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This book gives a comprehensive survey of the epidemiology of common environmental exposures, including diet, water, particulates in outdoor air, nitrogen dioxide, ozone, environmental tobacco smoke, radon in homes, electromagnetic fields, and lead. Design and analysis issues, risk assessment and meta-analysis, and future directions in environmental epidemiology are also covered. All chapters provide a review of the literature as well as a discussion of important methodologic issues, particularly exposure assessment and statistical methods. The book's focus is on environmental exposures that are suspected of causing disease, but often remain controversial. Most of these exposures are widespread and low-level, and are thought to increase the risk of chronic diseases that have many causes. Although the disease risks due to these exposures may be low, the public health burden may be important because large numbers of people are exposed. Such exposures are inherently difficult to detect via observational epidemiology. This book seeks to clarify the challenges involved and suggests ways to move forward. It will be useful to students and practitioners of public health, environmental health, and epidemiology.
This casebook is designed for use in courses on epidemiology or occupational epidemiology. The chapters are based on actual studies and are written by the principal investigators. They are divided into four parts: cohort studies, case-control and proportionate mortality studies, cross-sectional studies, and surveillance and screening studies. A brief introduction to each part describes the study design, and a statistical appendix is included so that students can easily find the tools needed to answer analytical questions in the text. Questions in each chapter deal with study design, data collection, analysis, and interpretation. Complete answers are provided at the end of each chapter. Data sets accompany many of the chapters, and most of the analytical questions can be answered with a pocket calculator. The studies presented in this lucid, well-organized text involve a broad range of disease outcomes, including spontaneous abortion, carpal tunnel syndrome, kidney dysfunction, cytogenetic changes, ischemic heart disease, dermatitis, chronic renal disease, and several types of cancer. The exposures of interest are equally diverse, including VDT use, repetitive hand-wrist motion, heavy metals, carbon monoxide, diesel exhaust, lead, vinyl chloride, pesticides, solvents, silica, and acid mists. These outcomes and exposures cover many of the current topics of interest in occupational health.
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