摘要：
The field of environmental public health is at an important
crossroad. Our current biomonitoring efforts document widespread exposure
to a host of chemicals for which toxicity information is lacking.
At the same time, advances in the fields of genomics, proteomics,
metabolomics, genetics and epigenetics are yielding volumes of data
at a rapid pace. Our ability to detect chemicals in biological and
environmental media has far outpaced our ability to interpret their
health relevance, and as a result, the environmental risk paradigm,
in its current state, is antiquated and ill-equipped to make the best
use of these new data. In light of new scientific developments and
the pressing need to characterize the public health burdens of chemicals,
it is imperative to reinvigorate the use of environmental epidemiology
in chemical risk assessment. Two case studies of chemical assessments
from the Environmental Protection Agency Integrated Risk Information
System database are presented to illustrate opportunities where epidemiologic
data could have been used in place of experimental animal data in
dose-response assessment, or where different approaches, techniques,
or studies could have been employed to better utilize existing epidemiologic
evidence. Based on the case studies and what can be
learned from recent scientific advances and improved approaches to
utilizing human data for dose-response estimation, recommendations
are provided for the disciplines of epidemiology and risk assessment
for enhancing the role of epidemiologic data in hazard identification
and dose-response assessment.
