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In the late 1980s, the National Cancer Institute initiated an investigation of cancer risks in populations near 52 commercial nuclear power plants and 10 Department of Energy nuclear facilities (including research and nuclear weapons production facilities and one reprocessing plant) in the United States. The results of the NCI investigation were used a primary resource for communicating with the public about the cancer risks near the nuclear facilities. However, this study is now over 20 years old. The U.S. Nuclear Regulatory Commission requested that the National Academy of Sciences provide an updated assessment of cancer risks in populations near USNRC-licensed nuclear facilities that utilize or process uranium for the production of electricity. Analysis of Cancer Risks in Populations near Nuclear Facilities: Phase 1 focuses on identifying scientifically sound approaches for carrying out an assessment of cancer risks associated with living near a nuclear facility, judgments about the strengths and weaknesses of various statistical power, ability to assess potential confounding factors, possible biases, and required effort. The results from this Phase 1 study will be used to inform the design of cancer risk assessment, which will be carried out in Phase 2. This report is beneficial for the general public, communities near nuclear facilities, stakeholders, healthcare providers, policy makers, state and local officials, community leaders, and the media.
Epidemiology faces its limits: the search for subtle links between diet, lifestyle, or environmental factors and disease is an unending source of fear - but often yields little certainty. Studies on weak associations - or small effects - often produce contradictory results which confuse the public. In this book, numerous contributions and illustrated examples show the effects of this problem, and sets out how future research should be approached in order to minimize the problems, thus producing clear results of significance.
First edition published in 2002. Second edition published in 2008.
Depleted uranium, a component of some weapons systems, has been in use by the U.S. military since the 1991 Gulf War. Military personnel have been exposed to depleted uranium as the result of friendly fire incidents, cleanup and salvage operations, and proximity to burning depleted uranium-containing tanks and ammunition. Under a Congressional mandate, the Department of Defense sought guidance from the Institute of Medicine in evaluating the feasibility and design of an epidemiologic study that would assess health outcomes of exposure to depleted uranium. The study committee examined several options to study health outcomes of depleted uranium exposure in military and veteran populations and concluded that it would be difficult to design a study to comprehensively assess depleted uranium-related health outcomes with currently available data. The committee further concluded that the option most likely to obtain useful information about depleted uranium-related health outcomes would be a prospective cohort study if future military operations involve exposure to depleted uranium. The book contains recommendations aimed at improving future epidemiologic studies and identifying current active-duty military personnel and veterans with potential DU exposure.
This User’s Guide is a resource for investigators and stakeholders who develop and review observational comparative effectiveness research protocols. It explains how to (1) identify key considerations and best practices for research design; (2) build a protocol based on these standards and best practices; and (3) judge the adequacy and completeness of a protocol. Eleven chapters cover all aspects of research design, including: developing study objectives, defining and refining study questions, addressing the heterogeneity of treatment effect, characterizing exposure, selecting a comparator, defining and measuring outcomes, and identifying optimal data sources. Checklists of guidance and key considerations for protocols are provided at the end of each chapter. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews. More more information, please consult the Agency website: www.effectivehealthcare.ahrq.gov)
Epidemiology Matters offers a new approach to understanding and identifying the causes of disease -- and with it, how to prevent disease and improve human health. Utilizing visual explanations and examples, this text provides an accessible, step-by-step introduction to the fundamentals of epidemiologic study, from design to analysis. Across fourteen chapters, Epidemiology Matters teaches the individual competencies that underlie the conduct of an epidemiologic study: identifying populations; measuring exposures and health indicators; taking a sample; estimating associations between exposures and health indicators; assessing evidence for causes working together; assessing internal and external validity of results. With its consequentialist approach -- designing epidemiologic studies that aim to inform our understanding, and therefore improve public health -- Epidemiology Matters is an introductory text for the next generation of students in medicine and public health.
This book will serve as a primer for both laboratory and field scientists who are shaping the emerging field of molecular epidemiology. Molecular epidemiology utilizes the same paradigm as traditional epidemiology but uses biological markers to identify exposure, disease or susceptibility. Schulte and Perera present the epidemiologic methods pertinent to biological markers. The book is also designed to enumerate the considerations necessary for valid field research and provide a resource on the salient and subtle features of biological indicators.
The most recent volume in the Drinking Water and Health series contains the results of a two-part study on the toxicity of drinking water contaminants. The first part examines current practices in risk assessment, identifies new noncancerous toxic responses to chemicals found in drinking water, and discusses the use of pharmacokinetic data to estimate the delivered dose and response. The second part of the book provides risk assessments for 14 specific compounds, 9 presented here for the first time.
The amount of hazardous waste in the United States has been estimated at 275 million metric tons in licensed sites alone. Is the health of Americans at risk from exposure to this toxic material? This volume, the first of several on environmental epidemiology, reviews the available evidence and makes recommendations for filling gaps in data and improving health assessments. The book explores: Whether researchers can infer health hazards from available data. The results of substantial state and federal programs on hazardous waste dangers. The book presents the results of studies of hazardous wastes in the air, water, soil, and food and examines the potential of biological markers in health risk assessment. The data and recommendations in this volume will be of immediate use to toxicologists, environmental health professionals, epidemiologists, and other biologists.
Can the electric and magnetic fields (EMF) to which people are routinely exposed cause health effects? This volume assesses the data and draws conclusions about the consequences of human exposure to EMF. The committee examines what is known about three kinds of health effects associated with EMF: cancer, primarily childhood leukemia; reproduction and development; and neurobiological effects. This book provides a detailed discussion of hazard identification, dose-response assessment, exposure assessment, and risk characterization for each. Possible Health Effects of Exposure to Residential Electric and Magnetic Fields also discusses the tools available to measure exposure, common types of exposures, and what is known about the effects of exposure. The committee looks at correlations between EMF exposure and carcinogenesis, mutagenesis, neurobehavioral effects, reproductive and developmental effects, effects on melatonin and other neurochemicals, and effects on bone healing and stimulated cell growth.