Toxicology and Epidemiology (1st of 10 Lectures on Toxicologic Epidemiology)

1. Toxicologyand Epidemiology(1st of 10 Lectures onToxicologic Epidemiology) Michael H. Dong MPH, DrPA, PhD  readings

2. Taken in the early1990s, when desktop computers were still a luxury.

3. Learning Objectives • Learn the mission of public health and the concept of health risk assessment. • Study or revisit the scope and definition of toxicology and of epidemiology. • Recognize the close link between toxicology and epidemiology, and hence the being and the growing of toxicologic epidemiology.

4. Performance Objectives • Interrelate public health with health risk assessment. • Interrelate toxicology with epidemiology. • Accept and appreciate the existence and the career opportunities of toxicologic epidemiology, by interrelating the scopes, missions, and concepts just learned.

5. In Theory . . . . Public Health Health Risk Assessment Epidemiology Toxicology Other Areas

6. In Practice . . . . Public Health Health Risk Assessment Epidemiology Toxicology Other Areas

7. The mission of public health is to “fulfill society’s interest in assuring conditions in which people can be healthy.”

8. as a core function of public health . . . . “Assessment and monitoring of the health of communities and populations at risk to identify health problems and priorities.”

9. Health Risk Assessment: The process by which the potential adverse health effects of human exposure to etiologic agents (usually chemicals) are characterized.

10. Health Risk Assessment Components Hazard Identification Risk Characterization Dose-Response Assessment Exposure Assessment

11. Hazard Identification: What adverse effect(s) does the agent cause, if any? • Epidemiologic studies. • Toxicologic studies. • Biological, medical, physical science, and other studies.

12. Dose-Response Assessment: What is the correlation between dose and incidence in humans? • Epidemiologic studies. • Toxicologic studies. • Physiological and statistical modeling.

13. Exposure Assessment: What are the current and anticipated human exposures? • Epidemiologic studies. • Biological and toxicologic studies. • Physiological and statistical modeling.

14. Risk Characterization: What is the estimated risk of the adverse effect(s) in a population? • Epidemiologic studies. • Toxicologic studies. • Public health laws and interests.

15. Epidemiology: The study of factors that modify or influence the distribution of diseases (or of adverse health effects) in a (human) population.

16. Toxicology: The science that deals with toxic agents and their adverse health effects.

17. The Hybridization of Epidemiology and Toxicology: As a Sub-Discipline • Not quite here to an appreciable extent. • Epidemiology faculties and studies are more medical-, less bioassay-oriented. • Toxicology faculties and studies are more lab-, less medical-oriented.

18. The Hybridization of Epidemiology and Toxicology: As a Sub-Profession • Is gradually surfacing. • Regulatory health laws for health risk assessment; journals. • Professionally-related; sharing the same job duties, and health problems/issues.

19. Examples of Shared Interests and Responsibilities • Use of biomarkers in human exposure assessment; cancer epidemiology, etc. • Chemical accidents: the Minimata Bay incident; the Seveso accident; the Itai-Itai disease, etc. • Medical incidents: diethylstilbesterol; thalidomide, etc.

20. Impact of Health Policies on Health Risk Assessment FD&CAct; TSCAct; OSHAct; FQPAct; CAAct; FIFRAct; SDWAct; CPSAct; FHSAct; CWAct, etc.

21. Impact of Health Risk Assessment on Toxicology • Risk assessment included in toxicology textbooks, journals, societies, etc. • Toxicology issues/studies included in risk assessment journals, textbooks, societies, etc.

22. Impact of Health Risk Assessment on Epidemiology • Risk assessment included in epidemiology textbooks, journals, societies, etc. • Epidemiology issues/studies included in risk assessment journals, textbooks, societies, etc.

23. In Practice . . . . Public Health Health Risk Assessment Epidemiology Toxicology Other Areas

24. Overview of Next Lecture: Public Health (PH) and Risk Assessment (RA) Revisit of Mission of PH and concept of RA; RA and health policies/acts; RA and environmental health impact assessment (EHIA); monitoring and mitigation of exposure.