Journal of Environmental Medicine最新文献

{"title":"The use and misuse of surrogate variables in environmental epidemiology","authors":"Frederick W. Lipfert","doi":"10.1002/jem.40","DOIUrl":"https://doi.org/10.1002/jem.40","url":null,"abstract":"<p>This paper discusses some common statistical problems that are often encountered in the specification and interpretation of regression models used in environmental epidemiology; such models have been used to establish new or modified ambient standards intended to protect public health. These statistical problems include: collinearity (identifying the ‘correct’ pollutant), confounding (omission of other variables that may be correlated with both response and putative dose), the ‘ecological fallacy’ (aggregating individual doses and responses over space or time), measurement error (uncertainties in data, applicability and measurement <i>per se</i>) and linearity (identifying curvature or thresholds in dose-response function). These problems occur in both time-series and cross-sectional studies. Although none of these potential problem areas is new, they have rarely been considered together or comprehensively. This paper considers them as specific instances of the general problem of surrogate variables, for which an analytical framework is presented together with some examples of their practical consequences and some guidelines for interpreting environmental epidemiology studies. Findings of the analysis include: single-pollutant regression models are likely to overstate effects; although aggregation results in loss of information, it biases the estimates only when confounding is present; the traditional approaches to correcting for measurement errors implied by the difference between personal exposures and ambient air quality do not apply, but estimates may be based on consideration of the ‘error’ term as an additional source of exposure; it may not be possible to deduce the correct shape of a dose-response function in the presence of measurement error and correlated covariates. These findings are intended to be descriptive rather than definitive; the main purpose is to stimulate the detailed research required to develop practical remedies that would allow epidemiology to be used appropriately in setting environmental standards.Copyright © 1999 John Wiley &amp; Sons, Ltd.</p>","PeriodicalId":100780,"journal":{"name":"Journal of Environmental Medicine","volume":"1 4","pages":"267-278"},"PeriodicalIF":0.0,"publicationDate":"2001-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jem.40","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72167424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mini-symposium on the effects of particles on Health: Introduction","authors":"RL Maynard","doi":"10.1002/jem.45","DOIUrl":"https://doi.org/10.1002/jem.45","url":null,"abstract":"","PeriodicalId":100780,"journal":{"name":"Journal of Environmental Medicine","volume":"1 4","pages":"259"},"PeriodicalIF":0.0,"publicationDate":"2001-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jem.45","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72167425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of occupational and environmental diseases by implementation of ISO14000 and BS8800 for industries","authors":"Jung-Der Wang,&nbsp;Chih-Wen Chung","doi":"10.1002/jem.34","DOIUrl":"https://doi.org/10.1002/jem.34","url":null,"abstract":"<p>Rapid industrialization usually brings both economic development and environmental pollution, which often produces occupational diseases in the workplace and environmental diseases in the nearby community. From experience of documenting 17 occupational diseases, we found that they resulted from a lack of a comprehensive hazard communication system. The spillage of such unknown chemical hazards also produced environmental diseases for the neighbouring factories and community. Because the general treatment of occupational and environmental diseases must include the identification of hazard and taking preventive procedures to avoid further exposure, it is essential to recognize and control the hazard at the start of an industry. Thus, implementation of the life cycle assessment in ISO (International Organization of Standardization) 14000 series will guide an industry to identify and minimize the use of hazardous chemicals. A similar practice of risk assessment and reduction for every unit operation in the production process proposed by BS (British Standard) 8800 will also help to improve occupational health. Although implementation of such systems is a voluntary compliance, actual practice demands the same systems in related or satellite factories and has a strong market implication. Copyright © 1999 John Wiley &amp; Sons, Ltd.</p>","PeriodicalId":100780,"journal":{"name":"Journal of Environmental Medicine","volume":"1 4","pages":"225-234"},"PeriodicalIF":0.0,"publicationDate":"2001-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jem.34","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72167429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wildlife as sentinels for human health hazards: a review of study designs","authors":"Peter M. Rabinowitz,&nbsp;Mark R. Cullen,&nbsp;Heather R. Lake","doi":"10.1002/jem.33","DOIUrl":"https://doi.org/10.1002/jem.33","url":null,"abstract":"<p>A systematic search of the peer-reviewed biomedical literature was performed for original studies linking environmental hazards with health effects in wild animal populations. Some 104 original studies were identified in the BIOSIS and Medline databases since 1966 and classified in terms of study design. A marked increase in published studies has occurred over the past decade, examining a wide range of hazards and outcomes. Most analytic studies were ecologic or cross-sectional in nature. All cross-sectional studies sampled subjects on the basis of exposure, using a reference population for the selection of controls. Studies of wild animal populations may hold unique advantages for toxicant hazard identification, yet the current range of study designs appears restricted. Increased use of study approaches such as sampling based on outcome, intra-population comparisons, as well as cohort and case-control designs may improve hazard identification and priority setting for confirmatory toxicologic and human studies of effects seen in wildlife. Copyright © 1999 John Wiley &amp; Sons, Ltd.</p>","PeriodicalId":100780,"journal":{"name":"Journal of Environmental Medicine","volume":"1 4","pages":"217-223"},"PeriodicalIF":0.0,"publicationDate":"2001-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jem.33","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72167432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence of a threshold effect for TSP in the Philadelphia data set","authors":"Mark J. Nicolich,&nbsp;John F. Gamble","doi":"10.1002/jem.41","DOIUrl":"https://doi.org/10.1002/jem.41","url":null,"abstract":"<p>The purpose of the present paper is to examine the complex set of questions about the PM-mortality exposure–response (E-R) relationship by looking at the practical and demonstrable consequences of time series model building and by considering alternate modelling methods.</p><p>Two questions are posed. The first is how to demonstrate goodness-of-fit for an exposure–response model and the effectiveness of a particular term in the model. The second is how to detect poor model fit associated with unusual relationships in the data, such as thresholds or other non-linear patterns. Suggested solutions are demonstrated using the Philadelphia data set used by Kelsall. These solutions are potentially applicable to other time series data analyses.</p><p>Examination of the example data indicate several findings. First, the addition of the pollution terms to a model which contains temporal and weather variables has a negligible change on the predictive ability of the model. While the statistical criteria are slightly improved the practical improvement in mortality prediction is minimal. Second, for these data, there is demonstrable evidence that there is a threshold effect for total suspended particulate (TSP) on predicted mortality. The threshold is also seen in the gaseous pollutants. Lastly, the inclusion of terms representing the day of the week statistically improves model fit to a greater extent than the pollution terms.</p><p>The results from this exercise suggest that several steps should be added to the traditional analysis and presentation of time-series data. These include visual and tabular presentation of results from each major model and analysis for a threshold at least for the criteria pollutant terms. The presentation elements allow the reader to independently assess model fit and the predictive capabilities of the model. Determination of a threshold allows objective determination of a no adverse effect level. Overall, application of these methods to time-series analyses provides more specificity for testing the predictive power of the model and for protecting health.Copyright © 1999 John Wiley &amp; Sons, Ltd.</p>","PeriodicalId":100780,"journal":{"name":"Journal of Environmental Medicine","volume":"1 4","pages":"279-290"},"PeriodicalIF":0.0,"publicationDate":"2001-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jem.41","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72192280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Could industrial noise be regarded as a risk factor for arterial hypertension?","authors":"L. Soleo,&nbsp;G. Pesola,&nbsp;L. Vimercati,&nbsp;G. Lasorsa,&nbsp;C. Zocchetti,&nbsp;F. Cassano,&nbsp;S. Palmi,&nbsp;F. Merluzzi","doi":"10.1002/jem.32","DOIUrl":"https://doi.org/10.1002/jem.32","url":null,"abstract":"<p>The aim of this study was to determine whether occupational noise exposure is a risk factor that may favour a chronic increase of diastolic and systolic blood pressure and a higher prevalence of arterial hypertension. A cross-sectional study was performed on 1372 workers employed in 11 cement plants in central and southern Italy. In 1985 the workers were subjected to a medical examination during which blood pressure was measured and information about personal features, occupational activity, diseases, family history of hypertension, use of antihypertensive drugs, smoking habit and alcohol intake were also gathered by questionnaire. For each worker noise exposure (dBA) was estimated using a series of indicators representing both the levels of exposure at the time of study and loud energy previously absorbed during the occupational life spent in the industry considered. 41.4% of the examined workers were hypertensive, according to the World Health Organization (WHO) definition (i.e. systolic blood pressure (SBP) levels ≥140 and/or diastolic blood pressure (DBP) levels ≥90 mmHg and/or reported antihypertensive treatment). Linear regression analysis showed a positive influence of age, BMI and use of antihypertensive drugs for both systolic and diastolic blood pressure. Noise exposure, independent of the indicators, was negatively associated with diastolic blood pressure only. The logistic regression analysis of the different variables contributing to high blood pressure showed a positive influence of age, BMI and family history of hypertension, while only some indicators of noise exposure were found to be negatively associated with arterial hypertension. Noise exposure, as assessed by all the different indicators used in the study, does not seem to influence systolic arterial pressure, but does have a negative influence on diastolic pressure. The prevalence of arterial hypertension, as defined by WHO criteria, appears negatively associated with noise exposure. The results obtained could be related both to a physiological variation of blood pressure following chronic noise exposure and to an unfavourable combination of elements further accentuated by the limitations of the cross-sectional study. Copyright © 1999 John Wiley &amp; Sons, Ltd.</p>","PeriodicalId":100780,"journal":{"name":"Journal of Environmental Medicine","volume":"1 4","pages":"207-216"},"PeriodicalIF":0.0,"publicationDate":"2001-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jem.32","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72167430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative sensory testing in gulf war veterans with chronic fatigue syndrome","authors":"Arnold Peckerman,&nbsp;Benjamin H. Natelson,&nbsp;Howard Kipen,&nbsp;Sharon L. Smith,&nbsp;Kristina Dahl,&nbsp;Chclaudia Pollet,&nbsp;John E. Ottenweller","doi":"10.1002/jem.35","DOIUrl":"https://doi.org/10.1002/jem.35","url":null,"abstract":"<p>The study assessed peripheral sensory function and its relation to self-reported wartime exposures to potentially neurotoxic substances in Gulf War veterans with chronic fatigue syndrome (CFS). Male Gulf veterans fulfilling the 1994 CDC diagnostic criteria for CFS were compared with matched controls. Quantitative sensory testing was performed to establish thresholds of perception for the sense of light touch and radiant heat. The Devens survey was used to collect data on self-reported exposures to by-products of combustion and organophosphate compounds. Gulf veterans with CFS had elevated tactile but normal thermal thresholds compared with their controls. Sick veterans had greater rates of self-reported exposures and/or noxious side effects for all assessed toxicants. Interestingly, both Gulf veteran groups, including those reporting no symptoms, had impaired perception of light touch when compared with age-matched samples of non-Gulf war veteran men. The results of this study are consistent with a hypothesis that Gulf veterans with CFS have a subtle neurological deficit that might reflect underlying peripheral neuropathy. The association between this deficit and self-report of multiple potentially neurotoxic exposures suggests that war zone pollutants may be possible contributing factors. Copyright © 1999 John Wiley &amp; Sons, Ltd.</p>","PeriodicalId":100780,"journal":{"name":"Journal of Environmental Medicine","volume":"1 4","pages":"235-240"},"PeriodicalIF":0.0,"publicationDate":"2001-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jem.35","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72167428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-based environmental indicators: approaches, potential and limitations","authors":"Zdravko P. Vassilev,&nbsp;Mark G. Robson,&nbsp;Marjorie B. Kaplan","doi":"10.1002/jem.31","DOIUrl":"https://doi.org/10.1002/jem.31","url":null,"abstract":"<p>The concept of indicators has long been applied for describing the trends and dynamics in both the environment and in human health. In recent years, significant effort has been devoted to estimating the negative impacts of the environment on human health, as well as to developing integrated metrics for the evaluation of the adverse health outcomes attributable to environmental exposures. The health-based environmental indicators (HBEIs) are measures designed to describe the status of human health with direct reference to the environmental conditions. Important potentials and limitations of the most promising approaches for developing HBEIs are examined from both a national and New Jersey prospective. The strengths and applicability of the health-based environmental measures are discussed with respect to the complex nature of the host–environment interactions and the scientific uncertainty about the environmental causation of diseases. It is concluded that the health-based environmental indicators are only supplemental tools for understanding of the relationship between environment and public health and do not provide solutions for the problems that might be encountered. Nevertheless, they can be efficiently used for improved environmental management and policy decisions. Copyright © 1999 John Wiley &amp; Sons, Ltd.</p>","PeriodicalId":100780,"journal":{"name":"Journal of Environmental Medicine","volume":"1 4","pages":"201-206"},"PeriodicalIF":0.0,"publicationDate":"2001-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jem.31","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72167431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational toxic risks in dental laboratory technicians","authors":"Léon Choël,&nbsp;Brigitte Grosgogeat,&nbsp;Denis Bourgeois,&nbsp;Jacques Descotes","doi":"10.1002/jem.44","DOIUrl":"https://doi.org/10.1002/jem.44","url":null,"abstract":"<p>Dental laboratory technicians use a wide range of materials and techniques. They are thus subject to occupational exposures of many different kinds. The aim of this review is to present the circumstances of exposure, the related risks, and the epidemiological data available in the literature. Exposures to metals, waxes, resins and silica can cause irritation or allergic reactions, affecting either the skin or the respiratory tract. The risks of benign pneumoconiosis induced by hard metals are well documented. A prevalence of 15.4% after 20 or more years of exposure has been reported, whereas the prevalence in the general population is less than 1%. Malignant pneumoconiosis is caused by dust from crystalline silica, asbestos or beryllium. Silicosis is the most common occupational disease among dental technicians, while for berylliosis the risk is not well documented. Isolated cases of systemic autoimmune diseases have been observed. No study has yet demonstrated a link between these diseases and occupational exposure of dental technicians. Silica is known to provoke systemic scleroderma, but its role in prosthetists remains to be established. The first steps in prevention are the identification, classification and evaluation of exposure and the effects of that exposure on the health of exposed workers. Reduction or elimination of exposure by collective or individual protective measures are the best modalities of prevention.Copyright © 1999 John Wiley &amp; Sons, Ltd.</p>","PeriodicalId":100780,"journal":{"name":"Journal of Environmental Medicine","volume":"1 4","pages":"307-314"},"PeriodicalIF":0.0,"publicationDate":"2001-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jem.44","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72192277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality among workers at a plastics manufacturing plant","authors":"Nalini Sathiakumar,&nbsp;Elizabeth Delzell,&nbsp;Philip Cole,&nbsp;Rodney Larson","doi":"10.1002/jem.36","DOIUrl":"https://doi.org/10.1002/jem.36","url":null,"abstract":"<p>This study evaluated the 1970–1993 mortality experience of 2550 of white and black men employed at a Texas plastics plant that made polyethylene, polypropylene, K-resin (a copolymer of 1,3-butadiene and styrene) and other materials. Of particular interest was the relationship between work in plastics manufacturing and colorectal cancer, as certain epidemiological investigations have reported an increase in this form of cancer among workers with potential exposure to polypropylene.</p><p>Overall, subjects had fewer than expected deaths from all causes combined (269 observed/364.3 expected), from all cancer (79/89.3) and from colorectal cancer (5/9.5). Polypropylene workers had one observed compared with 0.4 expected death from colorectal cancer. A two-fold increase in deaths from accidents among hourly men was attributable to an explosion in the polyethylene area. Certain subgroups of workers had a slight increase in lung cancer deaths. These results were not statistically significant, did not display marked patterns with duration of employment or time since hire and were not clearly attributable to occupational exposure. Some subgroups of employees had more than expected deaths from oesophagus cancer, pancreas cancer and prostate cancer. These findings were based on small numbers, and there is no persuasive evidence that the excesses were due to chemicals at the plant. However, longer follow-up will be necessary to obtain more precise results for subjects with long-term employment and with long potential induction time. Copyright © 1999 John Wiley &amp; Sons, Ltd.</p>","PeriodicalId":100780,"journal":{"name":"Journal of Environmental Medicine","volume":"1 4","pages":"241-248"},"PeriodicalIF":0.0,"publicationDate":"2001-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jem.36","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72167426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}