Selikoff I J
Environ Health Perspect. 1976 Oct;17:5-11. doi: 10.1289/ehp.76175.
Experiences in the past decade provide guidance in selecting priorities for investigation of health hazards in chemical industries. Pride of place should be given to the experience of large industrial populations, in part simply because large numbers of people are at risk and in part because such studies are more likely to give reliable answers. This recommendation has further strength when there is community exposure as well. Parenthetically, large populations provide opportunity to study multiple factor interaction; without this, toxic potential of a single agent may be obscured. Second, investigations should be mounted when there is reason for suspicion, as with particular chemical configurations, observed organ toxicity, animal carcinogenicity, unusual clinical experience ("signal" tumors). It may be added that when agents have already been used several decades, evaluation of human experience with them is now in order, if only to document absence of toxicity. The same recommendations hold for planned introduction of new agents or widened distribution of existing ones, until we have better information concerning validity of "pretesting" programs. Major advances have been made in epidemiological methods for these investigations. These now allow us to successfully focus on small defined groups as well as to manage large populations.
过去十年的经验为化工行业健康危害调查重点的选择提供了指导。首先应重视大型工业人群的经验，部分原因在于大量人员面临风险，部分原因在于此类研究更有可能给出可靠答案。当存在社区暴露时，这一建议更具说服力。顺便提一下，大量人群提供了研究多因素相互作用的机会；否则，单一物质的潜在毒性可能会被掩盖。其次，当有理由怀疑时，如特定的化学结构、观察到的器官毒性、动物致癌性、不寻常的临床经验（“信号”肿瘤），就应展开调查。还可以补充一点，当某些物质已经使用了几十年，现在应对人类接触这些物质的情况进行评估，哪怕只是为了证明其无毒性。对于计划引入新物质或扩大现有物质的使用范围，同样适用这些建议，直到我们获得有关“预测试”项目有效性的更好信息。在这些调查的流行病学方法方面已经取得了重大进展。这些进展现在使我们能够成功地聚焦于小范围的特定群体，也能够对大量人群进行管理。
