Skip to main content
NCBI home page
Environmental Health Perspectives logoLink to Environmental Health Perspectives
. 1993 Dec;101(Suppl 4):49–57. doi: 10.1289/ehp.93101s449

Measurement issues in environmental epidemiology.

M Hatch 1, D Thomas 1
PMCID: PMC1519685  PMID: 8206042

Abstract

This paper deals with the area of environmental epidemiology involving measurement of exposure and dose, health outcomes, and important confounding and modifying variables (including genotype and psychosocial factors). Using examples, we illustrate strategies for increasing the accuracy of exposure and dose measurement that include dosimetry algorithms, pharmacokinetic models, biologic markers, and use of multiple measures. Some limitations of these methods are described and suggestions are made about where formal evaluation might be helpful. We go on to discuss methods for assessing the inaccuracies in exposure or dose measurements, including sensitivity analysis and validation studies. In relation to measurement of health outcomes, we discuss some definitional issues and cover, among other topics, biologic effect markers and other early indicators of disease. Because measurement error in covariates is also important, we consider the problems in measurement of common confounders and effect modifiers. Finally, we cite some general methodologic research needs.

Full text

PDF
49

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Antonarakis S. E. Parental origin of the extra chromosome in trisomy 21 as indicated by analysis of DNA polymorphisms. Down Syndrome Collaborative Group. N Engl J Med. 1991 Mar 28;324(13):872–876. doi: 10.1056/NEJM199103283241302. [DOI] [PubMed] [Google Scholar]
  2. Armstrong B. G. The effects of measurement errors on relative risk regressions. Am J Epidemiol. 1990 Dec;132(6):1176–1184. doi: 10.1093/oxfordjournals.aje.a115761. [DOI] [PubMed] [Google Scholar]
  3. Brenner H., Savitz D. A., Jöckel K. H., Greenland S. Effects of nondifferential exposure misclassification in ecologic studies. Am J Epidemiol. 1992 Jan 1;135(1):85–95. doi: 10.1093/oxfordjournals.aje.a116205. [DOI] [PubMed] [Google Scholar]
  4. Brown L. M., Pottern L. M., Blot W. J. Lung cancer in relation to environmental pollutants emitted from industrial sources. Environ Res. 1984 Aug;34(2):250–261. doi: 10.1016/0013-9351(84)90093-8. [DOI] [PubMed] [Google Scholar]
  5. Brunekreef B., Noy D., Clausing P. Variability of exposure measurements in environmental epidemiology. Am J Epidemiol. 1987 May;125(5):892–898. doi: 10.1093/oxfordjournals.aje.a114606. [DOI] [PubMed] [Google Scholar]
  6. Cartwright R. A., Glashan R. W., Rogers H. J., Ahmad R. A., Barham-Hall D., Higgins E., Kahn M. A. Role of N-acetyltransferase phenotypes in bladder carcinogenesis: a pharmacogenetic epidemiological approach to bladder cancer. Lancet. 1982 Oct 16;2(8303):842–845. doi: 10.1016/s0140-6736(82)90810-8. [DOI] [PubMed] [Google Scholar]
  7. Cohen B. L. Ecological versus case-control studies for testing a linear-no threshold dose-response relationship. Int J Epidemiol. 1990 Sep;19(3):680–684. doi: 10.1093/ije/19.3.680. [DOI] [PubMed] [Google Scholar]
  8. Crump K. S., Ng T. H., Cuddihy R. G. Cancer incidence patterns in the Denver metropolitan area in relation to the Rocky Flats plant. Am J Epidemiol. 1987 Jul;126(1):127–135. doi: 10.1093/oxfordjournals.aje.a114644. [DOI] [PubMed] [Google Scholar]
  9. Davis D. L., Hoel D., Fox J., Lopez A. International trends in cancer mortality in France, West Germany, Italy, Japan, England and Wales, and the USA. Lancet. 1990 Aug 25;336(8713):474–481. doi: 10.1016/0140-6736(90)92020-i. [DOI] [PubMed] [Google Scholar]
  10. Doll R. Are we winning the fight against cancer? An epidemiological assessment. EACR--Mühlbock memorial lecture. Eur J Cancer. 1990 Apr;26(4):500–508. doi: 10.1016/0277-5379(90)90025-o. [DOI] [PubMed] [Google Scholar]
  11. Dosemeci M., Wacholder S., Lubin J. H. Does nondifferential misclassification of exposure always bias a true effect toward the null value? Am J Epidemiol. 1990 Oct;132(4):746–748. doi: 10.1093/oxfordjournals.aje.a115716. [DOI] [PubMed] [Google Scholar]
  12. Eifler C. W., Stinnett S. S., Buffler P. A. Simple models for community exposure from point sources of pollution. Environ Res. 1981 Jun;25(1):139–146. doi: 10.1016/0013-9351(81)90085-2. [DOI] [PubMed] [Google Scholar]
  13. Everson R. B., Randerath E., Santella R. M., Cefalo R. C., Avitts T. A., Randerath K. Detection of smoking-related covalent DNA adducts in human placenta. Science. 1986 Jan 3;231(4733):54–57. doi: 10.1126/science.3941892. [DOI] [PubMed] [Google Scholar]
  14. Greenland S. Statistical uncertainty due to misclassification: implications for validation substudies. J Clin Epidemiol. 1988;41(12):1167–1174. doi: 10.1016/0895-4356(88)90020-0. [DOI] [PubMed] [Google Scholar]
  15. Greenland S. The effect of misclassification in the presence of covariates. Am J Epidemiol. 1980 Oct;112(4):564–569. doi: 10.1093/oxfordjournals.aje.a113025. [DOI] [PubMed] [Google Scholar]
  16. Hatch M. C., Beyea J., Nieves J. W., Susser M. Cancer near the Three Mile Island nuclear plant: radiation emissions. Am J Epidemiol. 1990 Sep;132(3):397–417. doi: 10.1093/oxfordjournals.aje.a115673. [DOI] [PubMed] [Google Scholar]
  17. Hatch M. C., Warburton D., Santella R. M. Polycyclic aromatic hydrocarbon-DNA adducts in spontaneously aborted fetal tissue. Carcinogenesis. 1990 Sep;11(9):1673–1675. doi: 10.1093/carcin/11.9.1673. [DOI] [PubMed] [Google Scholar]
  18. Hui S. L., Walter S. D. Estimating the error rates of diagnostic tests. Biometrics. 1980 Mar;36(1):167–171. [PubMed] [Google Scholar]
  19. Kang H. K., Watanabe K. K., Breen J., Remmers J., Conomos M. G., Stanley J., Flicker M. Dioxins and dibenzofurans in adipose tissue of US Vietnam veterans and controls. Am J Public Health. 1991 Mar;81(3):344–349. doi: 10.2105/ajph.81.3.344. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Khoury M. J., Flanders W. D., Greenland S., Adams M. J. On the measurement of susceptibility in epidemiologic studies. Am J Epidemiol. 1989 Jan;129(1):183–190. doi: 10.1093/oxfordjournals.aje.a115107. [DOI] [PubMed] [Google Scholar]
  21. Kupper L. L. Effects of the use of unreliable surrogate variables on the validity of epidemiologic research studies. Am J Epidemiol. 1984 Oct;120(4):643–648. doi: 10.1093/oxfordjournals.aje.a113926. [DOI] [PubMed] [Google Scholar]
  22. Lawrence C. E., Taylor P. R., Trock B. J., Reilly A. A. Trihalomethanes in drinking water and human colorectal cancer. J Natl Cancer Inst. 1984 Mar;72(3):563–568. [PubMed] [Google Scholar]
  23. Lewalter J., Korallus U. Blood protein conjugates and acetylation of aromatic amines. New findings on biological monitoring. Int Arch Occup Environ Health. 1985;56(3):179–196. doi: 10.1007/BF00396596. [DOI] [PubMed] [Google Scholar]
  24. Lioy P. J. Exposure analysis and assessment for low-risk cancer agents. Int J Epidemiol. 1990;19 (Suppl 1):S53–S61. doi: 10.1093/ije/19.supplement_1.s53. [DOI] [PubMed] [Google Scholar]
  25. London S. J., Thomas D. C., Bowman J. D., Sobel E., Cheng T. C., Peters J. M. Exposure to residential electric and magnetic fields and risk of childhood leukemia. Am J Epidemiol. 1991 Nov 1;134(9):923–937. doi: 10.1093/oxfordjournals.aje.a116176. [DOI] [PubMed] [Google Scholar]
  26. Marshall J. R., Graham S. Use of dual responses to increase validity of case-control studies. J Chronic Dis. 1984;37(2):125–136. doi: 10.1016/0021-9681(84)90054-7. [DOI] [PubMed] [Google Scholar]
  27. Meyer F., Verreault R. Erythrocyte selenium and breast cancer risk. Am J Epidemiol. 1987 May;125(5):917–919. doi: 10.1093/oxfordjournals.aje.a114610. [DOI] [PubMed] [Google Scholar]
  28. Milham S., Jr Mortality from leukemia in workers exposed to electrical and magnetic fields. N Engl J Med. 1982 Jul 22;307(4):249–249. doi: 10.1056/nejm198207223070412. [DOI] [PubMed] [Google Scholar]
  29. Ozonoff D., Colten M. E., Cupples A., Heeren T., Schatzkin A., Mangione T., Dresner M., Colton T. Health problems reported by residents of a neighborhood contaminated by a hazardous waste facility. Am J Ind Med. 1987;11(5):581–597. doi: 10.1002/ajim.4700110510. [DOI] [PubMed] [Google Scholar]
  30. Phillips A. M., Silbergeld E. K. Health effects studies of exposure from hazardous waste sites--where are we today? Am J Ind Med. 1985;8(1):1–7. doi: 10.1002/ajim.4700080102. [DOI] [PubMed] [Google Scholar]
  31. Polissar L. The effect of migration on comparison of disease rates in geographic studies in the United States. Am J Epidemiol. 1980 Feb;111(2):175–182. doi: 10.1093/oxfordjournals.aje.a112885. [DOI] [PubMed] [Google Scholar]
  32. Prentice R. L. Surrogate endpoints in clinical trials: definition and operational criteria. Stat Med. 1989 Apr;8(4):431–440. doi: 10.1002/sim.4780080407. [DOI] [PubMed] [Google Scholar]
  33. Preston-Martin S., Thomas D. C., White S. C., Cohen D. Prior exposure to medical and dental x-rays related to tumors of the parotid gland. J Natl Cancer Inst. 1988 Aug 17;80(12):943–949. doi: 10.1093/jnci/80.12.943. [DOI] [PubMed] [Google Scholar]
  34. Rosner B., Spiegelman D., Willett W. C. Correction of logistic regression relative risk estimates and confidence intervals for measurement error: the case of multiple covariates measured with error. Am J Epidemiol. 1990 Oct;132(4):734–745. doi: 10.1093/oxfordjournals.aje.a115715. [DOI] [PubMed] [Google Scholar]
  35. Rothman K. J., Poole C. A strengthening programme for weak associations. Int J Epidemiol. 1988 Dec;17(4):955–959. doi: 10.1093/ije/17.4.955. [DOI] [PubMed] [Google Scholar]
  36. Schoenberg J. B., Klotz J. B., Wilcox H. B., Nicholls G. P., Gil-del-Real M. T., Stemhagen A., Mason T. J. Case-control study of residential radon and lung cancer among New Jersey women. Cancer Res. 1990 Oct 15;50(20):6520–6524. [PubMed] [Google Scholar]
  37. Smith T. J. Exposure assessment for occupational epidemiology. Am J Ind Med. 1987;12(3):249–268. doi: 10.1002/ajim.4700120303. [DOI] [PubMed] [Google Scholar]
  38. Somervaille L. J., Chettle D. R., Scott M. C., Tennant D. R., McKiernan M. J., Skilbeck A., Trethowan W. N. In vivo tibia lead measurements as an index of cumulative exposure in occupationally exposed subjects. Br J Ind Med. 1988 Mar;45(3):174–181. doi: 10.1136/oem.45.3.174. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Sorsa M., Ojajärvi A., Salomaa S. Cytogenetic surveillance of workers exposed to genotoxic chemicals: preliminary experiences from a prospective cancer study in a cytogenetic cohort. Teratog Carcinog Mutagen. 1990;10(3):215–221. doi: 10.1002/tcm.1770100304. [DOI] [PubMed] [Google Scholar]
  40. Stein Z., Hatch M. Biological markers in reproductive epidemiology: prospects and precautions. Environ Health Perspect. 1987 Oct;74:67–75. doi: 10.1289/ehp.877467. [DOI] [PMC free article] [PubMed] [Google Scholar]
  41. Stevens W., Thomas D. C., Lyon J. L., Till J. E., Kerber R. A., Simon S. L., Lloyd R. D., Elghany N. A., Preston-Martin S. Leukemia in Utah and radioactive fallout from the Nevada test site. A case-control study. JAMA. 1990 Aug 1;264(5):585–591. [PubMed] [Google Scholar]
  42. Vineis P., Caporaso N. Applications of biochemical epidemiology in the study of human carcinogenesis. Tumori. 1988 Feb 29;74(1):19–26. doi: 10.1177/030089168807400104. [DOI] [PubMed] [Google Scholar]
  43. Wald N., Boreham J., Bailey A. Serum retinol and subsequent risk of cancer. Br J Cancer. 1986 Dec;54(6):957–961. doi: 10.1038/bjc.1986.267. [DOI] [PMC free article] [PubMed] [Google Scholar]
  44. Wallace L. A., Pellizzari E. D., Hartwell T. D., Sparacino C., Whitmore R., Sheldon L., Zelon H., Perritt R. The TEAM (Total Exposure Assessment Methodology) Study: personal exposures to toxic substances in air, drinking water, and breath of 400 residents of New Jersey, North Carolina, and North Dakota. Environ Res. 1987 Aug;43(2):290–307. doi: 10.1016/s0013-9351(87)80030-0. [DOI] [PubMed] [Google Scholar]
  45. Wallace L. A., Ziegenfus R. C. Comparison of carboxyhemoglobin concentrations in adult nonsmokers with ambient carbon monoxide levels. J Air Pollut Control Assoc. 1985 Sep;35(9):944–949. doi: 10.1080/00022470.1985.10465982. [DOI] [PubMed] [Google Scholar]
  46. Wertheimer N., Leeper E. Electrical wiring configurations and childhood cancer. Am J Epidemiol. 1979 Mar;109(3):273–284. doi: 10.1093/oxfordjournals.aje.a112681. [DOI] [PubMed] [Google Scholar]
  47. Willett W. C., Sampson L., Stampfer M. J., Rosner B., Bain C., Witschi J., Hennekens C. H., Speizer F. E. Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol. 1985 Jul;122(1):51–65. doi: 10.1093/oxfordjournals.aje.a114086. [DOI] [PubMed] [Google Scholar]
  48. Wrensch M., Swan S., Murphy P. J., Lipscomb J., Claxton K., Epstein D., Neutra R. Hydrogeologic assessment of exposure to solvent-contaminated drinking water: pregnancy outcomes in relation to exposure. Arch Environ Health. 1990 Jul-Aug;45(4):210–216. doi: 10.1080/00039896.1990.9940804. [DOI] [PubMed] [Google Scholar]

Articles from Environmental Health Perspectives are provided here courtesy of National Institute of Environmental Health Sciences

RESOURCES