Approaches to disease cluster investigations in a state health department.
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.
Smith
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D
Environmental Health Investigations Branch, California Department of Health Sciences, Emeryville 94608.
Neutra
R
R
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
D000393:Air Pollutants; D010575:Pesticides