Do Environmental Contaminants Play a Role in GTFP?
Identification of putative environmental cofactors and analysis of their specific roles in GTFP development is a major challenge. Development of hypotheses for specific cofactors in GTFP pathogenesis must be met with suitable criteria for accepting or rejecting them. Koch’s postulates are one set of criteria that are appropriate for primary infectious disease, but they are probably inappropriate for complex, multifactorial diseases (12). Hill’s criteria (12) are more appropriate for epidemiologic analysis and conclusions based on statistical inference and should be used when deciding between alternate explanations for the observed GTFP prevalence patterns . The perceived association of high GTFP prevalence with near-shore habitats in proximity to human activities has led to speculation that environmental contaminants may play a role in GTFP pathogenesis. Associations between contaminant levels and neoplastic diseases have been made in several aquatic species (13-18). Biologically plaus
