Psychosocial and chemical stressors

Abstract

Psychosocial stress has been consistently linked with alterations in immune, endocrine, and metabolic function, and growing evidence indicates that psychosocial stressors-including noise, poverty, and exposure to violence-may alter human susceptibility to environmental chemical exposures. As a result, there is a growing need for methods to disentangle patterns in chemical and non-chemical exposures and to quantify their independent and interacting effects on health. Here, a framework is presented for integrating psychosocial stressors into a traditional risk assessment approach, with attention to exposure assessment for non-chemical stressors and to statistical methods for incorporation of very disparate exposures into a risk assessment. Finally, an illustrative case example is presented, to demonstrate an approach for incorporating a psychosocial stressor (here, exposure to violence, a key stressor in urban U.S. communities) into a cumulative risk assessment aiming to quantify air pollution effects on health.