Waller L A
Department of Biostatistics, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, Georgia 30322, USA.
Regul Toxicol Pharmacol. 2000 Oct;32(2):174-83. doi: 10.1006/rtph.2000.1428.
A reported "cluster" of excess childhood leukemia cases and possible environmental causes in Woburn, Massachusetts, formed a key motivation for the events described in the popular book and motion picture A Civil Action. Although statistical methods to assess spatial clustering existed prior to the events in Woburn, increasing interest in environmental risk factors and recent developments in geographical information systems and data availability prompt increased attention to such methods and their application to public health data. In this article, we review statistical and epidemiological concepts involved in the analysis of disease clusters. We discuss data issues, outline some methodological approaches, and illustrate ideas using data regarding leukemia incidence in upstate New York for the years 1978-1982.
据报道，马萨诸塞州沃本出现了儿童白血病病例过多的“聚集”现象以及可能的环境成因，这成为了畅销书及电影《民事诉讼》中所描述事件的关键推动因素。尽管在沃本事件发生之前就已存在评估空间聚集性的统计方法，但对环境风险因素的兴趣日益浓厚，以及地理信息系统和数据可用性方面的最新进展，促使人们更加关注此类方法及其在公共卫生数据中的应用。在本文中，我们回顾了疾病聚集性分析中涉及的统计和流行病学概念。我们讨论了数据问题，概述了一些方法学途径，并利用1978 - 1982年纽约州北部白血病发病率的数据来说明相关观点。
