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Introduction to Forensic Epidemiology

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.

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Introduction to Forensic Epidemiology

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  1. Introduction to Forensic Epidemiology

  2. 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.

  3. 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

  4. Goals of Epidemiology • Examples: • Identify individuals at high risk for disease • Recognize and control epidemics • Monitor rates of disease and exposures in populations

  5. Types of Epidemiology • Examples: • Occupational • Infectious Disease • Cardiovascular • Cancer • Nutrition • Environmental • Injury

  6. 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

  7. 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

  8. 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

  9. Epidemiology in the Courtroom • Investigative experts • Interview case-patients • Consulting experts • Understand scientific principles • Understand statistical principles • Testimony experts • Present data

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

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