* Division of the National Toxicology Program, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina 27709;
Toxicol Sci. 2014 Jan;137(1):3-11. doi: 10.1093/toxsci/kft228. Epub 2013 Oct 23.
Recent efforts to update cumulative risk assessment procedures to incorporate nonchemical stressors ranging from physical to psychosocial reflect increased interest in consideration of the totality of variables affecting human health and the growing desire to develop community-based risk assessment methods. A key roadblock is the uncertainty as to how nonchemical stressors behave in relationship to chemical stressors. Physical stressors offer a reasonable starting place for measuring the effects of nonchemical stressors and their modulation of chemical effects (and vice versa), as they clearly differ from chemical stressors; and "doses" of many physical stressors are more easily quantifiable than those of psychosocial stressors. There is a commonly held belief that virtually nothing is known about the impact of nonchemical stressors on chemically mediated toxicity or the joint impact of coexposure to chemical and nonchemical stressors. Although this is generally true, there are several instances where a substantial body of evidence exists. A workshop titled "Cumulative Risk: Toxicity and Interactions of Physical and Chemical Stressors" held at the 2013 Society of Toxicology Annual Meeting provided a forum for discussion of research addressing the toxicity of physical stressors and what is known about their interactions with chemical stressors, both in terms of exposure and effects. Physical stressors including sunlight, heat, radiation, infectious disease, and noise were discussed in reference to identifying pathways of interaction with chemical stressors, data gaps, and suggestions for future incorporation into cumulative risk assessments.
最近，人们努力更新累积风险评估程序，纳入从物理到心理社会等各种非化学应激因素，这反映出人们对影响人类健康的所有变量的关注日益增加，以及开发基于社区的风险评估方法的愿望日益强烈。一个关键的障碍是，人们不确定非化学应激因素与化学应激因素之间的相互作用方式。物理应激因素为测量非化学应激因素及其对化学效应的调节作用（反之亦然）提供了一个合理的起点，因为它们与化学应激因素明显不同；而且许多物理应激因素的“剂量”比心理社会应激因素更容易量化。人们普遍认为，几乎不了解非化学应激因素对化学介导毒性的影响，也不了解同时接触化学和非化学应激因素的联合影响。尽管这在总体上是正确的，但也有一些情况下存在大量证据。在 2013 年毒理学学会年会上举行的一次题为“累积风险：物理和化学应激因素的毒性和相互作用”的研讨会上，为讨论研究物理应激因素的毒性以及它们与化学应激因素在暴露和效应方面的相互作用提供了一个论坛。讨论了包括阳光、热、辐射、传染病和噪声在内的物理应激因素，以确定与化学应激因素相互作用的途径、数据差距，并提出将其纳入累积风险评估的建议。
