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Epidemiologic approaches to persons with exposures to waste chemicals.

Environ Health Perspect 1983; 48:93-97
Epidemiological tenets to guide the evaluation of persons exposed to chemical dumps are reviewed. First, documentation of the nature and extent of exposure is discussed. An inventory of materials contained in the dump must be developed and possible interactions among the discarded materials should be considered. The nature and quantity of major emissions from the dump and probable routes of human exposure must be determined. Factors affecting estimates of human exposure are examined. Second, populations at risk must be defined using occupational monitoring and environmental mapping. Third, medical evaluation of populations exposed to waste chemical dumps must be targeted. Means of deciding what adverse health effects should be sought are considered. Clinical studies must be as specific and sensitive as possible to avoid either over diagnosis or under diagnosis. Fourth, etiologic association between exposure and disease must be established. The most convincing evidence for the existence of a cause/effect relationship is demonstration of a dose/response relationship. The evaluation of negative data is considered. Problems of small study population size and the slow development of chronic disease are discussed. The author concludes that future epidemiological studies should be conducted with proper regard for study design conventions. Development of improved methods for tracing persons who have been exposed to toxic chemicals and establishment of federal statistical territories are suggested.
NIOSH-Author; Clinical-symptoms; Biological-effects; Physiological-response; Dose-response; Exposure-levels; Epidemiology; Clinical-diagnosis; Health-hazards; Disease-incidence
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Environmental Health Perspectives