Statistical Techniques for Complex Environmental Epidemiological Studies

描述（由申请人提供）：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。主要目标是提供方法，提取与环境暴露相关的健康风险的简明评估，并辅以适当的统计推断。第一个主题将评估暴露与健康结果风险之间的关联，使用一组个体的诊断数据，并补充未诊断参与者的筛选信息。这些方法将应用于Seveso妇女健康研究的数据，该研究涉及接触高水平二恶英的妇女的健康风险。预期统计方法将普遍适用于包括诊断和筛选数据组合的类似研究。第二个项目涉及调查多种环境暴露对健康和发展结果影响的统计技术。这些想法将被应用到来自CHAMACOS研究的数据，该研究针对加州的拉丁裔妇女及其子女，收集了一组妇女及其婴儿在子宫内和儿童期的环境（主要是农药）暴露信息。统计问题涉及估计和排序的重要性，适当的因果关系的影响，每一个曝光，辅之以严格的评估，这些代表真实的影响，而不是虚假的协会，允许适当的多重比较。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不良健康结果的风险。将以开放源码、方便用户的格式开发和提供统计和计算算法，以便其他调查人员迅速传播和使用。与公共卫生的相关性是双重的：首先，该研究将使环境流行病学家能够准确地描述（i）急性二恶英暴露对妇女生殖健康的影响，特别是对子宫肌瘤的发病，以及（ii）农药暴露对出生结果和随后的拉丁美洲妇女所生儿童的神经发育的影响，在一个农业劳动社区。其次，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.