There is strong presumptive evidence that people living in poverty and certain racial and ethnic groups bear a disproportionate burden of environmental health risk. Many have argued that conducting formal assessments of the health risk experienced by affected communities is both unnecessary and counterproductive—that instead of analyzing the situation our efforts should be devoted to fixing obvious problems and rectifying observable wrongs. We contend that formal assessment of cumulative health risks from combined effects of chemical and nonchemical stressors is a valuable tool to aid decision makers in choosing risk management options that are effective, efficient, and equitable. If used properly, cumulative risk assessment need not impair decision makers’ discretion, nor should it be used as an excuse for doing nothing in the face of evident harm. Good policy decisions require more than good intentions; they necessitate analysis of risk-related information along with careful consideration of economic issues, ethical and moral principles, legal precedents, political realities, cultural beliefs, societal values, and bureaucratic impediments. Cumulative risk assessment can provide a systematic and impartial means for informing policy decisions about environmental justice.
References
[1]
National Research Council. Science and Decisions: Advancing Risk Assessment; National Academy Press: Washington, DC, USA, 2009.
[2]
Callahan, MA; Sexton, K. If cumulative risk assessment is the answer, what is the question? Environ. Health Perspect?2007, 115, 799–806, doi:10.1289/ehp.9330. 17520071
[3]
Framework for Cumulative Risk Assessment; US EPA Risk Assessment Forum: Washington, DC, USA, 2003.
[4]
Institute of Medicine. Toward Environmental Justice: Research, Education, and Health Policy Needs; National Academy Press: Washington, DC, USA, 1999.
[5]
Institute of Medicine. Unequal Treatment; National Academy Press: Washington, DC, USA, 2002.
[6]
National Environmental Justice Advisory Council. Ensuring Risk Reduction in Communities with Multiple Stressors: Environmental Justice and Cumulative Risks/Impacts; Report to the Office of Environmental Justice; US EPA: Washington, DC, USA, 2004.
[7]
National Research Council. Risk Assessment in the Federal Government: Managing the Process; National Academy Press: Washington, DC, USA, 1983.
[8]
Sexton, K. Socioeconomic and racial disparities in environmental health: Is risk assessment part of the problem or part of the solution? Human Ecol. Risk Assess?2000, 6, 561–574, doi:10.1080/10807030008951330.
[9]
Sexton, K. Sociodemographic aspects of human susceptibility to toxic chemicals: Do class and race matter for realistic risk assessment? Environ. Tox. Pharma?1997, 4, 261–269, doi:10.1016/S1382-6689(97)10020-5.
[10]
Silbergeld, EK. Risk assessment: The perspective and experience of U.S. environmentalists. Environ. Health Perspect?1993, 101, 100–104, doi:10.1289/ehp.93101100. 8354185
[11]
Israel, BD. An environmental justice critique of risk assessment. N.Y. Univ. Environ. Law J?1995, 3, 469–522.
[12]
Kuehn, RR. The environmental justice implications of quantitative risk assessment. Univ. Ill. Law Rev?1996, 1, 103–172.
[13]
O’Brien, M. Making Better Environmental Decisions: An Alternative to Risk Assessment; MIT Press: Cambridge, MA, USA, 2000.
[14]
Montague, P. Reducing the harms associated with risk assessment. Environ. Impact Assess. Rev?2004, 24, 733–748, doi:10.1016/j.eiar.2004.06.004.
[15]
Michaels, D. Doubt in Their Product: How Industry’s Assault on Science Threatens Your Health; Oxford University Press: New York, NY, USA, 2008.
[16]
National Research Council. Science and Judgment in Risk Assessment; National Academy Press: Washington, DC, USA, 1994.
[17]
Sexton, K; Adgate, JL. Looking at environmental justice from an environmental health perspective. J. Exp. Anal. Environ. Epidemiol?1999, 9, 3–8, doi:10.1038/sj.jea.7500021.
[18]
Graham, JD; Hammitt, JK. Refining the CRA Framework. In Comparing Environmental Risks: Tools for Setting Government Priorities; Davies, JC, Ed.; Resources for the Future: Washington, DC, 1996; pp. 93–109.
[19]
Guidelines for the Health Risk Assessment of Chemical Mixtures; US EPA Risk Assessment Forum: Washington, DC, USA, 1986.
[20]
Supplementary Guidance for Conducting Health Risk Assessment of Chemical Mixtures; US EPA Risk Assessment Forum: Washington, DC, USA, 2000.
[21]
Considerations for Developing Alternative Health Risk Assessment Approaches for Addressing Multiple Chemicals, Exposures, and Effects; US EPA National Center for Environmental Assessment: Washington, DC, USA, 2006.
[22]
Concepts, Methods, and Data Sources for Cumulative Health Risk Assessment of Multiple Chemicals, Exposures and Effects: A Resource Document; US EPA National Center for Environmental Assessment: Washington, DC, USA, 2007.
[23]
Barzyk, TM; Conlon, KC; Chanine, T; Hammond, DM; Zartarian, G; Schultz, BD. Tools available to communities for conducting cumulative exposure and risk assessments. J. Exp. Sci Environ. Epidemiol?2010, 20, 371–384, doi:10.1038/jes.2009.25.
[24]
Gee, GC; Payne-Sturges, DC. Environmental health disparities: A framework integrating psychosocial and environmental concepts. Environ. Health Perspect?2004, 112, 1645–1650, doi:10.1289/ehp.7074. 15579407
[25]
Morello-Frosch, R; Shenassa, ED. The environmental “riskscape” and social inequality: Implications for explaining maternal and child health disparities. Environ. Health Perspect?2006, 114, 1150–1153, doi:10.1289/ehp.8930. 16882517
[26]
Payne-Sturges, DC; Gee, GC; Crowder, K; Hurley, BJ; Lee, C; Morello-Frosch, R; Rosenbaum, A; Schulz, A; Wells, C; Woodruff, T; Zenick, H. Workshop summary: Connecting social and environmental factors to measure and track environmental health disparities. Environ. Res?2006, 102, 146–153, doi:10.1016/j.envres.2005.11.001. 16438950
[27]
Morello-Frosch, R; Lopez, R. The riskscape and the color line: Examining the role of segregation in environmental health disparities. Environ. Health Perspect?2006, 102, 181–196.
[28]
Defur, PL; Evans, GW; Cohen, Hubal EA; Kyle, AD; Morello-Frosch, RA; Williams, DR. Vulnerability as a function of individual and group resources in cumulative risk assessment. Environ. Health Perspect?2007, 115, 817–824, doi:10.1289/ehp.9332. 17520073
[29]
Linder, SH; Sexton, K. Conceptual models for cumulative risk assessment. Am J Public Health?2010. submitted.
[30]
Sexton, K; Linder, SH. Cumulative risk assessment for combined health effects from chemical and nonchemical stressors. Am J Public Health?2010. submitted.
[31]
Su, JG; Morello-Frosch, R; Jesdale, BM; Kyle, AD; Shamasunder, B. An index for assessing demographic inequities in cumulative environmental hazards with application to Los Angeles. Environ. Sci. Technol?2009, 43, 7626–7634, doi:10.1021/es901041p. 19921871
[32]
Urban Heart: Urban Health Equity Assessment and Response Tool; WHO Publications: Kobe, Japan, 2010.
[33]
Zartarian, VG; Schultz, BD. The EPA’s human exposure research program for assessing cumulative risk in communities. J. Exp. Sci. Environ. Epidemiol?2010, 20, 351–358, doi:10.1038/jes.2009.20.
[34]
National Environmental Justice Advisory Council. Nationally Consistent Environmental Justice Screening Approaches; EPA: Washington, DC, USA, 2010.
[35]
Sexton, K; Hattis, D. Assessing cumulative health risks from exposure to environmental mixtures—Three fundamental questions. Environ. Health Perspect?2007, 115, 825–832, doi:10.1289/ehp.9333. 17520074
[36]
Sexton, K. Science and policy in regulatory decision making: getting the facts right about hazardous air pollutants. Environ. Health Perspect?1995, 103, 213–221. 8549476