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EH 500 > Environmental Epidemiology (3) > Flashcards

Environmental Epidemiology (3) Flashcards

1
Q

Different types of environmental epidemiologic design

A
  1. Descriptive studies
  2. Ecologic or correlational studies
  3. Analytic (or etiologic) studies
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2
Q

Descriptive studies

A
  1. Not hypothesis driven

2. Cluster studies, surveillance studies

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3
Q

Ecologic or correlational studies

A
  1. Association at group level, not individual
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4
Q

Analytic (or etiologic) studies

A
  1. Test hypotheses, often informed by previous designs
  2. RCTs
  3. Observational studies (cohort, case-cntrl, cross-sectional)
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5
Q

Why can’t we conduct randomized human experiments to investigate health effects of environmental agents?

A

Ethical reasons so we take an ecological approach to draw comparisons

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6
Q

Concentrated Animal Feeding Operations (CAFOs)

A

Large-scale factory farms

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7
Q

Problems with spraying of pig fecal waste

A
  1. Odor –> eye irritation, respiratory problems
  2. Hydrogen sulfide –> eye irritation, respiratory problems
  3. Particulate matter –> eye irritation, wheezing
  4. Endotoxins –> sore throat, chest tightness, nausea
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8
Q

How can we study health implications of CAFOs if RCTs are unethical?

A

Option #1: Location contrasts –> ppl living near CAFOs vs. ppl living far away from CAFOs

Option #2: Time period contrasts –> among ppl living near CAFOs, compare illness rates on high vs. low pollution days (case-crossover design)

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9
Q

What is the key assumption in “Location Contrasts” design?

A

Populations are “exchangeable”

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10
Q

What is exchangeability?

A

Morbidity in unexposed = morbidity in exposed had they not been exposed

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11
Q

What happens when populations are not exchangeable?

A

There is confounding

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12
Q

Is there exchangeability in RCTs or observational studies?

A
  1. RCTs –> Yes

2. Observational –> No randomization so it is unknowable

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13
Q

In the pig farming example, which design is appropriate for hypotheses about short-term effects?

A

Case-crossover

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14
Q

Why is the quality of exposure assessments important?

A

Because it affects the validity of an environmental epi study

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15
Q

What is the case-specular design?

A

Similar to case-crossover, but the comparison is spatial (rather than temporal)

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16
Q

Significance of RR = 1.02 for Water Quality and GI Illnesses study

A

Because we’re dealing w a water system (which has the potential to affect a large # of people) then perhaps this RR should be given more weight because we derived this RR from population data

17
Q

What is the ecological fallacy?

A

When effects at the aggregate/population level do not hold for individuals

18
Q

What is a disease cluster?

A

“An aggregation of relatively uncommon events or disease in space and/or time in amounts that are believed to be greater than could be explained by chance”

19
Q

What is Environmental Public Health Tracking (EPHT)?

A

The ongoing collection, integration, analysis, interpretation, and dissemination of data on human exposure to environmental hazards and health effects that may be related to those exposures

20
Q

What is the motivation for EPHT?

A

Clusters

21
Q

Why is environmental epi unique?

A
  1. Exposures/response may be small

2. Necessitate creative designs

22
Q

Strengths of environmental epi

A
  1. Measure “real world” exposure scenarios
  2. Follow ppl in natural settings
  3. Measure highly relevant endpoints
  4. Can follow/identify sensitive populations
23
Q

Challenges of environmental epi

A
  1. Causality difficult to demonstrate
  2. No control over exposures
  3. Difficult to obtain accurate measures of individual exposure (ecologic bias; measurement error)
  4. Difficult to eliminate/cntrl for confounders
24
Q

Asthma Rates & Traffic-related Air Pollutants Example - options for exposure assessment?

A
  1. Looking at location differences
  2. Modeling approach (distance from road, modeling where pollutants would be)
  3. Measuring biomarkers in urine or blood
  4. Air monitors

EH 500 (8 decks)

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