Michael H' Dong

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Toxicologic Epidemiology (10th of 10 Lectures
onToxicologic Epidemiology)

• Michael H. Dong
• MPH, DrPA, PhD

readings
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Taken in the early 90s, when desktop computers
were still a luxury.
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• Learning Objectives
• Revisit the definition and scope of toxicologic
  epidemiology (TE).
• Study the arguments for the linkage between
  toxicology and epidemiology.
• Learn about the educational and career
  opportunities in TE.
• Learn about the future of TE as predicted in this
  series of lectures.

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• Performance Objectives
• Be able to delineate the scope of toxicologic
  epidemiology (TE).
• To outline the strengths and limitations of
  toxicology vs. epidemiology.
• To identify the institutes for formal training
  and places for employment.
• To provide sound arguments for the series
  prediction of the future of TE.

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• Structure of This Final Lecture of the Series
• Into 5 parts to facilitate discussion of
  toxicologic epidemiology (TE)
• (1) definition and scope of TE (2) linkage
  between toxicology and epidemiology (3)
  education in TE (4) employment in TE and (5)
  future of, and nutrients for, TE.

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• Scope of Toxicologic Epidemiology (I)
• Toxicology and epidemiology each play an
  important role in health risk assessment.
• The field is built upon the premise that most
  contaminants originate from materials considered
  essential and beneficial to a community.

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• Scope of Toxicologic Epidemiology (II)
• The field is also built up the premise that
  exposure to environmental contaminants is
  preventable.
• And that the exposure needs only to be potential
  to be of concern.
• Health risk assessment is the subject matter of
  toxicologic epidemiology.

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• Scope of Toxicologic Epidemiology (III)
• Epidemiologic methods and tools are increasingly
  used to identify specific environmental/occupation
  al hazards.
• Risk assessment is more within the scope of
  epidemiology than of toxicology this biased
  perspective might have to be corrected soon.

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• Scope of Toxicologic Epidemiology (IV)
• The health effects of a contaminant are
  relatively more static.
• In contrast, the communitys exposure to the
  contaminant is more dynamic.
• More objectively, it is rather difficult to
  determine if the role of toxicology, or that of
  epidemiology, that is more important to health
  risk assessment.

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• Dialectic Arguments (I)
• While toxicology has a longer history,
  epidemiology studies document the actual human
  health experiences.
• It also deals with the effects of real human
  exposure.
• Observational studies used to place less emphasis
  on the measure of exposure, as epidemiologists
  tended to be physicians in the old days.

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• Dialectic Arguments (II)
• The toxic endpoints studied by the toxicologist
  and the epidemiologist are largely different.
• Only in the case of cancer, do they both obtain
  the same quality of information about their
  endpoints.
• Some toxicologists contend that the principles of
  toxicology are a critical part of environmental
  epidemiology.

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• Dialectic Arguments (III)
• Epidemiologists often consider toxicologic
  information in formulating hypotheses.
• Toxicologists recognize the preeminence of
  well-conducted epidemiologic studies.
• Animal toxicologic studies are important in
  complementing epidemiologic results.
• Unlike that for epidemiologic studies, the size
  of the study population for normal laboratory
  studies is severely limited.
• Risk assessment is the fad since the 1980s.

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• Educational Opportunities (I)
• Doctoral program available in human exposure
  assessment at Rutgers Univ.
• Training in sampling strategies new
  measurement methods for ingestion, inhalation,
  and dermal exposure chemical biological markers,
  etc.
• Students will also gain the ability to use their
  training in risk assessment.

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• Educational Opportunities (II)
• Yale University has the most explicit and
  comprehensive doctoral program in health risk
  assessment.
• Courses include models for exposure assessment
  applied risk assessment toxicology molecular
  epidemiology environmental epidemiology
  environmental chemistry and more.

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• Educational Opportunities (III)
• Less-structured doctoral and masters degree
  programs in fields closely related to exposure or
  risk assessment are also available.
• In the USA, these institutes include Johns
  Hopkins Univ. Harvard Univ. Univ. of
  Pittsburgh Univ. of Michigan, etc.

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• Educational Opportunities (IV)
• Graduate programs in fields closely related to
  exposure/risk assessment are rather limited on
  the west coast of the United States.
• In the west, institutes with more promising
  programs include UC Berkeley Univ. of
  Washington San Diego State Univ. in California.

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• Career Opportunities (I)
• Post-doctoral research at the National Exposure
  Research Laboratory and at the National Center
  for Environmental Assessment, both are part of
  U.S. EPA.
• These positions conduct research in environmental
  monitoring human and ecological exposure
  analysis dose-response and exposure assessment
  methodologies fate of pollutants in multiple
  media, etc.

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• Career Opportunities (II)
• Risk-related research positions available at the
  Lawrence Berkeley National Laboratory, managed by
  UC Berkeley for the U.S. Department of Energy.
• Risk assessment grants were awarded recently by
  the U.S. Food and Drug Administration to several
  universities.
• At the Medical Univ. of South Carolina,
  researchers can focus on the development of risk
  assessment methodologies.

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• Recruitment of Toxicologic Epidemiologists
• New and old graduates can also work for the
  industry as regulatory scientists.
• Most graduate programs in exposure and risk
  assessment are offered through environmental
  health sciences divisions/ departments at schools
  of public health.
• Recruitment programs should be effective to avoid
  having unqualified candidates to fill the
  positions.

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• The Ideal Practice of Toxicologic Epidemiology
• Best qualified candidates should be hired to fill
  positions in risk assessment (RA).
• Risk management is not solely the job of a
  regulatory administrator.
• Regulatory administrators should have technical
  training in RA, and be there to implement/support
  the recommendations of their army of health
  scientist staff.
• Regulatory decisions can be decentralized.

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• Future of Toxicologic Epidemiology (TE)
• The growth rate of TE as a health science
  discipline is likely at its peak.
• The above prediction is based on the observation
  that many assessment methodologies and
  developments have been made too fast.
• And these assessment tools require a much larger,
  ever lacking database.