Abstract:
:Quantitative risk assessment provides formalized scientific input to regulatory agencies that set occupational and environmental standards for potentially toxic exposures. Current practice relies heavily on statistical extrapolation from high-dose animal studies. Human data obviate the need for interspecies extrapolation and reduce the range of high-to-low dose extrapolation. This paper proposes a framework for classifying individual epidemiologic studies as to their adequacy for use in dose-response extrapolation. The framework considers five criteria: (1) a stable positive association with an adverse health outcome; (2) high overall study quality; (3) no substantial confounding; (4) quantitative exposure assessment for individuals; (5) evidence of a dose-response relationship. With these criteria, studies can be categorized as (1) suitable to serve as a basis for extrapolation; (2) inadequate to be the basis for direct extrapolation but appropriate to use for evaluating the plausibility of animal-derived risk estimates; or (3) useful only for hazard identification, not for dose-response assessment. Methods for using studies in the first two categories are briefly described. The emphasis is not on establishing rigid rules, but rather on ensuring a consistent, reliable process that makes optimum use of available data.
journal_name
Am J Public Healthjournal_title
American journal of public healthauthors
Hertz-Picciotto Idoi
10.2105/ajph.85.4.484subject
Has Abstractpub_date
1995-04-01 00:00:00pages
484-91issue
4eissn
0090-0036issn
1541-0048journal_volume
85pub_type
杂志文章abstract::The evolution of the emergency medical services system in the United States accelerated rapidly between 1960 and 1973 as a result of a number of medical, historical, and social forces. Current emergency medical services researchers, policy advocates, and administrators must acknowledge these forces and their limitatio...
journal_title:American journal of public health
pub_type: 历史文章,杂志文章
doi:10.2105/AJPH.2004.048793
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:We assessed the quality of hospital care for women who underwent a hysterectomy to compare Medicaid-covered women with privately insured women and minority women with White women. METHODS:We evaluated medical decisions, inpatient care, quality of inpatient care, and outcomes. RESULTS:Quality of hospital car...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.94.8.1399
更新日期:2004-08-01 00:00:00
abstract:OBJECTIVES:This study assessed the effectiveness of a family planning intervention with and without husband's participation in reducing pregnancy and abortion rates in Shanghai, China. METHODS:In this 3-arm randomized trial among 1800 nonsterilized married women, educational interventions targeting both spouses and ta...
journal_title:American journal of public health
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.2105/ajph.88.4.646
更新日期:1998-04-01 00:00:00
abstract:OBJECTIVES:We examined individual, friend or family, and community or tribe correlates of suicidality in a representative on-reserve sample of First Nations adolescents. METHODS:Data came from the 2002-2003 Manitoba First Nations Regional Longitudinal Health Survey of Youth. Interviews were conducted with adolescents ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2011.300385
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES:This study assessed the prevalence and correlates of tobacco use among high school students in Buenos Aires, Argentina. METHODS:Anonymous, self-administered questionnaires were given to 3909 8th and 11th graders in a stratified random sample of 49 public and private schools. The instrument included items fr...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.91.2.219
更新日期:2001-02-01 00:00:00
abstract::Increasing knowledge is an important goal of human immunodeficiency virus (HIV) prevention strategies, although increased knowledge may not be associated with increased preventive behaviors. This study examines the association of (1) objective and subjective acquired immunodeficiency syndrome (AIDS) knowledge, and (2)...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.83.10.1460
更新日期:1993-10-01 00:00:00
abstract:OBJECTIVES:We examined US health educators' likelihood of adopting genomic competencies--specific skills and knowledge in public health genomics--into health promotion and the factors influencing such likelihood. METHODS:We developed and tested a model to assess likelihood to adopt genomic competencies. Data from 1607...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2007.122663
更新日期:2008-09-01 00:00:00
abstract::We prospectively identified 102 mechanically restrained hospital patients and determined their hospital course. The cohort was elderly, cognitively impaired with multiple chronic diseases. The in-hospital mortality was 21 percent. Nosocomial infection developed in 12 percent and new pressure sores in 22 percent. Prolo...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.79.6.735
更新日期:1989-06-01 00:00:00
abstract::In Russia, rates of alcohol consumption and homicide are among the highest in the world, and already-high levels increased dramatically after the breakup of the Soviet Union. Rates of both, however, vary greatly among Russia's 89 regions. We took advantage of newly available vital statistics and socioeconomic data to ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.92.12.1921
更新日期:2002-12-01 00:00:00
abstract::We examined refusal rates for sensitive demographic questions to determine whether questions on sexual orientation are too sensitive for routine use on public health surveys. We compared the percentage of active refusals in New Mexico for a sexual orientation question and 6 other sensitive demographic questions. In 20...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2009.186270
更新日期:2010-12-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to determine the prevalence of recovery from alcohol problems with and without treatment, including whether such recoveries involved abstinence or moderate drinking. METHODS:Data from two surveys of randomly selected adults in the general population were analyzed. Random-digit ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.86.7.966
更新日期:1996-07-01 00:00:00
abstract::In recent years, advocates for increasing access to medical and oral health care have argued for expanding the scope of practice of dentists and physicians. Although this idea may have merit, significant legal and other barriers stand in the way of allowing dentists to do more primary health care, physicians to do mor...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2015.302654
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVES:We sought to describe the extent and nature of contact with the health care system before suicide among veterans with substance use disorders (SUDs). METHODS:We examined all male Veterans Health Administration patients who died by suicide between October 1, 1999, and September 30, 2007, and who had a docume...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2011.300392
更新日期:2012-03-01 00:00:00
abstract::An analysis of morbidity was made in 11 kibbutzim (cooperative agricultural settlements), with a total population of 3,040, that had switched from nonwastewater to wastewater sprinkler irrigation or vice versa. Generally, partially treated stabilization pond effluent of poor microbial quality was used for irrigation. ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.76.8.977
更新日期:1986-08-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to ascertain how economic reform has affected nutritional well-being of the elderly in the Russian Federation. METHODS:A sample of more than 2932 Russians 60 years of age and older was selected from a nationally representative survey of Russian households. A 24-hour dietary rec...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.86.3.355
更新日期:1996-03-01 00:00:00
abstract::With this article, we develop the Drinking Water Disparities Framework to explain environmental injustice in the context of drinking water in the United States. The framework builds on the social epidemiology and environmental justice literatures, and is populated with 5 years of field data (2005-2010) from California...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2013.301664
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVES:We investigated the health profile of lesbian, gay, and bisexual (LGB) adults in North Carolina, the first state in the South to include a measure of sexual orientation identity in a probability-based statewide health survey. METHODS:Using data from 9876 respondents in the 2011 North Carolina Behavioral Ris...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2013.301751
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVES:This study sought to identify characteristics of high-risk pregnant women that predicted long-term participation in a home visitation program. METHODS:Data regarding sociodemographic characteristics, perceived needs, psychological functioning, substance use, and informal social support were collected prospe...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.90.1.121
更新日期:2000-01-01 00:00:00
abstract::Accidental exposure to the blood of hepatitis B patients produced less fear than does accidental exposure today to the human immunodeficiency virus (HIV), even though both have an approximately equal overall risk of death (approximately 1%). Subjects responding to hypothetical insect-exposure and disease-exposure scen...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.82.4.584
更新日期:1992-04-01 00:00:00
abstract::The relationship of physical activity to the development of definite coronary heart disease was examined separately in middle-aged (45-64 years) and elderly men (65-69 years) participating in the Honolulu Heart Program. After 12 years of follow-up, results indicate that increased levels of physical activity reported a...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.78.6.683
更新日期:1988-06-01 00:00:00
abstract::Although researchers acknowledge that health disparities have multiple determinants, most recommendations for reducing inequities focus on a single approach. We suggest integrating 2 approaches for reducing disparities: improving access to primary care and updating and more vigorously enforcing consumer and environmen...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2009.166389
更新日期:2010-04-01 00:00:00
abstract::Data were collected from 141 women under age 18 attending an abortion clinic that did not require parental notification. Most of them informed their girl friend but not their parents of the plans for abortion. Younger minors and those who perceive their parents to hold positive attitudes toward abortion were more apt ...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.72.3.283
更新日期:1982-03-01 00:00:00
abstract:OBJECTIVES:This study examined characteristics of gay and bisexual men who attend circuit parties, frequency of and motivations for attending parties, drug use and sexual behavior during circuit party weekends, and use of risk reduction materials available at parties. METHODS:A cross-sectional survey was conducted amo...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.91.6.953
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:Studies have indicated that cigarette smokers have more occupational accidents and injuries and use more sick time and health benefits than nonsmokers, thereby producing sizeable costs for employers. However, they usually have not controlled for other possible sources of these costs. We analyzed occupational...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.82.1.29
更新日期:1992-01-01 00:00:00
abstract::We report on the use of an instrument to measure exposure to stressors among 149 women presenting with their children for pediatric care at an urban primary care center. Overall, 38.3 percent of the women had significant levels of depressive symptoms; 71.4 percent of those in the "high stress" group had an adjusted pr...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.79.9.1295
更新日期:1989-09-01 00:00:00
abstract::Cancer mortality in Texas 1969-80 was 25 per cent lower among Mexican American males compared to other Whites; among females, rates were only 4 per cent lower. Reduced mortality was primarily a result of lower rates for cancers of the most common sites: lung, colon, breast and prostate. However, for cancers of the sto...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/ajph.77.7.851
更新日期:1987-07-01 00:00:00
abstract::Twenty-eight states have laws that limit payments in malpractice cases, and several studies indicate that these laws reduce the frequency and severity of malpractice claims and lower premiums. Moreover, proponents believe that such laws reduce health care expenditures by reducing the practice of defensive medicine. Ho...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2005.077883
更新日期:2006-08-01 00:00:00
abstract::In the Whitehall Study, which followed 17,139 male civil servants over 33 years, the association between tall stature and coronary heart disease (CHD) mortality differed between employment grades. In men without CHD at study entry, the hazard ratio per 15-cm increase in height was 0.77 (95% confidence interval [CI]=0....
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/2004.046219
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVES:We investigated attitudes toward provider-initiated HIV testing and counseling (PITC) in the suburbs of Harare, Zimbabwe, where late presentation after mother-to-child HIV transmission (MTCT) is a major cause of adolescent mortality. METHODS:Adolescents (10-18 years) attending 2 primary clinics were offered...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2011.300250
更新日期:2011-12-01 00:00:00
abstract:OBJECTIVES:We sought to ascertain the types of ethical challenges public health practitioners face in practice and to identify approaches used to resolve such challenges. METHODS:We conducted 45 semistructured interviews with public health practitioners across a range of occupations (e.g., health officers, medical dir...
journal_title:American journal of public health
pub_type: 杂志文章
doi:10.2105/AJPH.2008.137588
更新日期:2009-02-01 00:00:00