Statistical Techniques for Complex Environmental Epidemiological Studies

描述（由申请人提供）：本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接触有关的健康风险进行简明评估的方法，并辅以适当的统计推断。第一个专题将利用一组个体的诊断数据和未确诊参与者的筛查信息，评估接触与健康结果风险之间的关系。这些方法将应用于Seveso妇女健康研究的数据，该研究涉及暴露于高水平二恶英的妇女的健康风险。它的目的是统计方法将普遍适用于类似的研究，包括诊断和筛选数据的组合。第二个项目涉及调查多重环境接触对健康和发展结果的影响的统计技术。这些想法将应用于加州拉美裔妇女及其子女CHAMACOS研究的数据，该研究收集了一组妇女及其婴儿在子宫和童年时期接触环境（主要是杀虫剂）的信息。统计问题包括对每次暴露的适当因果效应的重要性进行估计和排序，并辅以对哪些是真实影响而不是虚假关联的严格评估，从而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，这些环境暴露有可能增加不良健康结果的风险。统计和计算算法将以开放来源的用户友好格式编制和提供，使其他调查人员能够迅速传播和使用。与公共卫生的相关性是双重的：首先，这项研究将使环境流行病学家能够准确地描述(i)急性二恶英暴露对妇女生殖健康的影响，特别是对肌瘤的发病的影响，以及（ii）农药暴露对农业劳动社区拉丁裔妇女所生儿童的出生结果和随后的神经发育的影响。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下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.