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Review Articles

Problem formulation for risk assessment of combined exposures to chemicals and other stressors in humans

, , , , , , & show all
Pages 835-844 | Received 08 Feb 2016, Accepted 07 Jul 2016, Published online: 11 Aug 2016

Figures & data

Figure 1. Diagrammatic representation of the processes of risk assessment and its relationship to risk management. Communication between the assessors and managers (dashed arrows) and the iterative nature of the process is also illustrated (modified from USEPA Citation1992).

Figure 1. Diagrammatic representation of the processes of risk assessment and its relationship to risk management. Communication between the assessors and managers (dashed arrows) and the iterative nature of the process is also illustrated (modified from USEPA Citation1992).

Figure 2. Schematic representation and description of the steps involved in PF for CRA, including the “gatekeeper” step.

Figure 2. Schematic representation and description of the steps involved in PF for CRA, including the “gatekeeper” step.

Figure 3. Diagrammatic representation of temporal differences in exposures and how these may interact with persistence of the stressor in the organism and/or latency of response or length of recovery from the stressor. Examples: (A) a mixture of a carbamate and organophosphorus insecticides, (B) an organophosphorus insecticide followed by a carbamate and (C) a carbamate followed by an organophosphorus insecticide. While this representation may not apply to apical end-points, it may help understanding and visually describing the need for CRA when an intermediate KE occurs, although, when considering an individual compound, no clear apical effect is observed. In the example provided, AChE can be inhibited at subthreshold levels by each individual compound, but, depending on timing, the threshold can be reached (overcome) after combined exposure. Heavy black lines – exposure; shaded areas – response.

Figure 3. Diagrammatic representation of temporal differences in exposures and how these may interact with persistence of the stressor in the organism and/or latency of response or length of recovery from the stressor. Examples: (A) a mixture of a carbamate and organophosphorus insecticides, (B) an organophosphorus insecticide followed by a carbamate and (C) a carbamate followed by an organophosphorus insecticide. While this representation may not apply to apical end-points, it may help understanding and visually describing the need for CRA when an intermediate KE occurs, although, when considering an individual compound, no clear apical effect is observed. In the example provided, AChE can be inhibited at subthreshold levels by each individual compound, but, depending on timing, the threshold can be reached (overcome) after combined exposure. Heavy black lines – exposure; shaded areas – response.

Table 1. Modulating factors.

Figure 4. Generic conceptual model for cumulative risk.

Figure 4. Generic conceptual model for cumulative risk.