Will attach essay requirements. Please make sure you give this assay to an expert in epidemiology! This is ENVIRONMENTAL and OCCUPATIONAL EPIDEMIOLOGY PhD program final exam essay. MUST be done correctly, please.

If you do not have such specialists please let me know.

Thank you.


Essay II: (25 points)

As you may recall from the term project introduction:
Several residents of the Bayou Vista and Omega Bay communities in South East Texas have expressed concerns that their long-term health may have been deleteriously affected by exposure to chemicals from the Motco waste pits prior to their being completely cleaned and buried as a declared Superfund site in 1997.

When residents of a community are concerned about potential adverse health effects from a possible toxic exposure, a rapid epidemiologic assessment may be conducted as one step in the overall process of scientifically examining whether the community s health has been adversely affected. Specifically, the key goal of such studies is to assess whether there is an increase in the incidence or prevalence of specific disease(s) of interest in the community as compared to what would have been expected if the community had the same rates of disease as found in a reference population (i.e., the United States or the larger area in which the community is located). Some of the key ways to investigate the communities overall health include direct examination of medical records, interviews with residents on their health status, and review of community death certificate data over time. Objective assessment of the external and internal environment (i.e., air or water samples and blood or urine samples) may also be taken when feasible. These studies are often rapidly executed to quickly answer the public health question of concern so that proper steps may be taken, if scientific evidence indicates they are necessary, to protect the community s health.

These studies have frequently appeared in the peer-reviewed epidemiology and medical literature. These studies have been used to assess a broad range of both exposures and disease and have included such diverse areas as an examination of whether a perceived cluster of cases of Lou Gehrig s disease (i.e., amyotrophic lateral sclerosis) might be related to consumption of fish (with ostensibly high levels of toxins) caught in Lake Michigan or whether a cluster of cases of leukemia were related to proximity to strong electromagnetic fields produced by high voltage power lines.

This community has been exposed to many environmental contaminants but mainly to the following:
1- Bis-Chloromethyl Ether (BCME)
2- Benzene
3- 1, 2 Dichloroethane
4- Styrene
5- Vinylchloride (VC)
6- Polyvinylchloride (PVC)
7- Polycyclic Aromatic Hydrocarbons (PAH)

Much of the guidelines used in Environmental and Occupational Epidemiology are derived from laboratory, animal and human experience such as Motco.

Assume you are an Environmental Epidemiologist and you were asked to:

1- Investigate three out of the seven chemicals listed above and categorize their carcinogenicity (definite, possible or probable) and their respective health effects. Please provide specific references in relation to the health outcomes. Also, be sure to make a reference to which organization categorized each chemical.
2- Choose one cancer outcome and provide a tabular format relating to each of the three chemicals you selected to cover the type of studies, whether laboratory / animal or human, that can be found in the literature. Also, provide the summary evidence, by simulating a Meta analysis scenario, whether each chemical is considered to be conclusive or inconclusive with its relation to the disease you selected.
3- Provide the proof of causation from the Bradford Hill criteria stand point with each chemical.