Epidemiology and Air Pollution (1985) / Chapter Skim
Currently Skimming:
Executive Summary
Executive Summary
Pages 1-20
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 1... ...
• Determine the types of epidemiologic studies and research strategies that are needed for assessing health effects of exposure to air pollutants. • Identify populations and exposure conditions that merit additional epidemiologic study to determine health effects of air pollution.
|
From page 2... ...
This report assesses the limits of available epidemiologic techniques for studying air pollution problems and discusses opportunities for expanding these limits and for using epidemiologic studies effectively in an overall program of research on air pollution. Outdoor concentrations of many air pollutants -- such as sulfur dioxide, particles, ozone, and lead -- over most of the United States have decreased during the last 20 years.
|
From page 3... ...
Future pulmonary research to clarify the basis for individual variation in response and determine the relation between acute effects and long-term lung function will be particularly important in defining new opportunities for epidemiologic study of air pollution and acute effects. Chronic effects that warrant study include chronic obstructive pulmonary disease (COPD)
|
From page 4... ...
Some of the nonrespiratory effects that warrant further epidemiologic study are the effects of lead on childhood neurobehavioral development and on blood pressure and the effects of carbon monoxide on ischemic heart disease. Possible carcinogenic, mutagenic, or neurotoxic effects of community exposures to benzene and other volatile organic substances are also of concern, but full-scale epidemiologic studies might not yet be feasible except in selected areas near point sources.
|
From page 5... ...
Information on internal dose and biologically effective dose is not generally available, but should be developed. In the interim, epidemiologic studies of air pollution will continue to rely on outdoor and indoor ambient exposure data, including data based on personal monitoring.
|
From page 6... ...
The Committee recognizes that total personal exposure to an air pollutant is a conceptually important measure for epidemiology, in that it provides the most valid overall predictor of the risk of any air-pollution-related health effect. Several factors that can modify personal exposure might also be relevant in planning exposure assessment for epidemiologic studies, including activity, respiratory tract physiology, and weather patterns.
|
From page 7... ...
Research is needed to characterize pollutants and to validate the use of surrogate measures. Exposure assessment data can be used during study planning to improve several aspects of study design, including selection of study populations, specification of the relevant physical, chemical, or biologic characteristics of pollutants, and determination of needed sample size.
|
From page 8... ...
Another factor that has become an integral part of epidemiologic research planning concerns estimating the costeffectiveness of various ways to answer specific questions. Epidemiologic methods that could be applied to air pollution questions include descriptive epidemiology or univariate studies; ecologic studies; cohort studies; case-control methods, including the nested case-control method; crosssectional studies; and intervention studies.
|
From page 9... ...
Using a framework that considers critical components of study strategy and design, the Committee addresses questions involving four health effects of concern: acute respiratory infection, chronic obstructive pulmonary disease (COPD) , asthma, and lung cancer.
|
From page 10... ...
For studying the effects of woodsmoke, ecologic studies might be especially helpful initially, whereas indoor monitoring is crucial for studying the effects of nitrogen dioxide. In some studies of air pollution effects, it might be useful to eliminate direct smoking as a confounder by restricting study subjects to nonsmokers; however, only by including smokers can interactions between air pollution and smoking be detected.
|
From page 11... ...
A productive epidemiologic research program must have a dual character with respect to sensitivity to outside forces. Part of the program must be dedicated to responding to rapidly changing conditions that offer important opportunities for study, to the varying concerns of regulators, and to new information from technologic development and parallel disciplines.
|
From page 12... ...
Modification in the routinely collected air sampling data alone might be appropriate, to facilitate use of these data in some types of epidemiologic studies. THE FOCUS FOR RESEARCH For the immediate future, the epidemiologic research program should focus on the following exposures and effects of concern: • Persistent air pollution problems, including the health effects of acid sulfate particles, ozone, nitrogen dioxide, carbon monoxide, lead, and radon.
|
From page 13... ...
These changes will result in increased exposures to volatile and particulate organic compounds, radon, carbon monoxide, and other potentially hazardous materials. Indoor air pollution can be a major factor -- in some instances the principal factor -- in determining total personal exposure (averaged and acute)
|
From page 14... ...
Air pollution might have nonrespiratory effects that, although not emphasized in this report, also deserve study. These include neurobehavioral deficits and essential hypertension related to lead exposure, ischemic heart disease related to carbon monoxide, and carcinogenesis and mutagenesis related to various volatile hydrocarbons.
|
From page 15... ...
, and limitations in our understanding of the biology underlying the gradual evolution of chronic damage. Epidemiologic studies can show whether exposure to a complex pattern of polluted air increases the risk of adverse health effects in human populations, but studies are often limited in their ability to delineate the quantitative relationships between concentrations or sources of specific air pollutants and health.
|
From page 16... ...
Personal exposure monitoring and modeling are sometimes needed in epidemiologic research to define study populations, optimal sample sizes, relationships of surrogate measures to exposures, and the extent of exposure misclassification associated with the use of central monitoring data. Depending on the design of a given study, only a sample of the study population might require such detailed monitoring; various strategies need to be explored and their performance documented.
|
From page 17... ...
Development of biochemical markers for epidemiologic studies requires particular attention to constraints imposed by the need to study large groups of relatively healthy people.
|
From page 19... ...
19 Chapter 1 Introduction
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.