Epidemiology: a foundation of environmental decision making

Our plain-English summary of Epidemiology: a foundation of environmental decision making, by K.C.K. Deener, J.D. Sacks, E.F. Kirrane, et al (Journal of Exposure Science & Environmental Epidemiology, 2018).

The study

• Authors: K.C.K. Deener, J.D. Sacks, E.F. Kirrane, B.S. Glenn, M.R. Gwinn, T.F. Bateson, T.A. Burke
• Journal: Journal of Exposure Science & Environmental Epidemiology
• Published: 2018;28(6):515-521
• Type of article: Review
• Cited by: 7 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Many epidemiologic studies are designed so they can be drawn upon to provide scientific evidence for evaluating hazards of environmental exposures, conducting quantitative assessments of risk, and informing decisions designed to reduce or eliminate harmful exposures. However, experimental animal studies are often relied upon for environmental and public health policy making despite the expanding body of observational epidemiologic studies that could inform the relationship between actual, as opposed to controlled, exposures and health effects. This paper provides historical examples of how epidemiology has informed decisions at the U.S. Environmental Protection Agency, discusses some challenges with using epidemiology to inform decision making, and highlights advances in the field that may help address these challenges and further the use of epidemiologic studies moving forward.

In plain English

This article is a perspective (an overview and opinion piece), not a study, and it reports no new data. The authors, all employed at the U.S. Environmental Protection Agency (EPA) when it was written, described past examples of epidemiologic studies informing EPA decisions. The examples were air quality standards for particulate matter, lead, and EPA's IRIS assessment of Libby amphibole asbestos, an amphibole asbestos mixture that contaminated vermiculite mined in Libby, Montana. For Libby, they described how EPA used a NIOSH study of a cohort of workers associated with the mining operation, whose deaths were followed through 2001, to derive a cancer inhalation unit risk. Because of possible exposure measurement error, EPA restricted that cohort to workers hired after 1959, when job and air sampling records became better. The authors also discussed challenges in using epidemiology, such as exposure assessment and bias. They described advances that may help, including systematic review methods, statistical methods for causes and bias, better exposure measures, and cross-disciplinary training. The authors concluded that epidemiology could play an even stronger role in environmental decision making.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Perspective (commentary) describing historical examples of how epidemiology informed U.S. EPA decisions; no original data
• Who was studied: No study population. The article discusses EPA case examples: particulate matter air standards, lead, and the IRIS assessment of Libby amphibole asbestos, which used a NIOSH cohort of workers associated with the Libby, Montana mining operation
• Exposure: Asbestos-related example: Libby amphibole asbestos, an amphibole asbestos mixture that contaminated vermiculite mined in Libby, Montana. Other examples covered particulate matter and lead
• Main results:
  • The authors reported that the toxicity values in EPA's IRIS assessment of Libby amphibole asbestos were based on epidemiologic studies
  • The authors described how EPA used the results of a NIOSH cohort of Libby mining workers, whose mortality was followed through 2001, to derive a cancer inhalation unit risk
  • The authors described exposure measurement error as one challenge with the Libby study, and said EPA restricted the cohort to workers hired after 1959, when job data and air sampling data improved
  • The authors highlighted advances that may help the use of epidemiology in risk assessment: systematic review methods, methodological advances, improved exposure measures, clinical disease knowledge, and cross-disciplinary training
• The authors' conclusion: The authors concluded that, as the field advances, epidemiology may play an even stronger role in environmental protection and decision making

Topics

Medical terms in this study, explained in our Lexicon: Epidemiology, Environmental Exposure.

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