General Oral Health Assessment

The General Oral Health Assessment Index (GOHAI) (Atchison, 1997 Tubert-Jeannin et al., 2003). This 12-item questionnaire measures self-report oral functional problems together with the psychosocial impacts associated with oral disease. The maximum score is 60. A score of 57-60 corresponds to a good oral quality of life, while a score of 50 or less reflects a poor oral quality of life. 

Atchison, K. (1997). The general oral health assessment index. Measuring Oral Health and Quality of Life. Chapel HUl University of North Carolina, 71-80. 

As indicated above and discussed below, the health effects of DEHP are generally well characterized by the oral route in laboratory animal models. While additional information is always desirable, from a health assessment perspective, there appear to be few overriding needs for additional toxicological information for the principal route of human exposure to DEHP. Of particular importance are additional data that could enable derivation of an acute-duration oral MRL, which is currently precluded by insufficient information on male reproductive system development in offspring acutely exposed during gestation and/or lactation. 

The tools for nutritional assessment include medical history and screening aides, physical examination and anthropometric measurements, biochemical assessment, and tests of immune function. A general health assessment and medical history are required to rule out causes of secondary malnutrition such as poor oral health, chronic illness, disease, and medication. Malnutrition is influenced by lifestyle, which includes alcohol usage in adults, food preference, eating habits, social interactions, and economic status. Various screening tools, such as the DETERMINE checklist (White et al., 1991), are available to assess the risk of malnutrition. 

Chronic Reference Dose (RfD) RfD is an estimate (with uncertainty spanning perhaps an order of magnitude) of a daily oral exposure for a chronic duration (up to a lifetime) to the human population (including sensitive subgroups) that is likely to be without an appreciable risk of deleterious effects during a lifetime. It can be derived from a NOAEL, LOAEL, or benchmark dose, with uncertainty factors generally applied to reflect limitations of the data used. The RfD is generally used in EPA s noncancer health assessments. 

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