Causation and epidemiologic evidence: insights from “toxic cases” in the US and Italy

Proving causation between exposure to toxic substances and long latency disease is often a challenging task. This is clearly showed by the U.S. toxic tort litigation, as well as by the Italian experience of criminal investigation and trials for occupational and pollution-related diseases. After a summary of the main hurdles surrounding the proof of causation in “toxic cases”, this post addresses the question of whether the most readily available type of scientific evidence – i.e. epidemiologic studies – could be used in a different, more effective way than has been done so far.