v/EPA
                                  United States
                                  Environmental Protection
                                  Agency
                                  Health Effects Research
                                  Laboratory
                                  Research Triangle Park NC 27711
                                  Research and Development
                                  EPA-600/S1-81-039  June 1981
Project  Summary
                                  Report of  Workshops  on
                                  Epidemiologic  Studies  of
                                  Airborne  Particles
                                 Edward P. Radford
  i US GOVERNMENT PRINTING OFFICE 1961- 757-012/7153
  The report upon which this summary
is based represents the cumulative
effort of both the members of the
Workshop on Epidemiologic Studies
of Airborne Particulates and EPA
staff. The workshop was conducted
after EPA developed a program called
a Problem Definition Study for Epide-
miologic Studies on Airborne Particles.
The full report presents the recom-
mendations that the workshop mem-
bers prepared to assist the EPA in
developing a research program to
ascertain the biomedical effects of
inhalable particulate matter. This
definition of research was accom-
plished by identification of  gaps in
current knowledge, identification of
research that needs to be performed to
fill these gaps, and determination of
research that has a high probability of
providing a clear examination of the
health effects of particles.
  A summary of the recommendations
follows:
   -to study acute and chronic res-
   piratory and acute cardiovascular
   diseases, in relation to exposure
   to airborne particles, a single
   cross-sectional prospective inves-
   tigation involving  several institu-
   tions should be given priority
   -investigation of stomach cancer
   in relation to airborne particles is
   recommended
   -adequate exposure estimates
   must be made
   -quality assurance/control of all
   measurements is very important.
  This Project Summary was devel-
oped by EPA's Health Effects Research
Laboratory, Research Triangle Park,
NC, to announce key findings of the
research project that is fully docu-
mented in a separate report of the
same title (see Project Report ordering
information at back).

Introduction
  The members  of the Workshop on
Epidemiologic Studies of Airborne
Particulates have met to assist the EPA
in determining the research needed to
meet the present and future research
requirements of the Environmental
Protection Agency in this field. This goal
was accomplished by identification of
gaps  in current knowledge, identifica-
tion of research that needs to be per-
formed to fill these gaps and determina-
tion of research that the workshop
members believe has a high probability
of success.
  Despite more than a decade of re-
search, knowledge relating human
disease to air pollutants is still incom-
plete. The question of primary interest
to epidemiologists is: "What is the
disease risk for a given level of exposure
to a population?" This is the implicit
question that needs to be answered for
inhaled particles, but the panel agreed
that before this  question could be
successfully addressed and meaningful
studies performed, our knowledge of
what to measure in the air and in human
subjects, and which groups to measure,
had to be evaluated. It was evident that

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    there were serious flaws in previous
    research  in the  area of particulate
    pollution. Some of these flaws included
    inadequate methods  and the use of
    incomplete data sets;  either exposure
    measurements and/or the measure-
    ments of disease endpoints were inade-
    quate, resulting in  improper conclusions.
      The research areas that were explored
    and considered to be of prime concern in
    future research in  studying  possible
    health effects of airborne particles are
    outlined in the following section.

    Summary of Recommendations
    Note:  In the body  of the Project Report
    text, asterisks have  been  placed in the
    margin where recommendations con-
    cerning various aspects of the program
    were  made to EPA. The following sum-
    mary incorporates the major components
    of these individual recommendations:
    1. To study acute cardiovascular and
       acute and chronic  respiratory dis-
       eases,  in relation to  exposure to
       airborne particles, a single cross-
       sectional prospective investigation
       involving several centers should be
       given priority. The design would
       stratify communities by levels of
       airborne particles  and by disease
       frequency and would include careful
       clinical evaluation and functional
       testing of preselected populations.
       Such a single multicenter study
       design  is considered by the panel as
       having the best  chance of a clear
       demonstration  of effects of airborne
       particles on human health.
    2. Special studies of potentially sensi-
       tive subgroups  could be incorporated
       within  the multicenter design, and
       combined effects of other pollutants
       should be investigated  in such
       studies.
            Investigation of stomach cancer in
            relation to airborne particles is rec-
            ommended. The appropriate study
            design here should be developed as
            additional information is available.
            Adequate biostatistical methodology
            should be an integral part of planning
            any studies.
            Behavioral or psychological effects
            of particulate pollution are considered
            to be potentially important to EPA,
            and the panel recommends that a
            separate workshop be convened by
            EPA to consider pilot  studies in this
            area.
            In the epidemiologic studies pro-
            posed, careful attention to definition
            of exposure characteristics will be
            required. Included are the particle
   size range investigated, appropriat
   field  measuring equipment needei
   physical and chemical characteristic
   of the particles, degree of similarii
   of particle sources and characteristic
   among the centers evaluated fc
   health effects,  sampling methoc
   including appropriate monitorin
   strategies,  and personal exposur
   assessment of both indoor and ou
   door sources.
7.  Quality assurance of both air me;
   surements and clinical  methods wi
   be crucial  to the success of an
   studies done. The workshop partic
   pants  recommend that  up to 30% <
   the funds available for air monitorir
   be allocated for quality  assurance <
   these  measurements.
           Edward P. Radford is with the Center for Environmental Epidemiology, Graduate
             School  of Public Health, University of Pittsburgh, Pittsburgh, PA  15261.
           D. J. Kotchmar is the EPA Project Officer (see below).
           The complete report, entitled "Report of Workshop on Epidemiologic Studies of
             Airborne Particles," (Order No. PB 81-190 480; Cost: $6.50, subject to
             change} will be available only from:
                   National Technical Information Service
                   5285 Port Royal Road
                   Springfield. VA 22161
                   Telephone: 703-487-4650
           The EPA Project Officer can be contacted at:
                   Health Effects Research Laboratory
                   U.S. Environmental Protection Agency
                   Research Triangle Park, NC 27711
United States
Environmental Protection
Agency
Center for Environmental Research
Information
Cincinnati OH 45268
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Penalty for Private Use $300
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