Approaches for cumulative dietary risk assessment of pesticides

Strategies to estimate the risks from dietary exposure to multiple pesticides have been developed since the 1980s, based on the dose-addition of substances within a mixture with similar biological activity that differ in their potencies. In this paper, the different strategies to estimate the exposure and characterize the cumulative risks are presented and discussed, and some studies conducted in the last three years are reviewed. The main challenge is to define a cumulative assessment group (CAG), which depends primarily on a sound and high-quality toxicological database. Owing to the complexity of the process, harmonization has not yet been reached among regulatory agencies, and the process is not used for setting maximum residue levels. Most studies conducted around the world have shown potential health risks from cumulative exposure only when very conservative assumptions are used in the assessment.