Spitzer W O, Dales R, Schechter M T, Tousignant P, Hutcheon M
Department of Epidemiology, McGill University, Montreal, Quebec, Canada.
Trans Assoc Am Physicians. 1987;100:40-4.
A political emergency arose in 1985 for the province of Alberta, Canada, because allegations of increased health risk had frightened rural Alberta residents exposed for 28 years to the airborne effluent of sour gas processing plants. In an epidemiologic study that took 3 months in the field, cross-sectional and cohort comparisons were conducted for these residents and for two carefully selected control groups. Clinical examinations were conducted with objective methods and criteria. No excess rates were found in the exposed group for any life-threatening or seriously disabling conditions. For the exposed group in the index area the reported cardinal symptoms were slightly higher than in the main unexposed reference group, but the observed cardinal signs were slightly lower. This project shows that scientifically sound strategies can be used to investigate major health controversies. Rigorous clinical methods of measurement, incorporated into a classical epidemiologic study, can inspire confidence in the studied population and can make the results acceptable to clinicians and policy makers. The studies can be done rapidly in response to urgent or crisis situations without compromising methodologic rigor or the quality of the analyses.
1985年，加拿大艾伯塔省出现了一场政治危机，原因是有指控称，健康风险增加吓坏了艾伯塔省农村地区的居民，他们在28年里一直暴露于酸性气体加工厂的废气中。在一项历时3个月的实地流行病学研究中，对这些居民以及两个精心挑选的对照组进行了横断面和队列比较。采用客观的方法和标准进行临床检查。在暴露组中，未发现任何危及生命或严重致残疾病的超额发病率。在指标区域的暴露组中，报告的主要症状略高于主要未暴露的参照组，但观察到的主要体征略低于参照组。该项目表明，可以采用科学合理的策略来调查重大的健康争议问题。将严格的临床测量方法纳入经典的流行病学研究中，能够增强研究人群的信心，并使研究结果为临床医生和政策制定者所接受。这些研究可以针对紧急或危机情况迅速开展，而不会影响方法的严谨性或分析质量。
