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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26538.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26538.
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This activity was supported by Contract No. 68HERC19D0011 between the National Academy of Sciences and the U.S. Environmental Protection Agency. Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.

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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2022. Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/26538.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26538.
×

The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.

The National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. John L. Anderson is president.

The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president.

The three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine.

Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org.

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26538.
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Consensus Study Reports published by the National Academies of Sciences, Engineering, and Medicine document the evidence-based consensus on the study’s statement of task by an authoring committee of experts. Reports typically include findings, conclusions, and recommendations based on information gathered by the committee and the committee’s deliberations. Each report has been subjected to a rigorous and independent peer-review process and it represents the position of the National Academies on the statement of task.

Proceedings published by the National Academies of Sciences, Engineering, and Medicine chronicle the presentations and discussions at a workshop, symposium, or other event convened by the National Academies. The statements and opinions contained in proceedings are those of the participants and are not endorsed by other participants, the planning committee, or the National Academies.

Rapid Expert Consultations published by the National Academies of Sciences, Engineering, and Medicine are authored by subject-matter experts on narrowly focused topics that can be supported by a body of evidence. The discussions contained in rapid expert consultations are considered those of the authors and do not contain policy recommendations. Rapid expert consultations are reviewed by the institution before release.

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26538.
×

PLANNING COMMITTEE ON WORKSHOPS TO SUPPORT EPA’S DEVELOPMENT OF HUMAN HEALTH ASSESSMENTS

Members

ELAINE M. FAUSTMAN (Chair), University of Washington

SCOTT AUERBACH, National Institute of Environmental Health Sciences

LAURA BEANE FREEMAN, National Cancer Institute

NICHOLAS CHARTRES, University of California, San Francisco

AISHA DICKERSON, Johns Hopkins Bloomberg School of Public Health

CHIRAG PATEL, Harvard Medical School

DAVID M. REIF, North Carolina State University

DAVID RICHARDSON, University of California, Irvine

JOYCE S. TSUJI, Exponent, Inc.

CHERYL L. WALKER (NAM), Baylor College of Medicine

BYRON WALLACE, Northeastern University

Staff

KALEY BEINS, Program Officer

RAYMOND A. WASSEL, Scholar

KATHRYN Z. GUYTON, Senior Program Officer

LESLIE BEAUCHAMP, Senior Program Assistant

CLIFFORD DUKE, Board Director

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26538.
×

BOARD ON ENVIRONMENTAL STUDIES AND TOXICOLOGY

Members

FRANK W. DAVIS (Chair), University of California, Santa Barbara

ANN M. BARTUSKA, U.S. Department of Agriculture

DANA BOYD BARR, Emory University

GERMAINE M. BUCK LOUIS, George Mason University

FRANCESCA DOMINICI (NAM), Harvard University

GEORGE M. GRAY, The George Washington University

R. J. LEWIS, ExxonMobil Biomedical Sciences, Inc.

LINSEY C. MARR, Virginia Polytechnic Institute and State

MARIE L. MIRANDA, Children’s Environmental Health Initiative

R. CRAIG POSTLEWAITE, U.S. Department of Defense

REZA J. RASOULPOUR, Corteva Agriscience

JOSHUA TEWKSBURY, Smithsonian Tropical Research Institute

SACOBY M. WILSON, University of Maryland, College Park

TRACEY J. WOODRUFF, University of California, San Francisco

Staff

CLIFFORD DUKE, Director

RAYMOND A. WASSEL, Scholar and Director of Environmental Studies

KATHRYN Z. GUYTON, Senior Program Officer

KALEY BEINS, Program Officer

LAURA LLANOS, Finance Business Partner

TAMARA DAWSON, Program Associate

LESLIE BEAUCHAMP, Senior Program Assistant

THOMASINA LYLES, Senior Program Assistant

Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26538.
×

Reviewers

This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.

We thank the following individuals for their review of this proceedings:

Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by MARK CULLEN, Stanford University. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. We also thank staff member ROBERTA WEDGE for reading and providing helpful comments on this manuscript. Responsibility for the final content rests entirely with the rapporteurs and the National Academies.

Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26538.
×

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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26538.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26538.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26538.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26538.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26538.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26538.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26538.
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26538.
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Page viii Cite
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26538.
×
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Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26538.
×
PageR9
Suggested Citation:"Front Matter." National Academies of Sciences, Engineering, and Medicine. 2022. Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop. Washington, DC: The National Academies Press. doi: 10.17226/26538.
×
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Triangulation in Environmental Epidemiology for EPA Human Health Assessments: Proceedings of a Workshop Get This Book
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Human health risk assessments provide the basis for public health decision-making and chemical regulation in the United States. Three evidence streams generally support the development of human health risk assessments - epidemiology, toxicology, and mechanistic information. Epidemiologic studies are generally the preferred evidence stream for assessing causal relationships during hazard identification. However, the available studies may be limited in scope, subject to bias, or otherwise inadequate to inform causal inferences. In addition, there are challenges in assessing coherence, validity, and reliability during synthesis of individual epidemiological studies with different designs, which in turn affects conclusions on causation.

Triangulation aims to address the challenge of synthesizing evidence from diverse studies with distinct sources of bias. Bias is a systematic error that leads to inaccurate study results. Tools for assessing risk of bias provide a structured list of questions for systematic consideration of different domains (such as confounding, selective reporting, and conflict of interest). These tools also provide a structured framework for identifying potential sources of bias and informing judgments on individual studies. The National Academies of Sciences, Engineering, and Medicine convened a workshop to understand and explore triangulation and opportunities to use the practice to enhance the EPA's human health assessments. The workshop was held virtually on May 9 and 11, 2022. This publication summarizes the key presentations and discussions conducted during the workshop.

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