From Epidemiologic Exposure and Risk Assessment to Probabilistic Models: Experience with the Investigation of Health Effects of Soil Contamination in Germany

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Abstract
Exposure and risk assessment can be based on direct epidemiological investigations that study exposed individuals or on models. Examples from situations in Germany for both approaches are presented and discussed here. Epidemiological studies for the health risk assessment of contaminated soil typically have one or more of the following problems: the number of exposed persons is too small: critical confounders cannot be measured and controlled for appropriately; or the expected effects are not large enough to be detected. Therefore, at least for most situations in Germany, epidemiological investigations designed to measure health risks infrequently provide clear answers. In contrast, direct epidemiological investigations are more likely to be able to quantify exposure. If the soil concentrations are high, one is able to identify the location of relevant “hot spots” using biological and environmental monitoring. Further, epidemiology can be used to get information about the distribution of exposure in specific populations, such as young children or amateur gardeners. Exposure assessment by modeling provides answers in situations in which no reasonable answers can be expected using epidemiological means. The model gives quantitative estimates for average and reasonable worst-case situations. The latter can be determined by modeling probability distributions.