Bender A P, Williams A N, Johnson R A, Jagger H G
Section of Chronic Disease and Environmental Epidemiology, Minnesota Department of Health, Minneapolis 55440.
Am J Epidemiol. 1990 Jul;132(1 Suppl):S48-52. doi: 10.1093/oxfordjournals.aje.a115788.
Between 1981 and 1988, the Minnesota Department of Health actively responded to over 400 reports from persons concerned about disease occurrence in their community, school, or workplace. Almost all of these reports involved perceived excesses of cases of cancer. Although there is little potential for identifying unsuspected public health problems or developing new etiologic insights, the Minnesota Department of Health has found that responding to reported clusters is a legitimate and necessary public health activity. To be responsibly responsive to these concerns, the Department has developed four steps to prioritize investigation of reported disease clusters, as well as six criteria for determination of the feasibility of environmental epidemiologic investigations. Approximately 95% of all concerns have been handled within the first two steps of this approach, generally requiring only education, or sometimes examination of readily-available data. Less than 5% of the concerns have required additional data collection and evaluation, and only about 1% have resulted in full-scale epidemiologic studies. Successful conclusions at all levels of this process require that public health officials develop effective communication, maintain objectivity, and provide leadership for controversial and difficult issues.
1981年至1988年间，明尼苏达州卫生部积极回应了400多份来自关注其社区、学校或工作场所疾病发生情况的人员的报告。几乎所有这些报告都涉及到被认为的癌症病例过多情况。尽管识别未被怀疑的公共卫生问题或形成新的病因学见解的可能性很小，但明尼苏达州卫生部发现，对报告的聚集性病例做出回应是一项合理且必要的公共卫生活动。为了对这些担忧做出负责任的回应，该部门制定了四个步骤来确定对报告的疾病聚集性病例进行调查的优先级，以及六个标准来确定环境流行病学调查的可行性。大约95%的所有担忧都在该方法的前两个步骤中得到处理，通常只需要进行教育，或者有时检查现成的数据。不到5%的担忧需要额外的数据收集和评估，只有约1%的担忧导致了全面的流行病学研究。在这个过程的各个层面取得成功的结论都要求公共卫生官员开展有效的沟通、保持客观性，并为有争议和困难的问题提供领导。
