IL RISCHIO CANCEROGENO OCCUPAZIONALE OGGI e&p

Epidemiology is a public health oriented discipline and is aimed to detect the spatial, temporal, social and causal distribution of diseases in the human population, in order to promote timely and effective preventive solutions. This paper highlights some gold standard of the epidemiological method and suggests some consid erations for a critical comprehension of epidemiological studies, in particular those that deny or minimize the existence of public health risks. This paper will focus on some crucial elements such as definition, attribution, misclassification and underestimation of the harmful exposures caused by a multitude of factors, under valuation of the possible interactions among harmful agents (even when law limits are respected), selection of exposed populations, insufficient number of studied diseases, importance of the right comparisons between similar groups when the reference popula tion is used, disproportion between shortness of follow-up in respect with long latency period of the studied diseases, including cancer. This paper also observes that many epidemiologists carry out confirmative studies rather than exploratory ones, and they end to both underestimate and underevaluate the multiplicity of the causal associations in favour of a reductive and acritical approach to the statistics which, in final analysis, wants to replace epidemiology. It points out, moreover, that neglecting primary prevention as well as precautionary principles in the interpreta tion of public health studies, arises the suspicion of professional limitation or strong conflict of interests (business bias). Epidemiology is naturally oriented to both primary prevention and public health defense, and today, more than ever before, for many reasons, among which the overwhelming market power that is first and foremost the cause of the general increase of pop ulations affected by avoidable pathologies, a systematic, correct and timely application of this precious discipline seems to be urgent to us. In conclusion, we would suggest that some technicalscientific and institutional initiatives should overcome the intrin sic limits of the current aetiological researches. The rigorous adhe sion of epidemiology to its scientific method appears to be absolutely necessary in order to enforce the Italian constitutional principle which states that health defence is a fundamental right of each individual and a concern for the whole community. (Epidemiol Prev 2009; 33(4-5) Suppl 2: 49-56 )