An integrated environmental health exposure assessment (IEHA) refers to the integration of human biomonitoring data (HBM) and environmental measurements and aims to optimize the exposure assessment process. Due to lack of data, this approach remains an issue during chemical incidents. This study aims to explore integrated exposure approaches for assessing human health risks during chemical incidents. Based on the Preferred Reporting Items of Systematic reviews and Meta-Analyses statement, a literature analysis was performed. A level of confidence ranging from 1 to 4 was established to define the quality and strength of data used to undertake an IEHA approach. Twenty-seven articles (n = 18) and texts (n = 9) from Europe (41%) and the United States (37%) were analyzed. Among the 18 scientific articles, 61% (n = 11) presented a quantitative approach and 17% (n = 3) presented a qualitative approach. Quantitative approaches must be based on accurate data, coupled with predictive models. Of all the scientific papers, 40% (n = 7) responded to a confidence level greater than or equal to 2. Uncertainties detected through the integrated exposure approaches were related to input data, analytical methods, and HBM reference value interpretations. During chemical incidents, direct measurements were the most relevant data. Few scientific studies have developed an integrated approach during emergency situations. However, when this was used, they presented a high level of confidence by defining levels of exposure that support decision-making processes. Despite the multiple approaches, there was a lack of guidelines allowing an integrated risk assessment to be performed during an emergency chemical exposure. Integr Environ Assess Manag 2024;20:481-497. © 2023 SETAC.
Keywords: Acute exposure; Chemical incident; Exposure assessment; Integrated human health risk assessment; Principles and practices.
© 2023 SETAC.