摘要：We examined traditional environmental justice populations and other groups whose exposure to contaminants is often disproportionately high. Risk assessment methods may not identify these populations, particularly if they are spatially dispersed. We suggest using a National Health and Nutrition Examination Survey approach to oversample minority communities and develop methods for assessing exposure at different distances from pollution sources; publishing arithmetic and geometric means and full distributions for minority populations; and paying particular attention to high-end exposures. Means may sufficiently characterize populations as a whole but are inadequate in identifying vulnerable groups and subgroups. The number of individuals above the 95th percentile of any distribution may be small and unrepresentative, but these outliers are the ones who need to be protected. Environmental risks are not uniformly distributed across groups of people. Age, poverty, and minority status place some groups at a disproportionately high risk for environmental disease. Such groups are exposed to hazardous chemicals or conditions at levels well above those for the general populations. 1 , 2 These exposures may be high-end exposures (> 95th or 99th percentile) to common agents or exposures the general population does not encounter. In traditional risk assessment and management, outliers are excluded or log-transformed; however, special attention should be paid to them. We discuss populations with high-end, unique exposure pathways (children, Native Americans, minorities, rural and urban poor), whose risk from combined exposures (chemical, physical, psychosocial) is likely to be underestimated by risk assessment practices, and examine their contribution to health disparities. Some of these populations are traditionally recognized environmental justice communities. We build on our conceptual model for unique exposure pathways, and we also make specific recommendations regarding how a National Health and Nutrition Examination Survey approach can focus attention on addressing information disparities. We used Medline searches to identify the articles included in this review, using keywords for vulnerable populations, tables of contents searches for environmental justice in biomedical journals, US Environmental Protection Agency documents, 1 and our cumulative research experience. More search details are provided in our other article in this issue Our review is also based on our work with environmental health, exposure, and risk assessment.
