Description
Epidemiology is a scientific discipline that evaluates the effect of exposures on health. What is unique is that the studies are conducted on human beings in the real world, not in a laboratory or with other species. It is also distinct in that researchers do not introduce the exposure or assign it randomly to some people and not others the way we do in an experiment, but instead the exposure is monitored along with health outcomes. Such studies determine whether those who are more highly exposed to a possible hazard have a greater risk of developing disease than those who are less exposed. For nonionizing radiation, we may ask whether those who live in homes near high tension power lines have a higher risk of developing leukemia than those who do not live inside homes near high tension power lines or whether those who use cell phones for extended periods of time have a higher risk of brain cancer than those who are less intensive users of cell phones.
Epidemiology has distinctive strengths, but also some limitations. By studying the experience of real people in the real world, the information from this research is directly relevant to the public health concerns since there is not a need to translate findings from laboratory animals or cell cultures to humans, or from extremely high exposures to more typical exposures. But there are corresponding challenges that come from studying humans in their natural environment. It can be difficult to accurately measure exposure and sometimes hard to find substantial enough variation in exposure. For example, if nearly everyone uses a cell phone, then we cannot find non-users for comparison to users and if we ask people to recall how much time they used their cell phone, their memory may not be accurate. Another major challenge is that the exposure we are interested in may be correlated with other exposures, so it is hard to separate one from the other. If those who live near cellular base stations more often reside in urban areas compared to those who live far from base stations, other characteristics of the urban environment such as air pollution may be correlated with potential radiofrequency radiation exposure so researchers need to make sure that they can distinguish between any effects of the two exposures.
There are two main types of epidemiology studies, cohort studies and case-control studies. Cohort studies are most like experiments, with groups of people identified who are exposed and unexposed (or more and less exposed) and then followed over time to find out how frequently each group develops disease. We compare the two groups with a relative risk, which is the risk of disease in the more exposed group divided by the risk of disease in the less exposed group, for example a relative risk of 2 means that higher exposure is associated with double the risk of lower exposure. The other major study type is a case-control study. In this design, we identify two groups, one that has developed a disease we are interested in and a healthy comparison group that is free of that disease. We then find out the exposure history of both of those groups in order to see whether those who got the disease have a history of more exposure than those who did not get the disease. The relative risk measure is called an odds ratio, which determines the odds of getting the disease among exposed versus unexposed persons.