Index

A

Abortion, spontaneous, 78, 168

ACE. See Alternating-conditional-expectations regression

Adipose tissue samples. See Sampling, personal Adverse outcomes. See Diseases

Aerometric Information Retrieval System. See Storage and Retrieval of Aerometric Data

Aged populations, susceptibility of, 84

Agency for Toxic Substances and Disease Registry, 4, 14-15, 28-29, 99, 102-103, 116-118, 121-122, 155-156, 174-175

Air pollution, 47-49

airborne particulate, 6, 45, 69-73

ambient, 47

factors affecting uptake of, 7

indoor, 9, 39, 147

measuring, 32, 38-41, 43

smog, 7, 46, 48

toxic, 4

Air-quality standards, 70-72

Alcohol use. See Lifestyle factors

Alpha probabilities, 21

Alternating-conditional-expectations regression, 142

Alzheimer's disease, 74

Ambulance calls, tracking, 111

Amyotrophic lateral sclerosis, 74

Analysis of variance (ANOVA), 132

Applied dose. See Dose

Applied Occupational and Environmental Hygiene,50

Arsenic, 44, 57

Asbestos, 13, 19

Asthma, 18, 48, 71, 140

adult-onset, 2

childhood, 7, 70

ATSDR. See Agency for Toxic Substances and Disease Registry

ATSDR Guidance Manual,28

Attention-deficit disorders, in primates, 75

Attributable risk, 23

Autoregressive structures, 135-136

Aversive conditioning, 74

B

Background effects, 14

Bayes rule methodology, 139, 181



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--> Index A Abortion, spontaneous, 78, 168 ACE. See Alternating-conditional-expectations regression Adipose tissue samples. See Sampling, personal Adverse outcomes. See Diseases Aerometric Information Retrieval System. See Storage and Retrieval of Aerometric Data Aged populations, susceptibility of, 84 Agency for Toxic Substances and Disease Registry, 4, 14-15, 28-29, 99, 102-103, 116-118, 121-122, 155-156, 174-175 Air pollution, 47-49 airborne particulate, 6, 45, 69-73 ambient, 47 factors affecting uptake of, 7 indoor, 9, 39, 147 measuring, 32, 38-41, 43 smog, 7, 46, 48 toxic, 4 Air-quality standards, 70-72 Alcohol use. See Lifestyle factors Alpha probabilities, 21 Alternating-conditional-expectations regression, 142 Alzheimer's disease, 74 Ambulance calls, tracking, 111 Amyotrophic lateral sclerosis, 74 Analysis of variance (ANOVA), 132 Applied dose. See Dose Applied Occupational and Environmental Hygiene,50 Arsenic, 44, 57 Asbestos, 13, 19 Asthma, 18, 48, 71, 140 adult-onset, 2 childhood, 7, 70 ATSDR. See Agency for Toxic Substances and Disease Registry ATSDR Guidance Manual,28 Attention-deficit disorders, in primates, 75 Attributable risk, 23 Autoregressive structures, 135-136 Aversive conditioning, 74 B Background effects, 14 Bayes rule methodology, 139, 181

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--> BDMP. See Birth Defects Monitoring Program Behavioral changes, subtle, 73-74 Behavioral Risk Factor Surveillance System, 106 Benzene, 19 Beta probabilities, 21 Biologically effective dose. See Dose Biologic markers, 17, 20, 33, 51, 56-58, 62, 81-84. See also Sampling, personal cost of, 81 validating, 56, 58, 82, 86-87 Biologic Markers in Immunotoxicology,81 Birth defects. See Congenital anomalies Birth Defects Monitoring Program, 105, 108-109, 163-165 Blood samples. See Sampling, personal Bootstrap procedure, 141-142 Breathing zone measurements, 38-39 Breath samples. See Sampling, personal Bronchitis acute, in children, 70 chronic, 18, 72 C Cancer Incidence Reporting System (Canada), 123 Cancers, 15, 23, 46, 68-69, 80 endometrial carcinoma, 14 hepatic angiosarcoma, 23 laryngeal, 147 leukemia, 19 lung, 22-24, 73, 170 mesothelioma, 19 stomach, 14 Carbon monoxide, 39 Cardiac defects, 78 Cardiovascular disease, 6, 15, 18 Case-cohort studies, 19, 148 Case-control studies, 17-19, 115, 148, 176 Case-crossover studies, 148 Case reports, 13 Causality, inferring. See Epidemiology studies Census data, 15-16 Centers for Disease Control and Prevention, 126, 163-164, 168 Central nervous system (CNS) complications. See Neurologic symptomatology CERCLA. See Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) Chemicals agricultural (See Herbicides; Pesticides) mixed, 50-51, 54, 61-62, 69 synthetic organic, 7, 100 volatile organic, 41, 74 xenobiotic, 50, 80 Children, susceptibility of, 85 Chlorine gas, 44, 112 Chromium, 46 Classification errors. See Misclassification Cleaning products, 39 Clean Water Act, 102 Cleft lip and palate, 164-165 CNS. See Neurologic symptomatology Coefficients of variation, 83 Cohort studies, 17-18, 114, 176. See also Case-cohort studies Complex mixtures. See Chemicals, mixed Comprehensive Environmental Response, Compensation, and Liability Act of 1980, 116 Confidence bounds, 22 Confidentiality issues, 120-123 Confounding factors, 5-6, 15-16, 19, 22, 50, 83, 120, 134, 174 Congenital anomalies, 2, 78-79, 162-163, 167-168 Congenital Malformations Surveillance Report, 168 Consumer products, measuring concentrations of, 38-39 Cox proportional hazard model, 144 Cross-sectional surveys, 19-20, 114 Croup attacks, 71

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--> D Death-certificate diagnoses, 114 Dermal uptake, 30 ''Design effect,"; 137 Design of studies, 13-22, 28, 44, 56-57, 147-148, 159-160. See also Cross-sectional surveys; Modeling; Statistical techniques Developing world, versus developed, 2, 9, 170-171 Developmental health effects, 3, 77-79 Diaries, 45, 48, 133, 147 Dioxin, 14, 41 Disease-incidence data systems. See Surveillance systems Diseases acute, 70-72 chronic, 3, 8, 51, 72-73, 114 infectious, 2-3, 8, 118 multifactorial, 6, 18, 20, 114, 149 rare, 12, 21, 124 shifting patterns of, 86 of unknown etiology, 1-3, 10, 24, 68 Dose applied, 29 biologically effective, 29, 56-59 cumulative, 61 defined, 29, 51 internal, 29, 32-33, 40-41, 56, 59, 101-104, 106-107 patterns, 24, 30, 80 potential, 29, 32-33 tissue, 59 Dose-response relations, 2-3, 15, 19, 31, 34, 44, 49, 61. See also Epidemiology studies, inferring causality in; Statistical techniques consistency of, 23 correlated data, 133-142 covariant correlations, 139-142 longitudinal correlations, 134-135 random-effect correlations, 136-139 serial correlations, 135-136 discrete data, 132-133 nonlinearity in, 54, 142-144 specificity of, 23 strength of, 22-23 unknown relations, 142-144 Dosimetric modeling. See Modeling Drinking habits. See Lifestyle factors Drinking water sampling, 36-37 Drugs. See Lifestyle factors E "Ecologic fallacy,";15 Ecologic studies, 14-16 Elderly, 84 Emergency room visits, tracking, 111, 115 Environmental epidemiology assessment in, 5-6, 26-27 (See also Health status data; Monitoring) analytic studies, 16-19, 35, 42 descriptive studies, 13-16, 34-35 defined, 2, 12-13 origins of, 12 Environmental Epidemiology, Volume1, 3-4, 6, 22, 27, 31, 35, 48-49, 51, 54, 61, 78, 81, 131, 154 Environmental protection, 2, 94-97. See also Developing world, versus developed Environmental Protection Agency, 4, 27-30, 44, 98, 124 Environmental tobacco smoke. See Tobacco smoke EPA. See Environmental Protection Agency Epidemiologists, 7 Epidemiology,78 Epidemiology studies, 20, 50-51, 59 adequacy of, defining, 2, 5-6 evaluating, 2, 62, 157-162 (See also Peer-review of studies) inferring causality in, 15, 22-24, 26, 31 limitations of, 10, 12, 42 (See also Confounding factors) Estrogen use, postmenopausal, 14 Exposed populations, 99-101, 104-105, 131 defined, 20, 29, 117

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--> geographic location, 15-16, 125, 138, 178 size of (See Sample size) Exposure analysts, 7, 51, 60, 62 Exposure-dose relations. See Dose-response relations Exposure-response relations. See Dose-response relations Exposures, 3. See also Dose; Pollutant discharges assessing, 26-62, 160-161 (See also Monitoring; Sampling, personal) costs of, 42, 45, 61 data needed, 31-42 measurements needed (See Measurements) need for improvement in, 44-47, 56 possible approaches, 34, 96-97 databases of, 15, 94-126, 179 analyzing, 130-150 linking, 113, 121-123, 177-178 defined, 29-30 developing relevant gradients, 7, 15, 24 indexes of, 51-54 low levels of, 21, 54 past, 49-50, 86 F False negatives, 21, 140, 174 False positives, 21, 140 Fecundity health effects, 76-77 Fish tissue contaminants, 38-39 Fixed-location monitoring. See Monitoring FOIA. See Freedom of Information Act Followup studies. See Trends Food contaminants, 33, 36-37, 40-41, 102-103. See also Fish tissue contaminants Freedom of Information Act, 121 G GAO. See U.S. General Accounting Office Gene-environment interactions, 58, 85, 142 Geographic coding. See Exposed populations Gray literature, 4, 154-171 defined, 1, 154-155 need for databases of, 9 Groundwater contaminants. See Water contaminants Group exposure, 15. See also Sample size Guidance Manual. See ATSDR Guidance Manual H Hair samples. See Sampling, personal Hazardous-waste sites, 4, 7-8, 39, 49-50, 54-55, 61, 78-79, 107, 167-168. See also Superfund sites Health Care Financing Administration, 115-116, 177 Health Effects Institute Environmental Epidemiology Planning Project, 131 Health Interview Survey (HIS), 48 Health outcomes. See Diseases Health status data, 104-112, 115 Heavy metal poisoning, 41, 85 Hepatic health effects, 80, 114. See also Cancers Herbicides, 46, 100 Heteroscedastic distributions, 133 HIS. See Health Interview Survey Hormone levels, 76 Hospital admissions, tracking, 111, 115 Human Exposure Assessment for Airborne Pollutants,28, 48 I Immunologic health effects, 80-84 Immunotoxicology, future of, 82 Internal dose. See Dose International Classification of Diseases,164

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--> International Society of Exposure Analysis, 27 IQ, downward shifts in, 74-75 J Journal of Exposure Analysis and Environmental Epidemiology,28 K Kidney diseases, 80 Korn-Whittemore approach, 140 Kriging, 145-147 L Latency period, 18, 23-24 Lead poisoning, 2, 6-7, 18, 20, 23, 41, 69, 74-75, 79, 112, 124 Learning disorders, in primates, 75 Least-squares regression, 133 Legal issues, 56, 85, 155 Lestimates, 145 Lifestyle factors drinking habits, 3, 170 drugs, 3 smoking, 3-4, 44, 73, 170 Linear regression, 132, 143. See also Kriging Linking data. See Exposures, databases of Liver diseases. See Hepatic health effects LOELs. See Lowest-observed-effects levels Logistic regression, 133, 136, 140, 143, 179 Logs. See Diaries Longitudinal correlations. See Dose-response relations, correlated data Low birthweights, 77-78 Lowest-observed-effects levels, 142 M Markers. See Biologic markers Markov-type structures, 135 Mathematical modeling. See Modeling Mathematical transformations, 143 Measurements errors in, 21, 43, 148-149 of exposure, 28-31, 61 of human health effects, 8 types needed to characterize exposure, 36-41 Medline, 1 MEDPAR, 104 Mercury, 77, 124 Mestimates, 145 Meta-analysis, 23, 71, 179 Methyl mercury, 13, 69 Microenvironmental studies, 38-39, 47 Miscarriages, 77, 165-167 Misclassification, 23, 42-44, 47, 50, 59, 61 Modeling, 7, 18, 145-149. See also Statistical techniques covariance (See Dose-response relations, correlated data) dosimetric, 58-60 multiple-regression, 141 random-effect (See Dose-response relations, correlated data) toxicokinetic, 50-51, 59 validating, 7 Molecular-epidemiology studies, 20 Monitoring, 112-120 biologic, 31, 45 (See also Sampling, personal) difficulties with, 112-113, 120 fixed-location, 36-37, 97-98 indirect, 31, 47 need to increase, 6 short-term, 36-37 sources (See Pollutant discharges, sources of) Monotonicity, departures from, 31, 34. See also Epidemiology studies, inferring causality in Monte Carlo pseudosamples, 141 Moving-average structures, 135 Multiple comparisons problem, 22 Myelin, damage to, 73

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--> N Nail samples. See Sampling, personal National Air Monitoring Stations, 99 National Cancer Institute, 46, 105, 170 National Center for Chronic Disease Prevention and Health Promotion, 106 National Center for Environmental Health, 105, 126 National Center for Health Statistics, 14, 103-104 National Center for Injury Control and Prevention, 126 National Death Index, 124, 126, 179 National Exposure Registry, 104-105, 111, 116, 118, 121, 126 National Governors' Association, 155-157 National Health and Nutrition Examination Survey, 103-110, 112, 126, 178 National Health Interview Survey, 104-105, 108-109, 111, 124, 126, 178 National Human Adipose Tissue Survey, 106 National Human Exposure Assessment Survey, 27-28, 44, 124 National Institute for Occupational Safety and Health, 60, 99, 126 National Institutes of Health, 126 National Library of Medicine, 175 National Mortality Data Base (Canada), 123 National Occupational Exposure Survey, 104 National Occupational Hazards Survey, 111 National Priority List (of sites), 100, 102, 117-118 National Research Council, 1, 3-4, 28-29, 31, 68, 162 National Stream Quality Accounting Network, 99 National Toxicology Program, 76-77 National Vital Statistics Program, 108-109, 178 Negatives, false, 21, 140, 174 Nested case-control studies, 18-19, 148 Neurologic symptomatology, 2, 20, 23, 69, 73-76, 164-165, 168 NGA. See National Governors' Association NHANES. See National Health and Nutrition Examination Survey NHEXAS. See National Human Exposure Assessment Survey NHIS. See National Health Interview Survey NIOSH. See National Institute for Occupational Safety and Health Nitrogen dioxide, 47-48, 71 NOELs. See No-observed-effects levels Nonlinearity. See Dose-response relations Nonparametric regression, 143-144 No-observed-effects levels, 142 O Occupational epidemiology, 50-51, 59 Odds ratio, 22, 43, 52-53 1-beta. See Beta probabilities OR. See Odds ratio Oral uptake, 30 Organic chemicals. See Chemicals Outbreak investigations, 115 Outcomes, adverse. See Diseases Ozone, 6, 48-49, 69-72, 96, 139-140 P Pan American Health Organization, 4, 170 Parkinsonism, 74 Patterns of health, 12 PCBs. See Polychlorinated biphenyls Peer-review of studies, 4, 157, 159, 174 standards for, 1, 4 Periodic regression, 142-143 Personal identifiers, 120-123

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--> Personal monitoring. See Monitoring Pesticides, 4, 41, 46-47, 100 Poison center data, 115 Poisson distributions, 132-133, 136, 138, 140, 143-144, 179 Policy issues, 27, 95-96, 125 Political issues, 8, 155, 162, 169, 173 Pollutant discharges concentrations of, 99, 102-103 sources of, 36-37, 98, 100-101 Polychlorinated biphenyls, 41, 79, 85 Populations, exposed. See Exposed populations Positives, false, 21, 140 Potential dose. See Dose Power considerations, 18, 20-22, 28, 42, 158, 160, 169 Pregnancy outcome effects, 76-77 Privacy Act of 1974, 121 Privacy issues, 120-123 Probit regression, 133 Prospective cohort studies, 17-18 Proxy variables, 59 Psychogenic factors, 54, 74 "Publication bias," 155 Public health, 161. See also Policy issues developing programs to promote, 5, 86 impacts on, 6 Public-health departments, 7-9. See also State health-department reports Pulmonary disease, 51, 59 P values, 22 R Racial groups, varying susceptibilities of, 85 Radiation, 4 Radon, 13, 39 Random-effect correlations. See Dose-response relations, correlated data Recall bias, 17, 49, 54-56 Recommendations, 85-87, 123-126, 173-179 Reconstructed dose. See Dose, internal Regression, 132-133 Regulatory considerations, 102, 155 Relative risk, 20, 22-23, 69, 176 Renal health effects, 80 Reproductive health effects, 2-3, 76-77, 86, 162-169 Resampling, 141 Reserve capacity, of immune system, 83 Respiratory ailments, 2, 9, 30, 43, 48, 69-73. See also Pulmonary disease Retrospective cohort studies, 17 Risk factors. See Attributable risk; Dose-response relations; Pollutant discharges; Relative risk; individual toxic substances RR. See Relative risk S Salmonella, 120 Sample size, 6, 9, 18, 20-21, 42, 95, 160 Sampling, personal, 40-41, 107 Sampling instruments, new developments in, 45 Sanitation, basic, 9 SARA. See Superfund Amendments and Reauthorization Act of 1986 SAROAD. See Storage and Retrieval of Aerometric Data monitoring Secondary data. See Exposures, databases of Second National Health and Nutrition Examination Survey, 7 Secrecy issues, 8-9, 155. See also Confidentiality issues Sediment contaminants. See Soil and sediment contaminants SEER. See Surveillance, Epidemiology, and End Results Semen biochemistry, 76 Sentinel health events, 113, 124 Serial correlations. See Dose-response relations, correlated data Serum-cholesterol measurement, 58 Sexual function effects, 76-77

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--> Short-term monitoring. See Monitoring Significance, statistical. See Statistical techniques Silica, 54 Silicon carbide, 59 Six Cities Study of Air Pollution and Health, 48, 71 Skin patch samples. See Sampling, personal Smoking. See Lifestyle factors, Tobacco smoke Smoothing techniques, 143-144 SMR. See Standard mortality ratio Software, mapping, 15 Soil and sediment contaminants, 33, 38-39 Source monitoring. See Monitoring Spatial-covariance function, estimated. See Kriging Sperm counts, 76 Standard mortality ratio, 22 State Environmental Health Information Clearinghouse, 156, 174 State health-department reports, 1, 4, 9, 155-169 Statistical power. See Power considerations Statistical techniques, 50, 62, 130-150. See also individual analytic methods aggregate, 6 robust methods, 144-145 significance testing, 21 Storage and Retrieval of Aerometric Data monitoring, 48, 102, 110 Stress, 74 Study design. See Design of studies Study size. See Sample size Subjective symptoms. See Symptom incidence Sulfate, 71 Sulfur dioxide, 71-72 Superfund Amendments and Reauthorization Act of 1986, 103 Superfund sites, 4-5, 15 Surface soil contaminants. See Soil and sediment contaminants Surveillance, Epidemiology, and End Results program, 105, 107-109, 118 Surveillance systems, 14, 118-120 Susceptible populations, 84-86, 116-117 Symptom incidence, 52-56 Syndromes. See Diseases T Temporality. See Latency period Tetrachloroethane, 41, 44-45 Thalidomide, 77 Time-activity diaries. See Diaries Time factor. See Latency period Tobacco smoke, 2, 13, 22, 24, 45-46 Total exposure, 29 Total suspended particle concentrations, 72, 138, 140 Toxicokinetic modeling. See Modeling Toxicology,50 Toxic Release Inventory, 107 Toxic-waste sites. See Hazardous-waste sites Training. See Exposure analysts Transient populations, 116-117 Trends, 6, 14, 18 Trichloroethylene, 14, 41, 69 TSP. See Total suspended particle concentrations Type I errors. See False positives Type II errors. See False negatives U Uncertainty, random. See P values Urine samples. See Sampling, personal U.S. General Accounting Office, 4 V Variation in immunologic markers, coefficients of, 83 Variograms. See Kriging

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--> Vinyl chloride, 23 VOCS. See Chemicals, volatile organic Volatile organic compounds. See Chemicals, volatile organic W Water contaminants, 78 factors affecting uptake of, 7 measuring, 32, 40-41, 49 World Bank, 2, 4, 170