Improving exposure assessment in environmental epidemiology: Application of spatio-temporal visualization tools

A thorough assessment of human exposure to environmental agents should incorporate mobility patterns and temporal changes in human behaviors and concentrations of contaminants; yet the temporal dimension is often under-emphasized in exposure assessment endeavors, due in part to insufficient tools for visualizing and examining temporal datasets. Spatio-temporal visualization tools are valuable for integrating a temporal component, thus allowing for examination of continuous exposure histories in environmental epidemiologic investigations. An application of these tools to a bladder cancer case-control study in Michigan illustrates continuous exposure life-lines and maps that display smooth, continuous changes over time. Preliminary results suggest increased risk of bladder cancer from combined exposure to arsenic in drinking water (>25 μ g/day) and heavy smoking (>30 cigarettes/day) in the 1970s and 1980s, and a possible cancer cluster around automotive, paint, and organic chemical industries in the early 1970s. These tools have broad application for examining spatially- and temporally-specific relationships between exposures to environmental risk factors and disease.