Prioritizing future resources for epidemiologic research on old and newly emerging occupational hazards.
BACKGROUND
Inevitably, occupational epidemiologists must decide when and how to shift research attention and resources from investigations of old, established health hazards to a focus on newly emerging potential risk factors. As yet unknown occupational health consequences of burgeoning worldwide technologies, such as the microelectronics industry, and increasing recognition of the importance of common, yet non-traditional occupationally-related health effects, such as musculoskeletal disorders in office workers, give strong impetus for embarking in new directions. However, there remains much to be learned from continued investigation of well-established occupational hazards, such as asbestos, benzene, and lead.


OBJECTIVE
A rational strategy for planning future research will need to consider optimizing resources.


CONCLUSIONS
The following suggestions are offered. 1) First and foremost, occupational risk factors are most directly, and arguably most validly, identified by studying workers in well-defined cohorts, ideally when exposures are adequately characterized. To this end, industry-based cohort studies should be given priority, at least for older hazards, over population-based case-control and surveillance designs. 2) Defined cohorts with extensive exposure and health outcome data should continue to be followed, as resources permit; 3) Launching cohort studies for potential new hazards should incorporate extensive exposure assessments at the outset, and should preferentially select inception cohorts of newly hired workers. Valid biomarkers of pre-clinical disease will be especially valuable in this regard. 4) Capitalizing on new technological advances in exposure assessment, clinical medicine, molecular genetics should be encouraged
Checkoway
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University of Washington, Department of Environmental and Occupational Health Sciences, Box 357234, Seattle, Washington 98195-7234, USA. checko@u.washington.edu
D015415:Biomarkers; D016022:Case-Control Studies; D015984:Causality; D015331:Cohort Studies; D005500:Follow-Up Studies; D005544:Forecasting; D020022:Genetic Predisposition to Disease; D015386:Hazardous Substances; D006801:Humans; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology / Q000235:genetics / Q000517:prevention & control; D016273:Occupational Exposure; D016272:Occupational Health; D012106:Research; D012107:Research Design; D012109:Research Support as Topic; D040841:Resource Allocation; D012307:Risk Factors; D017751:Safety Management / Q000639:trends; D013672:Technology / Q000639:trends
D015415:Biomarkers; D015386:Hazardous Substances