Cole D C, Tarasuk V, Frank J W, Eyles J
Institute for Work & Health, Toronto, Ontario, Canada.
Arch Environ Health. 1996 Sep-Oct;51(5):352-8. doi: 10.1080/00039896.1996.9934422.
Traditional epidemiological approaches based on biomedical models may be limited with respect to their response to "outbreaks of concern" among work-force or community populations. Three published Canadian "outbreaks" were reviewed in this study. In all three instances, research was initiated because lay persons were concerned about either nonspecific symptoms or hazardous exposures, and individuals publicly called for a response. Epidemiologic analyses were inconclusive as to the reasons for the outbreaks, and they contributed little toward the resolution of concerns. There is a need for a fuller recognition of the role of social context and of the action-oriented nature of such research. The elucidation of multifactorial and culturally mediated causation, as well as the development of remedial actions, require a rethinking of research methods. We specifically call for (a) an expansion of the disciplinary base of research teams to include social scientists, and (b) the adoption of combined qualitative and quantitative research approaches.
基于生物医学模型的传统流行病学方法在应对劳动力或社区人群中的“关注性疫情”时可能存在局限性。本研究回顾了三篇已发表的加拿大“疫情”报告。在所有三个案例中，研究的启动都是因为非专业人士对非特异性症状或有害暴露表示担忧，并且有人公开呼吁做出回应。关于疫情爆发的原因，流行病学分析尚无定论，对解决这些担忧的贡献也很小。有必要更充分地认识社会背景的作用以及此类研究的行动导向性质。阐明多因素和文化介导的因果关系以及制定补救措施需要重新思考研究方法。我们特别呼吁：（a）扩大研究团队的学科基础，纳入社会科学家；（b）采用定性和定量相结合的研究方法。
