Assessing the power and quality of epidemiologic studies of asbestos-exposed populations

This paper briefly discusses criteria for evaluating epidemiologic studies for risk assessment purposes, using asbestos as an example. Asbestos is one of the few carcinogens for which substantial data exist on exposures to humans. However, there are major difficulties in using these data for conducting risk assessments. In particular, exposure data are often incomplete, and risk assessments usually involve extrapolating from the higher exposures of the occupational environments to the lower levels typically encountered in the nonoccupational environment. The term "asbestos" refers to the fibrous form of several minerals, and levels of exposures to these fibers are not easily assessed. Criteria for evaluating epidemiologic studies used in an Ontario Royal Commission report on asbestos are discussed. The importance of considering the statistical power of studies to detect an excess risk is examined using as examples major cohort studies of asbestos-exposed workers, as summarized in a report by the U.S. National Research Council.