%0 Journal Article %T Cumulative Risk Assessment Toolbox: Methods and Approaches for the Practitioner %A Margaret M. MacDonell %A Lynne A. Haroun %A Linda K. Teuschler %A Glenn E. Rice %A Richard C. Hertzberg %A James P. Butler %A Young-Soo Chang %A Shanna L. Clark %A Alan P. Johns %A Camarie S. Perry %A Shannon S. Garcia %A John H. Jacobi %A Marcienne A. Scofield %J Journal of Toxicology %D 2013 %I Hindawi Publishing Corporation %R 10.1155/2013/310904 %X The historical approach to assessing health risks of environmental chemicals has been to evaluate them one at a time. In fact, we are exposed every day to a wide variety of chemicals and are increasingly aware of potential health implications. Although considerable progress has been made in the science underlying risk assessments for real-world exposures, implementation has lagged because many practitioners are unaware of methods and tools available to support these analyses. To address this issue, the US Environmental Protection Agency developed a toolbox of cumulative risk resources for contaminated sites, as part of a resource document that was published in 2007. This paper highlights information for nearly 80 resources from the toolbox and provides selected updates, with practical notes for cumulative risk applications. Resources are organized according to the main elements of the assessment process: (1) planning, scoping, and problem formulation; (2) environmental fate and transport; (3) exposure analysis extending to human factors; (4) toxicity analysis; and (5) risk and uncertainty characterization, including presentation of results. In addition to providing online access, plans for the toolbox include addressing nonchemical stressors and applications beyond contaminated sites and further strengthening resource accessibility to support evolving analyses for cumulative risk and sustainable communities. 1. Introduction The public has become increasingly aware of the wide variety of chemicals present¡ªnot just in the environmental media to which they are exposed (such as air, water, and soil) but also in the food they eat and the products they use. As access to relevant information continues to grow, notably via the Internet, many communities have voiced concerns about health effects associated with the multiple chemicals in their daily lives. To address these concerns, many organizations have responded with approaches, guidelines, focused workshops, and illustrative applications to better assess cumulative risks. These organizations include the US Environmental Protection Agency (EPA), National Institute for Occupational Safety and Health (NIOSH), Agency for Toxic Substances and Disease Registry (ATSDR), World Health Organization (WHO), California Environmental Protection Agency (Cal/EPA), the Environmental Justice (EJ) community, and professional organizations such as the Society of Toxicology. Cumulative risk assessment (CRA) explicitly considers the combined fate and effects of multiple contaminants from multiple sources through multiple exposure %U http://www.hindawi.com/journals/jt/2013/310904/