An alternative approach for investigating the carcinogenicity of indoor air pollution: Pets as sentinels of environmental cancer risk

Traditionally, the cancer risks associated with radon, environmental tobacco smoke (ETS), and similar indoor residential exposures have been evaluated through either laboratory experiments in rodents or epidemiology studies in people. Laboratory studies have the advantage of being controlled experiments, but their utility as estimators of human risk is limited by the uncertainties of extrapolating from rodents, to people and from high doses to those typically experienced in the home. These experiments also subject animals to noxious exposures, causing suffering that map be considered cruel. Traditional epidemiology studies evaluate human risk directly, at the exposure levels present in residences; however, these studies are limited by their potential For misclassification, biased recall, and uncontrolled confounding. Thr long rime intervals involved between exposure and disease (often 30 years or more) make accurate recall particularly problematic. In this paper we discuss the limitations of these traditional approaches, especially as they relate to residential studies of radon and ETS. The problems associated with the maximum tolerated dose in rodent bioassays and exposure misclassification in traditional epidemiology are particularly examined. A third approach that supplements the traditional approaches and overcomes some of their limitations is suggested. This approach, dubbed per epidemiology, estimates residential cancer risk examining the exposure experience of pet dogs with naturally occurring cancers. The history of yet epidemiology is reviewed and its strengths and limitations are examined.