Table 1.

Adverse Outcome Pathways (AOP) leading to long-term health consequences.

Level of organisation	AOP
Macromolecular (seconds, hours, days)	Deposition of energy to tissue
	DNA Damage			Damage to other cellular components (RNA, proteins and lipids)
	DNA mutation	Misrepair	Apoptosis	Biochemical response to damage
	Mutations in critical genes	Chromosomal aberrations Complex damage	Damage reponse	Induction of oxidative stress	Cytokines reponding to damage
Cell/tissue (days, weeks)	Oncogene activation	Altered signalling, bystander effects		Senescence	Epigenetic changes
	Tumour suppressor gene inactivation	Increased proliferation	Genomic instability	Oxidative damage	Inflammation
Organ/Organ system (months, years)	Clonal expansion Hyperproliferation Genomic instability	Altered physiology	Systemic effects	Immunological effects	Endothelial dysfunction
	Tumour	Tumour microenvironment	Dyslipidemia Insulin resistance	Circulatory disease	Atherosclerosis
Health outcome (years, decades)	Cancer Metastasis		Metabolic syndrome	Mortality	Heart attack