In this book, both basic and advanced concepts are discussed for considering mixtures from initial exposure characterization through evaluation of risk associated with combined exposures. This book will provide an introduction to key issues and multiple options for evaluating both the toxicity of mixtures as well as the risk associated with exposure to mixtures. Additionally, promising tools adapted from other disciplines will be discussed in the context of mixtures toxicology and risk assessment. Finally, the discussion will move beyond chemical mixtures to address incorporating non-chemical stressors into toxicity studies and cumulative risk assessments. Although exposure to multiple chemical and non-chemical stressors is the rule, not the exception, consideration of mixtures in toxicology and risk assessment continues to be a significant challenge. This book will be an essential resource for researchers and professionals in the fields of toxicology, epidemiology, exposure science,risk assessment, and statistics.

Introduction

Combined exposures.-Measuring combined exposures
Modeling complex exposures.-Prioritizing mixtures for study
Environment-Wide Association Studies
Biogeographical analysis of chemical co-occurrence
Combining exposure and toxicity information to develop logical groupings for assessment
Maximum Cumulative Ratio for deciding when to assess mixtures
Establishing the "no interaction" baseline
Dose addition models
Response addition
Integrated addition
Mixture statistics - comparing predicted to observed
Cumulative Risk Assessment
Deciding which approach to use
Component-based approaches
Sufficient similarity of whole mixtures
Other whole mixtures approaches
Assessing interactions
Likelihood and examples of chemical interactions
PBPK modeling of chemical interactions
Adding interactions to cumulative risk assessment
Consideration of nonchemical stressors
Toxicity and interactions of physical and chemical stressors
Psychosocial and chemical stressors
Adding nonchemical stressors to cumulative risk assessments
Disease-based risk assessment
Community-based risk assessment.