Abstract
Cumulative risk assessments (CRAs) address combined risks from exposures to multiple chemical and nonchemical stressors and may focus on vulnerable communities or populations. Significant contributions have been made to the development of concepts, methods, and applications for CRA over the past decade. Work in both human health and ecological cumulative risk has advanced in two different contexts. The first context is the effects of chemical mixtures that share common modes of action, or that cause common adverse outcomes. In this context two primary models are used for predicting mixture effects, dose addition or response addition. The second context is evaluating the combined effects of chemical and nonchemical (e.g., radiation, biological, nutritional, economic, psychological, habitat alteration, land-use change, global climate change, and natural disasters) stressors. CRA can be adapted to address risk in many contexts, and this adaptability is reflected in the range in disciplinary perspectives in the published literature. This article presents the results of a literature search and discusses a range of selected work with the intention to give a broad overview of relevant topics and provide a starting point for researchers interested in CRA applications.
Highlights
Key features of cumulative risk, ecological health, and ecosystem services papers presented in the tables in the Supplementary Materials and highlighted are summarized in Table 2 below
To provide a state of the practice and an overview of current methods and tools for Cumulative risk assessments (CRAs), a literature search was conducted using terms selected through consultation with EPA staff, and found many studies of cumulative risk problems in the science and practice literature from 2007 to 2016
Studies contributing methods and applications for assessment of cumulative risks were gathered from varied subject areas including geographic information systems (GIS), biomarkers, genetics, and “omics” research, social epidemiology, ecotoxicology, and climate change research
Summary
The human health, ecological health, and ecosystem services results sections introduce and briefly highlight papers that are presented in the tables in the Supplementary Materials. This manuscript presents work from each of these subject areas in an effort to address recommendations to develop more integrative approaches to assessing cumulative risks. The Millennium Ecosystem Assessment (MEA) [117] evaluated links between ecosystem degradation and human well-being and prompted efforts to develop conceptual frameworks for and quantify the effects of ecosystem services on human health and well-being. This section highlights recent articles that help elucidate the role ecosystem services play in the connection between ecological and human health risk assessment.
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