An epidemiological perspective on environmental health indicators.

H Pastides
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Abstract

There is a great amount of ongoing discussion about the need to develop new ways to assess and monitor a population's disease susceptibility to environmental factors. The ultimate goal in developing these tools, called environmental health indicators, is to increase the public health community's capacity for implementing interventions to prevent disease. Much of the discussion focuses on the requirement that the indicators be relatively easy and quick to apply. However, in the rush to find useful existing indicators, or to develop new ones, there is the danger that certain other important attributes of the indicator may be overlooked. These include: (a) whether the indicator truly represents an underlying causal relationship between an environmental exposure and a health consequence; and (b) whether the proposed indicator is a reasonably valid estimate of the underlying causal factor. This article provides a framework for relating environmental health indicators to the methods of epidemiology including some guidance for selecting and evaluating the appropriateness of proposed environmental health indicators. Examples are given which demonstrate how environmental health indicators can lead to a biased interpretation of underlying associations between environmental factors and the potential for disease when they are improperly conceived. These problems can be avoided by employing routine epidemiological concepts and methods as indicators are developed and evaluated.

从流行病学角度看环境卫生指标。
目前正在进行大量讨论,讨论是否需要开发新的方法来评估和监测人口对环境因素的疾病易感性。制定这些被称为环境卫生指标的工具的最终目标是提高公共卫生界实施预防疾病干预措施的能力。大部分讨论集中在指标相对容易和快速应用的要求上。然而,在急于寻找有用的现有指标或开发新指标的过程中,有一种危险,即指标的某些其他重要属性可能被忽视。这些指标包括:(a)该指标是否真正代表环境暴露与健康后果之间的潜在因果关系;(b)建议的指标是否对潜在的因果因素作出合理有效的估计。本文提供了一个将环境卫生指标与流行病学方法联系起来的框架,包括选择和评估拟议环境卫生指标的适当性的一些指导。文中列举的例子表明,如果环境健康指标的构思不当,它们如何可能导致对环境因素与潜在疾病之间的潜在关联的有偏见的解释。在制定和评价指标时,可以通过采用常规流行病学概念和方法来避免这些问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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