Who should provide research initiative and support?

The study of low dose environmental exposure is a major concern for epidemiologists. The problem is a special example of a common source epidemic with either single or continuous exposure. Usually the most common source investigations begin with an epidemic, cluster of cases. However, environmental studies often start with an exposure that is considered to be potentially hazardous and a search for cases. The relatively low attack rate and also relative risk requires large sample sizes for testing hypotheses. The incubation period from exposure to onset of the disease may be very long, and therefore the exposure dose is difficult to define. Many of the diseases of interest also have multiple etiologies, and the amount of disease attributed to the specific environmental exposure may be relatively small (the attributable risk). Many of the other potential etiological agents also share common host characteristics with the environmental agent of interest further confounding the analysis. The identification of specific, unusual characteristics of disease such as rare histological type or location, or host characteristic may be a valuable approach to the study of environmental agents. The cost of doing environmental studies are substantial. Various resources are currently being utilized. There are several problems associated with many of these nongovernmental resources. One possible solution to the availability of a large funding source for environmental research, independent of special interest groups, may be a consumer-oriented tax on adverse personal health behavior, such as alcohol consumption and cigarette smoking.