Spatial epidemiology is concerned with describing, quantifying and explaining geographical variations in disease, especially with respect to variations in environmental exposures at the small-area scale. The recent and rapid expansion of the field looks set to continue in line with growing public, government and media concern about environment and health issues, and a scientific need to understand and explain the effects of environmental pollutants on health. This book brings together contributions from an international group of practitioners from a wide spectrum of disciplines including epidemiologists, statisticians, geographers, demographers and pollution modellers, providing a comprehensive reference on state-of-the-art methods and applications in the emerging field of spatial epidemiology. The book is divided into four sections. Section one gives an introduction to spatial epidemiological studies and summarises data requirements and problems with respect to modelling health events, including bias and confounding. Section two gives an overview of the state-of-the-art in statistical methodology, including Bayesian approaches to disease mapping, cluster detection, analysis of point exposures, geostatistical methods and methods for ecological correlation studies. Section three gives examples of disease mapping and cluster studies, involving mortality data, communicable disease data, Hodgkins disease, diabetes and childhood leukemias. Section four reviews methods of exposure assessment for use in spatial epidemiological studies, and discusses possible links between exposure and health data in risk asessment, and in the effects on human health of traffic related pollution, water quality and climate change. This book aims to give an authoritative account of current practice and developments in the field. As such it should be of interest to epidemiologists, public health practitioners, statisticians, geographers, environmental scientists and others concerned with understanding the geographical distribution of disease and the effects of environmental exposures on human health. It will be a a valuable source for undergraduate and postgraduate coursees in epidemiology, medical geography, biostatistics, environmental health and environmental science as well as a useful source of reference for health policy makers, health economists, regulators and others in the field of environmental health.
