Methods for Evaluating the Combined Effects of Chemical and Nonchemical Exposures for Cumulative Environmental Health Risk Assessment
Abstract
:1. Introduction
2. Psychosocial Stressors in Cumulative Risk Assessment
3. Understanding Biological Mechanisms: Animal Models and Human Biomonitoring
3.1. Animal Models to Examine Combined Effects
3.2. Human Biomarker Studies to Assess Combined Effects
4. Identifying Environmental Stressors Relevant to Communities
5. Challenges in Exposure Assessment for Nonchemical Stressors
5.1. Construct Validity and Publicly-Available Databases for Nonchemical Stressors
5.2. Spatial Scale and Chemical and Nonchemical Exposure Assessment
6. Statistical Methods for Assessing Combined Effects on Health
6.1. Latent Variable Modeling
6.2. Structural Equation Modeling (SEM)
6.3. Alternative Approaches for Evaluating Complex Interactions
7. Discussion
8. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Short Title | Full Title | Institution(s) | Link to Grant Abstract and Annual Reports | Exposures | Outcomes | |
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Psychosocial/Nonchemical Stressors Evaluated | Pollutant/Chemical Stressors Evaluated | Health Outcomes Evaluated | ||||
The BU/Chelsea STAR Project | New Methods for Analysis of Cumulative Risk in Urban Populations | Boston University; The Chelsea Collaborative | https://cfpub.epa.gov/ncer_abstracts/index.cfm/fuseaction/display.abstractDetail/abstract/9278/report/0 | Crisis In Family Systems (CRISYS) survey items: financial, legal and home issue domains; Neighborhood/Block Conditions, IV Environmental Assessments, Exposure to Violence Assessment, Inner City Asthma Study, The Multigroup Ethnic Identity Measure, Reactions to Race; food accessibility, use of parks, perceptions of noise and odor. | High traffic roadways, toxic release inventories, land uses. | Self-rated health; diagnosed diabetes, heart attack, heart disease, asthma, emphysema/respiratory disease, overweight, arthritis, hypertension, psoriasis, vitiligo, cancer, depression/mental health and chronic disease; symptoms |
The BU/NorthStar STAR Project | Effects-Based Cumulative Risk Assessment in a Low-Income Urban Community near a Superfund Site | Boston University; NorthStar Learning Centers | https://cfpub.epa.gov/ncer_abstracts/index.cfm/fuseaction/display.abstractDetail/abstract/9144/report/0 | Sociodemographic proxies (education, race/ethnicity, income), maternal smoking during pregnancy, maternal stress during pregnancy (characterized in part by community violence), diet, access to health care. | ADHD-like behavior: Blood Pb (cord blood and at various ages), serum polychlorinated biphenyls (PCBs), serum DDE, hair mercury, ETS exposure approximated by questionnaire data and modelsBlood pressure: Blood Pb, blood Hg, blood Cd, ETS | ADHD-like behavior, blood pressure |
The University of Pittsburgh/WE ACT STAR Project | Community Stressors and Susceptibility to Air Pollution in Urban Asthma | University of Pittsburgh; West Harlem Environmental Action (WE ACT) | https://cfpub.epa.gov/ncer_abstracts/index.cfm/fuseaction/display.abstractDetail/abstract/9279/report/0 | Community stressors were identified in citywide focus groups. GIS indicators were collected from administrative data (yrs 2008–2010) on crime and violence, mental and general health, built environment, healthcare access, noise disruption, child-specific stressors (e.g., schools conditions), socio-economic position. Citywide surveys measured perceived stress, anxiety, depression, caregiver stress, urban life events, unfair treatment, social support, and perceived neighborhood disorder, social capital, and violence. | DOHMH New York City Community Air Survey (NYCCAS) city-wide pollution (PM2.5, NO2, EC, SO2, O3), 2008–2010. Environmental Protection Agency (EPA) AQS regulatory daily. | Child asthma exacerbation and morbidity |
The Rutgers/Ironbound STAR Project | Effects of Stress and Traffic Pollutants on Childhood Asthma in an Urban Community | Rutgers, The State University of New Jersey; Ironbound Community Corporation (ICC) | https://cfpub.epa.gov/ncer_abstracts/index.cfm/fuseaction/display.abstractDetail/abstract/9277/report/0 | UCLA interview, focus groups, stress reactivity, glucocorticoid and b2-adrenergic receptor levels. | Personal real-time black carbon, 24-h NO2 by passive sampler, EPA central site priority pollutant | Emergency department data on asthma exacerbation measured as symptoms, medication use, exhaled nitric oxide, spirometry |
The Rochester STAR Project | Combined Effects of Metals and Stress on Central Nervous System Function | University of Rochester School of Medicine and Dentistry | https://cfpub.epa.gov/ncer_abstracts/index.cfm/fuseaction/display.abstractDetail/abstract/9275/report/0 | In animal models, the stressors are directly imposed and measures of its efficacy can include any changes in function of the hypothalamic-pituitary-adrenal (HPA) axis or changes in behavior or brain function. | Blood lead and brain measures of metals by atomic absorption spectrometry | Cognitive function, IQ, attention deficit |
The UT/TCCAP STAR Project | Analytical Strategies for Assessing Cumulative Effects of Chemical and Nonchemical Stressors | University of Texas; Texas City Community Advisory Panel (TCCAP) | https://cfpub.epa.gov/ncer_abstracts/index.cfm/fuseaction/display.abstractDetail/abstract/9276/report/0 | Neighborhood stressors (crime, infrastructure, income distribution, segregation) Social stressors (poverty, employment, discrimination, access to care, educational attainment) Psychosocial stress (perceived stress, perception of environmental risk, self-reported coping, social support. | Chronic: EPA National Air Toxics Assessment 2005 ambient concentrations of air toxics (cumulative cancer risk). Acute: Upset event releases of toxics, monitoring data, ozone warning days, PM alerts, high allergen counts, self-reported exposures. | Allostatic load, SR-36, glucose and lipid markers, antibody titers, inflammatory markers, current conditions, current meds |
The UTHealth/Mano a Mano STAR Project | Hypertension in Mexican-Americans: Assessing Disparities in Air Pollutant Risks | University of Texas Health Science Center at Houston (UTHealth) School of Public Health; MD Anderson Cancer Center; National Chiao-Tung University | https://cfpub.epa.gov/ncer_abstracts/index.cfm/fuseaction/display.abstractDetail/abstract/9147/report/0 | Individual-, family- and neighborhood-level stressors identified through community focus groups:—Individual level (anxiety/depression, aches and pains, trouble sleeping, worrying about health/money/time for oneself)—Family level (family illness/separation, domestic violence, trouble with children)—Neighborhood level (noise, traffic, litter, safety, violence at children‘s school)—Other social stressors (coming into contact with authorities, feeling discriminated against due to race/ethnicity or immigration status)—Stressors at work (worrying about working too hard or harmful substance exposures) | Publicly available data sets from the Texas Commission on Environmental Quality (TCEQ); concentrations of particulate matter ≤2.5 micrometers in aerodynamic diameter (PM2.5) and ozone (O3). | Self-reported hypertension |
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Payne-Sturges, D.C.; Scammell, M.K.; Levy, J.I.; Cory-Slechta, D.A.; Symanski, E.; Carr Shmool, J.L.; Laumbach, R.; Linder, S.; Clougherty, J.E. Methods for Evaluating the Combined Effects of Chemical and Nonchemical Exposures for Cumulative Environmental Health Risk Assessment. Int. J. Environ. Res. Public Health 2018, 15, 2797. https://doi.org/10.3390/ijerph15122797
Payne-Sturges DC, Scammell MK, Levy JI, Cory-Slechta DA, Symanski E, Carr Shmool JL, Laumbach R, Linder S, Clougherty JE. Methods for Evaluating the Combined Effects of Chemical and Nonchemical Exposures for Cumulative Environmental Health Risk Assessment. International Journal of Environmental Research and Public Health. 2018; 15(12):2797. https://doi.org/10.3390/ijerph15122797
Chicago/Turabian StylePayne-Sturges, Devon C., Madeleine K. Scammell, Jonathan I. Levy, Deborah A. Cory-Slechta, Elaine Symanski, Jessie L. Carr Shmool, Robert Laumbach, Stephen Linder, and Jane E. Clougherty. 2018. "Methods for Evaluating the Combined Effects of Chemical and Nonchemical Exposures for Cumulative Environmental Health Risk Assessment" International Journal of Environmental Research and Public Health 15, no. 12: 2797. https://doi.org/10.3390/ijerph15122797