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Figure 1 WHO/IPCS framework for assessing combined exposures to multiple chemicals from multiple sources [[1]].
The decision tree is intended to address a wide range of combined exposures that include exposures to multiple chemicals from single or multiple sources that occur over time.
The decision tree is intended to address combined exposures to multiple chemicals from one or more sources; however, many of the steps in the tree are only appropriate for the evaluation of mixtures exposures.
To summarize, sewage workers are exposed to multiple chemicals from multiple pathways resulting in a complicated matrix of exposure to chemicals and concentrations.
Often, in the United States, characterization of a hazardous waste site reveals multiple chemicals from multiple pathways resulting in a complicated matrix of chemicals and concentrations.
It is believed that humans are exposed to multiple chemicals from food, air, water, and so forth, including natural products; industrial products, such as polychlorinated biphenyls (PCBs), pesticides, and pharmaceuticals; and nonintentional products, such as dioxins.
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When doses of multiple chemicals are received from one source (multiple chemicals co-occurring in a medium or a commercial product) they can be referred to as a mixture exposure.
For example, one comparison of estimated and measured BAFs for multiple chemicals in fish from three ecosystems (n = 606) found 60%and98%8% of the estimated log BAFs were within 0.3 and 1.0 log unit of their measured values, respectively, with a correlation coefficient (r) of 0.88 (Arnot and Gobas 2004).
For example, Price & Han (2011) show how Maximum Cumulative Ratio (MCR), the ratio of the cumulative toxicity received by an individual from exposure to multiple chemicals to the largest toxicity from a single chemical, can be used as part of the WHO/IPCS Tier 1 and Tier 2 assessments.
2010 Apr 27. [Epub ahead of print] "Biological definition of multiple chemical sensitivity from redox state and cytokine profiling and not from polymorphisms of xenobiotic-metabolizing enzymes".
Sheila Bushkin-Bedient, a co-author on the study, said that another major unknown was how low level, but long-term, exposure from multiple chemicals might effect peoples' health.
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