Statistical methods for linking health, exposure, and hazards.
The Environmental Public Health Tracking Network (EPHTN) proposes to link environmental hazards and exposures to health outcomes. Statistical methods used in case-control and cohort studies to link health outcomes to individual exposure estimates are well developed. However, reliable exposure estimates for many contaminants are not available at the individual level. In these cases, exposure/hazard data are often aggregated over a geographic area, and ecologic models are used to relate health outcome and exposure/hazard. Ecologic models are not without limitations in interpretation. EPHTN data are characteristic of much information currently being collected--they are multivariate, with many predictors and response variables, often aggregated over geographic regions (small and large) and correlated in space and/or time. The methods to model trends in space and time, handle correlation structures in the data, estimate effects, test hypotheses, and predict future outcomes are relatively new and without extensive application in environmental public health. In this article we outline a tiered approach to data analysis for EPHTN and review the use of standard methods for relating exposure/hazards, disease mapping and clustering techniques, Bayesian approaches, Markov chain Monte Carlo methods for estimation of posterior parameters, and geostatistical methods. The advantages and limitations of these methods are discussed.
Department of Biostatistics, Academic Information Systems, Center for Applied Environmental Public Health, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, New Orleans, LA 70112, USA. mather@tulane.edu
Frances Jean
FJ
Mather
LuAnn Ellis
LE
White
Elizabeth Cullen
EC
Langlois
Charles Franklin
CF
Shorter
Christopher Martin
CM
Swalm
Jeffrey George
JG
Shaffer
William Ralph
WR
Hartley
D016022:Case-Control Studies; D015331:Cohort Studies; D003625:Data Collection; D004781:Environmental Exposure; D004782:Environmental Health / Q000706:statistics & numerical data*; D004785:Environmental Pollutants / Q000506:poisoning*; D040362:Geographic Information Systems; D006801:Humans; D007256:Information Systems; D008962:Models, Theoretical; D009010:Monte Carlo Method; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D015203:Reproducibility of Results; D018570:Risk Assessment; D014481:United States
D004785:Environmental Pollutants