Transcript Slide 1

Introduction to Forensic
Epidemiology
Goals



Describe forensic epidemiology and the
groups that may be involved in a
forensic epidemiology investigation.
Explain how forensic epidemiology is
used in the courtroom and in the field.
Provide examples when forensic
epidemiology might be used.
Definition of Epidemiology


“The study of the distribution and
determinants of health related states or
events in populations, and the application
of this study to control health problems”
The basic science of public health
Goals of Epidemiology

Examples:



Identify individuals at high risk for disease
Recognize and control epidemics
Monitor rates of disease and exposures in
populations
Types of Epidemiology

Examples:







Occupational
Infectious Disease
Cardiovascular
Cancer
Nutrition
Environmental
Injury
Epidemiologic Studies of Naturally
Occurring Phenomena


Historical examples dating to 1747
Modern examples:




Fluoride use and dental caries
Cigarette use and lung cancer
Tampon use and Toxic Shock Syndrome
HPV exposure and cervical cancer
Epidemiology in Health-Related
Crime Investigations

Examples:





Deliberate poisoning
Bioterrorism
Need unlikely partners to work together
Epidemiology can link disciplines
Goal is to protect health of public
Forensic Epidemiology

Application of public health methods in
a potential criminal investigation

Litigation of health-related incidents


Examples: silicone breast implants, E. coli
infections, toxic shock syndrome, tobacco use
Field-based investigations with law
enforcement

Example: intentional anthrax release in 2001
Epidemiology in the
Courtroom

Investigative experts


Consulting experts



Interview case-patients
Understand scientific principles
Understand statistical principles
Testimony experts

Present data
Differences between Science
and Law

Science




Ever-changing, open to peer review
Disease in populations
Evidence for association only
Law



Final
Disease in individual
Requires causal link
Field-Based Forensic
Epidemiology

During the investigation

Disciplines involved:







Local and state health
departments
Police and firefighters
State bureaus of
investigation
Emergency
management services
Hospitals and health
clinics
State laboratories
Pharmacists







Federal Bureau of Investigation
National Guard and other military
units
Centers for Disease Control and
Prevention
Federal Emergency Management
Administration
United States Department of
Agriculture
Department of Homeland Security
Attorney General’s Office
Field-Based Forensic
Epidemiology-Bioterrorism

Two key groups: Public health and law
enforcement

Common goals:




Protect the public
Prevent/Stop the spread of disease
Identify the responsible individual/party
Safeguard those involved in investigation
Field-Based Forensic
Epidemiology-Bioterrorism

Law enforcement contributions:




Public health criminology expertise
Forensic laboratory collaboration
Law enforcement connections
Public health contributions:



Medical expertise
Laboratory expertise
Public health connections
Examples of Confirmed
Health-Related Criminal Cases







Rabbit hemorrhagic disease virus; 1997
Shigella dysenteriae type 2; 1996
Bacillus anthracis, botulinum toxin, sarin;
1990-1995
Salmonella typhimurium; 1984
Ricin; 1978
Curacit; 1977-1980
Ascaris suum; 1970
Conclusion



Forensic epidemiology has been used
for many years; 2001 terrorist events
have increased attention on field
Public health and law enforcement can
learn from each other
Public health and law enforcement can
successfully work together