Adverse effect, defined

NDA requires manufacturers to submit product-labeling language, which describes the proper use, benefits, and risks of the product in question. FDA may also require, as a condition of approval of an NDA or BLA application, that postmarketing studies be conducted to monitor and confirm the safety and efficacy of a product as it is used more widely in clinical practice. In addition, all sponsors or manufacturers are required to monitor and report adverse effects, defined as health effects that may or may not be related to the drug in question. For vaccines, adverse events that occur after immunization must be reported to the Vaccine Adverse Event Reporting System. 

Threshold limit value—time weighted average. Defined as the maximum time weighted average concentration to which a worker may be exposed repeatedly and without adverse effects for a normal 8 h/d, 40 h/wk period. 

The U.S. Clean Air Amendments of 1977 define two kinds of air quality standards primary standards, levels that will protect health but not necessarily prevent the other adverse effects of air pollution, and secondary standards, levels that will prevent all the other adverse effects of air pollution (Table 22-7). The amendments also define air quality levels that cannot be exceeded in specified geographic areas for "prevention of significant deterioration" (PSD) of the air of those areas. Although they are called "increments" over "baseline air quality" in the law, they are in effect tertiary standards, which are set at lower ambient levels than either the primary or secondary standards (Table 22-8). 

Notes National primary ambient air quality standards define levels of air quality which the EPA Administrator judges are necessary, with an adequate margin of safety, to protect the public health. National secondary ambient air quality standards define levels of air quality, which the Administrator judges necessary to protect the public welfare from any known or anticipated adverse effects of a pollutant. 

Compatibility. Clear definition of compatibility is rather difficult. Compatibility has been defined as the ability of two or more materials to exist in close and permanent association for an indefinite period without phase separation and without adverse effect of one on the other [28]. On the other hand, compatibility is easily recognized in solvent-borne adhesives as a homogeneous blend of materials without phase separation. Normally, compatibility is understood as a clear transparent mixture of a resin with a given polymer. But, compatibility is a more complex thermodynamic phenomenon which can be evaluated from specific... 

However, for some type of adverse effects, such as genotoxicity, carcinogenicity, and respiratory sensitization, it may not be possible from present knowledge to define this threshold of activity, so we may conclude that any level of exposure might carry some finite risk. In this case, OELs should be established at levels sufficiently low to avoid risks these are called pragmatic OELs. 

TLV-TWA is defined as the time-weighted average concentration for a normal 8-hour workday and a 40-hour workweek, to wliich nemly all workers may be repeatedly c.xposcd, dtiy after day, witliout any long-tenii adverse effect. 

Most human or environmental healtli hazards can be evaluated by dissecting tlie analysis into four parts liazard identification, dose-response assessment or hazard assessment, exposure assessment, and risk characterization. For some perceived healtli liazards, tlie risk assessment might stop with tlie first step, liazard identification, if no adverse effect is identified or if an agency elects to take regulatory action witliout furtlier analysis. Regarding liazard identification, a hazard is defined as a toxic agent or a set of conditions that luis the potential to cause adverse effects to hmnan health or tlie environment. Healtli hazard identification involves an evaluation of various forms of information in order to identify the different liaz.ards. Dose-response or toxicity assessment is required in an overall assessment responses/cffects can vary widely since all chemicals and contaminants vary in their capacity to cause adverse effects. This step frequently requires that assumptions be made to relate... 

Since 1970 tlie field of healtli risk assessment Itas received widespread attention witliin both tlie scientific and regulatoiy committees. It has also attracted tlie attention of the public. Properly conducted risk assessments have received fairly broad acceptance, in part because they put into perspective the terms to. ic, Itazard, and risk. Toxicity is an inlierent property of all substances. It states tliat all chemical and physical agents can produce adverse healtli effects at some dose or under specific exposure conditions. In contrast, exposure to a chemical tliat lias tlie capacity to produce a particular type of adverse effect, represents a health hazard. Risk, however, is tlie probability or likelihood tliat an adverse outcome will occur in a person or a group tliat is exposed to a particular concentration or dose of the hazardous agent. Tlierefore, risk can be generally a function of exposure and dose. Consequently, healtli risk assessment is defined as tlie process or procedure used to estimate tlie likelihood that... 

Hazard identification is defined as tlie process of determining whetlier human exposure to an agent could cause an increase in the incidence of a health condition (cancer, birtli defect, etc.) or whetlier exposure to nonliumans, such as fish, birds, and otlier fonns of wildlife, could cause adverse effects. Hazard identification cliaracterizes tlie liazard in terms of tlie agent and dose of the agent. Since tliere are few hazardous chemicals or hazardous agents for wliich definitive exposure data in humans exists, tlie identification of health hazards is often characterized by the effects of health hazards on laboratory test animals or other test systems. ... 

The price risk can be defined and understood in alternative ways. One can view the risk as the probable fluctuation of the price around its expected level (i.c., the mean). The larger the deviation around the mean the larger is the perceived price risk. The volatility around the mean can be measured by standard deviation and be used as a quantitative measure for price risk. At the same time, in the industry it is common to define risk referring only to a price movement that would have an adverse effect on the profitability. Thus, one would talk about an upward potential and downside risk. ... 

As with all drugs, the specific side effects of the quinolones must be considered when they are chosen for treatment of bacterial infections [5]. Reactions of the gastrointestinal tract and the central neivous system are the most often observed adverse effects during therapy with quinolones. It should be underlined, however, that compared with many other antimicrobials, diarrhea is less frequently observed during quinolone treatment. Antibiotic-associated colitis has been observed rarely during quinolone therapy. Similarly, hypersensitivity reactions, as observed during therapy with penicillins and other (3-lactams, is less frequently caused by quinolones. Some other risks of quinolone therapy have been defined and must be considered if a drug from this class is chosen for treatment of bacterial infections. 

Estimates of exposure levels posing minimal risk to humans (Minimal Risk Levels or MRLs) have been made for methyl parathion. An MRL is defined as an estimate of daily human exposure to a substance that is likely to be without an appreciable risk of adverse effects (noncarcinogenic) over a specified duration of exposure. MRLs are derived when reliable and sufficient data exist to identify the target organ(s) of effect or the most sensitive health effect(s) for a specific duration within a given route of exposure. MRLs are based on noncancerous health effects only and do not consider carcinogenic effects. MRLs can be derived for acute, intermediate, and chronic duration exposures for inhalation and oral routes. Appropriate methodology does not exist to develop MRLs for dermal exposure. 

To define the beneficial (or adverse) effects of dietary phytochemicals research is required which can study effects at doses that reasonably reflect likely human exposures and which will ... 

NOAEL (no-observed-adverse-effect level) is defined as the highest dose at which no adverse effects are observed in the most susceptible animal species. The NOAEL is used as a basis for setting human safety standards for acceptable daily intakes (ADIs), taking into account uncertainty factors for extrapolation from animals to humans and inter-individual variabilities of humans. The adequacy of any margin of safety or margin of exposure must consider the nature and quality of the available hazard identification and dose-response data and the reliability and relevance of the exposure estimations. In some cases, no adverse endpoint can be identified such as for many naturally occurring compounds that are widespread in foods. In that case, an ADI Not Specified is assigned. ... 

To calculate the safe re-entry interval (REI), the margin of exposure (MOE) must be considered. Worker risk is measured as a margin of exposure and is related to how closely the occupational exposure comes to the no observed adverse effect level (NOAEL, for oxamyl 50 mg kg day ). MOE is defined as... 

Fever is the most frequently reported adverse effect in children and adolescents. Fever associated with vaccination is defined as a temperature of greater than or equal to 38°C (100.4°F)... 

The goals of treatment are to maximally and durably suppress viral replication, avoid the development of drug resistance, restore and preserve immune function, prevent opportunistic infections, and minimize drug adverse effects. Elimination of HIV is not possible with currently available therapies. Instead, maximal suppression of viral replication (defined as HIV RNA concentrations undetectable by the most sensitive... 

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