Assessment of health effects in epidemiologic studies of air pollution.

As we increasingly recognize the complexity of the pollutants in indoor and outdoor microenvironments, a broad array of inhaled mixtures has assumed scientific, public health, and regulatory importance. Few adverse effects of environmental pollutants are specific, that is, uniquely associated with a single agent; the adverse effects that might be considered in an investigation of the consequences of exposure to an inhaled complex mixture are generally nonspecific. In the context of this paper, we will refer to binary mixtures as complex, though we realize that a more precise definition of complexity would restrict the term to mixtures of three or more constituents. Their causes potentially include not only pollutant exposures through the medium of inhaled air but other environmental agents, such as infectious organisms and radiation, and inherent characteristics of the exposed persons, such as atopy. We review the outcome measures that have been used in epidemiologic studies of the health effects of single pollutants and complex mixtures. Some of these outcome measures have been carefully standardized, whereas others need similar standardization and modification to improve sensitivity and specificity for investigating the health effects of air pollution.

[1]  W. Mcdonnell.  Utility of controlled human exposure studies for assessing the health effects of complex mixtures and indoor air pollutants. , 1993, Environmental health perspectives.

[2]  D. E. Barber,et al.  Comparative dosimetry of radon in mines and homes , 1992 .

[3]  T. Nakazawa.  [Mortality from asthma]. , 1991, Kokyu to junkan. Respiration & circulation.

[4]  M. Lebowitz,et al.  The normal range of diurnal changes in peak expiratory flow rates. Relationship to symptoms and respiratory disease. , 1991, The American review of respiratory disease.

[5]  R. Letz.  Use of computerized test batteries for quantifying neurobehavioral outcomes. , 1991, Environmental health perspectives.

[6]  D. Dockery,et al.  Daily diaries of respiratory symptoms and air pollution: methodological issues and results. , 1991, Environmental health perspectives.

[7]  H. Nelson,et al.  The role of the peak flow meter in the diagnosis and management of asthma. , 1991, The Journal of allergy and clinical immunology.

[8]  L. Mølhave,et al.  Volatile Organic Compounds, Indoor Air Quality and Health , 1991 .

[9]  L. Folinsbee,et al.  Ozone concentration and pulmonary response relationships for 6.6-hour exposures with five hours of moderate exercise to 0.08, 0.10, and 0.12 ppm. , 1990, The American review of respiratory disease.

[10]  J M Samet,et al.  The Risk of Nitrogen Dioxide: What have we Learned from Epidemiological and Clinical Studies? , 1990, Toxicology and industrial health.

[11]  N. Graham,et al.  The epidemiology of acute respiratory infections in children and adults: a global perspective. , 1990, Epidemiologic reviews.

[12]  S. C. Darby,et al.  Health Risks of Radon and Other Internally Deposited Alpha-Emitters-BEIR IV. , 1989 .

[13]  J D Hackney,et al.  Short-term effects of carbon monoxide exposure on the exercise performance of subjects with coronary artery disease. , 1989, The New England journal of medicine.

[14]  L. Taussig,et al.  THE TUCSON CHILDREN'S RESPIRATORY STUDY. II. LOWER RESPIRATORY TRACT ILLNESS IN THE FIRST YEAR OF LIFE , 1989, American journal of epidemiology.

[15]  J. Mauderly.  Susceptibility of Young and Aging Lungs to Inhaled Pollutants , 1989 .

[16]  J. Samet.  Definitions and methodology in COPD research , 1989 .

[17]  D. Sparrow,et al.  Airway responsiveness and atopy in the development of chronic lung disease , 1989 .

[18]  A. Watson,et al.  Asthma and Automotive Emissions , 1988 .

[19]  J D Spengler,et al.  Health effects and sources of indoor air pollution. Part II. , 1988, The American review of respiratory disease.

[20]  R. Schlesinger,et al.  Effect of repeated exposures to nitrogen dioxide and sulfuric acid mist alone or in combination on mucociliary clearance from the lungs of rabbits. , 1987, Environmental research.

[21]  L. Bates.  ENVIRONMENTAL TOBACCO SMOKE: MEASURING EXPOSURES AND ASSESSING HEALTH EFFECTS , 1987 .

[22]  R. E. Anderson,et al.  Cause of death. Proper completion of the death certificate. , 1987, JAMA.

[23]  F. J. Miller,et al.  Dosimetry modeling of inhaled toxic reactive gases , 1986 .

[24]  C. Franck,et al.  Eye symptoms and signs in buildings with indoor climate problems (‘office eye syndrome’) , 1986, Acta ophthalmologica.

[25]  F. W. Denny,et al.  Acute lower respiratory tract infections in nonhospitalized children. , 1986, The Journal of pediatrics.

[26]  L. Mølhave,et al.  Human reactions to low concentrations of volatile organic compounds , 1986 .

[27]  Education . Office on Smoking,et al.  The health consequences of involuntary smoking : a report of the Surgeon General , 1986 .

[28]  K. Kilburn,et al.  Neurobehavioral and respiratory symptoms of formaldehyde and xylene exposure in histology technicians. , 1985, Archives of environmental health.

[29]  Hackney,et al.  Inhalation toxicology of air pollution : clinical research considerations , 1985 .

[30]  A. Miller,et al.  Standardized lung function testing. , 1984, Bulletin europeen de physiopathologie respiratoire.

[31]  J. Siebelink.  The relationship between respiratory illness in childhood and chronic air-flow obstruction in adulthood. , 1983, The American review of respiratory disease.

[32]  D. Wegman,et al.  Smoking, occupation, and histopathology of lung cancer: a case-control study with the use of the Third National Cancer Survey. , 1983, Journal of the National Cancer Institute.

[33]  M. Schenker,et al.  Health effects of residence in homes with urea formaldehyde foam insulation: a pilot study , 1982 .

[34]  F. Speizer,et al.  The relationship between air pollution and emergency room visits in an industrial community. , 1981, Journal of the Air Pollution Control Association.

[35]  C. Percy,et al.  Accuracy of cancer death certificates and its effect on cancer mortality statistics. , 1981, American journal of public health.

[36]  A S Whittemore,et al.  Asthma and air pollution in the Los Angeles area. , 1980, American journal of public health.

[37]  J. Samet.  A historical and epidemiologic perspective on respiratory symptoms questionnaires. , 1978, American journal of epidemiology.

[38]  F. Speizer,et al.  Surveillance techniques for respiratory illness. , 1976, Archives of environmental health.

[39]  A. Monto,et al.  Acute respiratory illness in an American community. The Tecumseh study. , 1974, JAMA.

[40]  Jerome L. Martin,et al.  Respiratory Function in Disease , 1972 .

[41]  A. Monto,et al.  The Tecumseh study of respiratory illness. I. Plan of study and observations on syndromes of acute respiratory disease. , 1971, American journal of epidemiology.

[42]  P. J. Lawther,et al.  Air pollution and exacerbations of bronchitis , 1970, Thorax.

[43]  William S. Jordan,et al.  Illness in the home : a study of 25,000 illnesses in a group of Cleveland families , 1964 .