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ENVIRONMENTAL EPIDEMIOLOGY: Volume 1
Index
A
Abortion, spontaneous, 36, 37, 133–134, 190, 192–193
Acceptable Daily Intakes, 213–214
Agency for Toxic Substances and Disease Registry (ATSDR), 2, 5, 7, 8, 26, 45–47, 65–75, 81–83, 84–85, 94–97, 212–213, 257, 260
biologic markers, 230–231
funding, 65, 85, 92, 93, 95
health assessments, 66, 83, 95, 103–104, 119
priority substances, 8, 104, 106, 108–109, 146–148
states, assistance for, 92–93, 97, 259, 269
Agricultural chemicals, see Nitrates;
Pesticides
Airborne toxins, 8, 9–12
birth defects, 11, 194
cancer, general, 11, 160–162, 168, 173
case-control studies, 168
children, effects on, 162–164, 166, 167
computer technology for assessing, 11, 169
cost of monitoring, 172
cross-sectional studies, 11, 157, 159–161, 163–165, 169, 262
dose-response assessment, 164, 170
exposure assessment, 12, 117, 118, 157–173, 125, 137, 262–264
federal law, 75, 180, 261
historical perspectives, 44
individual studies, 165–167, 160
indoor, 117–118, 157, 169–171, 263
lead, 212, 235
local studies, 163–165
longitudinal studies, 11–12, 157, 158–159, 161–163, 173
lung cancer, 38–39, 40, 41, 42, 160, 181–182, 187
morbidity studies, 11, 157, 156–169
neurotoxic effects, 12, 162, 166, 213, 225
symptomatology, 164–165, 170, 173
volatilization, 15, 18, 117, 140–141, 179, 195, 264
Air conditioning, 170
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Alaska, 131
American Petroleum Institute, 46, 65
Analytic studies, 29
Angiosarcoma, 11, 38, 160–161
Animal studies, 46–47, 143
air pollution exposure, 12
ATSDR, 46
biologic markers, 229, 233–234, 238
food-borne toxins, 207, 208
sentinels, 17, 214–215
soil pollution, 17, 204, 214–215
waterborne toxins, congenital defects, 194
Aquifers, see Groundwater
Arizona
Arsenic, 107, 131, 160, 184, 191, 210–211
Asthma, 171–172, 264
Australia, 14, 189
B
Benzopyrene, 119
Beryllium, 164
Biologic markers, 3, 17–19, 47, 116, 120, 121–123, 124, 128, 130, 219–249
animal studies, 229, 233–234, 238
birth defects, 229
blood, 18, 206, 222, 223, 224, 235, 236, 243–244
carcinogens, 18, 232–233, 234, 238
causal inference and, 220, 236–239
children, 224
classification of, 219–220, 246
defined, 17, 219–223
developmental toxins, 162–163
DNA adducts, 163, 222, 223, 232, 230, 236, 239, 241–242
dose response and, 221, 224, 229, 235, 238, 241, 242, 243–244
evaluation issues, 220, 236–239, 247
exposure assessment, general, 17, 239, 241–242
immune system, 220, 223, 233, 236, 241, 242–245
liver, 18, 223–224, 231–232
methodology, general, 236–239, 244–245
models, 239, 248
mutagens, general, 229–230, 234
neurotoxins, 18, 224, 225, 226–229
occupational toxicology, 231–236
PCBs, 18, 224, 230, 232–233
protein adducts, 220, 222, 230, 233–234, 242
reproductive toxicology, 18–19, 229, 233
respiratory disease, 245–246
statistical approaches, 220, 236–239, 247, 248
Superfund sites, 224–225
TCE, 18, 224–225, 229, 230, 236
urine, 224, 225, 235, 236
Birth defects, 36, 38, 133–134, 139, 140
airborne toxins, 11, 194
biologic markers, 229
waterborne toxins, 14–15, 180, 189–197, 265
Birth weight, 20, 190, 198–199, 209–210, 224
Blackfoot disease, 184
Bladder cancer, 13–14, 85, 139, 161, 181, 183–184, 188, 198, 222, 265, 268
Blood
biologic markers, 18, 222, 223, 224, 235, 236, 243–244
food-borne toxins, 206
Blood pressure, 18, 184, 224
Body weight
at birth, 20, 190, 198–199
children, exposure per unit of, 15, 208, 224
soil-borne toxins, 17
Bone disease, 206
Breast cancer, 14, 185
British Clean Air Act, 44
C
Cadmium, 195, 206
California, 10, 37, 78, 94, 107, 110–111, 132–136, 167, 187, 191–193, 198, 214, 259, 266
Canada, 137–138, 159, 164, 182, 213
Cancer and carcinogens, 30, 36–38, 46, 139, 209
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airborne toxins, cancers other than lung, 11, 160–162, 168, 173
angiosarcoma, 11, 38, 160–161
biologic markers, 18, 232–233, 234, 238
bladder, 13–14, 85, 139, 161, 181, 183–184, 188, 198, 222, 265, 268
breast, 14, 185
colon, 181, 183, 232
esophageal, 188–189
food-borne toxins, 207–208
gastric cancer, 187
gender differences, 14, 140–141, 160, 182–183, 185, 187
leukemia, 41, 131–133, 139, 140–141, 168, 185–187, 198
lung, 38–39, 40, 41, 42, 160, 181–182, 187
multinational study, 38–39
rectal, 181
soil-borne toxins, 215
testicular, 215
waterborne toxins, 13–14, 110, 180, 181–189, 198, 265–266
Case-control studies, 48–54 , 121, 132–133
airborne toxins, 168
soil-borne pollutants, 215
waterborne toxins, 13–14, 180, 183–184, 187, 188–189, 191
Causal inference, 29–42, 33, 35–42, 113
biologic markers, 220, 236–239
effect size, 32
legal issues, 43–44
time dimension, 40, 35, 36, 40–41
water pollution, disease and, 180, 186
see also Statistics and statistical approaches
Centers for Disease Control, 92, 131
biologic markers, 230-231
National Center for Health Statistics, 169
waterborne toxins, congenital defects, 193–194
Chemical Manufacturers Association, 46, 65
Children, 68, 85, 131–132, 268
airborne toxins, 162–164, 166, 167
biologic markers, 224
birth weight, 20, 190, 198–199
lead poisoning, 162, 166
pesticides, 16
sex ratio, births, 160
soil-borne toxins, 203, 211, 212, 215, 266
waterborne toxins, 185–186, 190
weight, exposure per unit, 15, 208, 224
see also Birth defects
Chlorinated hydrocarbons, 196, 215
Chlorination, 13–15, 180, 182, 183–184, 195, 225–226
Chronic disease, general, 25, 46, 47, 106
waterborne toxins and, 180, 194–195
see also specific diseases and organs
Chronic obstructive pulmonary disease, 245–246, 268
Cities Hazardous-waste Site Discovery Plan, 77
Classification
biologic markers, 219–220, 246
error in, 33, 35, 38, 130, 141, 181, 183, 191, 207, 222–223, 246, 248
Standard Industrial Classification, 140
Clean Air Act, 75, 180, 261
Clean Water Act, 180
Cohort studies, 121
Colon cancer, 181, 183, 232
Colorado, 212
Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA),6, 45, 46, 61–65, 102
Information System (CERCLIS), 62–64, 78, 80, 83–84, 95, 102–103, 258, 259
see also National Priorities List;
Superfund sites
Computer technology
air pollution mortality, 11, 169
data bank analyses, 169, 172
simulations, 47
Confidence intervals, 32, 42
Congressional Research Service, 45
Cost and cost-effectiveness, 62, 257
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airborne toxins, monitoring, 172
remediation, 77, 78
site assessment, 95, 257
see also Funding
Court cases, see Litigation
Cross-sectional studies, 48–54 , 121
airborne toxins, 11, 157, 159–161, 163–165, 169, 262
biologic markers, 238
waterborne toxins, 194–195, 196
D
Data bases and data banks
analyses of, 169, 172
community, 97
disease registries, 37, 45–47, 70, 181–182, 188
exposure registries, 8, 75, 97
national site inventory, 6, 8, 76–77, 93, 94, 96, 268–269
NPL, 7, 9, 64, 66, 67–68, 70, 71–74, 75, 77, 79, 80, 81, 83, 93, 95, 103–105, 108–109, 119, 144–146, 187, 211, 258, 259, 260
DDT, 205, 206–207
Demography
of groundwater use, 5, 10, 61, 259
minorities, 26, 133, 183, 244
population-based studies, 168–169, 183, 248
proximity to waste sites, 2, 26, 67, 68, 103, 114–116, 137–138, 257
and research methodology, 29, 40, 127
rural areas, 5, 61
urban areas, 77, 160, 172, 179, 185, 212, 262, 267
Denmark, 170
Descriptive studies, 28–29
causal inference and, 113
water pollution, 13, 14, 180
Diary records, 12, 166–167, 170, 173, 264
Dibromochloropropane (DBCP), 110, 133, 187, 191, 233
Dichloroacetic acid, 225, 229
Dichloroethylene, 140, 194
Dioxin, 207–208, 209
Disease occurrence, general, see Chronic diseases;
Mortality and morbidity;
specific diseases andorgans
Disease registries, 37, 45–47, 70, 181–182, 188
Distance factors, see Spatial factors
DNA adducts, 163, 222, 223, 230, 232, 236, 239, 241–242
Dose response, 35, 40–41, 64, 120–121, 122–123, 131
airborne toxins, 164, 170
biologic markers, 221, 224, 229, 235, 238, 241, 242, 243–244
food-borne toxins, 206, 208
odors and, 135
waterborne toxins, 184, 194
E
Eastern Europe, 27, 197
Ecologic studies, 121, 132–133, 160, 187, 191, 222
Economic issues, see Cost and cost-effectiveness;
Funding
Effect size, 32
Elderly persons, 68, 166
Emphysema, 245–246
Environmental Defense Fund, 46, 65
Environmental Epidemiology, 27–28
Environmental Protection Agency (EPA), 2, 26, 45, 66, 75, 103
biologic markers, 239
policy, 7, 268
priority substances, 8, 104, 106, 108–109, 146–148
risk assessments, 64, 66, 82,
site assessment, 107
site discovery, 76–78, 259, 268
site remediation, 81–83
TCE limits, 18
TEAM, 117, 124, 128
water quality control, 179, 185–186
see also Superfund sites
Error of measurement, 11, 32, 33–34, 36–37, 191
confidence intervals, 32, 42
cross-sectional studies, 163
exposure assessment, 127–128, 141, 163
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misclassification, 33, 35, 38, 130, 141, 181, 183, 191, 207, 222–223, 246, 248
recall bias, 11, 12, 33, 135, 164–165, 263–264, 268
Esophageal cancer, 188–189
Ethical issues, 29, 247–248
Evaluation issues, 2, 42
biologic markers, 220, 236–239, 247
exposure assessment, 8–10, 20, 257–258
site assessment, 7–8, 20, 96, 257–258
Europe, 207
Eastern Europe, 27, 197
Experimental methods, 45, 46–47
biologic markers, 237
see also Animal studies
Exposure assessment, 8–10, 19, 61, 101–148, 259–264
airborne toxins, 12, 117, 118, 157–173, 125, 137, 262–264
biologic markers, 17, 239, 241–242
body weight, exposure per unit, 15, 208, 224
causal inference, 29–42, 33, 35–42, 43–44, 113, 220, 236–239
defined, 101, 219, 220, 239
disease, general, and, 29–34, 40–41
error in, 127–128, 141, 163
evaluation issues, 8–10, 20, 257–258
federal activities, 26, 64–65, 75–78
ground water toxins, 107, 110–111, 112–113, 116, 117, 125, 130–134, 142, 143, 259
health risk assessments, 4, 30, 35, 66, 83, 95, 103–104, 119
historical perspectives, 102–103
local actions, 131–143
methodology, general, 102, 117, 119–144
models, 65, 86, 118–119, 123, 124, 128–129, 134
multiple exposures, 39, 102, 114, 116, 157–158, 160, 208, 213, 232, 246, 267
PCBs, 16
potential exposures, 4, 8, 7, 76–78
registries, 8, 75, 97
risk assessment, 4, 30, 35, 45, 64, 66, 82, 86
routes of exposures, general, 117–119, 203
sentinel health events, 85, 97, 268
statistics on, limitations of, 126–131
surrogate measures, 120, 124, 131–142
time factors, 102, 116, 132, 134
waterborne toxins, 131–134, 135, 139–142
F
Federal Emergency Management Agency, 70
Federal government, 21, 60, 62–86, 96–98, 258–259
exposure assessment, 26, 64–65, 75–78
local actions, cooperation with, 8
regulations, 1, 2, 5–8, 26, 60, 180
remediation programs, 62, 63–64, 80–83
site assessment, 62–63, 65–75, 79–80, 84, 93–95, 107
states, cooperation with, 7, 8, 69–70, 75, 78, 85, 92–93, 97, 259, 268, 269
technical assistance, 7, 8, 268, 269
see also Agency for Toxic Substances and Disease Registry;
Environmental Protection Agency;
Laws, specific federal;
Superfund sites;
other specific agencies
Federal Register, 83
Federal Water Pollution Control Act, 179, 180
Finland, 163, 171
Fish consumption, 15, 16, 19, 203, 204–208, 214, 267
Follow-up studies, 161–162
Food-borne toxins
animal studies, 207, 208
blood, 206
carcinogens, 207–208
contaminants in, general, 15–17, 27, 203, 204–208, 213–214, 266–267
dose-response assessment, 206, 208
fish, 15, 16, 19, 203, 204–208, 214, 267
Hispanics, 133
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international efforts, 213–214
malnutrition, 189
meat, 16, 207
milk, 207
neurotoxic effects, 205, 208, 209
pesticides, 214
reproductive toxicology, 205, 208, 209
see also Fish consumption
Food and Drug Administration, 213–214
Formaldehyde, 170–171, 243–244
Funding, 5–6, 19, 61, 93
ATSDR, 65, 85, 92, 93, 95
research, 8, 85–86, 93–94, 97, 257
site discovery and assessment, general, 76–77, 95, 257, 268
site-specific, 87–91
state-level, 85, 92–93
see also Superfund
G
Gastric cancer, 187
Gender differences
cancer, 14, 140–141, 160, 182–183, 185, 187
kidney disease, 195
sex ratio, births, 160
see also Men;
Women
Genotoxicity
COPD, 245–246
DNA adducts, 163, 222, 223, 230, 232, 236, 239, 241–242
mutagens, general, 229–230, 234
protein adducts, 220, 222, 230, 233–234, 242
see also Birth defects;
Reproductive toxicology
Geographic factors, 121
air pollution-related mortality, 11
see also Rural areas
Government role, see Federal government;
Local action;
Regulations;
State-level actions
Great Lakes, 16
Groundwater toxins, 5, 8, 9, 10, 13, 41, 118, 179, 184–199, 267
demographic factors, 5, 10, 61, 259
exposure assessment, 107, 110–111, 112–113, 116, 117, 125, 130–134, 142, 143, 259
federal law, 75, 180
pesticides, 16, 46, 110, 206–208, 214
remediation, 20, 81
reproductive toxicology, 14
rural areas, 5, 61
state-level actions, 92, 110–113, 259
see also Water pollution
Guidelines on Studies in Environmental Epidemiology, 27
H
Halogenated hydrocarbons, 13
Hazard Ranking System, 79, 80
Health risk assessments, 4, 30, 35, 114, 119–120, 142
ATSDR, 66, 83, 95, 103–104, 119
EPA, 64, 66, 82, 239
Heart diseases and disorders, 15, 20, 139, 140, 191, 192, 193–193, 194, 265
Hispanics, 133
Historical perspectives, 25–26, 27–28
biologic markers, 220
context of study, 44–45
diary studies, 166
exposure assessment, 102–103
site assessment, 69, 102–103
vinyl chloride, 160–161
waterborne toxins, 179–180
see also Retrospective studies
Hospital-based studies, 168–169, 171
I
Illinois, 188
Immune system and immunology
asthma, 171–172, 264
biologic markers, 220, 223, 233, 236, 241, 242–245
waterborne toxins, 15, 199
India, 159
Individual studies, 120, 121, 128, 131–142
airborne toxins, 165–167, 160
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diary records, 12, 166–167, 170, 173, 264
waterborne toxins, 181
Indoor air pollution, 117–118, 157, 169–171, 263
Institute of Medicine, 16, 20–21
International Labor Organization, 27
International perspectives, 27–28
air pollution, symptoms, 12
Europe, 27, 197, 207
food-borne toxins, 212, 213–214
smoking and cancer, 38–39
see also Foreign countries;
specific countries
Iowa, 181–182, 183
Israel, 163
Itai-Itai byo, 206
J
Japan, 16, 205, 206
K
Kidney disease, 195, 236
L
Laws, specific federal
British Clean Air Act, 44
Clean Air Act, 75, 180, 261
Clean Water Act, 180
Federal Water Pollution Control Act, 179, 180
Resource Conservation and Recovery Act, 75, 103, 258
Safe Drinking Water Act, 75, 261
Superfund Amendment and Reauthorization Act, 46, 62, 65-66, 80
Toxic Substances Control Act, 45, 261
see also Comprehensive Environmental Response, Compensation, and Liability Act
Lead, 123, 162, 166, 195, 208, 211–213, 222, 235, 267
Legal issues, 27, 197–198, 247–248, 265
see also Litigation
Legislation, 5, 6, 26, 44–45, 47, 60, 269
state-level, 60, 86
see Laws, specific federal
Leukemia, 41, 131–133, 139, 140–141, 168, 185–187, 198
Lipophilic toxins, 16, 214, 267
Litigation, 2–3, 27, 42–44, 46, 47, 65, 197–198, 248, 265
Liver and liver diseases, 15, 139, 141–142
angiosarcoma, 11, 38, 160–161
biologic markers, 18, 223–224, 231–232
soil-borne toxins, 215
waterborne toxins, 184, 185, 195–196, 199
Local actions, 2, 8, 69
airborne toxins, morbidity studies, 163–165
exposure assessment, specific sites, 131–143
Longitudinal studies, 143
air pollution, 11–12, 157, 158–159, 161–163, 173
prospective studies, 121, 137–138, 161, 162, 238
time series analysis, 29, 173
waterborne toxins, 181
see also Retrospective studies
Love Canal, 17, 44, 138, 162, 184–185, 190–191, 196–197, 198–199, 214, 266
Lung cancer, 38–39, 40, 41, 42, 160, 181–182, 187
Lymphoma, 185, 198, 241
M
Massachusetts, 18, 41, 131–132, 137, 185–186, 188, 189–190, 224
Mathematical models, 128–129
Maximum Contaminant Levels, 18, 111
Meat, 16, 207
Memory, 208
Men, 181–182, 233
see also Gender differences
Mercury, 16, 203, 205, 236
Meta-analyses, 4–5, 39, 42, 97, 198, 261, 262, 266
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Methodology
air pollution research, 10–12
analytic studies, 29
biologic markers, 236–239, 244–245
causal inference, 29–42
cohort studies, 121
demographic factors, 29, 40, 127
descriptive studies, 13, 14, 28–29, 113, 180
ecologic studies, 121, 132–133, 160, 187, 191, 222
experimental methods, 45, 46–47, 237
exposure measurement, 102, 117, 119–144
follow-up studies, 161–162
misclassification, 33, 35, 38, 130, 141, 181, 183, 191, 207, 222–223, 246, 248
for policy decisions, 7–8, 268–269
population-based studies, 168–169, 183, 248
prevalence studies, 29
problems, general, 29, 126–131
prospective studies, 121, 137–138, 161, 162, 238
retrospective studies, 42, 48–54, 101, 134–135, 184–187, 238
sampling, 81–82, 126, 127, 128
site assessment, 8, 96–97, 259–260, 269
standards, 27–28, 39, 70
of study, 2, 26
see also Animal studies;
Case-control studies;
Cross-sectional studies;
Longitudinal studies;
Statistics and statistical approaches
Michigan, 44, 205
Milk, 207
Minamata disease, 205
Minorities, 26, 133, 183, 244
Mixed chemical exposure, see Multiple exposures
Models
biologic markers, 239, 248
computer simulations, 47
exposure,
indoor air pollution, 118
mathematical, 128–129
site discovery and assessment, 81, 94
toxicokinetic, 123
see also Animal studies
Montana, 211
Motor functions, 16, 197, 225
Mortality and morbidity, 35, 137–138
air pollution-related, 11, 157, 156–169
disease occurrence, general, 4, 29, 31, 33, 36, 40–41
disease registries, 37, 45–47, 70, 181–182, 188
historical perspectives, 25
sentinel health events, 85, 97, 268
water pollution-related, general, 14, 181–189
Multiple exposures, 39, 102, 114, 116, 157–158, 160, 208, 213, 232, 246, 267
Multivariate analysis, 182
N
National Cancer Institute, 13–14, 188
National Center for Health Statistics, 169
National Health and Nutrition Survey, 164
National Institute for Environmental Health Sciences (NIEHS), 8, 70, 85, 86, 209–210, 269
National Priorities List (NPL), 7, 9, 64, 66–68, 70, 71–74, 75, 77, 79, 80, 81, 83, 93, 95, 103–105, 108–109, 119, 144–146, 187, 211, 258, 259, 260
National Research Council, 2, 20, 117, 124, 129, 203, 215, 219
Neurotoxic effects, 20, 104, 106, 123
airborne toxins, 12, 162, 166, 213, 225
biologic markers, 18, 224, 225, 226–229
food-borne toxins, 205, 208, 209
lead, 162, 166, 213
memory, 208
motor functions, 16, 197, 225
PCBs, 16, 209–210
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waterborne toxins, 14, 15, 18, 189, 197, 199
New Jersey, 14, 41, 128, 165, 185, 186–187
New York, 69–70, 86–87, 138, 185
Love Canal, 17, 44, 138, 162, 184–185, 190–191, 196–197, 198–199, 214, 266
Nicaragua, 197
Nitrates, 14, 85, 179, 268
Nonconventional pollutants (NCPs), 10
Nonpoint source pollution, 107, 110–111, 260
see also Nitrates;
Pesticides
North Carolina, 14, 188, 210, 213, 265
O
Occupational toxicology, 169–171, 137–138, 141, 160
biologic markers, 231–236
dioxin, 207–208
International Labor Organization, 27
lead, 213
PCBs, 209
Standard Industrial Classification, 140
Odors, 134–135, 141
Office of Technology Assessment (OTA), 9, 45, 76, 77, 103, 258
Ouch-ouch disease, 206
Ozone, 164
P
Peer review, 15, 198
Pennsylvania, 139, 142
Personal studies, see Individual studies
Pesticides, 16, 46, 110, 179, 195, 203, 204, 205, 206–208, 209, 214, 233–234, 261
Poland, 241
Polychlorinated biphenyls (PCBs), 16–17, 204–205, 207, 208–210
biologic markers, 18, 224, 230, 232–233
neurotoxic effects, 16, 209–210
Population factors, see Demography;
Public opinion
Population-based studies, 168–169, 183, 248
Potential exposures, 4, 7, 8, 76–78
Prevalence studies, 29
Priority substances, 8, 104, 106, 108–109, 146–148
Private sector
ATSDR funding, 92
research standards, 70
Prospective studies, 121, 137–138, 161, 162
biologic markers, 238
Protein adducts, 220, 222, 230, 233–234, 242
Public health advisories, 70, 71–74, 205, 213
Public Health Service, 179
Public opinion, 1, 29, 60–61, 256
recall bias, 11, 12, 33, 135, 164–165, 263–264, 268
R
Racial factors, 183
see also Minorities
Radioactive pollutants, 181–182
Recall bias, 11, 12, 33, 135, 164–165, 263–264, 268
Rectal cancer, 181
Regulations, 1, 2, 5–8, 26, 60, 180
see also Standards
Remediation programs, 6, 8, 31, 97
cost of, 77, 78
federal, 62, 63–64, 80–83
groundwater contamination, 20, 81
site closure, 8, 92
state actions, 86, 92
Reproductive toxicology, 35, 36, 41, 68, 133–134
abortion, spontaneous, 36, 37, 133–134, 190, 192–193
biologic markers, 18–19, 229, 233
birth weight, 20, 190, 198–199, 209–210, 224
food- and soil-borne toxins, 205, 208, 209
mercury, 16, 205
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sex ratio, 160
sperm, 16, 19, 205, 220, 233–234
waterborne toxins, 14, 185, 189–195
see also Birth defects
Research, general, 28–30, 269
funding, 8, 85–86, 93–94, 97, 257
recommendations, 8, 26–27, 28–30
state-level, 93
tabular list of studies, 48–54
see also Methodology
Resource Conservation and Recovery Act, 75, 103, 258
Respiratory disease, 264, 268
asthma, 171–172, 264
biologic markers, 245–246
emphysema, 245–246
see also Lung cancer
Retrospective studies, 42, 101
biologic markers, 238
odors as surrogates, 134–135
specific sites, 48–54
waterborne toxins, 184–197
Risk assessment, 4, 30, 35, 45, 64, 66, 82, 123, 142
ATSDR, 66, 83, 95, 103–104, 119
EPA, 64, 66, 82, 239
state-level, 86
see also Biologic markers
Rural areas, groundwater, 5, 61
S
Safe Drinking Water Act, 75, 261
Sampling, 81–82, 126, 127, 128
Saudi Arabia, 188–189
Sex differences, see Gender differences
Sick building syndrome, see Indoor air pollution
Site assessment, 7–8, 20, 62–63, 65–75, 79–80, 84, 94–95, 103–106, 120, 261–262, 268, 269
cost of, 95, 257
detection of toxins, 213–215
evaluation issues, general, 7–8, 20, 96, 257–258
federal government, general, 62–63, 65–75, 79–80, 84, 93–95, 107
funding, 76–77, 95, 257, 268
historical perspectives, 69, 102–103
methodology, general, 8, 96–97, 259–260, 269
NPL, 7, 9, 64, 66, 67–68, 70, 71–74, 75, 77, 79, 80, 81, 83, 93, 95, 103–105, 108–109, 119, 144–146, 187, 211, 258, 259, 260
specific sites, 48–54, 69, 70, 71–74, 131–142
state actions, 69–70, 76, 86, 92, 268
Site closure, 8, 92
Site discovery, 7, 258–259
EPA, 76–78, 259, 268
funding, 76–77, 95, 257, 268
models, 81, 94
national inventory, 6, 8, 76–77, 93, 94, 96, 268–269
state-level, 86, 92
Skin diseases, 104, 106
Smoking, 38–39, 40, 41, 42, 182, 187, 232–233
Soil pollution, 8, 15–17, 143–144, 184–185, 203–215, 266–267
animal studies, 17, 204, 214–215
cancer, 215
case-control studies, 215
children and, 203, 211, 212, 215, 266
liver disease, 215
reproductive toxicology, 205, 208, 209
volatile organic compounds, 118, 195
Spatial factors
population proximate to waste sites, 2, 26, 67, 68, 103, 114–116, 137–138, 257
sampling, 126, 127
Sperm, 16, 19, 205, 220, 233–234
Standard Industrial Classification, 140
Standards
Acceptable Daily Intakes, 213–214
biologic markers, 244
Maximum Contaminant Levels, 18, 111
research methodology, 27–28, 39, 70
site sampling, 81–82, 268
TCE limits, 18
State-level actions, 21, 47, 55, 60, 86–93, 258–259
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ATSDR assistance, 92–93, 97, 259, 269
federal cooperation with, 7, 8, 69–70, 75, 78, 85, 92–93, 97, 259, 268, 269
funding, 85, 92–93
groundwater contamination, 92, 110–113, 259
health departments, information from, 2
legislation, 60, 86
NPL sites, 103
regulations, 2, 5–8, 60
remediation efforts, 86, 92
research, 93
risk assessment, 86
site assessment, 69–70, 76, 86, 92, 268
see also Demography;
specific states
Statistics and statistical approaches, 42, 256
biologic markers, 220, 236–239, 247, 248
confidence intervals, 32, 42
disease registries, 37, 45–47, 70, 181–182, 188
effect size, 32
exposure data, limitations, 126–131
exposure registries, 8, 75, 97
multivariate, 182
national site inventory, 6, 8, 76–77, 93, 94, 96, 268–269
number of sites, 9
power, 36
recall bias, 11, 12, 33, 135, 164–165, 263–264, 268
significance assessment, 2, 32–34, 38–39, 43, 185
volume of waste generated, 1–2, 26, 60, 102
see also Error of measurement
Superfund Amendment and Reauthorization Act (SARA), 46, 62, 65–66, 80
Superfund sites, 1, 5, 6, 10, 13, 15, 19, 61–86 , 92
air pollution, 161
biologic markers, 224–225
lead, 212–213
legislation for, 45, 46
National Priority List (NPL), 7, 9, 64, 66, 67–68, 70, 71–74, 75, 77, 79, 80, 81, 83, 93, 95, 103–105, 108–109, 119, 144–146, 187, 211, 258, 259, 260
population proximate to, 2, 26, 67, 68, 103, 114–116, 137–138, 257
remediation, 80–83
site discovery funding, 77
torts, 43
Surface water, 8, 20–21, 179, 180, 182
see also Water pollution
Surrogate measures, 120, 124, 131–142
Sweden, 160
Symptomatology, 4, 31, 70, 130, 137, 263
airborne toxins, 164–165, 170, 173
diary records, 12, 166–167, 170, 173, 264
nonspecific, 135–136
recall bias, 11, 12, 33, 135, 164–165, 263–264, 268
T
Taiwan, 184, 208, 224
Taxonomy, see Classification
Technical assistance, 7, 8, 268, 269
Tennessee, 18, 141, 214
Testicular cancer, 215
Tetrachlorethane, 166, 188
Time factors
causation and, 40, 35, 36, 40–41
exposure assessment, 102, 116, 132, 134
see also Longitudinal studies;
Retrospective studies
Time series analysis, 29, 173
Torts, see Litigation
Total Diet Study, 214
Total Exposure Assessment Methodology, 117, 124, 128
Toxic Substances Control Act, 45, 261
Toxicokinetics, 123
Trichloroethane (TCA), 133–134, 181
Trichloroethylene (TCE), water pollutant, 13, 14–15, 18, 118, 139–140, 142, 194, 197, 265, 266
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biologic markers, 18, 224–225, 229, 230, 236
Trihalomethanes (THMs), 13, 180, 181–184, 184, 265
U
United Kingdom, 41, 44, 159
United Nations Environmental Program, 27
Urban areas, 77, 160, 172, 179, 185, 212, 262, 267
Urine, 224, 225, 235, 236
Utah, 167, 168, 172
V
Vietnam, 215, 233
Vinyl chloride, 11, 38, 160–161, 205
Volatile organic compounds (VOCs), 13, 14–15, 18, 118–119, 123, 128, 131–134, 140–142, 158, 179, 196, 263
see also specific compounds
Volatilization, 15, 18, 117, 140–141, 179, 195, 264
W
Water pollutants, 9–10, 13–15, 19, 125, 158, 179–199, 264–266
animal studies, 194
birth defects, 14–15, 180, 189–197, 265
cancer, 13–14, 110, 180, 181–189, 198, 265–266
case-control studies, 13–14, 180, 183–184, 187, 188–189, 191
causal inference, 180, 186
CDC, 193–194
children and, 185–186, 190
chlorination, 13–15, 180, 182, 183–184, 195, 225–226
chronic diseases, general, 180, 194–195
cross-sectional studies, 194–195, 196
demographic factors, 5, 10, 61, 259
descriptive studies, 13, 14, 180
dose-response assessment, 184, 194
EPA, 179, 185–186
exposure analysis, 131–134, 135, 139–142
fish, bioaccumulation, 15, 16
immune system, 15, 199
individual studies, 181
liver disease, 184, 185, 195–196, 199
morbidity and mortality, general, 14, 181–189
neurotoxic effects, 14, 15, 18, 189, 197, 199
reproductive toxicology, 14, 185, 189–195
TCE, 13, 14–15, 18, 118, 139, 140, 139–140, 142, 194, 197, 224–225, 229, 230, 236, 265, 266
volatilization, 15, 18, 117, 140–141, 179, 195, 264
see also Groundwater;
Surface water
Weight, see Body weight
Women
cancer, 14, 140–141, 183
kidney disease, 195
see also Gender differences
World Health Organization, 27, 212
Representative terms from entire chapter:
waterborne toxins
