The territorialized exposome concept to characterize cumulative risk at the population level
Résumé
Risk assessors and risk managers are currently facing two realities: The need to consider the impact of multiple exposures and combined risks, and the substantial growth of environmental data production at the territory level. The exposome concept has been proposed as an emergent exposure science paradigm for conceptualizing the cumulative effects of environmental exposures across the whole human life. The need for risk manager to identify population at-risk in the context of substantial data deficiencies that hinder evaluation of cumulative health risks brings the operational declination of the concept at the territorial scale. The characterization of the territorialized exposome implies the development of dynamic, multidimensional, longitudinal approaches, and information systems that require the adoption of transdisciplinary methods of data analysis. Integrated approaches could bring together all information necessary for assessing the source-to--dose continuum using GIS, multimedia exposure and toxicokinetic model. Different approaches could be considered for screening-level analysis of spatialized cumulative risks based on toxicology data or multivariate approach to combine exposure variables at the population level. Several case studies will be presented in a tiered manner to illustrate organized data processing when the ultimate goal of cumulative risk assessment is to identify overexposed population. Review of toxicology data are conducted in order to group substances or risk factors sharing similar toxicological effect. In other cases, finding a common metric for dissimilar risks is not a strictly analytic process, because judgments must be made as how to link two or more separate scales of risks during a deliberative process, including stakeholders to identify operational actions adapted to the policy objectives.