Scherer K, Kraut A, Yassi A, Wajda A, Bebchuk J
Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Canada.
Environ Res. 1994 Aug;66(2):143-51. doi: 10.1006/enrs.1994.1050.
Following episodes of environmental contamination, health professionals are limited in their ability to detect adverse health effects in surrounding communities due to lack of relevant baseline health data, resources, and appropriate control populations. The objective of this study was to ascertain the feasibility of using administrative health data for these purposes. The Manitoba Health Services Commission's (MHSC) database is comprehensive since universal health care is free in Canada. As part of an evaluation of two proposed hazardous waste treatment sites, the feasibility of using MHSC's data was tested by (a) defining the two study and control sites through use of MHSC's population registry and (b) determining baseline morbidity rates through analysis of MHSC's physician visit payment files; diagnoses were coded using ICD-9-CM. The results indicated that there were some differences between the groups studied in the age- and sex-standardized morbidity rates of diagnoses potentially influenced by exposures to chemicals. Use of administrative data provided by a national health service is an inexpensive and efficient way to create and follow potentially exposed cohorts residing in defined communities. Despite limitations related to small populations in exposed communities and lack of standardized diagnostic criteria by physicians, this method should be explored further in environmental studies.
在发生环境污染事件后，由于缺乏相关的基线健康数据、资源以及合适的对照人群，卫生专业人员在检测周边社区人群健康不良影响方面能力有限。本研究的目的是确定利用行政卫生数据实现这些目的的可行性。由于加拿大实行全民免费医疗保健，曼尼托巴省卫生服务委员会（MHSC）的数据库较为全面。作为对两个拟议的危险废物处理场地评估的一部分，通过以下方式测试了使用MHSC数据的可行性：（a）利用MHSC的人口登记册确定两个研究地点和对照地点；（b）通过分析MHSC的医生就诊付费文件确定基线发病率；诊断使用ICD-9-CM进行编码。结果表明，在年龄和性别标准化发病率方面，研究组之间在可能受化学物质暴露影响的诊断方面存在一些差异。利用国家卫生服务提供的行政数据是创建和跟踪居住在特定社区的潜在暴露队列的一种低成本且高效的方法。尽管存在暴露社区人口较少以及医生缺乏标准化诊断标准等局限性，但这种方法在环境研究中应进一步探索。
