Fox Mary A, Brewer L Elizabeth, Martin Lawrence
Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA.
Office of the Science Advisor, U.S. Environmental Protection Agency, Oak Ridge Institute for Science and Education (ORISE), Washington, DC 20004, USA.
Int J Environ Res Public Health. 2017 Apr 7;14(4):389. doi: 10.3390/ijerph14040389.
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.
累积风险评估（CRA）涉及接触多种化学和非化学压力源所产生的综合风险，可能侧重于脆弱社区或人群。在过去十年中，CRA的概念、方法和应用的发展取得了重大进展。人类健康和生态累积风险方面的工作在两种不同背景下取得了进展。第一种背景是具有共同作用模式或导致共同不良后果的化学混合物的影响。在此背景下，有两种主要模型用于预测混合物的影响，即剂量相加或反应相加。第二种背景是评估化学和非化学（如辐射、生物、营养、经济、心理、栖息地改变、土地利用变化、全球气候变化和自然灾害）压力源的综合影响。CRA可以适用于解决多种背景下的风险，这种适应性反映在已发表文献中的学科视角范围内。本文展示了文献检索的结果，并讨论了一系列选定的工作，旨在对相关主题进行广泛概述，并为对CRA应用感兴趣的研究人员提供一个起点。
