Cumulative risk assessment (CRA) is a tool with the potential to revolutionize the piecemeal approach to health protective environmental regulations at US EPA and the single chemical risk assessment methods used to define them. CRA adopts the multiple determinants of health model providing an opportunity to re-align public and environmental health. Unfortunately cumulative risk assessment is well-defined conceptually but lacking methodologically. This project advanced and validated the toxicological basis of CRA in a case study examining the relationships between risk scores and health outcomes. A multi-endpoint toxicological database was developed to address a limitation of current toxicological references based on the single critical health effect of a chemical exposure. This multi-endpoint database was used to characterize the risks of the Clean Air Act Hazardous Air Pollutants for several Philadelphia neighborhoods. Non-parametric correlation and Poisson regression techniques were employed to test the hypothesis that the cumulative risk scores would be positively correlated and associated with mortality at the neighborhood and census tract levels. Positive correlations and statistically significant (p<0.001) associations between cumulative risk scores and total mortality rates were found when the cumulative risk assessment was conducted with the multi-endpoint toxicological database. Statistically significant increases in respiratory mortality rates, ranging from 8 to 23%, were associated with respiratory risk scores. While validating CRA concepts this work indicates that current approaches are too narrow and do not consider the full range of potential community health impacts from environmental exposures.
Learning Objectives: List three outcomes of public health concern currently under-represented in US EPA's toxicological reference databases. Describe potential applications of cumulative risk assessment in public/community health practice. Identify three inter-disciplinary areas of future public/environmental health research.
Keywords: Risk Assessment, Community Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.