title: International experience in addressing combined exposures: increasing the efficiency of assessment.
abstract: More efficient methodology for assessing the impact of combined exposures to multiple chemicals has been considered in a project of the World Health Organization (WHO) International Programme on Chemical Safety (IPCS). Recommendations regarding terminology and the status of development of the framework, its content, review and application are described. Evolving experience in its application is illustrated by example (polybrominated diphenyls) with special emphasis on the critical content of problem formulation, the role of predictive tools in grouping of chemicals for consideration and the importance of explicit delineation of relative uncertainty and sensitivity for tiered assessment. Priorities in increasing the efficiency of risk assessment not only for combined exposures, but more generally based on experience acquired in developing the framework and its application in case studies are identified and recommendations included.
authors.affiliation: Chemical Risk Assessment, McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, One Stewart St., Suite 309, Ottawa, Ont., Canada K1N 6N5. Electronic address: bmeek@uottawa.ca.
authors.forename: M E Bette
authors.initials: ME
authors.lastname: Meek
mesh_terms: D045424:Complex Mixtures / Q000633:toxicity*; D003661:Decision Support Techniques; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis; D006078:Government Programs; D007391:International Cooperation; D018570:Risk Assessment / Q000331:legislation & jurisprudence / Q000379:methods*; D014944:World Health Organization
chemical_list: D045424:Complex Mixtures
keywords: Combined exposure; Exposure assessment; Framework analysis; Predictive methodology; Threshold of toxicological concern; Tiered approach