ESTABLISHING LINKS BETWEEN AIR-QUALITY AND HEALTH - SEARCHING FOR THEIMPOSSIBLE

Traditional approaches in environmental spatial epidemiology have reli ed on assessing postulated links between environmental pollution and i ll health, often as a response to a perceived public health problem; c learly it may be necessary to go beyond this stage in order to establi sh the nature of potential causal mechanisms. Different disciplines ap proach this issue in different ways. Many toxicologists favour approac hes based on air quality monitoring, where raised levels of candidate pollutants may subsequently generate hypotheses about adverse health e ffects. Epidemiologists, however, assess the health of a population an d then look for an associated cause. This paper suggests that neither approach is completely satisfactory and that a combination of both is needed. If spatially referenced data are available for both health sta tus and air quality, then geographical analysis is needed to examine p ossible links, by using techniques such as atmospheric dispersion mode lling and Geographical Information Systems. We discuss the benefits an d constraints of these approaches, using empirical examples of environ mental epidemiology studies for northern England. Taking into account the problems involved in such studies, allied to the high costs incorp orated, the paper asks the question: Are we searching for the impossib le?