title: Approaches to disease cluster investigations in a state health department.
abstract: Classical tests for clustering rarely have a major role in the investigation of disease clusters at the neighbourhood level performed by a health department. When examining a single cluster, the boundaries are often ill-defined, and the dimension (geographic, occupational, iatrogenic) is rarely obvious. Furthermore, using cluster tests to routinely scan disease registries looking for clusters is undesirable for several reasons. A better approach is to be vigilant for unusual environmental exposures, and to evaluate the impact they may have. In this context, cluster techniques may serve as part of a larger investigation that includes other epidemiologic approaches.
authors.affiliation: Environmental Health Investigations Branch, California Department of Health Sciences, Emeryville 94608.
authors.forename: D
authors.initials: D
authors.lastname: Smith
authors.forename: R
authors.initials: R
authors.lastname: Neutra
mesh_terms: D000393:Air Pollutants / Q000009:adverse effects*; D002140:California / Q000453:epidemiology; D002648:Child; D016000:Cluster Analysis; D006296:Health Services / Q000191:economics; D006801:Humans; D015994:Incidence; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology; D010575:Pesticides / Q000009:adverse effects*; D011237:Predictive Value of Tests; D012042:Registries
chemical_list: D000393:Air Pollutants; D010575:Pesticides