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Cumulative risk assessment for combined health effects from chemical and nonchemical stressors

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  • Sexton, K.
  • Linder, S.H.

Abstract

Cumulative risk assessment is a science policy tool for organizing and analyzing information to examine, characterize, and possibly quantify combined threats from multiple environmental stressors. We briefly survey the state of the art regarding cumulative risk assessment, emphasizing challenges and complexities of moving beyond the current focus on chemical mixtures to incorporate nonchemical stressors, such as poverty and discrimination, into the assessment paradigm. Theoretical frameworks for integrating nonchemical stressors into cumulative risk assessments are discussed, the impact of geospatial issues on interpreting results of statistical analyses is described, and four assessment methods are used to illustrate the diversity of current approaches. Prospects for future progress depend on adequate research support as well as development and verification of appropriate analytic frameworks.

Suggested Citation

  • Sexton, K. & Linder, S.H., 2011. "Cumulative risk assessment for combined health effects from chemical and nonchemical stressors," American Journal of Public Health, American Public Health Association, vol. 101(SUPPL. 1), pages 81-88.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2011.300118_7
    DOI: 10.2105/AJPH.2011.300118
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    Cited by:

    1. Leah Zilversmit Pao & Emily W. Harville & Jeffrey K. Wickliffe & Arti Shankar & Pierre Buekens, 2019. "The Cumulative Risk of Chemical and Nonchemical Exposures on Birth Outcomes in Healthy Women: The Fetal Growth Study," IJERPH, MDPI, vol. 16(19), pages 1-16, October.
    2. Chris G. Buse & Valerie Lai & Katie Cornish & Margot W. Parkes, 2019. "Towards environmental health equity in health impact assessment: innovations and opportunities," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(1), pages 15-26, January.
    3. Timothy M. Barzyk & Sacoby Wilson & Anthony Wilson, 2015. "Community, State, and Federal Approaches to Cumulative Risk Assessment: Challenges and Opportunities for Integration," IJERPH, MDPI, vol. 12(5), pages 1-26, April.
    4. Kane, Natalie, 2022. "Revealing the racial and spatial disparity in pediatric asthma: A Kansas City case study," Social Science & Medicine, Elsevier, vol. 292(C).
    5. Ken Sexton & Jennifer J. Salinas & Thomas J. McDonald & Rose M. Z. Gowen & Rebecca P. Miller & Joseph B. McCormick & Susan P. Fisher-Hoch, 2013. "Biomarkers of Maternal and Fetal Exposure to Organochlorine Pesticides Measured in Pregnant Hispanic Women from Brownsville, Texas," IJERPH, MDPI, vol. 10(1), pages 1-12, January.
    6. Richard Todd Niemeier & Pamela R.D. Williams & Alan Rossner & Jane E. Clougherty & Glenn E. Rice, 2020. "A Cumulative Risk Perspective for Occupational Health and Safety (OHS) Professionals," IJERPH, MDPI, vol. 17(17), pages 1-19, August.
    7. Kristen Burwell-Naney & Sacoby M. Wilson & Siobhan T. Whitlock & Robin Puett, 2019. "Hybrid Resiliency-Stressor Conceptual Framework for Informing Decision Support Tools and Addressing Environmental Injustice and Health Inequities," IJERPH, MDPI, vol. 16(8), pages 1-19, April.
    8. Katherine von Stackelberg & Elizabeth Guzy & Tian Chu & Birgit Claus Henn, 2015. "Exposure to Mixtures of Metals and Neurodevelopmental Outcomes: A Multidisciplinary Review Using an Adverse Outcome Pathway Framework," Risk Analysis, John Wiley & Sons, vol. 35(6), pages 971-1016, June.
    9. Hongtai Huang & Timothy M. Barzyk, 2016. "Connecting the Dots: Linking Environmental Justice Indicators to Daily Dose Model Estimates," IJERPH, MDPI, vol. 14(1), pages 1-15, December.
    10. Chris G. Buse & Aita Bezzola & Jordan Brubacher & Tim K. Takaro & Arthur L. Fredeen & Margot W. Parkes, 2022. "Cumulative Impacts of Diverse Land Uses in British Columbia, Canada: Application of the “EnviroScreen” Method," IJERPH, MDPI, vol. 19(18), pages 1-17, September.
    11. Jonathan I. Levy & M. Patricia Fabian & Junenette L. Peters, 2015. "Meta‐Analytic Approaches for Multistressor Dose‐Response Function Development: Strengths, Limitations, and Case Studies," Risk Analysis, John Wiley & Sons, vol. 35(6), pages 1040-1049, June.
    12. Kathleen Hibbert & Nicolle S. Tulve, 2019. "State-of-the-Science Review of Non-Chemical Stressors Found in a Child’s Social Environment," IJERPH, MDPI, vol. 16(22), pages 1-27, November.

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