Costs of Environment-Related Health Effects A Plan for Continuing Study : Report of a Study (1981) / Chapter Skim
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Pages 64-84
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From page 67... ...
CHAPTER 3 INFORMATION NEEDED TO ASSESS AND QUANTIFY HEALTH EFFECTS Repeated attempts in recent years to assess the health impacts of environmental factors have been hampered by the fragmentary state of present knowledge. Public Law 95-623 specifically lists cancer, birth defects, genetic damage, emphysema, asthma, bronchitis and other respiratory diseases, heart disease, stroke, and mental illness and impairment as examples of health problems to be considered by the ongoing study.
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From page 68... ...
Three types of studies provide evidence about whether a substance or exposure may lead to health problems: o short-term experimental in vitro tests* and animal studies o clinical studies, particularly studies using human volunteers o epidemiologic studies, which provide data on the distribution and determinants of disease and illness in human populations.
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From page 69... ...
effects of radiation on human beings provide one of the better examples of an area where data on both exposure and health effects exist. Even in this example, however, controversy continues about estimating the health effects of low levels of radiation because of the need to extrapolate from results seen at higher doses.
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From page 70... ...
Although short-term tests are used primarily for detecting mutagenic and other effects that are assumed to be related to carcinogenesis, it would be useful if there were quick tests for other types of effects -- such effects could include problems with the reproductive or nervous system, liver function, or lung function. Researchers now are attempting to develop such tests.
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From page 71... ...
Risk extrapolation estimates using various models give similar results at high doses where measurements are available, and give very different results at low doses. In one massive experiment, called the EDO]
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From page 72... ...
epidemiologic studies. Clinical documentation of human disease that is similar to an animal disease permits more secure generalization from animal studies.
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From page 73... ...
of study With few the more carry it (1)
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From page 74... ...
(4) Case-control studies begin with two groups of individuals that differ according to whether or not they have a specific disease or illness.
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From page 75... ...
observable adverse health effect, the more likely it is that the relationship is causal and not attributable to known or unknown confounding factors.
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From page 76... ...
infectious agents, and exposure to physical and chemical environmental agents other than the one under inquiry, also will modify the biologic response to the causal agent. Analysis of Data from Varied Sources Large bodies of data have been collected on various characteristics of the environment and on the health status of individuals.
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From page 77... ...
Heart, Lung, and Blood Institute, has provided much useful information about risk factors for heart attacks.33,34 Although the power of well-designed longitudinal studies is great, they require long-term commitment of personnel and resources. See Appendix E for approximate costs associated with some epidemiologic studies.
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From page 78... ...
known to be exposed and to measure the success of efforts to remove the environmental hazards and to decrease environment-related disease over time. Environmental monitoring systems are numerous, / have had a wide range of objectives, and have been applied to many target areas; there are, however, fewer examples of systematic efforts to measure specific exposures for defined populations in whom disease or illness is also ascertained.
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From page 79... ...
studying effects of exposure on health outcome. In some cases, occupational groups provide the only sources of data on human health effects from specific chemicals, and this information is used to estimate risk to the general population from exposure to various amounts of the same substances.
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From page 80... ...
For these and other reasons, concepts of disease reporting that have been of considerable utility in the control of communicable diseases have found only limited application in occupational disease surveillance. With the institution of a National Death Index in 1981, use of death certificates for epidemiologic studies will become easier, but the certificates still must have relevant information coded dependably.
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From page 81... ...
adequate system for national surveillance of occupational hazards, disease, and death will appear in a later section of the report. Hazard surveillance The only nationally comparable worksite hazard identification system has been derived from the first National Occupational Hazard Survey (NOHS)
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From page 82... ...
3) Trade-name Product Ingredient Clarification File is being developed for use by workers, unions, employers, medical care providers, and occupational health researchers to identify the chemical constituents of trade-name products and possible toxicological risks.
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From page 83... ...
in Niagara Falls, New York, and a DDT spill in Triana, Alabama,48 are recent examples of environmental exposures that have led to long-term chronic exposure. The numbers of persons exposed each year to environmental toxins in episodes such as these is not known, but may be large.
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From page 84... ...
The primary responsibility of this team would be to go rapidly to the sites of acute environmental events in order to conduct studies that would document and measure: a)
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