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Interest in estimation the global burden of disease from exposure to outdoor concentrations of fine particulate matter has evolved from simplistic risk models based on a few studies to a complex integration of multiple independent particulate sources based on nearly one hundred studies. These models can now be used to estimate burden from not only outdoor air pollution sources covering the global range, but to other particulate sources including second hand smoke and household pollution from heating and cooking. The Integrated Exposure-Response (IER) model has now been extensively used to examine strategies to improve air quality throughout the world. But what is its future? Can the IER assumptions of equal toxicity among sources, independence of dosing rate, and exposure equivalence based on total inhaled dose even be clearly tested? Can it be replaced by simpler models requiring fewer …