title: The role of the assessment of spatial variation and clustering in environmental surveillance of birth defects.
abstract: This paper discusses the role of small area spatial analysis of birth defects in environmental surveillance. Two approaches are reviewed: (1) the investigation of identified geographically localised potential environmental hazards, and (2) the detection of clustering. Examples are given where these 2 types of investigation have been used in the follow-up of individual clusters. Finally, it is argued that environmental surveillance, incorporating the 2 groups of spatial methods, should become a part of public health practice on both proactive and reactive basis.
authors.affiliation: Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, UK. h.dolk@lshtm.ac.uk
authors.forename: H
authors.initials: H
authors.lastname: Dolk
mesh_terms: D015982:Bias; D015986:Confounding Factors, Epidemiologic; D000013:Congenital Abnormalities / Q000453:epidemiology* / Q000209:etiology*; D003627:Data Interpretation, Statistical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018811:Maternal Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data*; D011159:Population Surveillance / Q000379:methods*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D015203:Reproducibility of Results; D017062:Small-Area Analysis; D013029:Space-Time Clustering; D006113:United Kingdom / Q000453:epidemiology