If Cumulative Risk Assessment Is the Answer, What Is the Question?

Callahan, Michael A.; Sexton, Ken

doi:10.1289/ehp.9330

Cited by 121 publications

(135 citation statements)

References 27 publications

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“…Although the SHIELD study clearly demonstrates that these children were exposed to a plethora of hazardous environmental chemicals spanning multiple chemical classes, current scientific knowledge and understanding are insufficient to allow us to ascertain the seriousness of related cumulative health risks (Callahan and Sexton, 2007;Sexton and Hattis, 2007). There is, nevertheless, ample reason for concern.…”

Section: Discussionmentioning

confidence: 99%

Using exposure biomarkers in children to compare between-child and within-child variance and calculate correlations among siblings for multiple environmental chemicals

Sexton¹,

Ryan

2011

J Expo Sci Environ Epidemiol

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Longitudinal measurements of biomarkers for metals, phthalates, environmental tobacco smoke, organochlorine and organophosphate pesticides, polychlorinated biphenyls, and volatile organic compounds were made in blood and/or urine from a stratified, random sample of more than 100 elementary school-aged children living in an inner-city section of Minneapolis. Repeated measures of 31 exposure biomarkers indicate that between-child variance (B-CV) was greater than within-child variance (W-CV) for 8 compounds, B-CV was a significant proportion of total variance for 9 compounds, and variances were homogeneous for 14 compounds. Among siblings living in the same household, positive correlations were observed for biomarker concentrations of polychlorinated biphenyls, organochlorine pesticides, metals, and volatile organic chemicals in blood, and total cotinine in urine. Biologic markers confirm that children from a low-income, ethnically diverse neighborhood experienced concurrent exposure to a variety of hazardous environmental chemicals during their everyday activities. Future monitoring studies should examine the nature and magnitude of children's cumulative exposure to both chemical and non-chemical stressors, especially in disadvantaged populations.

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Section: Discussionmentioning

confidence: 99%

Using exposure biomarkers in children to compare between-child and within-child variance and calculate correlations among siblings for multiple environmental chemicals

Sexton¹,

Ryan

2011

J Expo Sci Environ Epidemiol

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“…In addition, most toxicology studies consider the health effects of individual pollutants 25 and limited work has been done to assess possible interactions. 26,27 Recent studies have emphasized the potential importance of chemical mixtures on human health 25,28,29 ; however, conducting multiple pollutant toxicology studies can be prohibitively expensive. There is a need for screening methods to help identify potentially important interactions for more detailed study 29 and to bound the uncertainties in interaction potential.…”

Section: Discussionmentioning

confidence: 99%

Spatial Variation in Ambient Air Toxics Concentrations and Health Risks between Industrial-Influenced, Urban, and Rural Sites

Logue

Small

Stern

et al. 2010

Journal of the Air & Waste Management Association

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Concentrations of 38 gas-phase organic air toxics were measured over a 2-yr period at four different sites in and around Pittsburgh, PA, to investigate spatial variations in health risks from chronic exposure. The sites were chosen to represent different exposure regimes: a downtown site with substantial mobile source emissions; two residential sites adjacent to one of the most heavily industrialized zones in Pittsburgh; and a regional background site. Lifetime cancer risks and non-cancer hazard quotients were estimated using a traditional and interactive risk models. Although study average concentrations of specific air toxics varied by as a much as a factor of 26 between the sites, the additive cancer risks of the gas-phase organic air toxics varied by less than a factor of 2, ranging from 6

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“…Over time and with increased analytical sophistication, the complexity and diversity of real-world environmental exposures to all types of stressors have become increasingly apparent, necessitating a more holistic approach to risk assessment; one that accounts for the combined effects from exposure to both chemical and nonchemical stressors (Callahan & Sexton 2007;NRC 2009).…”

Section: Introductionmentioning

confidence: 99%

Problem formulation for risk assessment of combined exposures to chemicals and other stressors in humans

Solomon

Wilks

Bachman

et al. 2016

Critical Reviews in Toxicology

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When the human health risk assessment/risk management paradigm was developed, it did not explicitly include a ''problem formulation'' phase. The concept of problem formulation was first introduced in the context of ecological risk assessment (ERA) for the pragmatic reason to constrain and focus ERAs on the key questions. However, this need also exists for human health risk assessment, particularly for cumulative risk assessment (CRA), because of its complexity. CRA encompasses the combined threats to health from exposure via all relevant routes to multiple stressors, including biological, chemical, physical and psychosocial stressors. As part of the HESI Risk Assessment in the 21st Century (RISK21) Project, a framework for CRA was developed in which problem formulation plays a critical role. The focus of this effort is primarily on a chemical CRA (i.e., two or more chemicals) with subsequent consideration of non-chemical stressors, defined as ''modulating factors'' (ModFs). Problem formulation is a systematic approach that identifies all factors critical to a specific risk assessment and considers the purpose of the assessment, scope and depth of the necessary analysis, analytical approach, available resources and outcomes, and overall risk management goal. There are numerous considerations that are specific to multiple stressors, and proper problem formulation can help to focus a CRA to the key factors in order to optimize resources. As part of the problem formulation, conceptual models for exposures and responses can be developed that address these factors, such as temporal relationships between stressors and consideration of the appropriate ModFs.

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If Cumulative Risk Assessment Is the Answer, What Is the Question?

Cited by 121 publications

References 27 publications

Using exposure biomarkers in children to compare between-child and within-child variance and calculate correlations among siblings for multiple environmental chemicals

Using exposure biomarkers in children to compare between-child and within-child variance and calculate correlations among siblings for multiple environmental chemicals

Spatial Variation in Ambient Air Toxics Concentrations and Health Risks between Industrial-Influenced, Urban, and Rural Sites

Problem formulation for risk assessment of combined exposures to chemicals and other stressors in humans

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