Statistical Techniques for Complex Environmental Epidemiological Studies

描述(由申请者提供)：该项目将开发与两种常见形式的环境流行病学研究相关的统计方法。主要目标是提供对与环境暴露相关的健康风险进行简明评估的方法，并辅之以适当的统计推断。第一个主题将使用一组个人的诊断数据以及未确诊参与者的筛查信息来评估暴露与健康结果风险之间的关联。这些方法将应用于塞维索妇女健康研究的数据，该研究旨在解决暴露于高水平二恶英的妇女的健康风险。其目的是统计方法将普遍适用于包括诊断和筛查数据的组合的类似研究。第二个项目涉及调查多种环境暴露对健康和发展结果的影响的统计技术。这些想法将被应用于CHAMACOS对加利福尼亚州拉丁裔妇女及其子女的研究的数据，该研究收集了一组妇女及其婴儿在宫内和童年期间接触环境(主要是农药)的信息。统计问题涉及对每一次接触的适当因果影响的估计和排序，并辅之以对其中哪一种代表真实影响而不是虚假联系的严格评估，以便适当地进行多重比较。这两项研究都涉及对暴露于高于平均水平的环境暴露的脆弱人群的研究，这些人群有可能增加健康结果不良的风险。将开发统计和计算算法，并以开放源码、方便用户的格式提供，以便其他调查人员能够迅速传播和使用。这项研究与公共卫生有两方面的相关性：首先，这项研究将使环境流行病学家能够准确地描述(I)急性接触二恶英对妇女生殖健康的影响，特别是对肌瘤发病的影响，以及(Ii)在农场劳动社区中接触杀虫剂对拉丁裔妇女所生孩子的分娩结局和随后的神经发育的影响。第二，拟议的研究将提供适当的统计工具和软件，使其他研究人员能够将这些复杂的方法应用于各种环境中环境暴露的影响的类似研究。

DESCRIPTION (provided by applicant): This project will develop statistical methods relevant to two common forms of environmental epidemiologic studies. The primary goal is to provide methods that extract a concise assessment of health risks associated with environmental exposures, supplemented by appropriate statistical inference. The first topic will evaluate the association between exposure and the risk of a health outcome using diagnosis data on a cohort of individuals supplemented with screening information on undiagnosed participants. The methods will be applied to data from the Seveso Women's Health Study which addresses health risks in women exposed to high levels of dioxin. It is intended that the statistical methods will apply generally to similar studies that include a combination of diagnostic and screening data. The second project concerns statistical techniques to investigate the effects of multiple environmental exposures on health and developmental outcomes. The ideas will be applied to data from the CHAMACOS study of Latino women and their children in California, where information has been collected on environmental (largely pesticide) exposures, in utero and in childhood, for a cohort of women and their infants. Statistical issues involve estimation and ranking-in importance-of suitable causal effects of each exposure, supplemented by a rigorous assessment of which of these represent real effects rather than spurious associations, allowing appropriately for multiple comparisons. Both studies involve the study of vulnerable populations exposed to above average environmental exposures with the potential for elevated risk for poor health outcomes. Statistical and computational algorithms will be developed and provided in an open source user-friendly format allowing their rapid dissemination and use by other investigators. The relevance to public health is two-fold: first, the research will allow environmental epidemiologists to accurately describe the effects of (i) acute dioxin exposure on the reproductive health of women, in particularly on the onset of fibroids, and of (ii) pesticide exposures on birth outcomes and subsequent neurodevelopment of children born to Latino women, in a farmworking community. Second, the proposed research will provide appropriate statistical tools and software to allow other investigators to apply these complex methods to similar studies of the effects of environmental exposures in a wide variety of settings.