Handbook of Environmental Chemistry

Human Health Risk Assessment (HHRA) and Environmental Risk Assessment (ERA) are well-established regulatory and scientific research fields that support regulatory decision-making in the European Union (EU) and are undergoing constant development. HHRA and ERA are crucial steps for reaching the objectives of Europe 2020, a strategy put forward by the Commission that sets out a vision of Europeâs social market economy for the twenty-first century. This chapter aims to describe the basic principles, the evolution and the future challenges of HHRA and ERA. The first part defines HHRA and ERA and describes the origins of risk assessment and management procedures at an international level. The precautionary principle has always been present in the European Union policies that aim to protect health and the environment. In the second part, current approaches that characterise risk assessment, such as the tiered approach, are presented. In the future, the implementation of recent scientific developments for the construction of integrated exposure scenarios models is of paramount importance to improve environmental and health risk assessment schemes. Moreover, the evaluation of uncertainties in the modelling inputs and outputs and the sensitivity analysis are two key elements to optimise current HHRA and ERA procedures

Surgical treatment for early osteoarthritis, part II: allografts and concurrent procedures

Young patients with early osteoarthritis (OA) represent a challenging population due to a combination of high functional demands and limited treatment options. Conservative measures such as injection and physical therapy can provide short-term pain relief but are only palliative in nature. Joint replacement, a successful procedure in the older population, is controversial in younger patients, who are less satisfied and experience higher failure rates. Therefore, while traditionally not indicated for the treatment of OA, cartilage repair has become a focus of increased interest due to its potential to provide pain relief and alter the progression of degenerative disease, with the hope of delaying or obviating the need for joint replacement. The field of cartilage repair is seeing the rapid development of new technologies that promise greater ease of application, less demanding rehabilitation and better outcomes. Concurrent procedures such as meniscal transplantation and osteotomy, however, remain of crucial importance to provide a normalized biomechanical environment for these new technologies