We live in an industrialized world and there remains significant concern about e

Question

We live in an industrialized world and there remains significant concern about environmental exposures and public health. One of the key components of environment epidemiology is exposure assessment. Describe an idealized study design that allows you to both assess the level of exposure to an important environmental pollutant and conduct an epidemiological investigation of the general public for a specific disease in the following scenario

Scenario: Air pollution from coal fire station and lung cancer

Explain the choice of epidemiological study design needed to conduct the investigation. If your study includes control groups describe them. How would you measure exposure and give examples of what you would measure. This should include both measures of the environment and biological measures (biomarkers). Indicate how you would collect the samples and how many collections would occur. Give a list of several potential toxins of concern in the scenario. It is difficult to measure every possible exposure ie measure all types of air pollutants from this source – so choose up to three toxins/pollutants to measure – what are the basis for your choices. Describe the age range you would be interested in studying and why. Describe any confounders that you think maybe of interest, and this should include what you know about how environmental justice (EJ) issues. Describe how issues around EJ may modify the observation(s) of the study. The study should not focus on occupational events, bur rather on populations near the coal burning station.

Explanation / Answer

The choice of study include case-control groups. The control population include people without the disease who potentially would be selected as cases if they were to develop the disease. Exposure histories of both cases and control are determined and compared.

Exposure is determined from current measurements. Blood is drawn from cases and control groups and stored as a part of regular evaluations of the study cohort.

Air Quality Index (AQI) is measured by non automatic monitoring using Diffusion tubes, Particulate PM10 Monitor, Dust Frisbee.

Biomarkers include 1-hydroxypyrene (1-OPH) which is a biomarker for exposure to polycyclic aromatic hydrocarbons (PAH).

Several potential Toxins include :

Sulfur dioxide

Nitrogen dioxide

lead

carbon monoxide

Fine particles

Ground-level ozone

Toxins that are to be measured :

Sulfer dioxide and nitrogen dioxide : Both pollutants cause adverse respiratory effects which increases asthma and are associated with chronic respiratory illness.

Lead : It has neurological effects like behavioral problems, high blood pressure, lower IQ and heart diseases.

The associations of lung cancer with exposure to ETS and to indoor radon may be a confounder.

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