The role of the assessment of spatial variation and clustering in environmental surveillance of birth defects.
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.
Dolk
H
H
Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, UK. h.dolk@lshtm.ac.uk
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