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PREFACE A N A L Y T I C A L CHEMISTS are increasingly able to measure s m a l l quantities of chemicals i n the h u m a n e n v i r o n m e n t . I n particular, the analysis of s y n thetic chemicals ( i n c l u d i n g solvents, c h e m i c a l i n t e r m e d i a t e s , metals a n d organometallics, pesticides a n d f o r m u l a t i o n contaminants, a n d c o m b u s t i o n products) has advanced to the p o i n t at w h i c h traces can be d e t e c t e d almost a n y w h e r e . A s the d e t e c t i o n l i m i t s have d r o p p e d , c e r t a i n synthetic c o m pounds have b e e n f o u n d to be u b i q u i t o u s , simultaneously measurable i n o u r food, water, air, a n d e v e n i n o u r tissues. A l t h o u g h these technological a d vances have p r o v i d e d a m o r e c o m p l e t e p i c t u r e of the trace c h e m i c a l c o m position of the e n v i r o n m e n t , o u r u n d e r s t a n d i n g of the significance of these residues has riot i m p r o v e d . T h e laboratory a n i m a l toxicity of m a n y of the substances, usually a d m i n i s t e r e d at h i g h doses, suggests that the exposures detected may also be h a r m f u l to h u m a n s . To advance the state of k n o w l e d g e , however, w e n e e d some way to test these hypotheses. Interpretation of the h e a l t h effects of c h e m i c a l residues involves h e a l t h risk assessment, the most sought-after c o m p o n e n t of w h i c h is e v i d e n c e f r o m w e l l - d e s i g n e d h u m a n e p i d e m i o l o g i c a l studies. E p i d e m i o l o g y is a h e a l t h s c i ence that examines the d i s t r i b u t i o n of disease i n populations a n d the factors associated w i t h that d i s t r i b u t i o n . T h e E n v i r o n m e n t a l C h e m i s t r y D i v i s i o n hosted a pedagogical s y m p o s i u m i n e n v i r o n m e n t a l e p i d e m i o l o g y at the S p r i n g 1992 m e e t i n g of the A m e r i c a n C h e m i c a l Society i n San F r a n c i s c o . W i t h support f r o m the U . S . D e p a r t m e n t of H e a l t h and H u m a n Services a n d the A m e r i c a n C h e m i c a l Society, a s y m p o s i u m was d e v e l o p e d that e x p l o r e d the basic p r i n c i p l e s a n d methods of e n v i r o n m e n t a l epidemiology. T h e speakers r e p r e s e n t e d a cross section of experts from academia, the c h e m i c a l i n d u s t r y , a n d g o v e r n m e n t . T h e y b r o u g h t to the s y m p o s i u m a w e a l t h of practical experience i n c o n d u c t i n g a n d i n t e r p r e t i n g e p i d e m i o l o g i c a l studies. T h e objective of the p r o gram was to p r o v i d e an i n t r o d u c t i o n a n d o v e r v i e w w i t h an emphasis that w o u l d be useful to chemists a n d others i n t e r e s t e d i n e n v i r o n m e n t a l c h e m i cals. T h i s v o l u m e , d e r i v e d f r o m the papers p r e s e n t e d at the pedagogical s y m p o s i u m , has b e e n arranged i n five sections. T h e first chapter serves as an i n t r o d u c t i o n . C h a p t e r s 2 - 4 , w h i c h cover the science of epidemiology, p r e sent basic p r i n c i p l e s of epidemiology, w i t h attention to n o m e n c l a t u r e a n d the design a n d i n t e r p r e t a t i o n of e p i d e m i o l o g i c a l studies. Toxicology is inextricably l i n k e d w i t h e p i d e m i o l o g y i n the risk-assessment process, a n d t h e r e fore C h a p t e r s 5 - 8 p r o v i d e a b r i e f o v e r v i e w of toxicology a n d toxicological risk assessment. C h a p t e r s 9 - 1 5 give an i n - d e p t h discussion of e n v i r o n m e n tal e p i d e m i o l o g y i n practice a n d s u p p l y a glimpse of the application of e p i -
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d e m i o l o g i c a l methods i n h u m a n studies. E x p o s u r e classification is a major challenge i n e p i d e m i o l o g i c a l research, a n d misclassification of exposure groups is a r e c u r r i n g p r o b l e m . T h i s situation is r e f l e c t e d i n m a n y of the chapters. N o t a b l y , exposure assessment is also the area i n w h i c h chemists a n d biochemists have the most to offer i n e p i d e m i o l o g i c a l research. T h e final chapters c o n t r i b u t e d b y two e x p e r i e n c e d m e d i c a l epidemiologists examine the u n i q u e constraints of epidemiology, a n observational science that m u s t b r i d g e n u m e r o u s legal, e t h i c a l , a n d logistical obstacles, i n a d d i t i o n to the m o r e f a m i l i a r h u r d l e s c o m m o n t h r o u g h o u t scientific research. T h i s v o l u m e w i l l be useful to scientists a n d engineers, p o l i c y makers a n d risk managers, a n d others w h o must d e a l w i t h p u b l i c h e a l t h issues s u r r o u n d i n g synthetic chemicals i n the e n v i r o n m e n t . T h e i n f o r m a t i o n m a y b e relevant w h e r e other types of technology are c o n c e r n e d as w e l l (e.g., n u clear p o w e r a n d radioactive wastes or electromagnetic radiation) as the p r i n ciples are u n i v e r s a l . Acknowledgments I thank the s y m p o s i u m speakers, authors, a n d r e v i e w e r s w h o g e n e r ously took t i m e from t h e i r busy schedules to c o n t r i b u t e to this u n c o n v e n tional u n d e r t a k i n g . T h e c o n t r i b u t i o n s a n d encouragement of D e a n A d a m s , J o h n Bailar, M a r g a r e t B r o w n , Joy C a r l s o n , H e n r y F a l k , W o l f g a n g F u h s , L y n n G o l d m a n , V e r n o n H o u k , H a r o l d H u m p h r e y , B i l l Jones, Jack M a n d e l , H e r b e r t N e e d l e m a n , R a y m o n d N e u t r a , E d o P e l l i z z a r i , G e r h a r d Raabe, C h e r y l Shanks, P a t r i c i a Spear, C o l l e e n S t a m m , R o b e r t Stephens, a n d W a r r e n W i n k e l s t e i n , J r . , are greatly appreciated. S u p p o r t for the s y m p o s i u m was p r o v i d e d b y C o n f e r e n c e G r a n t R 1 3 C C R 9 0 7 3 9 3 from the C e n t e r s for Disease C o n t r o l a n d P r e v e n t i o n a n d b y the A m e r i c a n C h e m i c a l Society C o m m i t t e e o n Science, Pedagogical S y m p o s i u m S u b c o m m i t t e e . WILLIAM M. DRAPER C a l i f o r n i a D e p a r t m e n t of H e a l t h Services Berkeley, CA 94704 J u n e 14, 1993
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