Hospital del Mar Medical Research Institute (IMIM PSMar PRBB), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red - Epidemiología y Salud Pública (CIBERESP), Spain; School of Medicine, Universitat Autònoma de Barcelona, Spain; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, North Carolina.
School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA.
J Clin Epidemiol. 2019 Jul;111:124-126. doi: 10.1016/j.jclinepi.2019.03.009. Epub 2019 Mar 21.
Clinical epidemiology rarely addresses biological, clinical, epidemiological, environmental, economic, and other social and scientific issues posed by environmental chemical contaminants such as endocrine-disrupting chemicals. There is a considerable gap between research and practice in clinical medicine and in environmental health. Organizations often fail to appreciate the human and economic costs of the diseases that environmental chemical contaminants contribute to cause. Also, the relative lack of attention to environmental causes of disease by researchers in medicine and clinical epidemiology cannot be explained just on scientific grounds. Many scientists have shown the virtues of integrative research. Knowledge on the causes of disease is often secondary in clinical practice, but in other instances, to help patients, clinicians tackle causes of diseases. We can better address how environmental contaminants influence negatively not just the occurrence of disease but its course. To do so, we can generate better evidence and strengthen the social conversation on environmental influences on all dimensions of health and disease.
临床流行病学很少涉及到生物、临床、流行病学、环境、经济和其他社会及科学问题，如内分泌干扰化学污染物。临床医学和环境卫生研究与实践之间存在相当大的差距。各组织往往没有意识到环境化学污染物导致的疾病的人力和经济成本。此外，医学和临床流行病学研究人员对环境致病原因相对缺乏关注，这不能仅仅从科学角度来解释。许多科学家已经展示了综合研究的优点。在临床实践中，疾病病因的知识往往是次要的，但在其他情况下，为了帮助患者，临床医生会针对病因进行治疗。我们可以更好地了解环境污染物如何不仅对疾病的发生，而且对疾病的进程产生负面影响。为此，我们可以生成更好的证据，并加强关于环境对健康和疾病各个方面影响的社会对话。
