• Title/Summary/Keyword: Epidemiologic Studies

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Methodologic Issues in Using Epidemiologic Studies for Quantitative Risk Assessment

  • Stayner Leslie
    • 대한예방의학회:학술대회논문집
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    • 1994.02a
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    • pp.417-425
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    • 1994
  • Although animal studies have been used most often for quantitative risk assessment, it is generally recognized that well-conducted epidemiologic studies would provide the best basis for estimating human risk. However, there are several features related to the design and analysis of epidemiologic studies that frequently limit their usefulness for quantitating risks. The lack of accurate information on exposure in epidemiologic studies is perhaps the most frequently cited limitation of these studies for risk assessment. However. other features of epidemiologic study design, such as statistical power, length of follow-up, confounding, and effect modification, may also limit the inferences that can be drawn from these studies. Furthermore, even when the aforementioned limitations are overcome, substantial uncertainty exists concerning the choice of an appropriate statistical (or biologic) model for extrapolation beyond the range of exposures observed in a particular study. This paper focuses on presenting a review and discussion of the methodologic issues involved in using epidemiologic studies for risk assessment. This review concentrates on the use of retrospective, cohort, mortality studies of occupational groups for assessing cancer risk because this is the most common application of epidemiologic data for quantitative risk assessment (QRA). Epidemiologic data should not be viewed as a panacea for the problems inherent in using animal bioassay data for QRA. Rather, information that can be derived from epidemiologic and toxicologic studies complement one another, and both data sources need to be used to provide the best characterization of human risk.

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Review for Retrospective Exposure Assessment Methods Used in Epidemiologic Cancer Risk Studies of Semiconductor Workers: Limitations and Recommendations

  • Park, Donguk
    • Safety and Health at Work
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    • v.9 no.3
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    • pp.249-256
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    • 2018
  • This article aims to provide a systematic review of the exposure assessment methods used to assign wafer fabrication (fab) workers in epidemiologic cohort studies of mortality from all causes and various cancers. Epidemiologic and exposure-assessment studies of silicon wafer fab operations in the semiconductor industry were collected through an extensive literature review of articles reported until 2017. The studies found various outcomes possibly linked to fab operations, but a clear association with the chemicals in the process was not found, possibly because of exposure assessment methodology. No study used a tiered assessment approach to identify similar exposure groups that incorporated manufacturing era, facility, fab environment, operation, job and level of exposure to individual hazardous agents. Further epidemiologic studies of fab workers are warranted with more refined exposure assessment methods incorporating both operation and job title and hazardous agents to examine the associations with cancer risk or mortality.

Epidemiologic Methods and Study Designs for Investigating Adverse Health Effects of Ambient Air Pollution (대기오염의 건강 영향 평가를 위한 역학연구 설계 및 방법론)

  • Kim, Ho;Lee, Jong-Tae
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.2
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    • pp.119-126
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    • 2001
  • Air pollution epidemiologic studies are intrinsically difficult because the expected effect size at general environmental levels is small, exposure and misclassification of exposure are common, and exposure is not selective to a specific pollutant. In this review paper, epidemiologic study designs and analytic methods are described, and two nationwide projects on air pollution epidemiology are introduced. This paper also demonstrates that possible confounding issues in time-series analysis can be resolved and the impact on the use of data from ambient monitoring stations may not be critical. In this paper we provide a basic understanding of the types of air pollution epidemiologic study designs that be subdivided by the mode of air pollution effects on human health (acute or chronic). With the improvements in the area of air pollution epidemiologic studies, we should emphasize that elaborate models and statistical techniques cannot compensate for inadequate study design or poor data collection.

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Nutritional Epidemiologic Studies for Colorectal Cancer Prevention

  • Hye Won Park;Jung Eun Lee
    • Journal of Digestive Cancer Research
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    • v.1 no.2
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    • pp.89-94
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    • 2013
  • The dramatic increase in colorectal cancer incidence in the population of East Asia indicates that diet and lifestyle play a role in colorectal cancer risk. Colorectal cancer prevention and etiologic studies have long provided dietary modification strategies for colorectal cancer prevention. In this review, we provide an overview of the epidemiologic evidence on the association between diet and colorectal cancer risk. Several cohort studies and a few intervention studies, most conducted in Western countries, have shown a possible link between red and processed meat, alcoholic beverages, calcium, vitamin D, vitamin B and the Western dietary pattern with colorectal cancer development. For colorectal cancer prevention in both Western and Asian populations, dietary modification is a key component of colorectal cancer prevention.

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Critical review of retrospective exposure assessment methods used to associate the reproductive and cancer risks of wafer fabrication workers (반도체 웨이퍼 가공 근로자의 생식독성과 암 위험 역학연구에서 과거 노출평가 방법 고찰)

  • Park, Donguk;Lee, Kyungmoo
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.22 no.1
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    • pp.9-19
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    • 2012
  • Objectives: The aim of this study is to critically review the exposure surrogates and estimates used to associate health effects in wafer fabrication workers such as spontaneous abortion and cancer, as well as to identify the limitations of retrospective exposure assessment methods Methods: Epidemiologic and exposure-assessment studies of wafer fabrication operations in the semiconductor industry were collected. Retrospective exposure-assessment methods used in cancer risk and mortality and reproductive toxicity were reviewed. Results: Eight epidemiologic papers and two reports compared cancer risk among workers in wafer fabrication facilities in the semiconductor industry with the risk of the general population. Exposure surrogates used in those cancer studies were fabrication(vs. non-fabrication), employment duration, manufacturing eras, job title (operator vs. maintenance worker) and qualitative classifications of agents without assessing specific agent or job-specific exposure. In contrast, specific operation, job title and agents were used to classify the exposure of fabrication workers, contributing to finding a significant association with spontaneous abortion (SAB). Conclusion: Further epidemiologic studies of fabrication workers using more refined exposure assessment methods are warranted in order to examine the associations between fabrication work, environment, and specific agents with cancer risk or mortality as used in SAB epidemiologic studies.

Relationship between Occupational Electromagnetic Field Exposure and Leukemia : A Meta-Analysis (직업성 전자장 노출과 백혈병 발생에 관한 메타분석)

  • Kim, Yoon-Shin;Song, Hae-Hiang;Hong, Seung-Cheol;Cho, Yong-Sung
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.1
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    • pp.125-133
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    • 2000
  • Objectives : This study uses meta-analysis methodology to examine the statistical consistency and importance of random variation among results of epidemiologic studies of occupational electromagnetic field exposure and leukemia. Methods : Studies for this meta-analysis were identified from previous reviews and by asking researcher active in this field for recommendations. Overall, 27 studies of occupational electromagnetic field exposures and leukemia were reviewed. A variety of meta-analysis statistical methods have been used to assess combined effects, to identify heterogeneity, and to provide a single summary risk estimate based on a set of simiar epidemiologic studies. In this study, classification of exposure metircs on occupational epidemiologic studies are reported for (1) job classification (20 individual studies); (2) leukemia subtypes (13 individual studies); and (3) country (27 individual studies). Results : Results of this study, an inverse-variance weighted pooling of all the data leads to a small but significant elevation in risk of f 1% (OR=1.11, 95% CI : $1.06\sim1.16$) among 27 occupational epidemiologic studies. Publication bias was assessed by the 'fail-safe n' that may be not influence for all combined results exception a few categories, ie, 'power station operators' and 'electric utility workers' by job classification on occupational study. And ail combined odds ratio results were similar for fixed-effects models and random-effects models, with slightly higher risk estimates for the random-effects model in situations where there was significant heterogeneity, ie, Q-statistic significant (p<.05). Conclusions : We found a small elevation in risk of leukemia, but the ubiquitous nature of exposure to electromagnetic fields from workplace makes even a weak association a public health issue of substantial power to influence the present overall conclusion about relationship between electromagnetic fields exposure and leukemia.

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Humidifier disinfectant disaster: what is known and what needs to be clarified

  • Kim, Sungkyoon;Paek, Domyung
    • Environmental Analysis Health and Toxicology
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    • v.31
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    • pp.25.1-25.9
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    • 2016
  • Objectives After the initial investigations by the Korea Centers for Disease Control in 2011, over 1000 suspicious cases of humidifier disinfectant (HD) victims were subsequently reported by 2015, and numbers are still increasing dramatically in 2016 in the midst of the prosecutors' office investigation. This study attempts to summarize the current understandings of the related health effects of HD based upon a systemic review of published epidemiologic studies and toxicology investigations. Methods Published studies of HDs were searched through PubMed and TOXLINE under the search words 'humidifier disinfectant,' and related reports were identified from the references and published report list of regulatory agencies including the Korean National Institute of Environmental Research, US Environmental Protection Agency, and EU European Chemicals Agency. Results Case reports and epidemiologic studies have reported the clinical features of severe forms of HD lung damage, together with epidemiologic findings of seasonal occurrence and demographic variations, including the heightened susceptibility of young children. Toxicological studies have reported inhalation toxicities together with positive findings of in vitro genotoxicity studies. Conclusions This study examined unsolved issues based on cases of upper respiratory diseases and diseases of other organs, including cancers, among suspected victims of HDs. These issues should be clarified in future research for the management and prevention of health effects from HDs and chemicals of other related household products.

Issues in the Design of Molecular and Genetic Epidemiologic Studies

  • Fowke, Jay H.
    • Journal of Preventive Medicine and Public Health
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    • v.42 no.6
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    • pp.343-348
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    • 2009
  • The final decision of study design in molecular and genetic epidemiology is usually a compromise between the research study aims and a number of logistical and ethical barriers that may limit the feasibility of the study or the interpretation of results. Although biomarker measurements may improve exposure or disease assessments, it is necessary to address the possibility that biomarker measurement inserts additional sources of misclassification and confounding that may lead to inconsistencies across the research literature. Studies targeting multi-causal diseases and investigating gene-environment interactions must not only meet the needs of a traditional epidemiologic study but also the needs of the biomarker investigation. This paper is intended to highlight the major issues that need to be considered when developing an epidemiologic study utilizing biomarkers. These issues covers from molecular and genetic epidemiology (MGE) study designs including cross-sectional, cohort, case-control, clinical trials, nested case-control, and case-only studies to matching the study design to the MGE research goals. This review summarizes logistical barriers and the most common epidemiological study designs most relevant to MGE and describes the strengths and limitations of each approach in the context of common MGE research aims to meet specific MEG objectives.

Relationship Between Exposure to Air Pollutants and Aggravation of Childhood Asthma : A Meta-Analysis (메타분석을 적용한 대기오염과 소아 천식 관련 입원의 상관성 평가 연구)

  • Cho, Yong-Sung;Kim, Ho;Lee, Jong-Tae;Hyun, Youn-Joo;Kim, Yoon-Shin
    • Journal of Korean Society for Atmospheric Environment
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    • v.17 no.5
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    • pp.425-437
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    • 2001
  • This study is based on the uses meta-analysis methodology to examine the statistical consistency and importance of random variation among results of epidemiologic studies between air pollutants exposure and childhood asthma. Studies for this meta-analysis were conducted by reviewing previous results and by asking researcher active in this field for recommendations. Overall, 10 cases of air pollutants exposures and childhood asthma were reviewed. A variety of statistical methods for meta-analysis have been used to assess the combined effects, to identify heterogeneity, and to provide a single summary risk estimate based on a set of simiar epidemiologic studies. In this study, classification of exposure metircs on air environmental epidemiologic studies are reported for (1) aggravation of childhood asthma by a 50 ppb increase SO$_2$(6 individual studies); (2) aggravation of childhood asthma by a 50 ppb increase NO$_2$(5 individual studies); (3) aggravation of childhood asthma by a 50 ppb increase $O_3$(7 individual studies); (4) aggravation of childhood asthma by a 10$\mu\textrm{g}$/m$^3$increase PM$_{10}$ (4 individual studies); (5) aggravation of childhood asthma by a 1 ppm increase CO (2 individual studies); and (6) comparison of results between a Korean study results and this meta-analytic study. Results of this study indicated that an inverse-variance weighted pooling of the hospital admission risk at a 1ppm increment of CO levels was 1.12% (95% CI : 1.01 ~ 1.24). The hospital admission risk was estimated to increase 5% (95% CI : 1.02~1.08), 6%(95% CI : 1.04~1.09), and 5% (95% CI : 1.02~1.09) with each 50ppb increase of SO$_2$, NO$_2$, and $O_3$, respectively. In addition, our results lead to a small but significant elevation in risk of 2% (RR = 1.02, 95% CI = 1.01~1.04) with each 10$\mu\textrm{g}$/m$^3$increase of PM$_{10}$ among 4 individual studies. We found a small elevation in risk of childhood asthma, and pooled results of 10 epidemiologic studies of childhood asthma using increase a cut-off-point levels of air pollutants showed a few pieces of evidence. The results of this meta-analysis suggested that air pollution associated with an increased incidence of childhood asthma. According to this study, relationship between exposure to air pollutants and childhood asthma in Korea seem to be high than results of this meta-analysis.sis.

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