Using biomarkers to inform cumulative risk assessment

P. Barry Ryan, Thomas A. Burke, Elaine A. Cohen Hubal, Jerome J. Cura, Thomas E. McKone

Research output: Contribution to journalArticlepeer-review


Background: Biomarkers are considered the method of choice for determining exposure to environmental contaminants and relating such exposures to health outcomes. However, the association between many biomarkers and outcome is not direct because of variability in sensitivity and susceptibility in the individual. Objectives: We explore the relationship between environmental exposures and health outcomes as mitigated by differential susceptibility in individuals or populations and address the question "Can biomarkers enable us to understand and quantify better the population burden of disease and health effects attributable to environmental exposures?" Methods: We use a case-study approach to develop the thesis that biomarkers offer a pathway to disaggregation of health effects into specific, if multiple, risk factors. We offer the point of view that a series or array of biomarkers, including biomarkers of exposure, biomarkers of susceptibility, and biomarkers of effect, used in concert offer the best means by which to effect this disaggregation. We commence our discussion by developing the characteristics of an ideal biomarker, then give some examples of commonly used biomarkers to show the strengths and weaknesses of current usage. We follow this by more detailed case-study assessment outlining the state-of-the-science in specific cases. We complete our work with recommendations regarding the future use of biomarkers and areas for continued development. Conclusions: The case studies provide examples of when and how biomarkers can be used to infer the source and magnitude of exposure among a set of competing sources and pathways. The answer to this question is chemical specific and relates to how well the biomarker matches the characteristics of an "ideal" biomarker-in particular ease of collection and persistence. The use of biomarkers in combination provides a better opportunity to disaggregate both source and pathway contributions.

Original languageEnglish (US)
Pages (from-to)833-840
Number of pages8
JournalEnvironmental health perspectives
Issue number5
StatePublished - May 2007


  • Biomarkers of effect
  • Biomarkers of exposure
  • Biomarkers of susceptibility
  • Cumulative exposure
  • Multiple stressors
  • Risk assessment

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


Dive into the research topics of 'Using biomarkers to inform cumulative risk assessment'. Together they form a unique fingerprint.

Cite this