The application of epidemiology to the prevention of occupational cancer.
Landrigan PJ; Rinsky RA
J Toxicol Clin Toxicol 1984 May; 22(3):209-238
The relationship between epidemiology and occupational cancer is reviewed. The function of epidemiology in the prevention of occupational cancer is defined and the rules of evidence that have been developed for assaying causality in epidemiologic studies of occupational cancer are discussed. The first step in this direction requires establishment of a causal hypothesis, followed by determination of whether or not the hypothesis provides an adequate explanation of observed realities. Studies that demonstrate a causal relationship between cigarette smoking and human lung cancer are presented as an example to show the difficulties that confront such exercises. The use of the 1981 Interagency Regulation guidelines is recommended during documentation of epidemiologic methods and assessment of published data. Six criteria for determining causality in epidemiologic studies, namely the strength of association, its reproducibility, temporality, dose response relationship and specificity, and its biological plausibility, are discussed. The contribution to increased relative risk by such confounding factors as cigarette smoking is noted. Studies that examine the association between occupational exposure to benzene (71432) and subsequent death from leukemia are used to illustrate the application of epidemiology to prevent occupational cancer. Epidemiologic risk assessments indicate that an unexpectedly large number of excess leukemia deaths will occur in populations exposed to the current legal standard of 10 parts per million benzene. If these findings help bring about reduction in benzene standard, then epidemiology will have assisted in the prevention of occupational cancer.
NIOSH-Author; Risk-factors; Exposure-limits; Occupational-exposure; Biological-effects; Chemical-properties; Trace-substances; Pulmonary-system-disorders; Smoke-inhalation; Occupational-hazards; Pulmonary-cancer
Journal of Toxicology: Clinical Toxicology