene
 1
 2    2. DOSE-RESPONSE ANALYSIS
 3    2.1. ORAL REFERENCE DOSE FOR EFFECTS OTHER THAN CANCER
 4          The oral reference dose (RfD) (expressed in units of mg/kg-day) is defined as an estimate
 5    (with uncertainty spanning perhaps an order of magnitude) of a daily exposure to the human
 6    population (including sensitive subgroups) that is likely to be without an appreciable risk of
 7    deleterious effects during a lifetime. It can be derived from a no-observed-adverse-effect level
 8    (NOAEL), lowest-observed-adverse-effect level (LOAEL), or the 95 percent lower bound on the
 9    benchmark dose (BMDL), with uncertainty factors (UFs) generally applied to reflect limitations of
10    the data used.

11    2.1.1.  Identification of Studies and Effects for Dose-Response Analysis
12          In Section 1.2.1, developmental, reproductive, and immunological toxicities were
13    highlighted as hazards of benzo[a]pyrene exposure by the oral route. Studies within each effect
14    category were evaluated using general study quality characteristics (as discussed in Section 6 of the
15    Preamble) to help inform the selection of studies from which to derive toxicity values. Rationales
16    for selecting the studies and effects to represent each of these hazards are summarized below.
17          Human studies are preferred over animal studies when quantitative measures of exposure
18    are reported and the reported effects are determined to be associated with exposure. For
19    benzo[a]pyrene, human studies of environmental PAH mixtures across multiple cohorts have
20    observed effects following exposure to complex mixtures of PAHs. The available data suggest that
21    benzo[a]pyrene exposure may pose health hazards other than cancer including reproductive and
22    developmental effects such as infertility, miscarriage, and reduced birth weight (Wuetal., 2010:
23    Nealetal..20Q8: Tangetal.. 2008: Pereraetal.. 2005b: Pereraetal.. 2005a) and cardiovascular
24    effects (Friesenetal., 2010: Burstynetal., 2005).  However, the available human studies that
25    utilized benzo[a]pyrene-DNA adducts as the exposure metric do not provide external exposure
26    levels of benzo[a]pyrene from which to derive a value, and exposure is likely to have occurred by
27    multiple routes. In addition, uncertainty exists due to concurrent exposure to other PAHs and other
28    components of the mixture (such as metals).
29          Animal studies were evaluated to determine which provided the most relevant routes and
30    durations of exposure; multiple exposure levels to provide information about the shape of the dose-
31    response curve; and power to detect effects at low exposure levels (U.S. EPA, 2002).  The oral
32    database for benzo[a]pyrene includes a variety of studies and datasets that are suitable for use in
33    deriving reference values. Specifically, chronic effects associated with benzo[a]pyrene exposure in
34    animals include observations of organ weight and histological changes and hematological

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                                                         Toxicological Review ofBenzo[a]pyrene

 1    parameters observed in several oral cancer bioassays [Kroese etal.. 2001: Beland and Gulp. 1998].
 2    Multiple subchronic studies are available which characterize a variety of effects other than cancer.
 3    In addition, several developmental studies are available which help inform hazards of exposure
 4    during sensitive developmental windows.

 5    Developmental Toxicity
 6          Numerous animal studies observed endpoints of developmental toxicity following oral
 7    exposure during gestational or early postnatal development [Chen etal., 2012: Tules etal., 2012:
 8    Bouayedetal.. 2009a: Kristensenetal.. 1995: Mackenzie and Angevine. 1981] and were considered
 9    for dose response analysis based on the above criteria. Kristensenetal. [1995], with only one dose
10    group, was not considered further given its concordance with Mackenzie and Angevine [1981],
11    which had multiple groups.  From the remaining studies demonstrating developmental toxicity, the
12    studies conducted by Chen etal. [2012] and Tules etal. [2012] were identified as the most
13    informative studies for dose-response analysis. The neurodevelopmental study by Chen et al.
14    [2012] was a well-designed and well-conducted study that evaluated multiple neurobehavioral
15    endpoints and measures of neurotoxicity in adolescent and adult rats. The study randomly
16    assigned a total of 10 male and 10 female pups per treatment group, with no more than one male
17    and one  female from each litter for behavioral testing. In addition, the pups were cross-fostered
18    with dams being rotated among litters every 2-3 days to distribute any maternal caretaking
19    differences randomly across litters and treatment groups.
20          Chen etal. [2012] observed increased latency in negative geotaxis, increased motor activity
21    in the open field test, decreased anxiety-like behaviors in the elevated plus maze test, and impaired
22    performance in the Morris water maze test as measured by an increase in latency time to find a
23    hidden platform. Chen etal. [2012] also observed increased latencies for treated pups to right
24    themselves in the surface righting test and the negative geotaxis test The data from the open field
25    test, negative geotaxis test, and surface righting test were considered less informative as male and
26    female data were pooled (male and female rats sometimes show differences in the maturation of
27    these developmental landmarks following challenge]. In addition, altered behaviors and
28    locomotion in open field tests could be attributed to anxiety responses  due to open spaces and
29    bright light, as well as changes to motor system function.  Chen etal.  [2012] reported increased
30    quadrants crossed, which could indicate either increased motor activity or decreased  anxiety (less
31    fear of the open spaces/bright lights]. EPA considered the elevated plus maze and Morris water
32    maze tests (which did report responses for each sex] to be the most informative and appropriate
33    measures of neurobehavioral function performed by Chen etal. [2012].
34          Significant, dose-related effects were reported in an established test of spatial learning and
35    memory (Morris water maze].  Specifically, increased escape latency in each of four hidden
36    platform trial days and decreased time spent in the target quadrant during a probe trial were
37    observed following benzo[a]pyrene exposure.  Due to the altered baseline performance of treated

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                                                          Toxicological Review ofBenzo[a]pyrene

 1    animals on day 1 of the hidden platform trials these findings cannot be specifically attributed to
 2    impaired learning. In fact, the slopes of the lines across trial days are nearly identical for the
 3    treatment groups suggesting the lack of an effect on learning. The impaired Morris water maze
 4    performance of treated animals could be due to effects on several other components of neurological
 5    function besides learning, including anxiety, vision, and locomotion. Similarly, as escape latencies
 6    were not comparable across groups after learning acquisition (i.e., the end of the hidden platform
 7    trials), differences in probe trial performance are likely to be influenced by factors other than
 8    impaired memory retention. As a result, although they identify significant effects of
 9    benzo[a]pyrene exposure, the Morris water maze data were considered less informative than the
10    results from the elevated plus maze test.  Chenetal. [2012] reported an increase in the number of
11    open arm entries in the elevated plus maze test, an indicator of decreased anxiety-like behavior.
12    These results indicate effects on a single, discreet neurological function which are unlikely to be
13    complicated by changes in other processes such as motor activity (total arm entries calculated by
14    summing open and closed arm entries were unchanged with treatment). This finding is considered
15    adverse, is supported by similar observations in developing (Bouayed et al., 2009a] and adult
16    (Grova etal..  2008] mice, and may be indirectly related to observations of increased aggression in
17    mice (Bouayed etal.. 2009b] as well as attention and anxiety problems in PAH-exposed children
18    (Pereraetal.. 2012b).
19           Tules  etal. (2012] was also identified for dose-response analysis. This study was of
20    sufficient duration, utilized multiple doses, did not observe maternal toxicity, and evaluated
21    multiple cardiovascular endpoints.  The study authors reported increases in both systolic
22    (approximately 20-50%) and diastolic (approximately 33-83%) pressure and heart rate in adult
23    rats that were exposed gestationally to benzo[a]pyrene. A limitation of this study is that the
24    authors only reported effects at the two highest doses. However, given the magnitude of the
25    response and the appearance of these effects in adulthood following gestational exposure, these
26    endpoints were selected for dose-response analysis because of their sensitivity and biological
27    plausibility.
28           Bouayed etal. (2009a) and Mackenzie and Ange vine (1981] were not selected for dose-
29    response analysis. Bouayed etal. (2009a) used the same tests as Chen etal. (2012], but at higher
30    doses (2 and 20 mg/kg-day compared to 0.02, 0.2, and 2 mg/kg-day, respectively). Similarly,
31    Mackenzie and Ange vine (1981) demonstrated developmental effects in a multi-dose study with
32    relevant routes and durations of exposure; however, the doses studied (10-160 mg/kg-day) were
33    much higher than those evaluated in other developmental toxicity studies (Chenetal., 2012: Tules
34    etal.. 2012).

35    Reproductive Toxicity
36           Male  reproductive toxicity was demonstrated in numerous subchronic studies (Chenetal..
37    2011: Chung etal.. 2011: Mohamedetal.. 2010: Zheng etal.. 2010]. Chung etal. (2011] was not

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                                                          Toxicological Review ofBenzo[a]pyrene

 1    included in the dose-response analysis because numerical data were not reported or only reported
 2    for the mid-dose of three doses. Chenetal. [2011] is a subchronic study that applied only a single
 3    dose level. This study corroborated other available multi-dose studies and is considered
 4    supportive, but it was not considered for dose-response analysis due to the limited reporting of
 5    numerical data. The studies conducted by Mohamedetal. [2010] and Zheng etal. [2010] were
 6    identified as the most informative male reproductive toxicity studies for dose-response analysis.
 7    Decreased sperm count and motility observed by Mohamedetal. [2010] and decreased
 8    intratesticular testosterone levels observed by Zheng etal. [2010] were selected for dose-response
 9    analysis as both represent sensitive endpoints of male reproductive toxicity and are indicators of
10    potentially decreased fertility.  These effects are also  consistent with human studies in PAH
11    exposed populations as effects on male fertility and semen quality have been demonstrated in
12    epidemiological studies of smokers [reviewed by Spares and Melo, 2008].
13           Female reproductive toxicity was demonstrated in two subchronic studies [Gao etal.,
14    2011a: Xu etal., 2010]. Specifically, Xu et al., 2010 demonstrated altered ovary weights and follicle
15    numbers, and Gao etal. [201 la] demonstrated cervical  epithelial cell hyperplasia following oral
16    exposure to benzo[a]pyrene. These studies were identified as the most informative studies on
17    female reproductive toxicity for dose-response  analysis. Gao etal. [201 la] identified statistically-
18    significant, dose-related increases in the incidence of cervical inflammatory cells in mice exposed to
19    low doses ofbenzo[a]pyrene for 98 days [Gao etal., 2 01 la: Gao etal., 2010].  Cervical effects of
20    increasing severity (including epithelial hyperplasia, atypical hyperplasia, apoptosis, and necrosis]
21    were also observed at higher doses [Gao etal., 2011a: Gao etal., 2010]. There are no data on
22    cervical effects in other species or in other mouse strains. However, Gao etal. [2 01 la] also
23    evaluated cervical effects in separate groups of mice exposed via i.p. injection, and observed similar
24    responses in these groups of mice, providing support for the association between effects in this
25    target organ and benzo[a]pyrene exposure.  Epidemiological studies have demonstrated an
26    association between cigarette smoking and increased risk of cervical cancer [Pate Capps etal.,
27    2009].  In addition, benzo[a]pyrene metabolites and benzo[a]pyrene-DNA adducts have been
28    detected in human cervical mucus and cervical tissues obtained from smokers [Phillips, 2002:
29    Melikianetal., 1999]. However, data to support that cervical hyperplasia following oral
30    benzo[a]pyrene exposure progresses to cervical tumors were not available (no cervical tumors
31    were noted in the two available chronic oral cancer bioassays]. Thus, in the absence of these data,
32    cervical hyperplasia is presented as a noncancer effect.
33           Xu etal. [2010] identified biologically and statistically significant decreases  in ovary weight,
34    estrogen, and primordial follicles, and altered estrus cycling in treated animals. These reductions in
35    female reproductive parameters are supported by a large database of animal studies indicating that
36    benzo[a]pyrene is ovotoxic with effects including decreased ovary weight, decreased primordial
37    follicles, and reduced fertility fBorman etal.. 2000: Kristensen etal.. 1995: Miller etal.. 1992:
38    Swartz  and Mattison. 1985: Mackenzie and Angevine. 1981: Mattison etal.. 1980]. Additionally,

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                                                         Toxicological Review ofBenzo[a]pyrene

 1    epidemiology studies indicate that exposure to complex mixtures of PAHs, such as through cigarette
 2    smoke, is associated with measures of decreased fertility in humans [Neal etal.. 2008: El-Nemr et
 3    al.. 1998). Specific associations have also been made between infertility and increased levels of
 4    benzo[a]pyrene in follicular fluid in women undergoing in vitro fertilization [Neal etal., 2008].

 5    Immunotoxicity
 6          As described in Section 1.1.3, the immune system was identified as a target of
 7    benzo[a]pyrene-induced toxicity based on findings of organ weight and immunoglobulin
 8    alterations, as well as effects on cellularity and functional changes in the immune system in animals.
 9    The only available studies to support development of an RfD were conducted by Kroese et al.
10    [2001] and De long et al. [1999]. These are subchronic studies with multiple exposure levels and
11    adequate power to detect effects. In comparing these studies, the Kroese  etal. [2001] study is
12    preferred for dose-response analysis due to its longer duration (90 days].
13          Decreased thymus weight, observed in Kroese etal. [2001], decreased IgM and IgA levels,
14    and decreased relative numbers of B-cells, observed in De long etal. [1999]. were selected for dose-
15    response analysis. It is recognized that thymus weight changes on their own have been noted to be
16    less reliable indicators of immunotoxicity [Luster etal., 1992]. However, there are converging lines
17    of evidence that support the derivation of an organ/system-specific RfD for benzo[a]pyrene
18    immunotoxicity. Alterations in immunoglobulin levels have been noted in humans after exposure to
19    PAHs, as well as in animal studies after exposure to benzo[a]pyrene. Changes in B cell populations
20    in the spleen provide additional evidence of immunotoxicity. Finally, functional effects on the
21    immune system, including dose-related decreases in SRBC-specific IgM levels and dose-dependent
22    decreases in resistance to pneumonia or Herpes simplex type 2 following short-term s.c. injection
23    have  been reported [Temple etal., 1993: Munsonetal., 1985]. The observed decreases in thymus
24    weight, IgM and IgA levels, and number of B cells associated with exposure to benzo[a]pyrene were
25    concluded to be representative of immunotoxicity following benzo[a]pyrene exposure and were
26    selected for dose-response analysis.

27    2.1.2. Methods of Analysis
28          No biologically based dose-response models are available for benzo[a]pyrene. In this
29    situation, EPA evaluates a range of dose-response models thought to be consistent with underlying
30    biological processes to determine how best to empirically model the dose-response relationship in
31    the range of the observed data. Consistent with this approach, all models available in EPA's
32    Benchmark Dose Software [BMDS] were evaluated. Consistent with EPA's Benchmark Dose
33    Technical Guidance Document [U.S. EPA. 2012b], the benchmark  dose [BMD] and the 95% lower
34    confidence limit on the BMD [BMDL] were estimated using a benchmark response [BMR] of
35    1  standard deviation [SD] from the control mean for continuous  data or a BMR of 10% extra risk for
36    dichotomous data in the absence of information regarding what  level of change is considered
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                                                         Toxicological Review ofBenzo[a]pyrene

 1    biologically significant, and also to facilitate a consistent basis of comparison across endpoints,
 2    studies, and assessments. The estimated BMDLs were used as points of departure (PODs). Further
 3    details including the modeling output and graphical results for the best fit model for each endpoint
 4    can be found in Appendix E of the Supplemental Information.
 5          Among the endpoints identified as representative of the hazards of benzo[a]pyrene
 6    exposure, the data for neurobehavioral changes in the elevated plus maze and Morris water maze
 7    tests [Chenetal., 2012], decreased ovary weight [Xu etal., 2010], increased cervical hyperplasia
 8    [Gao etal. [201 la], and decreased thymus weight [Kroese etal., 2001] were amenable to dose-
 9    response modeling.  For the water maze escape latency data, the data for male and female rats were
10    combined for dose-response analysis because of the strong similarity in responses and the lack of
11    information available suggesting there would be sex-specific differences in the results of this test
12    (see Appendix E of the Supplemental Information for details of statistical analyses].
13          The data for the remaining endpoints identified in Section 2.1.1 were not modeled.
14    Specifically, the data for cardiovascular effects observed in Jules etal. [2012] were limited due to
15    the reporting of results at only the two highest dose groups. The data for epididymal sperm counts
16    presented in the  Mohamedetal. [2010] study were reported graphically only and requests for the
17    raw data were unsuccessful. The observed decrease in IgM and IgA [De long et al.. 1999] was
18    inconsistent and not amenable to dose-response modeling. NOAELs or LOAELs were used as the
19    POD for these endpoints.
20          Human equivalent doses [HEDs] for oral exposures were derived from the PODs estimated
21    from the laboratory animal data as described in EPA's Recommended Use of Body Weight3/4 as the
22    Default Method in Derivation of the Oral Reference Dose [U.S. EPA. 2011]. In this guidance, EPA
23    advocates a hierarchy of approaches for  deriving HEDs from data in laboratory animals, with the
24    preferred approach being physiologically-based toxicokinetic modeling. Other approaches can
25    include using chemical-specific information in the absence of a complete physiologically-based
26    toxicokinetic model. As discussed in Appendix D of the Supplemental Information, several animal
27    physiologically based pharmacokinetic [PBPK] models for benzo[a]pyrene have been developed
28    and published, but a validated human PBPK model for benzo[a]pyrene for extrapolating doses from
29    animals to humans is not available.  In lieu of either chemical-specific models or data to inform the
30    derivation of human equivalent oral exposures, a body weight scaling to the % power (i.e., BW3/4]
31    approach is applied to extrapolate toxicologically equivalent doses of orally administered agents
32    from adult laboratory animals to adult humans for the purpose of deriving an oral RfD. BW3/4
33    scaling was not employed for deriving HEDs from studies in which doses were administered
34    directly to early postnatal animals because of the absence of information on whether allometric
35    (i.e., body weight] scaling holds when extrapolating doses from neonatal animals to adult humans
36    due to presumed toxicokinetic and/or toxicodynamic differences between lifestages [U.S. EPA,
37    2011: Hattis etal.. 20041
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                                                        Toxicological Review ofBenzo[a]pyrene
 1
 2
 3
 4
 5
 6
 7
 8
 9
10
11
12
13
14
15
16
17

18
       Consistent with EPA guidance [U.S. EPA. 20111. the PODs estimated based on effects in adult
animals are converted to HEDs employing a standard dosimetric adjustment factor (DAF) derived
as follows:
       where
                    BWa = animal body weight
                    BWh = human body weight

       Using a BWa of 0.25 kg for rats and 0.035 kg for mice and a BWh of 70 kg for humans (U.S.
EPA, 1988], the resulting DAFs for rats and mice are 0.24 and 0.15, respectively. Applying this DAF
to the POD identified for effects in adult rats or mice yields a PODnED as follows (see Table 2-1):
                    = Laboratory animal dose (mg/kg-day) x DAF
       Table 2-1 summarizes the sequence of calculations leading to the derivation of ahuman-
equivalent POD for each data set discussed above.

       Table 2-1. Summary of derivation of PODs
Endpoint and
Reference
Species/
Sex
Model3
BMR
BMD
(mg/kg-d)
BMDL
(mg/kg-d)
PODADJb
(mg/kg-d)
PODHEDC
(mg/kg-d)
Developmental
Neurobehavioral
changes
Chen etal. (2012)

Cardiovascular
effects
Jules etal. (2012)

Female
Sprague-
Dawley rats
Long-Evans
rats
Exponential
(M4)a
ISO
0.18
0.09
LOAEL(0.6mg/kg-d)
(15% -t in systolic BP; 33% -f in diastolic BP)
0.09
0.6
0.09
0.15
Reproductive
Decreased ovary
weight
Xu et al. (2010)

Decreased
intratesticular
testosterone
Zheng etal. (2010)

Decreased sperm
count and motility
Mohamed etal.
(2010)
Female
Sprague-
Dawley rats
Male
Sprague-
Dawley rats
Male C57BL/6
mice
Linear3
ISO
2.3
1.5
NOAEL (1 mg/kg-d)
(15% -^ in testosterone)
LOAELfl mg/kg-d)
(50% 4, in sperm count; 20% 4, in sperm motility)
1.5
1
1
0.37
0.24
0.15
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                                                             Toxicological Review ofBenzo[a]pyrene
Endpoint and
Reference
Cervical epithelial
hyperplasia
Gaoetal. (2011a)

Species/
Sex
Female ICR
mice
Model3
Log-
logistic3
BMR
10%
BMD
(mg/kg-d)
0.58
BMDL
(mg/kg-d)
0.37
PODADJb
(mg/kg-d)
0.37
PODHEDC
(mg/kg-d)
0.06
Immunological
Decreased thymus
weight
Kroese et al. (2001)

Decreased IgM levels
De Jong etal. (1999)

Decreased IgA levels
De Jong etal. (1999)

Decreased number
of B cells
De Jong etal. (1999)
Female
Wistar rats
Male
Wistar rats
Male
Wistar rats
Male
Wistar rats
Linear3
ISO
10.5
7.6
NOAEL(10mg/kg-d)
(14% ^ in IgM)
NOAEL(30mg/kg-d)
(28% ^ in IgA)
NOAEL(30mg/kg-d)
(7% 'Nn B cells at NOAEL; 31% ^ at LOAEL)
7.6
7.1
21
21
1.9
1.7
5.2
5.2
 1
 2
 3
 4
 5
 6
 7
 8
 9
10
11

12

13
14
15
16
17
18
19
20
21
22
23
24
25
3For modeling details, see Appendix E in Supplemental Information.
bFor studies in which animals were not dosed daily, administered doses were adjusted to calculate the TWA daily
 doses prior to BMD modeling.
CHED PODs were calculated using BW3/4scaling (U.S. EPA, 2011) for effects from dosing studies in adult animals
 (i.e., Gao etal., 2011a; Mohamed etal., 2010; Xu etal., 2010; De Jong etal., 1999) or for developmental effects
 resulting from in utero exposures.  BW   scaling was not employed for deriving HEDs from studies in which doses
 were administered directly to early postnatal animals (i.e., Chen etal., 2012) because of the absence of
 information on whether allometric (i.e., body weight) scaling holds when extrapolating doses from neonatal
 animals to adult humans due to presumed toxicokinetic and/or toxicodynamic differences between lifestages
 (U.S. EPA, 2011; Hattis et al., 2004).

2.1.3.   Derivation of Candidate Values

        Under EPA's A Review of the Reference Dose and Reference Concentration Processes [U.S. EPA.
2002: Section 4.4.5], also described in the Preamble, five possible areas of uncertainty and
variability were considered. An explanation of the five possible areas of uncertainty and variability
follows:
        An intraspecies uncertainty factor, UFn, of 10 was applied to account for variability and
uncertainty in toxicokinetic and toxicodynamic susceptibility within the subgroup of the human
population most sensitive to the health hazards of benzo[a]pyrene [U.S. EPA. 2002).  In the case of
benzo[a]pyrene, the PODs were derived from studies in inbred animal strains and are not
considered sufficiently representative of the exposure and dose-response of the most susceptible
human  subpopulations (in this case, the developing fetus). In certain cases, the toxicokinetic
component of this factor may be replaced when a PBPK model is available which incorporates the
best available information on variability in toxicokinetic disposition in the human population
(including sensitive subgroups). In the case of benzo[a]pyrene, insufficient information is available
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                                                         Toxicological Review ofBenzo[a]pyrene

 1    to quantitatively estimate variability in human susceptibility; therefore, the full value for the
 2    intraspecies UF was retained.
 3          An interspecies uncertainty factor, UFA, of 3 (101/2 = 3.16, rounded to 3) was applied, to all
 4    PODs in Table 2-2 except Chen et al. [2012], because BW3/4 scaling is being used to extrapolate oral
 5    doses from laboratory animals to humans. Although BW3/4 scaling addresses some aspects of cross-
 6    species extrapolation of toxicokinetic and toxicodynamic processes, some residual uncertainty
 7    remains. In the absence of chemical-specific data to quantify this uncertainty, EPA's BW3/4
 8    guidance [U.S. EPA, 2011] recommends use of an uncertainty factor of 3. BW3/4 scaling was not
 9    employed for deriving HEDs from studies in which doses were administered directly to early
10    postnatal animals [i.e. Chenetal.. 2012] because of the absence of information on whether
11    allometric (i.e., body weight] scaling holds when extrapolating doses from neonatal animals to adult
12    humans due to presumed toxicokinetic and/or toxicodynamic differences between lifestages [U.S.
13    EPA, 2011: Hattis etal., 2004]. In this case, a value of 10 was applied because of the absence of
14    quantitative information to characterize either the toxicokinetic or toxicodynamic differences
15    between animals and humans at this lifestage. A subchronic to chronic uncertainty factor, UFs, of 1
16    was applied when dosing occurred during gestation [Tules etal.. 2012] or the early postnatal period
17    [Chen etal.. 2012] that is relevant to developmental effects. The developmental period is
18    recognized as a susceptible lifestage and repeated exposure is not necessary for the manifestation
19    of developmental toxicity [U.S. EPA, 1991c]. A value of 10 was applied when the POD was based on
20    a subchronic study (studies in Table 2-2, other than the two developmental toxicity studies, were
21    42-90 days in duration] to account for the possibility that longer exposure may induce effects at a
22    lower dose.
23          An uncertainty factor for extrapolation from a LOAEL to  NOAEL, UFL, of 1 was applied when
24    the POD was  based on a NOAEL f Zheng etal.. 2010: De long etal.. 19991 A value of 1 was applied
25    for LOAEL-to-NOAEL extrapolation when a BMR of a 1 SD [Chenetal.. 2012: Kroese etal.. 2001] or
26    10% change [Gao etal., 2011b] from the control was selected under an assumption that it
27    represents a minimal biologically significant response level. A NOAEL was not determined for the
28    most sensitive effects observed in Tules etal. [2012] and Mohamedetal. [2010]. At the LOAEL,
29    Tules etal. [2012] observed statistically significant increases in systolic [15%] and diastolic [33%]
30    blood pressure when measured in adulthood following gestational exposure. Regarding the study
31    by Mohamedetal. [2010]. the authors observed a statistically significant decrease sperm count
32    [50%] and motility [20%] in treated FO males at the LOAEL and the observed decrements in sperm
33    count persisted in untreated Fl male offspring. The data reported in these studies were not
34    amenable to dose-response modeling which would have allowed for extrapolation to a minimally
35    biologically significant response level. Therefore, a full UF of 10 was applied to approximate a
36    NOAEL for these studies which observed a high magnitude of response at the LOAEL. A database
37    uncertainty factor, UFD, of 3 was applied to account for database deficiencies including the lack of a
38    standard multigenerational study or extended 1-generation study that includes exposure from

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                                                         Toxicological Review ofBenzo[a]pyrene
 1    premating through lactation, considering that benzo[a]pyrene has been shown to affect fertility in
 2    adult male and female animals by multiple routes of exposure (see Section 1.1.2). Considering that
 3    decreased fertility in adult male and female mice is observed following gestational exposure, it is
 4    assumed that exposure occurring over this more comprehensive period of development could
 5    result in a lower POD. Also, the lack of a study examining functional neurological endpoints
 6    following a more comprehensive period of developmental exposure (i.e., gestation through
 7    lactation) is a data gap, considering human and animal evidence indicating altered neurological
 8    development (see Section 1.1.1).
 9          Table 2-2 is a continuation of Table 2-1 and summarizes the application of UFs to each POD
10    to derive a candidate value for each data set. The candidate values presented in the table below are
11    preliminary to the derivation of the organ/system-specific reference values. These candidate
12    values are considered individually in the selection of a representative oral reference value for a
13    specific hazard and subsequent overall RfD for benzo[a]pyrene.

14          Table 2-2. Effects and corresponding derivation of candidate values


Endpoint and Reference

PODHEDa
(mg/kg-d)

POD
type


UFA


UFH


UFL


UFS


UFD

Composite
UF
Candidate
value
(mg/kg-d)
Developmental
Neurobehavioral changes in
rats
Chen etal. (2012)

Cardiovascular effects in rats
Jules etal. (2012)

0.09



0.15


BMDL1SD



LOAEL


10



3


10



10


1



10


1



1


3



3


300



1,000


3 x 10'4



2 x 10'4


Reproductive
Decreased ovary weight in
rats
Xu et al. (2010)

Decreased intratesticular
testosterone in rats
Zheng etal. (2010)

Decreased sperm count and
motility in mice
Mohamedetal. (2010)

Cervical epithelial
hyperplasia in mice
Gaoetal. (2011a)
0.37



0.24



0.15



0.06


BMDL1SD



NOAEL



LOAEL



BMDL10


3



3



3



3


10



10



10



10


1



1



10



1


10



10



10



10


3



3



3



3


1,000



1,000



10,000



1,000


4 x 10"4



2 x 10'4



Not calculated
due to UF>
3000a

6 x 10"5


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                                                            Toxicological Review ofBenzo[a]pyrene
Endpoint and Reference
PODHEDa
(mg/kg-d)
POD
type
UFA
UFH
UFL
UFS
UFD
Composite
UF
Candidate
value
(mg/kg-d)
Immunological
Decreased thymus weight in
rats
Kroese et al. (2001)

Decreased serum IgM in rats
De Jong etal. (1999)

Decreased serum IgA in rats
De Jong etal. (1999)

Decreased number of B cells
in rats
De Jong etal. (1999)
1.9
1.7
5.2
5.2
BMDL1SD
NOAEL
NOAEL
NOAEL
3
3
3
3
10
10
10
10
1
1
1
1
10
10
10
10
3
3
3
3
1,000
1,000
1,000
1,000
2 x 10"3
2 x 10"3
5 x 10"3
5 x 10"3
1
2
3
4
5
6
7
8
aAs recommended in EPA's A Review of the Reference Dose and Reference Concentration Processes (U.S. EPA,
 2002), the derivation of a reference value that involves application of the full 10-fold UF in four or more areas of
 extrapolation should be avoided.
       Figure 2-1 presents graphically the candidate values, UFs, and PODs, with each bar
corresponding to one data set described in Tables 2-1 and 2-2.
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                                                             Toxicological Review ofBenzo[a]pyrene

   >
   I—
   U
   U
   (D
   3
   o
                Ncurodevelopmontal
                 alterations in rats
                 (Chenetjl ,2012)

              Cardiovascular effects
             in rats (Jules et al., 2012)

               •i- Ovary weight in rats
                 (Xuctal., 2010)

                  4- Intratosticular
                 testosterone in rats
                 (Zhengetal., 2010)
                4r Sperm countand
                 motility in mice
              (Mohamedetal., 2010)
                  Cervical epithelial
                 hyperplasia in mice
                  (Gaoetal., 2011)

             4- Thymus weight in rats
               (Kroeseetal.,2001)

                ••I/ Serum IgM in rats
                (Do Jonget al., 1999)

                4- Serum IgA in rats
                (DeJongetal., 1999)

            4, Number of B cells in rats
              (DeJongetal., 1999)
                              0.00001
                                          0,0001       0.001       0,01        0.1
                                                           Doses (mg/kg-d)
                                                                                                 10
2
3

4
5
6
7
       Figure 2-1.  Candidate values with corresponding PODs and composite UFs.


2.1.4.  Derivation of Organ/System-specific Reference Doses
       Table 2-3 distills the candidate values from Table 2-2 into a single value for each organ or
system. These organ or system-specific reference values may be useful for subsequent cumulative
risk assessments that consider the combined effect of multiple agents acting at a common site.
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                                                         Toxicological Review ofBenzo[a]pyrene
 1
 2
Table 2-3. Organ/system-specific RfDs and proposed overall RfD for
benzo[a]pyrene
Effect
Developmental
Reproductive
Immunological
Proposed Overall RfD
Basis
Neurobehavioral changes
Decreased ovary weight
Decreased thymus weight and serum IgM
Developmental toxicity
RfD (mg/kg-d)
3 x irj4
4 x 10"4
2 x 10"3
3 x If/4
Exposure
description
Critical
window of
development
(postnatal)
Subchronic
Subchronic
Critical
window of
development
(postnatal)
Confidence
MEDIUM
MEDIUM
LOW
MEDIUM
 4    Developmental Toxicity
 5          The candidate value based on neurobehavioral changes in rats [Chenetal., 2012] was
 6    selected as the organ/system-specific RfD representing developmental toxicity. This candidate
 7    value was selected because it is associated with the application of the smaller composite UF and
 8    because similar effects were replicated across other studies [Bouayedetal., 2009a: Bouayedetal.,
 9    2009b:Grovaetal.. 20081

10    Reproductive Toxicity
11          Among the adverse reproductive effects associated with oral benzo[a]pyrene exposure,
12    decrements in sperm parameters, decreases in testosterone, and effects in the ovary were
13    supported by a large body of evidence.  The data supporting cervical effects are limited to a single
14    study, and therefore were given less weight compared to the other reproductive effects. The
15    derivation of a candidate value based on decreased sperm count and motility [Mohamedetal..
16    2010] involved too much uncertainty (see Table 2-2] and the study used to derive a candidate value
17    based on decreased testosterone  [Zheng et al., 2010] did not observe a dose-response relationship
18    (a 15% decrease in testosterone was seen at the low and high doses, with a statistically significance
19    at the high dose]. The study by Xu etal. [2010] observed a dose-response relationship for
20    decreased ovary weight (both doses were statistically significant]. Additionally, statistically
21    significant decreases in primordial follicles were observed at the high dose; supporting the ovaries
22    as a target of toxicity.  Therefore,  the candidate value based on decreased ovary weight in rats from
23    the Xuetal. (2010] study was selected as the organ/system-specific RfD representing reproductive
24    toxicity. The ovarian effects are supported by a large database of animal studies and human studies
25    of exposure to benzo[a]pyrene and PAH mixtures. While evidence in the benzo[a]pyrene database
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                                                          Toxicological Review ofBenzo[a]pyrene

 1    supports a male and female reproductive hazard, there is more confidence in the POD from Xu et al.
 2    [2010] as the basis for an organ/system specific RfD for reproductive effects.

 3    Immunotoxicity
 4          The candidate values based on decreased thymus weight [Kroese etal., 2001] and serum
 5    IgM levels in rats [De long et al., 1999] were selected as the organ/system-specific RfD representing
 6    immunotoxicity. The observed decreases in thymus weight, IgM and IgA levels, and number of
 7    B cells associated with exposure to benzo[a]pyrene were determined to be representative of
 8    immunotoxicity. In combination, these effects provide more robust evidence of immunotoxicity.
 9    The candidate values for decreased thymus weight [Kroese etal., 2001] and serum IgM levels in
10    rats [De  long et al.. 1999] were equal and provided the most sensitive POD; thus, these candidate
11    values were selected as the organ/system-specific RfDs representing immunotoxicity.

12    2.1.5. Selection of the Proposed Overall Reference Dose
13          For benzo[a]pyrene, multiple organ/system-specific reference doses were derived for
14    effects identified as potential hazards from benzo[a]pyrene including developmental toxicity,
15    reproductive toxicity,  and immunotoxicity. To estimate an exposure level below which effects from
16    benzo[a]pyrene exposure are not expected to occur, the lowest organ/system-specific RfD
17    (3 x 10-4 mg/kg-day] is proposed as the overall reference dose for benzo[a]pyrene.  This value,
18    based on induction of neurobehavioral changes in rats exposed to benzo[a]pyrene during a
19    susceptible lifestage is supported by several animal and human studies (see Section 1.1.1].
20          The overall reference dose is derived to be protective of all types of effects for a given
21    duration of exposure and is intended to protect the population as a whole including potentially
22    susceptible subgroups [U.S. EPA. 2002]. Decisions concerning averaging exposures over time for
23    comparison with the RfD should consider the types of toxicological effects and specific lifestages of
24    concern. Fluctuations in exposure levels that result in elevated exposures during these lifestages
25    could potentially lead  to an appreciable risk, even if average levels over the full exposure duration
26    were less than or equal to the RfD.
27          Furthermore, certain exposure scenarios may require particular attention to the risk-
28    assessment population of interest in order to determine whether a reference value based on
29    toxicity following developmental exposure is warranted.  For example, the use of an RfD based on
30    developmental effects may not be appropriate for a risk assessment in which the population of
31    interest is post-reproductive age adults.

32    2.1.6. Confidence Statement
33          A confidence level of high, medium, or low is assigned to the study used to derive the  RfD,
34    the overall database, and the RfD itself, as described in Section 4.3.9.2 of EPA's Methods for
35    Derivation of Inhalation Reference Concentrations and Application of Inhalation Dosimetry [U.S. EPA.
36    1994].

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 1          Confidence in the principal study [Chenetal.. 2012] is medium-to-high. The study design
 2    included randomized experimental testing, blinded observations, culling of pups to account for
 3    nutritional availability, treatment-randomization, and controls for litter and nursing bias.  Some
 4    informative experimental details were, however, omitted including the sensitivity of some assays at
 5    the indicated developmental ages and lack of reporting gender-specific data for all outcomes.
 6    Notably, these study limitations do not apply to the endpoint chosen to derive the RfD, and the
 7    overall methods and reporting are considered sufficient Confidence in the database is medium,
 8    primarily due to the lack of a multigenerational reproductive toxicity study given the sensitivity to
 9    benzo[a]pyrene during development Reflecting medium-to-high confidence in the principal study
10    and medium confidence in the database, confidence in the RfD is medium.

11    2.1.7.  Previous IRIS Assessment: Reference Dose
12          An RfD was not derived in the previous IRIS assessment.

13    2.2.  INHALATION REFERENCE CONCENTRATION FOR EFFECTS OTHER
14         THAN CANCER
15          The inhalation reference concentration (RfC) (expressed in units of mg/m3) is defined as an
16    estimate (with uncertainty spanning perhaps an order of magnitude) of a continuous inhalation
17    exposure to the human population (including sensitive subgroups) that is likely to be without an
18    appreciable risk of deleterious effects during a lifetime. It can be derived from a NOAEL, LOAEL, or
19    the 95 percent lower bound on the benchmark concentration (BMCL),  with UFs generally applied to
20    reflect limitations of the data used.

21    2.2.1.  Identification of Studies and Effects for Dose-Response Analysis
22          In Section 1.2.1, developmental and reproductive toxicities were highlighted as hazards of
23    benzo[a]pyrene exposure by the inhalation route.  Studies within each effect category were
24    evaluated using general study quality characteristics (as discussed in Section 6 of the Preamble) to
25    help inform the selection of studies from which to derive toxicity values. Rationales for selecting
26    the studies and effects to represent each of these hazards are summarized below.
27          Human studies of environmental PAH mixtures across multiple cohorts have observed
28    developmental and reproductive effects following prenatal exposure. However, these studies are
29    limited by exposure to complex mixtures of PAHs; and, within individual studies, there may have
30    been more than one route of exposure. In addition, the available human studies that utilized
31    benzo[a]pyrene-DNA adducts as the exposure metric do not provide external exposure levels of
32    benzo[a]pyrene from which to derive an RfC. Although preferred for derivation of reference values,
33    human studies were not considered because of the contribution to the observed hazard of multiple
34    PAHs across multiple routes of exposure and uncertainty due to concurrent exposure to other PAHs
35    and other components of the mixtures (such as metals).
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 1          Animal studies were evaluated to determine which provided the most relevant routes and
 2    durations of exposure, multiple exposure levels to provide information about the shape of the dose
 3    response curve, and relative ability to detect effects at low exposure levels. The only chronic animal
 4    inhalation study available for benzo[a]pyrene, Thyssenetal. [1981], was designed as a cancer
 5    bioassay and did not report other effects; however, the inhalation database for benzo[a]pyrene
 6    includes several shorter duration studies that are sufficient for use in deriving reference values
 7    [U.S. EPA, 2002]. Specifically, several reproductive toxicity studies are available for the inhalation
 8    route, including one subchronic study Archibong et al. [2008]. Furthermore, several developmental
 9    studies are available which help identify hazards of exposure during sensitive developmental
10    windows [Wormley etal.. 2004: Archibong et al.. 2002]. In addition, a four week inhalation study in
11    rats is available which investigated but did not detect lung injury [Wolff etal., 1989]. The
12    inhalation database for benzo[a]pyrene is less extensive than the database of studies by the oral
13    route, however, the types of non-cancer effects observed are consistent between routes and are
14    supported by studies in human populations (see Sections 1.1.1,1.1.2, and 1.1.3].

15    Developmental  Toxicity
16          Developmental toxicity, as represented by decreased fetal survival and developmental
17    neurotoxicity. was observed by Archibong et al. f20021 and fWu etal.. 2003al fWuetal.. 2003al
18    was not considered for dose-response analysis due to lack of study details related to number of
19    dams and litters per group and lack of reporting of numerical data. From the remaining studies
20    demonstrating developmental toxicity, the studies conducted by Archibong et al. [2002]  and
21    Wormley etal. [2004] were identified as the most informative studies for dose-response analysis.
22    Archibong et al. [2002] observed decreased fetal survival at the lowest dose tested by the
23    inhalation route on CDs 11-20 (i.e., LOAEL of 25 [ig/m3]. This study indicates that the developing
24    fetus is a sensitive target following inhalation exposure to benzo[a]pyrene. The observed decrease
25    in fetal survival is supported by the oral database for benzo[a]pyrene (e.g., decreased survival of
26    litters in mice following in utero exposure to benzo[a]pyrene on CDs 7-16] [Mackenzie and
27    Angevine, 1981]. In addition, a single exposure inhalation study by Wormley etal. [2004]
28    demonstrated developmental neurotoxicity, represented by electrophysiological changes in the
29    hippocampus, as a result of gestational exposure. This dose group appears to be the high exposure
30    group from Archibong et al. [2002] study (as indicated by identical outcomes for fetal survival], and
31    at this exposure  level, a 66% reduction in fetal survival was observed. Due to the apparent overt
32    toxicity at this exposure concentration, Wormley etal. [2004] was not considered for dose-
33    response analysis.

34    Reproductive Toxicity
35          Reproductive toxicity, as represented by reductions in sperm quality, both count and
36    motility, and testis weights in adults, was observed by Archibong et al. [2008] and Ramesh et al.
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                                                         Toxicological Review ofBenzo[a]pyrene

 1    [2008] and Archibong et al. [2002]. Archibongetal. [2008] and Rameshetal. [2008] reported the
 2    results of a single exposure, subchronic inhalation exposure study in male rats. This subchronic
 3    study was of sufficient duration and possessed adequate power to detect effects, but utilized a
 4    single  exposure concentration, which is less informative for dose-response analysis than a design
 5    using multiple exposure concentrations. However, this single-dose subchronic study is consistent
 6    with male reproductive effects observed across multiple studies by the oral route and with human
 7    studies in PAH exposed populations (see Section 1.1.2]. The endpoints of decreased testes weight
 8    and sperm count and motility reported in Archibongetal. [2008] were selected for dose-response
 9    analysis as both represent sensitive endpoints of male reproductive toxicity and are indicators of
10    potentially decreased fertility. These effects are also consistent with human studies in PAH
11    exposed populations as effects on male fertility and semen quality have been demonstrated in
12    epidemiological studies of smokers [reviewed by Spares and Melo, 2008].

13    2.2.2.  Methods of Analysis
14          Data for decreased fetal survival from Archibongetal. [2002] were reported as litter means
15    and standard deviations. These data were not amenable to BMD modeling due to the pattern of
16    variability in the data set, and attempts to obtain the raw data from the study authors were
17    unsuccessful. Therefore, the LOAEL from this study was used as the POD for dose-response
18    analysis. The study by Archibongetal. [2008], using only one exposure level, was judged not to
19    support dose-response modeling due to the lack of understanding of the underlying dose-response
20    relationship. LOAELs were also used as the PODs for dose-response analysis.
21          By definition, the RfC is intended to apply to continuous lifetime exposures for humans [U.S.
22    EPA. 1994]. EPA recommends that adjusted continuous exposures be used for inhalation
23    developmental toxicity studies as well as for studies of longer durations [U.S. EPA, 2002]. The
24    LOAELs identified from Archibongetal. [2002] and Archibongetal. [2008]  were adjusted to
25    account for the discontinuous daily exposure as follows:
26
27                 PODADj = POD x hours exposed per day/24 hours
28                        = LOAEL x (duration of exposure/24 hours]
29                        = PODAD,
30
31          Next, the human equivalent concentration [HEC] was calculated from the PODADj by
32    multiplying by a DAF, which, in this case, was the regional deposited dose ratio (RDDRER] for
33    extrarespiratory (i.e., systemic] effects as described in Methods for Derivation of Inhalation
34    Reference Concentrations and Application of Inhalation Dosimetry (U.S. EPA,  1994]. The observed
35    developmental effects are considered systemic in nature (i.e., extrarespiratory] and the normalizing
36    factor  for extrarespiratory effects of particles is body weight. The RDDRER was calculated as
37    follows:
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                           = BWHX(VE)AX(FTOT)A
 x                       -  BWA   (VE)H  (FTOT)H
 2          where:
 3                        BW = body weight (kg)
 4                        VE = ventilation rate (L/minute)
 5                        FTOT = total fractional deposition
 6
 7          The total fractional deposition includes particle deposition in the nasal-pharyngeal,
 8    tracheobronchial, and pulmonary regions. FTOT for both animals and humans was calculated using
 9    the Multi-Path Particle Dosimetry model, a computational model used for estimating human and rat
10    airway particle deposition and clearance (Multi-Path Particle Dosimetry [MPPD]; Version 2.0 ©
11    2006, publicly available through the Hamner Institute).  FTOT was based on the average particle size
12    of 1.7 ± 0.085 |im (mass median aerodynamic diameter [MMAD] ± geometric SD) as reported in Wu
13    etal. (2003a) for the exposure range 25-100 |im3. For the model runs, the Yeh-Schum 5-lobe model
14    was used for the human and the asymmetric multiple path model was used for the rat (see
15    Appendix E for MPPD model output).  Both models were run under nasal breathing scenarios with
16    the inhalability adjustment selected. A geometric SD of 1 was used as the default by the model
17    because the  reported geometric SD of 0.085 was <1.05.
18          The human parameters used in the model for calculating FTOT and in the subsequent
19    calculation of the PODnEc were as follows: human body weight, 70 kg; VE, 13.8 L/minute; breathing
20    frequency, 16 per minute; tidal volume, 860 mL; functional residual capacity, 3,300 mL; and upper
21    respiratory tract volume, 50 mL. Although the most sensitive population in (Archibongetal., 2002)
22    is the developing fetus, the adult rat dams were directly exposed. Thus, adult rat parameters were
23    used in the calculation of the HEC. The parameters used for the rat were body weight, 0.25 kg (a
24    generic weight for male and female rats); VE, 0.18 L/minute;  breathing frequency, 102 per minute;
25    tidal volume, 1.8 mL; functional residual capacity, 4 mL; and upper respiratory tract volume, 4.42
26    mL. All other parameters were set to  default values (see Appendix E).
27          Under these conditions, the MPPD model calculated FTOT values of 0.621 for the human and
28    0.181 for the rat. Using the above equation, the RDDRER was  calculated to be 1.1.
29          From this, the PODHEc was calculated as follows:
30          PODHEc = PODADj x  RDDRER
31
32          Table 2-4 summarizes the sequence of calculations leading to the derivation of ahuman-
33    equivalent POD for each data set discussed above.
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                                                           Toxicological Review ofBenzo[a]pyrene
             Table 2-4. Summary of derivation of PODs
Endpoint and
Reference
Species/ Sex
Model
Developmental
Decreased fetal survival
Archibongetal. (2002)
Pregnant F344 rats
BMR

LOAEL(25u.g/m3)
BMC
(Hg/m3)

19% ^
BMCL
(Hg/m3)
PODADJa
(Hg/m3)
PODHEcb
(Hg/m3)


4.2
4.6
Reproductive
Decreased testis weight
Archibongetal. (2008)
Decreased sperm count
and motility
Archibong et al. (2008)

Male F344 rats
Male F344 rats
LOAEL(75u.g/m3)34%4,
LOAEL(75u.g/m3)
69% 4/sperm count
73% 4, sperm motility
54% 1" abnormal sperm
12.5
12.5
13.8
13.8
 2
 3    aPODs were adjusted for continuous daily exposure: PODADJ= POD x hours exposed per day/24 hours.
 4
 5    bPODHEc calculated by adjusting the PODADJ by the RDDR calculated using particle size reported in Hood et al. (2000)
 6    using MPPD software as detailed in Section 2.2.2 and Appendix E in the Supplemental Information.

 7    2.2.3.  Derivation of Candidate Values
 8           Under EPA's A Review of the Reference Dose and Reference Concentration Processes [U.S. EPA,
 9    2002: Section 4.4.5). also described in the Preamble, five possible areas of uncertainty and
10    variability were considered. An explanation of the five possible areas of uncertainty and variability
11    follows:
12           An intraspecies uncertainty factor, UFn, of 10 was applied to account for variability and
13    uncertainty in toxicokinetic and toxicodynamic susceptibility within the subgroup of the human
14    population most sensitive to the health hazards of benzo[a]pyrene [U.S. EPA, 2002]. In the case of
15    benzo[a]pyrene, the PODs were derived from studies in inbred animal strains and are not
16    considered sufficiently representative of the exposure and dose-response of the most susceptible
17    human subpopulations (in this case, the  developing fetus). In certain cases, the toxicokinetic
18    component of this factor may be replaced when a PBPK model is available which incorporates the
19    best available information on variability in toxicokinetic disposition in the human population
20    (including sensitive subgroups). In the case of benzo[a]pyrene, insufficient information is available
21    to quantitatively estimate variability in human susceptibility; therefore, the full value for the
22    intraspecies UF was retained.
23           An interspecies uncertainty factor, UFA, of 3 (101/2 = 3.16, rounded to 3) was applied to
24    account for residual uncertainty in the extrapolation from laboratory animals to humans in the
25    absence of information to characterize toxicodynamic differences between rats and humans after
26    inhalation exposure to benzo[a]pyrene.  This value is adopted by convention where an adjustment
27    from animal to a human equivalent concentration has been performed as  described in EPA's
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                                                         Toxicological Review ofBenzo[a]pyrene

 1    Methods for Derivation of Inhalation Reference Concentrations and Application of Inhalation
 2    Dosimetry fU.S. EPA. 19941
 3          A subchronic to chronic uncertainty factor, UFs, of 1 was applied when dosing occurred
 4    during gestation [Archibongetal., 2002] or the early postnatal period that is relevant to
 5    developmental effects [U.S. EPA, 1991a]. A value of 10 was applied when the POD is based on a
 6    subchronic study to account for the possibility that longer exposure may induce effects at a lower
 7    dose [Archibongetal., 2008] was 60 days in duration]. An uncertainty factor for extrapolation
 8    from a LOAEL to a NOAEL, UFL, of 10 was applied when a LOAEL was used as the POD (Archibong et
 9    al.. 2008: Archibong et al.. 2002]. The data reported in these studies were not amenable to dose-
10    response modeling which would have allowed for extrapolation to a minimally biologically
11    significant response level.  At the LOAEL, these studies observed a high magnitude of response (see
12    Table 2-4]. Therefore, a full UF of 10 was applied to approximate a NOAEL for studies which
13    observed a high magnitude of response at the LOAEL. For example, the LOAEL used as the POD for
14    the developmental effect observed in Archibongetal. [2002] was based on a 19% decrease in fetal
15    survival.
16          A database uncertainty factor, UFo, of 10 was applied to account for database deficiencies
17    including the lack of a standard multigenerational study or extended 1-generation study that
18    includes exposure from premating through lactation, considering that benzo[a]pyrene has been
19    shown to affect fertility in adult male and female animals by multiple routes of exposure and that
20    decrements in fertility are  greater following developmental exposure (see Section 1.1.2].
21          In addition, the lack of a study examining functional neurological endpoints following
22    inhalation exposure during development is also a data gap, considering human and animal evidence
23    indicating altered neurological development following exposure to benzo[a]pyrene alone or
24    through PAH mixtures (see Section 1.1.1].
25          The most sensitive point of departure for the RfC candidate values in Table 2-5 is based on
26    the endpoint of decreased  fetal survival observed in Archibongetal. (2002].  However, oral
27    exposure studies have demonstrated neurotoxicity at doses lower than those  where decreased fetal
28    survival was observed.  A statistically significant decrease in fetal survival was observed following
29    treatment with 160 mg/kg-day benzo[a]pyrene, but not at lower doses (Mackenzie and Angevine,
30    1981]: however, other oral studies observed statistically significant neurobehavioral effects at
31    doses ofbenzo[a]pyrene around 0.2 to 2 mg/kg-day (Chenetal.. 2012: Bouayedetal.. 2009a].
32    Considering the relative sensitivity of the systemic health effects observed in the oral database, it is
33    likely that neurodevelopmental toxicity would be expected to occur at exposure concentrations
34    below the POD for the RfC  based on decreased fetal survival.
35          According to EPA's A Review of the Reference Dose and Reference Concentration Processes
36    (U.S. EPA, 2002: Section 4.4.5], the UFD is intended to account for the potential for deriving an under
37    protective RfD/RfC as a result of an incomplete characterization of the chemical's toxicity, but also
38    including a review of existing data that may also suggest that a lower reference value might result if

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                                                           Toxicological Review ofBenzo[a]pyrene
 1
 2
 3
 4
 5
 6
 7
 8
additional data were available. Therefore, a database UF of 10 for the benzo[a]pyrene inhalation
database was applied to account for the lack of a multigenerational study and the lack of a
developmental neurotoxicity study.
       Table 2-5 is a continuation of Table 2-4 and summarizes the application of UFs to each POD
to derive a candidate values for each data set  The candidate values presented in the table below
are preliminary to the derivation of the organ/system-specific reference values. These candidate
values are considered individually in the selection of an RfC for a specific hazard and subsequent
overall RfC for benzo[a]pyrene.

       Table 2-5.  Effects and corresponding derivation of candidate values
Endpoint
PODHEC
(Hg/m3)
POD
type
UFA
UFH
UFL
UFS
UFD
Composite
UFb
Candidate
value3 (mg/m3)
Developmental
Decreased fetal survival in
rats
Archibongetal. (2002)
4.6
LOAEL
3
10
10
1
10
3,000
2 x 10"6
Reproductive
Decreased testis weight in
rats
Archibongetal. (2008)
Decreased sperm count
and motility in rats
Archibongetal. (2008)
13.8
13.8
LOAEL
LOAEL
3
3
10
10
10
10
10
10
10
10
30,000
30,000
Not calculated
duetoUF>3,000
Not calculated
duetoUF>3,000
10
11
12
13
14
15
16
17
aCandidate values were converted from u.g/m3 to mg/m3.
bAs recommended in EPA's/4 Review of the Reference Dose and Reference Concentration Processes (U.S. EPA,
 2002), the derivation of a reference value that involves application of the full 10-fold UF in four or more areas of
 extrapolation should be avoided.

       Figure 2-2 presents graphically these candidate values UFs, and PODs, with each bar
corresponding to one data set described in Tables 2-4 and 2-5.
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                                                           Toxicological Review ofBenzo[a]pyrene
 1
 2

 3
 4
 5
 6
 7
 8
 9
10

11
12
               D-
               o
                  4^ fetal survival in rats
                 (Archibong etal., 2002)
                                                                                    Composite UF
                                                                                  A Candidate value
                                                                                  • POD(HEC)
                        4- testis weight in rats
                       (Archibongetal., 2008)
               Q
               o
               cr
                   N[/ sperm count and motility
                   in rats (Archibonget al., 2008)
                                        0.001       0.01        0.1         1
                                                        Exposure concentration (|ig/m3)
                                                                             10
100
       Figure 2-2. Candidate values with corresponding PODs and composite UFs.

2.2.4.  Derivation of Organ/System-specific Reference Concentrations
       Table 2-6 distills the candidate values from Table 2-5 into a single value for each organ or
system. These organ or system-specific reference values may be useful for subsequent cumulative
risk assessments that consider the combined effect of multiple agents acting at a common site. The
candidate values for reproductive toxicity derived from Archibongetal. [2008] were not selected to
represent reproductive toxicity because as recommended in EPA's A Review of the Reference Dose
and Reference Concentration Processes [U.S. EPA, 2002], the derivation of a reference value that
involves application of the full 10-fold UF in four or more areas of extrapolation should be avoided.

       Table 2-6. Organ/system-specific RfCs and proposed overall RfC for
       benzo[a]pyrene
Effect
Developmental
Reproductive
Proposed Overall RfC
Basis
Decreased fetal survival
Reductions in testes weight and
sperm parameters
Decreased fetal survival
RfC (mg/m3)
2 x 10"6
Not calculated
2 x 10'6
Exposure
description
Critical window of
development
Subchronic
Critical window of
development
Confidence
LOW-
MEDIUM
NA
LOW-
MEDIUM
13
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 1    2.2.5.  Selection of the Proposed Reference Concentration
 2           For benzo[a]pyrene, the derivation of multiple organ/system-specific reference doses were
 3    considered for effects observed following inhalation exposure and identified as potential hazards of
 4    benzo[a]pyrene including developmental and reproductive toxicity. However, an organ/system-
 5    specific RfC to represent reproductive toxicity could not be derived due to a composite UF of >3,000
 6    from the application of uncertainty factors to cover several areas of extrapolation.
 7           An overall RfC of 2 x 10'6 mg/m3 was selected based on the hazard of developmental
 8    toxicity. The study by Archibong et al. [2002] was selected as the study used for the derivation of
 9    the proposed overall RfC, as it observed biologically significant effects at the lowest dose tested by
10    the inhalation route. This study indicates that the developing fetus is a sensitive target following
11    inhalation exposure to benzo[a]pyrene and the observed decreased fetal survival/litter is the most
12    sensitive noncancer effect observed following inhalation exposure to benzo[a]pyrene. Additional
13    support for this endpoint of decreased fetal survival is provided by a developmental/reproductive
14    study conducted via the oral route [Mackenzie and Angevine. 1981).
15           This overall RfC is derived to be protective of all types of effects for a given duration of
16    exposure and is intended to protect the population as a whole including potentially susceptible
17    subgroups [U.S. EPA. 2002). Decisions concerning averaging exposures over time for comparison
18    with the RfC should consider the types of toxicological effects and specific lifestages of concern.
19    Fluctuations in exposure levels that result in elevated exposures during these lifestages could
20    potentially lead to an appreciable risk, even if average  levels over the full  exposure duration were
21    less than or equal to the RfC.
22           Furthermore, certain exposure scenarios may require particular attention to the risk-
23    assessment population of interest in order to determine whether a reference value based on
24    toxicity following developmental exposure is warranted. For example, the use of an RfC based on
25    developmental effects may not be appropriate for a risk assessment in which the population of
26    interest is post-reproductive age adults.

27    2.2.6.  Confidence Statement
28           A confidence level of high, medium, or low is assigned to the study used to derive the RfC,
29    the overall database, and the RfC itself, as described in Section 4.3.9.2 of EPA's Methods for
30    Derivation of Inhalation Reference Concentrations and Application of Inhalation Dosimetry [U.S. EPA,
31    19941.
32           The overall confidence in the RfC is low-to-medium. Confidence in the principal study
33    [Archibong etal., 2002] is medium. The conduct and reporting of this developmental study were
34    adequate; however, a NOAEL was not identified.  Confidence in the database is low due to the lack
35    of a multigeneration toxicity study, the lack of studies on developmental neurotoxicity and immune
36    endpoints, and the lack of information regarding subchronic and chronic inhalation exposure.
37    However, confidence in the RfC is bolstered by consistent systemic effects observed by the oral

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 1    route (including reproductive and developmental effects) and similar effects observed in human
 2    populations exposed to PAH mixtures.  Reflecting medium confidence in the principal study and low
 3    confidence in the database, confidence in the RfC is low-to-medium.

 4    2.2.7.   Previous IRIS Assessment: Reference Concentration
 5           An RfC was not derived in the previous IRIS assessment

 6    2.2.8.   Uncertainties in the Derivation of the RfD and RfC
 7           The following discussion identifies uncertainties associated with the RfD and RfC for
 8    benzo[a]pyrene. To derive the RfD, the UF approach (U.S. EPA. 2000.19941 was applied to a POD
 9    based on neurobehavioral changes in rats treated developmentally. To derive the RfC, this same
10    approach was applied to a POD from a developmental study for the effect of decreased fetal
11    survival. UFs were applied to the POD to account for extrapolating from an animal bioassay to
12    human exposure, the likely existence of a diverse population of varying susceptibilities, and
13    database deficiencies. These extrapolations are carried out with default approaches given the lack
14    of data to inform individual steps.
15           The database for benzo[a]pyrene contains limited human data. The observation of effects
16    associated with benzo[a]pyrene exposure in humans is complicated by several factors including the
17    existence ofbenzo[a]pyrene in the environment as one component of complex mixtures of PAHs,
18    exposure to benzo[a]pyrene by multiple routes of exposure within individual studies, and the
19    difficulty in obtaining accurate exposure information. Data on the effects of benzo[a]pyrene alone
20    are derived from a large database of studies in animal models. The database for oral
21    benzo[a]pyrene  exposure includes two chronic bioassays in rats and mice, two developmental
22    studies in mice, and several subchronic studies in rats.
23           Although the database is adequate for RfD derivation, there is uncertainty associated with
24    the database including that the principal study for the RfD exposed animals during a relatively short
25    period of brain development potentially underestimating the magnitude of resulting neurological
26    effects. Also, the database lacks a comprehensive multi-generation reproductive/developmental
27    toxicity studies and immune system endpoints were not evaluated in the available chronic-duration
28    or developmental studies.  Additionally, the only available chronic studies of oral or inhalational
29    exposure to benzo[a]pyrene focused primarily on neoplastic effects leaving non-neoplastic effects
30    mostly uncharacterized.
31           The only chronic inhalation study of benzo[a]pyrene was designed as a lifetime
32    carcinogenicity study and did not examine noncancer endpoints [Thyssenetal., 1981]. In addition,
33    subchronic and short-term inhalation studies are available, which examine developmental and
34    reproductive endpoints in rats.  Developmental studies by the inhalation route identified
35    biologically significant reductions in the number of pups/litter and percent fetal survival and
36    possible neurodevelopmental effects (e.g., diminished electrophysiological  responses to stimuli in
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 1    the hippocampus) following gestational exposures. Additionally, a 60-day oral study in male rats
 2    reported male reproductive effects (e.g., decreased testes weight and sperm production and
 3    motility), but provides limited information to characterize dose-response relationships with
 4    chronic exposure scenarios.
 5          The study selected as the basis of the RfC provided limited information regarding the
 6    inhalation exposures of the animals. Specifically, it is not clear whether the reported
 7    concentrations were target values or analytical concentrations and the method used to quantify
 8    benzo[a]pyrene in the generated aerosols was not provided.  Requests to obtain additional study
 9    details from the authors were unsuccessful, therefore the assumption was made that the reported
10    concentrations were analytical concentrations.
11          One area of uncertainty in the database pertains to the lack of information regarding
12    fertility in animals exposed gestationally to benzo[a]pyrene, especially in light of developmental
13    studies by the oral route indicating reduced fertility in the Fl generation and decreased
14    reproductive organ weights.  The database also lacks a multigenerational reproductive study via the
15    inhalation route. Areas of uncertainty include the lack of chronic inhalation studies focusing on
16    noncancer effects, limited data on dose-response relationships for impaired male or female fertility
17    with gestational exposure or  across several generations, and limited data on immune system
18    endpoints with chronic exposure to benzo[a]pyrene.
19          The toxicokinetic and toxicodynamic differences for benzo[a]pyrene between the animal
20    species in which the POD was derived and humans are unknown. PBPK models can be useful for
21    the evaluation of interspecies toxicokinetics; however, the benzo[a]pyrene database lacks an
22    adequate model that would inform potential differences. There is some evidence from the oral
23    toxicity data that mice may be more susceptible than rats to some benzo[a]pyrene effects (such as
24    ovotoxicity) (Borman et al.. 2000). although the underlying mechanistic basis of this apparent
25    difference is not understood.  Most importantly, it is unknown which animal species may be more
26    comparable to humans.

27    2.3.  ORAL SLOPE FACTOR FOR CANCER
28          The carcinogenicity assessment provides information on the carcinogenic hazard potential
29    of the substance in question and quantitative estimates of risk from oral and inhalation exposure
30    may be derived.  Quantitative risk estimates may be derived from the application of a low-dose
31    extrapolation procedure.  If derived, the oral slope factor is a plausible upper bound on the estimate
32    of risk per mg/kg-day of oral exposure.

33    2.3.1.  Analysis of Carcinogenicity Data
34          The database for benzo[a]pyrene contains numerous cancer bioassays that identify tumors,
35    primarily of the alimentary tract including the forestomach, following oral exposure in rodents.
36    Three 2-year oral bioassays are available that associate lifetime benzo[a]pyrene exposure with

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 1    carcinogenicity at multiple sites: forestomach, liver, oral cavity, jejunum, kidney, auditory canal
 2    (Zymbal gland) tumors, and skin or mammary gland tumors in male and female Wistar rats [Kroese
 3    etal.. 2001): forestomach tumors in male and female Sprague-Dawley rats [Brune etal.. 1981): and
 4    forestomach, esophageal, tongue, and larynx tumors in female B6C3Fi mice [Beland and Gulp, 1998:
 5    Gulp etal.. 19981.
 6          In addition to these 2-year cancer bioassays, there are studies available that provide
 7    supporting evidence of carcinogenicity but are less suitable for dose-response analysis due to one
 8    or more limitations in study design: [1] no vehicle control group, (2) only one benzo[a]pyrene dose
 9    group, or (3) a one-time exposure to benzo[a]pyrene [Benjamin etal.. 1988: Robinson etal.. 1987:
10    El-Bayoumy. 1985: Wattenberg. 1974: Roe etal.. 1970: Biancifiori etal.. 1967: ChouroulinkovetaL
11    1967: Berenblum and Haran, 1955]. Of the controlled, multiple dose-group, repeat-dosing studies
12    that remain, most treated animals for <1 year, which is less optimal for extrapolating to a lifetime
13    exposure [Weyandetal., 1995: Triolo etal., 1977: Fedorenko and Yansheva, 1967: Neal and Rigdon,
14    19671.
15          Brune etal. [1981] dosed rats (32/sex/group] with benzo[a]pyrene in the diet or by gavage
16    in a 1.5% caffeine solution, sometimes as infrequently as once every 9th day, for approximately 2
17    years and observed increased forestomach tumors. This study was not selected for quantitation
18    due to the nonstandard treatment protocol in comparison to the GLP studies conducted by Kroese
19    etal. [2001] and Beland and Gulp [1998] and the limited reporting of study methods.
20          The Kroese etal. [2001] and Beland and Gulp [1998]studies were selected as the best
21    available studies for dose-response analysis and extrapolation to lifetime cancer risk following oral
22    exposure to benzo[a]pyrene. The ratbioassay by Kroese etal. [2001] and the mouse bioassay by
23    Beland and Gulp  [1998] were conducted in accordance with Good Laboratory Practice as
24    established by the Organisation for Economic Co-operation and Development [OECD]. These
25    studies included histological examinations for tumors in many different tissues, contained three
26    exposure levels and controls, contained adequate numbers of animals per dose group
27    [~50/sex/group], treated animals for up to 2 years, and included detailed reporting of methods
28    and results (including individual animal data].
29          Details of the rat [Kroese et al., 2001] and female mouse [Beland and Gulp, 1998] study
30    designs are provided in Appendix D of the Supplemental Information. Dose-related increasing
31    trends in tumors were noted at the following sites:

32       •   Squamous cell carcinomas [SCCs] or papillomas of the forestomach or oral cavity in male
33          and female rats;

34       •   SCCs or papillomas of the forestomach, tongue, larynx, or esophagus in female mice;

35       •   Auditory canal carcinomas in male and female rats;

36       •   Kidney urothelial carcinomas in male rats;

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 1       •  Jejunum/duodenum adenocarcinomas in female and male rats;

 2       •  Hepatocellular adenomas or carcinomas in male and female rats; and

 3       •  SCCsor basal cell tumors of the skin or mammary gland in male rats.

 4          These tumors were generally observed earlier during the study with increasing exposure
 5    levels, and showed statistically significantly increasing trends in incidence with increasing
 6    exposure level (Cochran-Armitage trend test, p < 0.001). These data are summarized in Appendix D
 7    of the Supplemental Information. As recommended by the National Toxicology Program (NTP)
 8    [McConnell etal., 1986] and as outlined in EPA's Cancer Guidelines [U.S. EPA, 2005a], etiologically
 9    similar tumor types  (i.e., benign and malignant tumors of the same cell type) were combined for
10    these tabulations when it was judged that the benign tumors could progress to the malignant form.
11    In addition, when one tumor type occurred across several functionally related tissues, as with
12    squamous cell tumors in the tongue, esophagus, larynx, and forestomach, or adenocarcinomas of
13    the jejunum or duodenum, these incidences were also aggregated as counts of tumor-bearing
14    animals.
15          In the rat study [Kroese etal., 2001], the oral cavity and auditory canal were examined
16    histologically only if a lesion or tumor was observed grossly at necropsy.  Consequently, dose-
17    response analysis for these sites was not straightforward.  Use of the number of tissues examined
18    histologically as the  number at risk would tend to overestimate the incidence, because the
19    unexamined animals were much less likely to have a tumor.  On the other hand, use of all animals in
20    a group as the number at risk would tend to underestimate if any of the unexamined animals had
21    tumors that could only be detected microscopically.  The oral cavity squamous cell tumors were
22    combined with those in the forestomach because both are part of the alimentary tract, recognizing
23    that there was some potential for underestimating this cancer risk.
24          The auditory canal tumors from the rat study were not considered for dose-response
25    analysis, for several  reasons. First, the control and lower dose groups were not thoroughly
26    examined, similar to the situation described above for oral cavity tumors. Unlike the oral cavity
27    tumors, the auditory canal tumors were not clearly related to any other site or tumor type, as they
28    were described as a  mixture of squamous and sebaceous cells derived from pilosebaceous units.
29    The tumors were observed mainly in the high dose groups and were highly coincident with the oral
30    cavity and forestomach tumors. Because the only mid-dose male with an auditory canal tumor did
31    not also have a forestomach or oral cavity squamous cell tumor, and no auditory canal tumors were
32    observed in low-dose male or female rats, the data are insufficient to conclude  that the auditory
33    canal tumors occur independently of other  tumors. The investigators did not suggest that these
34    tumors were metastases from other sites (in which case, the auditory canal tumors would be
35    repetitions of other tumors, or statistically dependent). Therefore dose-response analysis was  not
36    pursued for this site, either separately or in combination with another tumor type.
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 1          The incidence data that were modeled are provided in Tables E-9, E-10, andE-11 [Kroese et
 2    al.. 2001: Beland and Gulp. 19981

 3    2.3.2.  Dose Response Analysis - Adjustments and Extrapolations Methods
 4          EPA's Cancer Guidelines [U.S. EPA, 2005a] recommend that the method used to characterize
 5    and quantify cancer risk from a chemical is determined by what is known about the mode of action
 6    of the carcinogen and the shape of the cancer dose-response curve. The dose response is assumed
 7    to be linear in the low-dose range, when evidence supports a mutagenic mode of action because of
 8    DNA reactivity, or if another mode of action that is anticipated to be linear is applicable. In this
 9    assessment, EPA concluded that benzo[a]pyrene carcinogenicity involves a mutagenic mode of
10    action (as discussed in Section 1.1.5). Thus, a linear approach to low-dose extrapolation was used.
11          The high-dose groups of both the rat and mouse studies were dead or moribund by week 79
12    for female mice, week 72 for female rats, and week 76 for male rats. Due to the occurrence of
13    multiple tumor types, earlier occurrence with increasing exposure and early termination of the
14    high-dose group in each study, methods that can reflect the influence of competing risks and
15    intercurrent mortality on site-specific tumor incidence rates are preferred. In this case, EPA has
16    used the multistage-Weibull model, which incorporates the time at which death-with-tumor
17    occurred as well as the dose.
18          Adjustments for approximating human equivalent slope factors applicable for continuous
19    exposure were applied prior to dose-response modeling.  First, continuous daily exposure for the
20    gavage study in rats [Kroese etal., 2001] was estimated by multiplying each administered dose by
21    (5 days)/(7 days) = 0.71, under the assumption of equal cumulative exposure yielding equivalent
22    outcomes. Dosing was continuous in the mouse diet study [Beland and Gulp. 1998). so no
23    continuous adjustment was necessary.  Next, consistent with the EPA's Cancer Guidelines [U.S. EPA,
24    2005a). an adjustment for cross-species scaling was applied to address toxicological equivalence
25    across species. Following EPA's cross-species scaling methodology, the time-weighted daily
26    average doses were converted to HEDs on the basis of (body weight)3/4 (U.S. EPA, 1992}. This was
27    accomplished by multiplying administered doses by (animal body weight (kg)/70 kg)1/4 (U.S. EPA,
28    19921 where the animal body weights were TWAs from each group, and the U.S. EPA T19881
29    reference body weight for humans is 70 kg. It was not necessary to adjust the administered doses
30    for lifetime equivalent exposure prior to modeling for the groups terminated early, because the
31    multistage-Weibull model characterizes the tumor incidence as a function of time, from which it
32    provides an extrapolation to lifetime exposure.
33          Details of the modeling and the model selection process can be found in Appendix E of the
34    Supplemental Information. PODs for estimating low-dose risk were identified at doses at the lower
35    end of the observed data, generally corresponding to 10% extra risk.
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 1
 2
 3
 4
 5
 6
 7
2.3.3.  Derivation of the Oral Slope Factor
       The PODs estimated for each tumor site are summarized in Table 2-7. The lifetime oral
cancer slope factor for humans is defined as the slope of the line from the lower 95% bound on the
exposure at the POD to the control response (slope factor = 0.1/BMDLio). This slope, a 95% upper
confidence limit represents a plausible upper bound on the true risk.  Using linear extrapolation
from the BMDLio, human equivalent oral slope factors were derived for each gender/tumor site
combination and are listed in Table  2-7.

       Table 2-7.  Summary of the oral slope factor derivations

Tumor
Forestomach, oral cavity:
squamouscell tumors
Kroese et al. (2001)

Hepatocellular adenomas or
carcinomas
Kroese et al. (2001)

Jejunum/duodenum
adenocarcinomas
Kroese et al. (2001)

Kidney: urothelial carcinomas
Kroese et al. (2001)

Skin, mammary:
Basal cell tumors
Squamous cell tumors
Kroese et al. (2001)

Forestomach, oral cavity:
squamous cell tumors
Kroese et al. (2001)
Hepatocellular adenomas or
carcinomas
Kroese et al. (2001)
Jejunum/duodenum
adenocarcinomas
Kroese et al. (2001)

Forestomach, esophagus, tongue,
larynx (alimentary tract):
squamouscell tumors
Beland and Gulp (1998)

Species/
Sex
MaleWistar
rats
MaleWistar
rats

MaleWistar
rats

MaleWistar
rats
MaleWistar
rats

Female
Wistar rats
Female
Wistar rats

Female
Wistar rats

Female
B6C3Fi
Mice

Selected
Model
Multistage
Weibull
Multistage
Weibull

Multistage
Weibull

Multistage
Weibull
Multistage
Weibull

Multistage
Weibull
Multistage
Weibull

Multistage
Weibull

Multistage
Weibull

BMR
10%
10%

10%

10%
10%

10%
10%

10%

10%

BMD
(mg/kg-d)
0.453
0.651

3.03

4.65
2.86
2.64
0.539
0.575

3.43

0.127
POD=
BMDL
(mg/kg-d)
0.281
0.449

2.38

2.50
2.35
1.77
0.328
0.507

1.95

0.071

Slope factor3
(mg/kg-d)1
0.4
0.2

0.04

0.04
0.04
0.06
0.3
0.2

0.05

1

0.5b


0.3b


1
 9
10
11
 Human equivalent slope factor = 0.1/BMDL10HED; see Appendix E of the Supplemental Information for details of
 modeling results.
bEstimates of risk of incurring at least one of the tumor types listed.
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 1
 2          Oral slope factors derived from rat bioassay data varied by gender and tumor site
 3    (Table 2-7). Values ranged from 0.04 per mg/kg-day, based on kidney tumors in males, to 0.4 per
 4    mg/kg-day, based on alimentary tract tumors in males. Slope factors based on liver tumors in male
 5    and female rats (0.2 per mg/kg-day) were only slightly lower than slope factors based on
 6    alimentary tract tumors (0.2-0.3 per mg/kg-day). The oral slope factor for alimentary tract tumors
 7    in female mice was highest at 1 per mg/kg-day (Table 2-7), which was approximately twofold
 8    higher than the oral slope factor derived from the alimentary tract tumors in male rats.
 9          Although the time-to-tumor modeling helps to account for competing risks associated with
10    decreased survival times and other causes of death including other tumors, considering the tumor
11    sites individually still does not convey the total amount of risk potentially arising from the
12    sensitivity of multiple sites—that is, the risk of developing any combination of the increased tumor
13    types.  A method, for estimating overall risk, involving the assumption that the variability in the
14    slope factors could be characterized by a normal distribution, is detailed in Appendix E of the
15    Supplemental Information. The resulting composite slope factor for all tumor types for male rats
16    was 0.5 per mg/kg-day, about 25% higher than the slope factor based on the most sensitive tumor
17    site, oral cavity and forestomach, while for female rats, the composite slope factor was equivalent to
18    that for the most sensitive site (Table 2-7; see Appendix E of Supplemental Information for
19    composite slope factor estimates).
20          The overall risk estimates from rats and mice spanned about a threefold range. As there are
21    no data to support any one result as most relevant for extrapolating to humans, the most sensitive
22    result was used to derive the oral slope factor. The recommended slope factor for assessing human
23    cancer risk associated with chronic oral exposure to benzo[a]pyrene is 1 per mg/kg-day, based on
24    the alimentary tract tumor response in female B6C3Fi mice.

25    2.3.4.  Uncertainties in the Derivation of the Oral Slope Factor
26          The oral slope factor for benzo[a]pyrene was based on the increased incidence of
27    alimentary tract tumors, including forestomach tumors, observed in a lifetime dietary study in mice
28    (Beland and Gulp, 1998). EPA has considered the uncertainty associated with the relevance of
29    forestomach tumors for estimating human risk from benzo[a]pyrene exposure. The rodent
30    forestomach serves to store foods and liquids for several hours before contents continue to the
31    stomach for further digestion (Clayson etal.. 1990: Grice etal.. 1986).  Thus, tissue of the
32    forestomach in rodents may be exposed to benzo[a]pyrene for longer durations than  analogous
33    human tissues in the oral cavity and esophagus. This suggests that the rodent forestomach may be
34    quantitatively more sensitive to the development of squamous epithelial tumors in the forestomach
35    compared to oral or esophageal tumors in humans. .
36          Uncertainty in the magnitude of the recommended oral slope factor is reflected to some
37    extent in the range of slope factors among tumors sites and species; the oral slope factor based on
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1    the mouse alimentary tract data was about threefold higher than the overall oral slope factor based
2    on male rat data (Table 2-8). These comparisons show that the selection of target organ, animal
3    species, and interspecies extrapolation can impact the oral cancer risk estimate. However, all of the
4    activation pathways implicated in benzo[a]pyrene carcinogenicity have been observed in human
5    tissues, and associations have been made between the spectra of mutations in tumor tissues from
6    benzo[a]pyrene-exposed animals and humans exposed to complex PAH mixtures containing
7    benzo[a]pyrene (see Section 1.1.5).
8
9
       Table 2-8. Summary of uncertainties in the derivation of cancer risk values
       for benzo[a]pyrene oral slope factor
            Consideration and
        Impact on Cancer Risk Value
                                        Decision
                              Justification and Discussion
     Selection of target organ
     •i, oral slope factor, up to fivefold, if
     alimentary tract tumors not selected
                                 Alimentary tract tumors
                                 (forestomach,
                                 esophagus, tongue,
                                 larynx)
                      Tumor site is concordant across rats and mice,
                      increasing support for its relevance to humans.
                      As there are no data to support any one result as
                      most relevant for extrapolating to humans, the
                      most sensitive result for alimentary tract tumors
                      was used to derive the oral slope factor.
     Selection of data set
     •i, oral slope factor ~threefold if rat
     bioassay were selected for oral slope
     factor derivation
                                 Beland and Gulp (1998)
                       Beland and Gulp (1998) was a well-conducted
                       study and had the lowest HEDs of the available
                       cancer bioassays, reducing low-dose
                       extrapolation uncertainty.
Selection of dose metric
Alternatives could 4/ or
factor
                                      Administered dose
                            slope
                       Experimental evidence supports a role for
                       metabolism in toxicity, but actual responsible
                       metabolites have not been identified.
     Interspecies extrapolation
     Alternatives could 4, or /T" slope
     factor (e.g., 3.5-fold 4, [scaling by
     body weight] or /T" 2-fold [scaling by
     BW2/3])
                                 BW3/4 scaling (default
                                 approach)
                      There are no data to support alternatives.
                      Because the dose metric was not an area under
                      the curve, BW   scaling was used to calculate
                      equivalent cumulative exposures for estimating
                      equivalent human risks. While the true human
                      correspondence is unknown, this overall
                      approach is expected to neither over- nor
                      underestimate human equivalent risks.
Dose-response modeling
Alternatives could 4, or 1
factor
                            slope
Multistage-Weibull
model
No biologically based models for benzo[a]pyrene
were available.  Because the multistage-Weibull
model could address additional available data
(time of death with tumor, and whether a tumor
caused the death of the animal), this model was
superior to other available models.
     Low-dose extrapolation
     •^ cancer risk estimate would be
     expected with the application of
     nonlinear low-dose extrapolation
                                 Linear extrapolation
                                 from POD (based on
                                 mutagenic mode of
                                 action)
                      Available mode-of-action data support linearity
                      (mutagenicity is a primary mode of action of
                      benzo[a]pyrene).
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                                                        Toxicological Review ofBenzo[a]pyrene
Consideration and
Impact on Cancer Risk Value
Statistical uncertainty at POD
4> oral slope factor 1.8-fold if BMD
used as the POD rather than BMDL
Sensitive subpopulations
1" oral slope factor to unknown
extent
Decision
BMDL (preferred
approach for calculating
plausible upper bound
slope factor)
ADAFs are
recommended for early
life exposures
Justification and Discussion
Limited size of bioassay results in sampling
variability; lower bound is 95% Cl on administered
exposure at 10% extra risk of alimentary tract
tumors.
No chemical-specific data are available to
determine the range of human toxicodynamic
variability or sensitivity.
 2    2.3.5.  Previous IRIS Assessment: Oral Slope Factor
 3          The previous cancer assessment for benzo[a]pyrene was posted on the IRIS database in
 4    1992. At that time, benzo[a]pyrene was classified as a probable human carcinogen (Group B2)
 5    based on inadequate data in humans and sufficient data in animals via several routes of exposure.
 6    An oral slope factor was derived from the geometric mean of four slope factor estimates based on
 7    studies of dietary benzo[a]pyrene administered in the diet for approximately 2 years in ten week
 8    old Sprague-Dawley rats [Brune etal.. 1981] and administered for up 7 months in two week to 5
 9    month old CFW-Swiss mice [Neal and Rigdon, 1967]. A single  slope factor estimate of 11.7 per
10    mg/kg-day, using a linearized multistage procedure applied to the combined incidence of
11    forestomach, esophageal, and laryngeal tumors, was derived from the Brune etal. [1981] study (see
12    Section 1.1.5 for study details]. Three modeling procedures were used to derive risk estimates
13    from the Neal and Rigdon (1967] bioassay (see Section 1.1.5].  In an analysis by Clement Associates,
14    commissioned by EPA, U.S. EPA (1990b] fit a two-stage response model, based on exposure-
15    dependent changes in both transition rates and growth rates of preneoplastic cells, to derive a value
16    of 5.9 per mg/kg-day. U.S. EPA(1991b] derived a value of 9.0  per mg/kg-day by linear
17    extrapolation from the 10% response point to the background response in a re-analysis of the
18    Clement model. Finally, using a Weibull-type model to reflect less-than-lifetime exposure to
19    benzo[a]pyrene, the same assessment (U.S. EPA, 1991b] derived an upper-bound slope factor
20    estimate of 4.5 per mg/kg-day. The four slope factor estimates, which reflected extrapolation to
21    humans assuming surface area equivalence (BW2/3 scaling] were within threefold of each other and
22    were judged to be of equal merit. Consequently, the geometric mean of these four estimates, 7.3
23    per mg/kg-day, was recommended as the oral slope factor.

24    2.4. INHALATION UNIT RISK FOR CANCER
25          The carcinogenicity assessment provides information on the carcinogenic hazard potential
26    of the substance in question and quantitative estimates of risk from oral and inhalation exposure
27    may be derived. Quantitative risk estimates may be derived from the application of a low-dose
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                                                          Toxicological Review ofBenzo[a]pyrene

 1    extrapolation procedure. If derived, the inhalation unit risk is a plausible upper bound on the
 2    estimate of risk per [J.g/m3 air breathed.

 3    2.4.1.  Analysis of Carcinogenicity Data
 4           The inhalation database demonstrating carcinogenicity of benzo[a]pyrene consists of a
 5    lifetime inhalation bioassay in male hamsters [Thyssenetal., 1981] and intratracheal instillation
 6    studies, also in hamsters [Feron and Kruysse, 1978: Ketkar etal., 1978: Feronetal., 1973: Henry et
 7    al., 1973: Saffiotti etal., 1972]. The intratracheal instillation studies provide supporting evidence of
 8    carcinogenicity of inhaled benzo[a]pyrene; however, the use of this exposure method alters the
 9    deposition, clearance, and retention of substances, and therefore, studies utilizing this exposure
10    technique are not as useful for the quantitative extrapolation of cancer risk from the inhalation of
11    benzo[a]pyrene in the environment [Driscoll etal., 2000].
12           The bioassay by Thyssenetal. [1981] represents the only lifetime inhalation cancer
13    bioassay available for describing exposure-response relationships for cancer from inhaled
14    benzo[a]pyrene. As summarized in Section 1.1.5, increased incidences of benign and malignant
15    tumors of the pharynx, larynx, trachea, esophagus, nasal cavity, or forestomach were seen with
16    increasing exposure concentration.  In addition, survival was decreased relative to control in the
17    high-exposure group; mean survival times in the control, low-, and mid-concentration groups were
18    96.4, 95.2, and 96.4 weeks, respectively, and 59.5 weeks in the high-exposure group animals.
19    Overall, tumors occurred earlier in the highest benzo[a]pyrene exposure group than in the mid-
20    exposure group.
21           Strengths of the study included: chronic exposures until natural death, up to 2.5 years;
22    multiple exposure groups; histological examination of multiple organ systems; and availability of
23    individual animal pathology reports with time of death and tumor incidence data by site in the
24    upper respiratory tract In addition, the availability of average weekly continuous chamber air
25    monitoring data and individual times on study allowed the calculation of TWA lifetime continuous
26    exposures for each hamster [U.S. EPA, 1990a]. Group averages of these TWA concentrations were
27    0,0.25,1.01, and 4.29 mg/m3.
28           Several limitations concerning exposure conditions in the Thyssenetal. [1981] study were
29    evaluated for their impact on the derivation of an inhalation unit risk for benzo[a]pyrene. These
30    issues include minimal detail about the particle size distribution of the administered aerosols,
31    variability of chamber concentrations, and the use of a sodium chloride aerosol as a carrier.
32           First, particle distribution analysis of aerosols, in particular the MMAD and  geometric SD,
33    was not reported, although the investigators did report that particles were within the respirable
34    range for hamsters, with >99% of the particles having diameters 0.2-0.5 |im and >80% having
35    diameters 0.2-0.3 |im.
36           Second, weekly averages of chamber concentration measurements varied two- to fivefold
37    from the overall average for each group, which exceeds the limit for exposure variability of <20%

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 1    for aerosols recommended by OECD [2009]. For risk assessment purposes, EPA generally assumes
 2    that cancer risk is proportional to cumulative exposure, and therefore to lifetime average exposure
 3    as estimated here, when there is no information to the contrary. Under this assumption, the
 4    variability of the chamber concentrations has little impact on the estimated exposure-response
 5    relationship. The impact of alternative assumptions are considered in Section 2.4.4.
 6          Lastly, exposure occurred through the inhalation of benzo[a]pyrene adsorbed onto sodium
 7    chloride aerosols, which might have irritant carrier effects,  and may have a different deposition
 8    than benzo[a]pyrene adsorbed onto carbonaceous particles (as is more typical in the environment).
 9    The above study design and reporting issues concerning the particle size composition, exposure
10    variability, and deposition do not negate the robust tumor response following benzo[a]pyrene
11    inhalation exposure. Consequently, EPA concluded thatthe strengths of the study supported the
12    use of the data to derive an inhalation unit risk for benzo[a]pyrene. See Section 2.4.4 for a
13    discussion of uncertainties in the unit risk.

14    2.4.2. Dose Response Analysis—Adjustments and Extrapolation Methods
15          Biologically based dose-response models for benzo[a]pyrene are not available. A simplified
16    version of the two-stage carcinogenesis model proposed by Moolgavkar and Venzon [1979] and
17    Moolgavkar and Knudson [1981] has been applied to the Thyssen et al. [1981] individual animal
18    data [U.S. EPA, 1990a]. However, the simplifications necessary to fit the tumor incidence data
19    reduced that model to an empirical model (i.e., there were no biological data to inform estimates of
20    cell proliferation rates for background or initiated cells]. Sufficient data were available to apply the
21    multistage-Weibull model, as used for the oral slope factor (described in detail in Appendix E of the
22    Supplemental Information], specifically the individual times of death for each animal. Unlike in the
23    oral bioassays, Thyssen etal. [1981] did not determine cause of death for any of the animals. Since
24    the investigators for the oral bioassays considered some of the same tumor types to be fatal at least
25    some of the time, bounding estimates for the Thyssen et al.  [1981] data were developed by treating
26    the tumors alternately as either all incidental to the death of an affected animal or as causing the
27    death of an affected animal.
28          The tumor incidence data used for dose-response modeling comprised the benign and
29    malignant tumors in the pharynx, larynx, trachea, esophagus, nasal cavity, or forestomach (tumors
30    of the upper respiratory and digestive tracts; see Table D-16]. The tumors in these sites were
31    judged to be sufficiently similar to combine as joint incidences by the following reasoning. While
32    the pharynx and larynx are associated with the upper digestive tract and the upper respiratory
33    tract, respectively, these sites are close anatomically and in some cases where both tissues were
34    affected, the site of origin could not be distinguished [U.S. EPA, 1990a]. In addition, the benign
35    tumors (e.g., papillomas, polyps, and papillary polyps] were considered early stages of the
36    squamous cell carcinomas in these tissues [U.S. EPA. 1990a]. Consequently, incidence data for
37    animals with malignant or benign tumors originating from the same cell type were selected for

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 1    dose-response modeling based on the assumption that the benign tumors could develop into
 2    malignancies, as outlined in EPA's Cancer Guidelines [Section 2.2.2.1.2: U.S. EPA. 2005a].
 3          A toxicokinetic model to assist in cross-species scaling of benzo[a]pyrene inhalation
 4    exposure was not available. EPA's RfC default dosimetry adjustments [U.S. EPA, 1994] were
 5    utilized in the benzo[a]pyrene RfC calculation (see Section 2.2.2) but could not be applied to the
 6    aerosols generated for the inhalation bioassay by Thyssenetal. [1981] as the approaches
 7    presented in the RfC methodology guidelines [U.S. EPA, 1994] were developed for insoluble and
 8    nonhygroscopic particles, not the sodium chloride particle used in Thyssenetal. [1981].
 9    Consequently, without data to inform a basis for extrapolation to humans, it was assumed that
10    equal risk for all species would be associated with equal concentrations in air, at least at anticipated
11    environmental concentrations. This is equivalent to assuming that any metabolism of
12    benzo[a]pyrene is directly proportional to breathing rate and that the deposition rate is equal
13    between species.
14          The multistage-Weibull model was fit to the TWA exposure concentrations and the
15    individual animal tumor and survival data for tumors in the larynx, pharynx, trachea, esophagus, or
16    forestomach (tumors of the upper respiratory and digestive tracts], using the software program
17    MSW [U.S. EPA. 2010].  Modeling results are provided in Appendix E  of the Supplemental
18    Information.
19          Because benzo[a]pyrene carcinogenicity involves a mutagenic mode of action, linear low-
20    exposure extrapolation from the BMCLio was used to derive the inhalation unit risk [U.S. EPA,
21    2005a].

22    2.4.3.  Inhalation Unit Risk Derivation
23          The results from modeling the inhalation carcinogenicity data from Thyssenetal. [1981]
24    are summarized in Table 2-9. Taking the tumors to have been the cause of death of the
25    experimental animals with tumors, the BMCio and BMCLio were 0.648 and 0.461 mg/m3,
26    respectively. Then, taking all of the tumors to have been incidental to the cause of death for each
27    animal with a tumor, the BMCio and BMCLio values were 0.285 and 0.198 mg/m3, respectively,
28    about twofold lower than the first case. Because the tumors were unlikely to have all been fatal, the
29    lower BMDLio from the incidental deaths analysis, 0.198 mg/m3, is recommended for the
30    calculation of the inhalation unit risk. Using linear extrapolation from the BMCLio of 0.198 mg/m3,
31    an inhalation unit risk of 0.5 per mg/m3, or 5 x 1Q-* per ng/m3 (rounding to one significant digit],
32    was calculated.
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                                                         Toxicological Review ofBenzo[a]pyrene
            Table 2-9. Summary of the Inhalation Unit Risk Derivation
Tumor Site and Context
Upper respiratory and digestive tracts;
all treated as cause of death
Thvssenetal. (1981)
Upper respiratory and digestive tracts;
all treated as incidental to death
Thvssenetal. (1981)
Species/
Sex
Male
hamsters
Male
hamsters
Selected
Model
Multistage
Weibull
Multistage
Weibull
BMR
10%
10%
BMC
(mg/ms)
0.648
0.285
POD=
BMCL
(mg/ms)
0.461
0.198
Unit Risk3
(mg/ms)-1
0.22
0.51
 2
 3    aHuman equivalent unit risk = 0.10/BMCL10; see Appendix E for details of modeling results.

 4    2.4.4. Uncertainties in the Derivation of the Inhalation Unit Risk
 5          Table 2-10 summarizes uncertainties in the derivation of the inhalation unit risk for
 6    benzo[a]pyrene; further detail is provided in the following discussion.  Only one animal cancer
 7    bioassay, in one sex, by the inhalation route is available that describes the exposure-response
 8    relationship for respiratory tract tumors with chronic inhalation exposure to benzo[a]pyrene
 9    [Thyssen et al., 1981]. Although corroborative information on exposure-response relationships in
10    other animal species is lacking, the findings for upper respiratory tract tumors are consistent with
11    findings in other hamster studies with intratracheal administration of benzo[a]pyrene (upper and
12    lower respiratory tract tumors), and with some of the portal-of-entry effects in oral exposure
13    studies.
14          The hamster inhalation bioassay by Thvssenetal. [1981] observed upper respiratory tract
15    tumors, but not lung tumors. The lack of a lung tumor response in hamsters, given the strong
16    association of inhaled PAH mixtures with lung cancer in humans across many studies (see Section
17    1.1.5] suggests that this study may not be ideal for extrapolating to humans. Hamsters have an
18    apparent lower sensitivity to lung carcinogenesis than rats and mice and a tendency to give false
19    negatives for particles classified as carcinogenic to humans by IARC (Mauderly, 1997]. However,
20    hamster laryngeal tumors have been used as an indication of the carcinogenic hazard of cigarette
21    smoke for more than 50 years (IARC, 2002].  For example, a large study investigating the inhalation
22    of cigarette smoke in hamsters (n=4400] indicated that the larynx was the most responsive tumor
23    site, which the authors indicated was due to a large difference in particle deposition between the
24    larynx and the lung (Dontenwill etal., 1973].  EPA's Guidelines for Carcinogen Assessment (U.S.
25    EPA. 2005a] stress that site concordance between animals and humans need not always be
26    assumed.  Therefore, the  robust tumor response in the upper respiratory tract of Syrian golden
27    hamsters was considered to be supportive of the use of the Thvssenetal. (1981] study for the
28    derivation of an inhalation unit risk.
29          An additional uncertainty includes the inability to apply U.S. EPA (1994] dosimetry
30    approaches to extrapolate inhaled concentrations from animals to humans, due to the use of a

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 1    soluble hygroscopic carrier particle (sodium chloride) for the delivery of benzo[a]pyrene. One
 2    likely consequence of the use of hygroscopic carrier particles would be the growth of
 3    benzo[a]pyrene-sodium chloride particles in the humid environment of the respiratory tract
 4    resulting in increased particle diameter and resulting changes in particle deposition, specifically,
 5    increased impaction in the upper respiratory tract and less deposition in the lung [Varghese and
 6    Gangamma, 2009: Asgharian, 2004: Perron, 1994: XuandYu, 1985]. In addition, sodium chloride
 7    can be irritating to the respiratory tract, depending on concentration. The Thyssenetal. [1981]
 8    study reported that vehicle controls were exposed to 240 |ig/m3, and it is unclear whether exposure
 9    to this concentration of sodium chloride could have potentiated the tumor response seen in the mid
10    and high concentration benzo[a]pyrene groups. Exposure to benzo[a]pyrene in the environment
11    predominantly occurs via non-soluble, non-hygroscopic, carbonaceous particles (such as soot and
12    diesel exhaust particles]. The potential impact of differences in carrier particle on the magnitude of
13    the inhalation unit risk is unknown.
14           Regarding uncertainty associated with exposure characterization, the individual exposure
15    chamber measurements varied from about an order of magnitude less than the target concentration
16    to about twofold higher than the target concentration.  Weekly average analytical concentrations
17    were documented to vary by two- to fivefold in all exposed groups, with no particular trends over
18    time. Continuous time weighted group average concentrations were used for dose response
19    modeling under the assumption that equal cumulative exposures are expected to lead to similar
20    outcomes.  This assumption is generally expected to lead to an unbiased estimate of risk when there
21    is incomplete information. However, it is possible that peak exposure above some concentration
22    may be more associated with the observed effects, or that deposition of particles may have reached
23    a maximum level or plateau, such as in the high-exposure group. Regarding the role of peak
24    exposures, the higher exposures for each group were distributed evenly throughout the study for
25    the most part, suggesting that any association of risk with peak exposures would also be
26    proportional to cumulative exposure. If particle deposition reached a plateau with the high-
27    exposure group, there is relatively less impact on the unit risk because the derivation relies on the
28    dose-response at lower exposure.  But the  actual dynamics of particle deposition at these or other
29    exposure levels are not well understood. There is not enough information available to estimate a
30    more quantitative impact on the estimated unit risk due to these uncertainties.
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                                                                Toxicological Review ofBenzo[a]pyrene
1
2
        Table 2-10. Summary of uncertainties in the derivation of cancer risk values
        for benzo[a]pyrene (inhalation unit risk)
             Consideration and
        Impact on Cancer Risk Value
                                          Decision
                               Justification and Discussion
     Selection of data set and target organ
     No inhalation unit risk if Thyssen et al.
     (1981) not used
                                   Respiratory tract tumors
                                   from Thyssen et al.
                                   (1981)
                       The Thyssen et al. (1981) bioassay is the only
                       lifetime inhalation cancer bioassay available for
                       describing exposure-response relationships for
                       cancer from inhaled benzo[a]pyrene.
                       Intratracheal installation studies support the
                       association of benzo[a]pyrene exposure with
                       respiratory tract tumors.
Selection of dose metric
Alternatives could 4, or
                             unit risk
Administered exposure
as TWA
Experimental evidence supports a role for
metabolism in toxicity, but actual responsible
metabolites are not identified.  The
recommended  unit risk is a reasonable estimate
if the proportion of the carcinogenic moiety
remains the same at lower exposures.
     Interspecies extrapolation
     Alternatives could 4, or 1" slope
     factor
                                   Cross-species scaling
                                   was not applied. The
                                   carrier particle used was
                                   soluble and hygroscopic,
                                   therefore the RfC
                                   methodology (U.S. EPA,
                                   1994) dosimetric
                                   adjustments could not
                                   be applied.
                       There are no data to support alternatives.  Equal
                       risk per |Jg/m3 is assumed.
Dose-response modeling
Alternatives could 4, or 1
factor
                             slope
Multistage-Weibull
model
No biologically based models for benzo[a]pyrene
were available. Because the multistage-Weibull
model could address additional available data
(time of death with tumor), this model was
superior to other available empirical models
     Low-dose extrapolation
     •^ cancer risk estimate would be
     expected with the application of
     nonlinear low-dose extrapolation
                                   Linear extrapolation
                                   from the POD (based on
                                   mutagenic mode of
                                   action)
                       Available mode-of-action data support linearity
                       (mutagenicity is a primary mode of action of
                       benzo[a]pyrene).
     Statistical uncertainty at POD
     •^ inhalation unit risk 1.4-fold if BMC
     used as the POD rather than BMCL
                                   BMCL (preferred
                                   approach for calculating
                                   plausible upper bound
                                   unit risk)
                       Limited size of bioassay results in sampling
                       variability; lower bound is 95% Cl on
                       administered exposure at 10% extra risk of
                       respiratory tract tumors.
     Sensitive subpopulations
     1" inhalation unit risk to unknown
     extent
                                   ADAFs are
                                   recommended for early
                                   life exposures
                       No chemical-specific data are available to
                       determine the range of human toxicodynamic
                       variability or sensitivity.
3

4
2.4.5.  Previous IRIS Assessment: Inhalation Unit Risk
        An inhalation unit risk for benzo[a]pyrene was not previously available on IRIS.
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                                                         Toxicological Review ofBenzo[a]pyrene
 l    2.5. DERMAL SLOPE FACTOR FOR CANCER
 2          Human and animal studies of exposure to PAH mixtures or benzo[a]pyrene alone
 3    demonstrate an increased incidence of skin tumors with increasing dermal exposure. This
 4    assessment for benzo[a]pyrene derives a dermal slope factor, a quantitative risk estimate that is a
 5    plausible upper bound on the estimate of risk per |ig/day of dermal exposure. This derivation
 6    provides the first dermal slope factor for the IRIS database.

 7    2.5.1.  Analysis of Carcinogenicity Data
 8          Skin cancer in humans has been documented to result from occupational exposure to
 9    complex mixtures of PAHs including benzo[a]pyrene, such as coal tar pitches, non-refined mineral
10    oils, shale oils, and soot [IARC. 2010: Baanetal.. 2009: IPCS. 1998: Boffettaetal.. 1997: ATSDR.
11    1995]. Although studies of human exposure to benzo[a]pyrene alone are not available, repeated
12    application of benzo[a]pyrene to skin (in the absence of exogenous promoters) has been
13    demonstrated to induce skin tumors in guinea pigs, rabbits, rats, and mice. Given the availability of
14    chronic bioassays of dermal benzo[a]pyrene exposure in mice, this analysis focuses on chronic
15    carcinogenicity bioassays in several strains of mice demonstrating predominantly malignant skin
16    tumors, as well as earlier occurrence of tumors with increasing exposure, following repeated
17    dermal exposure to benzo[a]pyrene for the majority of typical two-year chronic study durations.
18    These studies involved 2- or 3-times/week exposure protocols, at least two exposure levels plus
19    controls, and histopathological examinations of the skin and other tissues [Sivaketal., 1997:
20    Grimmer etal.. 1984: Habsetal.. 1984: Grimmer etal.. 1983: Habsetal.. 1980: Schmahletal..  1977:
21    Schmidt etal.. 1973: Roe etal.. 1970: Poel. 1960.1959] (see Tables D-15 to D-23 in the
22    Supplemental Information for study details].
23          Other carcinogenicity studies in mice were considered as supportive of the studies listed
24    above, but were not considered in the dose-response analysis. These studies included: (1] early
25    "skin painting" studies of benzo[a]pyrene carcinogenicity in mouse skin that did not report
26    sufficient information to estimate the doses applied (e.g., Wynder and Hoffmann, 1959: Wynder et
27    al., 1957]: (2] bioassays with one benzo[a]pyrene dose level or with only dose levels inducing 90-
28    100% incidence of mice with tumors, which provide relatively little information about the shape of
29    the dose-response relationship (e.g.. Wilson and Holland. 1988]: and (3] studies with shorter
30    exposure and observation periods (i.e., <1 year] (Higginbothametal., 1993: Albert etal., 1991:
31    Nesnowetal., 1983: Emmettetal., 1981: Levin etal., 1977], which are less relevant for
32    characterizing lifetime risk.
33          Regarding study design, these data sets varied in terms of number of exposure levels used
34    (two to nine, compared with three in typical NTP bioassays] and in number of mice per group (from
35    ~17 to 100 mice /dose group, compared with 50 used in most NTP bioassays]. While the largest
36    studies would be expected to have greater ability to detect low responses at low doses (Schmidt et
37    al., 1973], studies with smaller group sizes also showed significant dose-response trends involving

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                                                         Toxicological Review ofBenzo[a]pyrene

 1    lower doses [Sivak et al.. 1997: Poel. 1959). One of the data sets. Poel [I960], did not generate data
 2    between background and maximal responses (see Table C-16), and thus was not considered further
 3    for dose-response modeling, given the availability of other data sets with graded responses which
 4    could better support low-dose extrapolation.
 5          Additionally, an important consideration was that none of the available studies reported
 6    time on study or tumor status for individual animals. When exposure is associated with early
 7    mortality, this level of detail helps to understand the number at risk of development of tumors and
 8    the extent of exposure associated with tumor development, and helps to minimize under-
 9    estimation of cancer risk. Investigators did report that mortality was increased at higher exposures
10    and that tumors occurred earlier with increasing exposure, but reporting was mostly at the level of
11    dose groups rather than individual animals. These details facilitated some refinement of dose-
12    response results through data adjustments (described in Section 2.5.2), allowing for evaluation of
13    results on a more comparable basis across studies.
14          Finally, the available studies included different mouse strains, sexes, and vehicles.
15    However, for any given mouse strain only one sex and only one vehicle was tested. Thus, the
16    studies did not support evaluation of whether any particular vehicle  solvent enhanced or
17    diminished carcinogenicity, or whether one sex was more sensitive.
18          Given these considerations, the studies by Roe etal. (1970], Sivak etal. (1997] and Poel
19    (1959] showed the strongest study designs for supporting dose-response analysis, in that they
20    included at least three exposure levels and the lowest doses tested, and reported the actual
21    duration of exposure for each dose group.  All but one (Habs etal., 1980] of the remaining studies
22    provided incomplete exposure duration information for approximating lifetime (104-week]
23    equivalent exposures. The study with the most uncertainty for extrapolating to lower exposures
24    may be the Habs etal. (1984] study, which used only two exposure levels, the lower of which was
25    more than tenfold higher than the lowest doses used by Roe etal. (1970], Sivak etal. (1997] and
26    Poel (1959]. The reported duration of exposure in the higher dose group was approximately 80
27    weeks. The high tumor response at the lower dose (~50%] and the uncertainty in characterizing a
28    104-week equivalent exposure suggests that low-dose extrapolation would be relatively uncertain.
29    Nevertheless, all of these studies were included in the dose-response analysis in order to help
30    characterize similarities among the studies on a quantitative basis.

31    2.5.2. Dose Response Analysis - Adjustments and Extrapolation Methods
32          As with the oral and inhalation benzo[a]pyrene carcinogenicity data, benzo[a]pyrene's
33    dermal exposure carcinogenicity data were generally characterized by earlier occurrence of tumors
34    and increased mortality with increasing exposure level.  Because individual animal data were not
35    available for any of the identified studies, time-to-tumor modeling was not possible. Each of the
36    dermal data sets was modeled using the multistage model, incorporating data adjustments where
37    appropriate, as  summarized below.

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                                                         Toxicological Review ofBenzo[a]pyrene

 1          For all studies, administered doses were converted to average daily doses using the
 2    equation:
 3          Average daily dose/day = (ug/application] x (number of applications/week 4- 7 days/week)
 4
 5          Next, lifetime equivalent doses were estimated for study groups that were reported to end
 6    before 104 weeks by multiplying the relevant average daily doses by (Le/104)3, where Le is the
 7    length of exposure, based on observations that tumor incidence tends to increase with age [Doll,
 8    1971]. Note that exposure periods <52 weeks would lead to a relatively large adjustment [i.e.,
 9    (52/104)3 = 0.125, or an eightfold lower dose than administered], reflecting considerable
10    uncertainty in lifetime equivalent dose estimates generated from relatively short studies. This
11    adjustment was relevant for all dose groups in Poel [1959] and Roe etal. [1970], and the highest
12    dose group in Habsetal. [1980], and in Sivaketal. [1997].
13          Another adjustment made to minimize confounding by mortality was to omit the dose
14    groups with nearly 100% mortality occurring early in the study from dose-response modeling.  Poel
15    [1960,1959] exposed multiple strains of male mice to 7-9 levels of benzo[a]pyrene, with all mice
16    in the dose groups with >3.8 ug/application dying by week 44. For three of the strains—C57L
17    [Poel. 1959], SWR and CSHeB [Poel. 1960]—the remaining four dose groups in addition to control
18    survived most of the two-year exposure period and showed a graded dose response, adequate to
19    support derivation of a slope factor for chronic exposure.
20          Concerning the incidence data, some of these studies reported incidences of skin tumor-
21    bearing animals for tumors thought to be  malignant only [Roe etal., 1970: Poel, 1959] or without
22    clear designation of the relative percentages of animals with carcinomas and papillomas [Habs et
23    al.. 1980]. In the other studies, incidences of animals with skin papillomas and skin carcinomas
24    were clearly reported, showing that skin tumors from lifetime exposure to benzo[a]pyrene were
25    predominantly malignant [Sivaketal., 1997: Grimmer et al., 1984: Habs etal., 1984: Grimmer etal.,
26    1983: Schmahl et al., 1977: Schmidt etal.,  1973]. Following EPA's Guidelines for Carcinogen Risk
27    Assessment [Section 2.2.2.1.2: U.S. EPA, 2005a], incidence data for animals with malignant or benign
28    skin tumors were  selected for dose-response modeling based on the evidence that skin papillomas
29    can develop into malignant skin tumors. The data sets as modeled, including adjustments, are
30    presented in Tables E-19 through E-22 in  the Supplemental Information.
31          The multistage-cancer model was  then fit to each data set. If there was no adequate fit
32    using the multistage-cancer model, then other dichotomous models were used.  Because
33    benzo[a]pyrene is expected to cause cancer via a mutagenic mode of action, a linear approach to
34    low dose extrapolation from the PODs (i.e., BMDLio] was used [U.S. EPA, 2005a] for candidate
35    dermal slope factors.
36          Several data sets provided incomplete information about the length of exposure [Habs etal.,
37    1984: Grimmer etal.. 1983: Schmahl etal.. 1977: Schmidt etal.. 1973: Poel. 19601 Accordingly,
38    dermal slope factors derived from those studies may underestimate cancer risk, due to

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                                                         Toxicological Review ofBenzo[a]pyrene

 1    overestimation of exposure associated with the development of tumors for the higher exposure
 2    groups. In addition, several study designs generated only relatively high dose-response points
 3    [Grimmer etal.. 1984: Habsetal.. 1984: Grimmer etal.. 1983: Habsetal.. 1980). increasing the
 4    extent of low-dose extrapolation relative to the other studies. Under the assumption that duration
 5    of exposure was not impacted at lower exposures, linear extrapolation from the lowest dose-
 6    response point in a study, if the response was higher than 10%, was also used.

 7    2.5.3.  Derivation of the Dermal Slope Factor
 8          Adequate model fits were found using the multistage model for all but one of the mouse
 9    skin tumor incidence data sets (see Appendix E of the Supplemental Information). The data from
10    Grimmer etal. [1984] could not be adequately fit by the multistage model initially, and the other
11    dichotomous models available in BMDS were used. Due to the supralinear shape of the dose-
12    response data, only the log-logistic and dichotomous Hill models provided adequate fits. Also due
13    to the supralinear dose-response shape, the POD for slope factor derivation was identified near the
14    lowest response of ~70%, because of the lack of data to inform the dose-response relationship at
15    lower doses.  Overall, model fits demonstrated low statistical variability at the PODs, with BMDLs
16    generally less than twofold lower than corresponding BMDs.
17          For data sets designed with higher overall exposure  ranges [Grimmer etal.. 1984: Habs et
18    al.. 1984: Grimmer etal.. 1983: Habsetal.. 1980], consideration of PODs based on the lowest
19    response in each study, rather than based on an extrapolated 10% extra risk, led to slope factors
20    less than twofold lower than when based on the BMDLio (see non-shaded portion of Table 2-11).
21    The alternate slope factors (based on BMRs greater than 10%) are less impacted by interpretation
22    of the responses and estimated exposures of the higher exposure groups, but necessarily reflect
23    only an assumption of linearity between the lowest exposure and background responses, which
24    may not be supported.
25          Dermal slope factors, calculated using linear extrapolation from the BMDLioS, ranged from
26    0.25 to 1.8 per |ig/day, a roughly sevenfold range (see Table 2-11). Among the stronger studies
27    (shaded entries in Table 2-11), values for male mice ranged  from 0.9 to  1.7 per |ig/day, and for
28    female mice from 0.25 to 0.67 per |ig/day.  Results from the  remaining studies (shaded entries in
29    Table 2-11) suggest that some female mouse strains maybe as sensitive as some male mouse
30    strains, but the associated uncertainties—e.g., increased extent of low-dose extrapolation and
31    incomplete exposure information—provide less support for relying on many of these values. These
32    four female mice data sets were considered to be the most uncertain because of dose ranges
33    covered and incomplete information regarding length of exposure (Grimmer etal., 1984: Habs etal.,
34    1984: Grimmer etal., 1983: Habs etal., 1980], and are summarized in the shaded portion of Table
35    2-11. In particular, the data setreported by Habs et al. (1984) yielded the most uncertain result
36    with only two dose-response points; the lowest response was 40%, and the slope estimate is
37    determined by the characterization of both exposure estimates.

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                                                        Toxicological Review ofBenzo[a]pyrene
 1          There was insufficient information to conclude that males were more sensitive because
 2   both sexes were not tested for any strain. However, among the three better designed and reported
 3   studies [Sivaketal.. 1997: Roe etal.. 1970: Poel. 1959). male mice were more sensitive than female
 4   mice. Consequently, without any information indicating which data set is more relevant for
 5   extrapolation to humans, the male mouse results from the higher quality studies [Sivaketal., 1997:
 6   Poel, 1959] were selected for the proposed dermal slope factor. The female mouse results [Roe et
 7   al., 1970] were not considered further. The average of the BMDLioS for the two male data sets was
 8   0.068 ng/day.

 9          Table 2-11. Summary of dermal slope factor derivations -unadjusted for
10          interspecies differences
Reference
Mouse
Strain
Selected
Model3
BM
R
BMD
(Hg/d)
POD=
BMDL
(Hg/d)
Candidate
Dermal
Slope
Factors'5
(Hg/d)-1
Comments
Male mice
Sivak et al.
(1997)
Poel (1959)a'c

Poel (1960)a'c

Poel (1960)a'c

C3H/HeJ
C57L
SWR
CSHeB
Multistage 2°
Multistage 3°
Multistage 3°
Multistage 1°
10%
10%
10%
10%
0.11
0.13
0.13
0.16
0.058
0.078
0.11
0.11
1.7
1.3
0.91
0.91
Grouped survival data reported
Grouped survival data reported
No characterization of
survival/exposure duration
No characterization of
survival/exposure duration
Female mice
Roe etal.
(1970)
Schmidt et al.
(1973)
Schmidt et al.
(1973)
Schmahl et al.
(1977)
Habsetal.
(1980)
(Habsetal.,
1984)
Grimmer et
al. (1983)
Swiss
Swiss
NMRI
NMRI
NMRI
NMRI
CFLP
Multistage 2°
Multistage 3°
Multistage 2°
Multistage 2°
Multistage 4°
Multistage 1°
Multistage 1°
10%
10%
10%
10%
10%
30%
10%
50%
10%
40%
0.69
0.28
0.33
0.23
0.36
0.49
0.078
0.51
0.24
1.2
0.39
0.22
0.29
0.15
0.24
0.44
0.056
0.37
0.21
1.0
0.25
0.45
0.34
0.67
0.42
0.69
1.8
1.4
0.48
0.40
Grouped survival data reported
No characterization of exposure
duration
No characterization of exposure
duration
No characterization of exposure
duration
Higher overall exposure range;
unclear overall duration of exposure
No characterization of exposure
duration for high exposure; high
response at lowest exposure limits
usefulness of low-dose extrapolation
No characterization of exposure
duration
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                                                          Toxicological Review ofBenzo[a]pyrene
      Grimmer et
      al. (1984)a
            CFLP
Log-logistic
70%
1.07
0.48
1.5
No characterization of exposure
duration; high response at lowest
exposure limits usefulness of low-
dose extrapolation
 1
 2
 3
 4
 5

 6
 7
 8
 9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
aSee Appendix E for modeling details.
bUnadjusted for interspecies differences.  Slope factor=R/BMDLR, where R is the BMR expressed as a fraction.
cHigh exposure groups omitted prior to dose-response modeling.
2.5.4.  Dermal Slope Factor Cross-Species Scaling
       Different methodologies have been established for interspecies scaling of PODs used to
derive oral slope factors and inhalation unit risks.  Cross-species adjustment of oral doses is based
on allometric scaling using the % power of body weight This adjustment accounts for more rapid
distribution, metabolism, and clearance in small animals [U.S. EPA. 2005a). Cross-species
extrapolation of inhalation exposures is based on standard dosimetry models that consider factors
such as solubility, reactivity, and persistence [U.S. EPA, 1994]. No established methodology exists
to adjust for interspecies differences in dermal toxicity at the point of contact; however, allometric
scaling using body weight to the % power was selected based on known species differences in
dermal metabolism and penetration of benzo[a]pyrene. In vitro skin permeation was highest in the
mouse, compared to rat, rabbit, and human, and was enhanced by induction of CYP enzymes [Kao et
al.. 1985).  Using this approach, rodents and humans exposed to the same daily dose of a
carcinogen, adjusted for BW3/4, would be expected to have equal lifetime risks of cancer.
       Alternative approaches were also evaluated. A comparison of these alternatives is provided
in Appendix E of the Supplemental Information.
       The PODM derived from the mouse studies ofPoelfl9591 and Sivak et al. fl9971 is adjusted
to a HED as follows:
       POD HED (u-g/day)      = PODM (u_g/day)  x (BWH / BWM)3/4
                            = 0.068 u.g/day x  (70 kg/ 0.035 kg)3/4
                            = 20.3 [ig/day

       The resulting PODnED is used to calculate the dermal slope factor for benzo[a]pyrene:

       Dermal slope factor = BMR/PODHED = 0.1/(20.3 [ig/day)  = 0.005 per Hg/day

       Note that the dermal slope factor should only be used with lifetime human exposures
<20 |ig/day, the human equivalent of the PODM, because above this level, the dose-response
relationship may not be proportional to the mass of benzo[a]pyrene applied.
       Several assumptions are made in the use of this scaling method. First, it is assumed that the
toxicokinetic processes in the skin will scale similarly to interspecies differences in whole-body
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                                                         Toxicological Review ofBenzo[a]pyrene

 1    toxicokinetics. Secondly, it is assumed that the risk at low doses ofbenzo[a]pyrene is linear.
 2    Although one study indicates that at high doses of benzo[a]pyrene carcinogenic potency is related
 3    to mass applied per unit skin and not to total mass [Davies. 1969]. this may be due to promotional
 4    effects, such as inflammation, that are observed at high doses of benzo[a]pyrene.
 5          The dermal slope factor has been developed for a local effect and it is not intended to
 6    estimate systemic risk of cancer following dermal absorption of benzo[a]pyrene into the systemic
 7    circulation. Although some information suggests thatbenzo[a]pyrene metabolites can enter
 8    systemic circulation following dermal exposure in humans [Godschalketal., 1998a], lifetime skin
 9    cancer bioassays that have included pathological examination of other organs have not found
10    elevated incidences of tumors at distal sites [Higginbothametal.. 1993: Habs etal.. 1980: Schmahl
11    etal.. 1977: Schmidt etal.. 1973: Roe etal.. 1970: Poel. 19591. This may be because benzo[a]pyrene
12    tends to bind to targets within the skin rather than enter the plasma receptor fluid (a surrogate
13    measure of systemic absorption) in in vitro human skin experiments.  These data are consistent
14    with benzo[a]pyrene's metabolism to reactive metabolites within the viable layers of the skin
15    [Wester et al., 1990]. Some studies indicate that the fraction of benzo[a]pyrene left within the
16    viable layers of the skin is a large portion of the applied dose [Moody etal.. 2007: Moody and Chu.
17    1995). Taken together, these data support the conclusion that the risk of skin cancer following
18    dermal exposure likely outweighs cancer risks at distal organs.

19    2.5.5.  Uncertainties in the Derivation of the  Dermal Slope Factor
20          Uncertainty in the recommended dermal slope factor is partly reflected in the range of POD
21    values derived from the modeled mouse skin tumor data sets: the lowest and highest BMDLio
22    values listed in Table 2-11 show a sevenfold difference (0.058-0.39 |ig/day) in magnitude. There is
23    some indication that the recommended dermal slope factor may underestimate cancer risk, due to
24    inadequate data to take the observed decreasing tumor latency with increasing exposure level into
25    account with a more complex model, such as a time-to-tumor model. Reliance on studies with the
26    lowest exposure levels having low early mortality due to benzo[a]pyrene exposure and exposures
27    continuing for approximately 104 weeks tends to minimize this source of uncertainty.
28          Human dermal exposure to benzo[a]pyrene in the environment likely occurs predominantly
29    through soil contact. The available mouse dermal bioassays of benzo[a]pyrene relied on delivery of
30    benzo[a]pyrene to the skin in a solvent solution  (typically acetone or toluene).  The use of volatile
31    solvent likely results in a larger dose of benzo[a]pyrene available for uptake into the skin
32    (compared to soil). Consequently, reliance on these studies may overestimate the risk of skin
33    tumors from benzo[a]pyrene contact through soil; however, cancer bioassays delivering
34    benzo[a]pyrene through a soil matrix are not available.
35          There is uncertainty in extrapolating from the intermittent exposures in the mouse assays
36    to daily exposure scenarios. All of the dermal bioassays considered treated animals 2-3 times a
37    week.  This assessment makes the assumption that risk is proportional to total cumulative

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                                                          Toxicological Review ofBenzo[a]pyrene

 1    exposure. However, this may overestimate risk if duration adjusted doses are below doses that
 2    saturate or diminish detoxifying metabolic steps.
 3           The available data were not useful to determine which animal species may be the best
 4    surrogate for human dermal response to benzo[a]pyrene. In extrapolation of the animal dermal
 5    information to humans, the assumption is made that equal lifetime risks of cancer would follow
 6    from exposure to the same daily dose adjusted for BW3/4.  Qualitatively, the toxicokinetics and
 7    toxicodynamics in mouse and human skin appear to be similar [Knafla etal.. 2011: Bickers etal.,
 8    1984].  Specifically, all of the activation pathways implicated in benzo[a]pyrene carcinogenicity
 9    have been observed in mouse and human skin, and associations have been made between the
10    spectra of mutations in tumor tissues from benzo[a]pyrene-exposed animals and humans exposed
11    to complex PAH mixtures containing benzo[a]pyrene (see Section 1.1.5).
12           The dermal slope factor for benzo[a]pyrene is based on skin cancer and does not represent
13    systemic cancer risk from dermal exposure. It is unclear whether dermal exposure to
14    benzo[a]pyrene would result in elevated risk of systemic tumors. Some studies in humans suggest
15    that although the skin may be responsible for a "first pass" metabolic effect, benzo[a]pyrene-
16    specific adducts have been detected in WBCs following dermal exposure to benzo[a]pyrene,
17    indicating that dermally applied benzo[a]pyrene enters systemic circulation [Godschalketal..
18    1998a].  Although none of the lifetime dermal bioassays in mice,  which included macroscopic
19    examination of internal organs, reported an elevation of systemic tumors in benzo[a]pyrene-
20    treated mice compared to controls [Higginbothametal., 1993: Habs etal., 1980: Schmahletal.,
21    1977: Schmidt etal.. 1973: Roe etal.. 1970: Poel. 19591. most of these studies attempted to remove
22    animals with grossly observed  skin tumors from the study before the death of the animal, possibly
23    minimizing the development of more distant tumors with longer latency.  The risk of
24    benzo[a]pyrene-induced point-of-contact tumors in the skin possibly competes with systemic risk
25    of tumors. Currently, the potential contribution of dermally absorbed benzo[a]pyrene to systemic
26    cancer risk is unclear.
27
28
Table 2-12. Summary of uncertainties in the derivation of cancer risk values
for benzo[a]pyrene dermal slope factor
             Consideration and
        Impact on Cancer Risk Value
                              Decision
       Justification and Discussion
      Selection of data set
      •^ dermal slope factor if alternative
      data set were selected
                        Sivaketal. (1997); Poel
                        (1959)
Both studies included lowest doses among
available studies (where intercurrent mortality
was less likely to impact the number at risk) and
used typical group sizes (up to 50/group).
      Selection of target organ
      No dermal slope factor if skin tumor
      studies not used
                        Selection of skin tumors
Skin tumors were replicated in numerous studies
of male or female mice. No studies were
available indicating that other tumors occur
following dermal exposure.
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                                                            Toxicological Review ofBenzo[a]pyrene
             Consideration and
         Impact on Cancer Risk Value
                                       Decision
                             Justification and Discussion
Selection of dose metric
Alternatives could 4, or
factor
                            slope
Administered dose, as
TWA in u.g/d
Experimental evidence supports a role for
metabolism in toxicity, but actual responsible
metabolites are not identified.
      Interspecies extrapolation
      Alternatives could 4, or ^ slope
      factor
                                Total daily dose scaled
                                by BW3/4
                      Alternatives discussed in Appendix E. An
                      established methodology does not exist to adjust
                      for interspecies differences in dermal toxicity at
                      the point of contact. Benzo[a]pyrene
                      metabolism is known to occur in the dermal
                      layer. Viewing the skin as an organ, metabolic
                      processes were assumed to scale allometrically
                      without evidence to the contrary.
Dose-response modeling
Alternatives could 4, or
factor
                                      Multistage model
                            slope
                      No biologically based models for benzo[a]pyrene
                      were available.  The multistage model is
                      consistent with  biological processes and is the
                      preferred model for IRIS cancer assessments
                      (Gehlhausetal.,2011).
      Low-dose extrapolation
      •i, cancer risk estimate would be
      expected with the application of
      nonlinear low-dose extrapolation
                                 Linear extrapolation
                                 from POD (based on
                                 mutagenic mode of
                                 action)
                      Available mode of action data support linearity
                      (mutagenicity is a primary mode of action of
                      benzo[a]pyrene).
      Sensitive subpopulations
      "T* dermal slope factor to unknown
      extent
                                ADAFs are
                                recommended for early
                                life exposures
                      No chemical-specific data are available to
                      determine the range of human toxicodynamic
                      variability or sensitivity.
 2    2.5.6.  Previous IRIS Assessment: Dermal Slope Factor
 3           A dermal slope factor for benzo[a]pyrene was not previously available on IRIS.

 4    2.6.  APPLICATION OF AGE-DEPENDENT ADJUSTMENT FACTORS (ADAFS)
 5           Based on sufficient support in laboratory animals and relevance to humans, benzo[a]pyrene
 6    is determined to be carcinogenic by a mutagenic mode of action.  According to the Supplemental
 7    Guidance for Assessing Susceptibility from Early Life Exposure to Carcinogens ("Supplemental
 8    Guidance"] [U.S. EPA, 2005b], individuals exposed during early life to carcinogens with a mutagenic
 9    mode of action are assumed to have increased risk for cancer. The oral slope factor of 1 per mg/kg-
10    day, inhalation unit risk of 0.5 per mg/m3, and dermal slope factor of 0.005 per [ig/day for
11    benzo[a]pyrene, calculated from data applicable to adult exposures, do not reflect presumed early
12    life susceptibility to this chemical.  Although chemical-specific data exist for benzo[a]pyrene that
13    quantitatively demonstrate increased early life susceptibility to cancer [Vesselinovitch etal., 1975],
14    these data were not considered sufficient to develop separate risk estimates for childhood
15    exposure, as they used acute i.p. exposures  [U.S. EPA, 2005b]. In the absence of adequate chemical-
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                                                         Toxicological Review ofBenzo[a]pyrene
 1
 2
 3
 4
 5
 6
 7
 8
 9
10

11
12
specific data to evaluate differences in age-specific susceptibility, the Supplemental Guidance [U.S.
EPA. 2005b) recommends that ADAFs be applied in estimating cancer risk.
       The Supplemental Guidance [U.S. EPA. 2005b) establishes AD AFs for three specific age
groups. These AD AFs and their corresponding age groupings are: 10 for individuals exposed at
<2 years of age, 3 for exposed individuals at 2-<16 years of age, and 1 for exposed individuals
>16 years of age. The 10- and 3-fold adjustments are combined with age-specific exposure
estimates when estimating cancer risks from early life (<16 years of age) exposures to
benzo[a]pyrene. To illustrate the use of the AD AFs established in the Supplemental Guidance [U.S.
EPA. 2005b). sample calculations are presented for three exposure duration scenarios, including
full lifetime, assuming a constant benzo[a]pyrene exposure of 0.001 mg/kg-day (Table 2-13).

       Table 2-13. Sample application of ADAFs for the estimation of benzo[a]pyrene
       cancer risk following lifetime (70-year) oral exposure
Age Group
0-<2 yrs
2-<16 yrs
>16 yrs
ADAF
10
3
1
Unit Risk (per
mg/kg-d)
1
1
1
Sample Exposure
Concentration (mg/kg-d)
0.001
0.001
0.001
Duration
Adjustment
2 yrs/70 yrs
14 yrs/70 yrs
54 yrs/70 yrs
Total risk
Cancer Risk for
Specific Exposure
Duration
Scenarios
0.0003
0.0006
0.0008
0.002
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
       The example exposure duration scenarios include full lifetime exposure (assuming a
70-year lifespan).  Table 2-13 lists the four factors (ADAFs, cancer risk estimate, assumed exposure,
and duration adjustment) that are needed to calculate the age-specific cancer risk based on the
early age-specific group.  The cancer risk for each age group is the product of the four factors in
columns 2-5.  Therefore, the cancer risk following daily benzo[a]pyrene oral exposure in the age
group 0-<2 years is the product of the values in columns 2-5  or 10 x 1 x 0.001 x 2/70 = 3 x 10~4.
The cancer risk for specific exposure duration scenarios that are listed in the last column are added
together to get the total risk. Thus, a 70-year (lifetime) risk estimate for continuous exposure to
0.001 mg/kg-day benzo[a]pyrene is 2 x 1Q-3, which is adjusted for early-life susceptibility and
assumes a 70-year lifetime and constant exposure across age  groups.
       In calculating the cancer risk for a 30-year constant exposure to benzo[a]pyrene at an
exposure level of 0.001 mg/kg-day for ages 0-30 years, the duration adjustments would be 2/70,
14/70, and 14/70, and the age-specific risks for the three age groups would be 3 x 1Q-4, 6 x 1Q-4, and
2 x IQ-4, which would result in a total risk estimate of 1 x 1Q-3.
       In calculating the cancer risk for a 30-year constant exposure to benzo[a]pyrene at an
exposure level of 0.001 mg/kg-day for ages 20-50 years, the duration adjustments would be  0/70,
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 1
 2
 3
 4
 5

 6
 7
                                                  Toxicological Review ofBenzo[a]pyrene

0/70, and 30/70. The age-specific risks for the three groups are 0, 0, and 4 x 1Q-4, which would
result in a total risk estimate of 4 x 1Q-4.
       Consistent with the approaches for the oral route of exposure (Table 2-13), the ADAFs
should also be applied when assessing cancer risks for subpopulations with early life exposures to
benzo[a]pyrene via the inhalation and dermal routes (presented in Tables 2-14 and 2-15).

       Table 2-14. Sample application of ADAFs for the estimation of benzo[a]pyrene
       cancer risk following lifetime (70-year) inhalation exposure
Age Group
0-<2 yrs
2-<16 yrs
>16 yrs
ADAF
10
3
1
Unit Risk
(per ug/m3)
5 x irj4
5 x irj4
5 x irj4
Sample Exposure
Concentration (ug/m3)
1
1
1
Duration
Adjustment
2 yrs/70 yrs
14 yrs/70 yrs
54 yrs/70 yrs
Total risk
Cancer Risk for
Specific Exposure
Duration
Scenarios
0.0001
0.0003
0.0004
0.0008
 8
 9
       Table 2-15. Sample application of ADAFs for the estimation of benzo[a]pyrene
       cancer risk following lifetime (70-year) dermal exposure
Age Group
0-<2 yrs
2-<16 yrs
>16 yrs
ADAF
10
3
1
Unit Risk
(per ng/d)
0.005
0.005
0.005
Sample Exposure
Concentration (ng/d)
0.001
0.001
0.001
Duration
Adjustment
2 yrs/70 yrs
14 yrs/70 yrs
54 yrs/70 yrs
Total risk
Cancer Risk for
Specific Exposure
Duration
Scenarios
1 x 10"6
3 x 10"6
4 x 10"6
8 x 10"6
10
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                                                           Toxicological Review ofBenzo[a]pyrene
 1
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