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76   LIFE CYCLE ASSESSMENT   HANDBOOK

              In  practice  many  methods  do  not  report  the  endpoint  level  (case  of  skin
              cancer),  which  is  an  interim  result  but  reported  in  a  damage  units.  These
              damage models can have units   of Disability Adjusted  Life Years (DALYs), an
              aggregation  of environmental  impacts, monetary value, or other  aggregated
              damage   units.
                 Even  though  the  remainder  of  the  environmental  mechanism  from  mid-
              point  to endpoint  to damages  describes the link to environmentally  relevant
              endpoint  indicators,  this  sometimes  occurs  at  the  expenses  of  the  compre-
              hensive  nature  of  the  midpoint,  and  likely  resulting  in  higher  uncertainty.
              In  certain  categories,  providing  methodological  approaches  that  character-
              ize the environmental  mechanism  closer to endpoints and damages does   not
              provide  additional  distinction  of  differences  in  impact  between  substances.
              However,  a model between damage and midpoint may add      relevance  (either
              in  a  quantitative  or  qualitative  manner  -  in  cases  where  quantification  of
              endpoints  is  difficult  to  impossible),  and  this  relevance  may  be  added  for
              all  substances  in  the  same  way  This  could  also  enable  us  to  compare  the
              outcomes   of  different  midpoint  categories  using  models  based  on  natural
              science  instead  of  weighting  factors  based  on  social  science.  In  a  midpoint
              model  it  seems  wise  to  minimize  the  unnecessary  uncertainty  by  choosing
              a  midpoint  indicator  as  early  as  possible  in  the  environmental  chain  where
              all substances are unified  in an indicator yet the five criteria are still  satisfied:
              comprehensiveness,   relevance/reproducibility,  transparency,  validity  and
              compatibility  (see Section  1).
                 The  second  group  of  impact  categories,  illustrated  in  Figure  4.5, may  not
              have a common midpoint and are comprised    of different  environmental  mech-
              anisms.  Examples  of  the  second  type  of  impact  categories  which  are  almost
              always represented  at an aggregated  level (either at damage or midpoint  level)
              include human toxicity and ecotoxicity, where interim human health  endpoints
              that  may  be  aggregated  include  neurological,  reproductive,  respiratory,  and
              cardiovascular  health  endpoints.  The aggregation  may  be  in units  of  DALYs,
              monetary value, or a unitless score which is based on the relative human  toxic-
              ity  potency  after  including  the  fate,  transport,  and  toxicity  of  the  substances
              and comparing to a reference  substance.
                 The  ILCD  Handbook   suggests  considering  the  following  points  (EC-JRC
              2010a):


                   1.  For the first group  of impact  categories described  above, the  goal
                      of damage modeling   is to make results in different  midpoint  cat-
                      egories  comparable,  and  sometimes  to  arrive  to  a  single  score,
                      or  smaller  number  of  environmental  scores.  It  can  then  replace
                      or support  weighting  practices  in the midpoint  approaches.  The
                      choice  to  stay  at  the midpoint  level  or  go  to  the  damage  level  is
                      left  to the user.
                   2.  When the decision has been made to go to the damage level on an
                      impact category  of the first type (e.g., global climate change), care
                      must  be taken  to ensure  comprehensiveness.  For example,  while
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