Combined effects of nanoparticles and other environmental contaminants on human health - an issue often overlooked.

Air pollution is considered as a major public health issue worldwide. It consists of a complex mixture of pollutants including nanoparticles to which we are increasingly exposed to due to the dramatic development of the nanotechnologies and their incidental or intentional release in the environment. Consequently, some concerns have raised about the combined toxicity of air particulates and other air pollutants on human health. However, the interactions between the contaminants and their resulting combined toxicity are often overlooked. Indeed, the biological effects triggered by nanoparticles are usually assessed focusing on individual nanoparticles, while their interaction with co-contaminants can deeply impact, either positively or negatively, their biodistribution, fate in the organism and toxicological profile (additive, synergistic or antagonistic responses). This paper presents a bibliographic review on the combined toxicity of nanoparticles and co-pollutants and discusses the underlying mechanisms. It also highlights the scarcity of data in the current literature, arguing for an urgent need to take into account the mixture effects to be more representative of real-life conditions for a better and accurate human health risk assessment and management.