Total exposure from outdoor and indoor air pollution in the Arctic

Most of the chemical contaminants and radionuclides that have been identified in the arctic environment are known to have toxic, genotoxic, or carcinogenic endpoints in humans. However, knowledge is lacking on the health effects of exposure to low concentrations of mixtures of the contaminants in various periods of a lifetime, in utero included. Therefore, more detailed study is needed on the implications of present levels of air and food contamination for human health in arctic and subarctic regions, as part of ongoing environmental monitoring programs. Here we outline the prerequisites and precautions for such studies, in particular the rationale for a total human exposure approach. We emphasize using a concept of total exposure and dose analysis (TEDA), covering integration of (1) environmental monitoring, (2) personal monitoring, (3) biological monitoring, (4) analysis of selected biomarkers of individual susceptibility and pre-stages of disease, (5) evaluation of functional changes and adverse health effects reflecting human exposure, and (6) information collected from interviews and questionnaires, taking bias and potential confounders into account.