Curio F
Landratsamt Kronach, Gesundheitswesen.
Gesundheitswesen. 1996 Jul;58(7):391-9.
The purpose of this study, drawn up as a localised report, was to find out whether the accumulation of notified cases of leukaemia and haemoblastosis over a 40-year observation period, in a restricted region within a small village, can also be found in other localities of the northern Bavarian administration district of Kronach. This region was very out-of-the-way before German reunification. With its static indigenous population, and the retrieval possibilities of respective archives, it offered good conditions for a long-term study over four decades; 13 out of 63 administrative district communities could be randomly selected for research. Between 1950 and 1993, 144 patients who contracted either leukaemia or another type of malignant neoplasm of the lymphoid and haematopoetic tissues were recorded (Pos. C 81-C 96 ICD 10). When these patients' dwellings were charted, a sporadic, inconspicious, temporal-spatial distribution became apparent in seven out of 13 localities. However, in six of the 13 communities there was the same limited local concentration of cases spread over a period of time, as had been observed in the abovementioned village. This cartographically noticeable concentration was termed "cluster"; in these "clusters", both locals and long-term residents were affected. What these "clusters" have in common topographically is that they are noticeably located in moist areas. The study clearly demonstrates the difficulties in assessing these cartographically significant "clusters" from a statistical point of view, i.e. in making a risk quantification for small populations and with insufficient demographic data. Therefore, no statement can be made as to whether the observed "clusters" represent change findings, or rather, an epidemiological, i.e. endemic fundamental pattern of leukaemia and haemoblastoses; one that, within a shorter observation period, must remain undetected-that is, could be disguised by population migrations.
本研究撰写为一份局部报告，其目的是查明在一个小村庄的限定区域内，经过40年观察期白血病和造血组织病通报病例的积累情况，是否也能在克罗纳赫巴伐利亚行政区北部的其他地方发现。该地区在德国统一之前非常偏远。因其常住人口稳定，且有相应档案可供检索，为进行长达四十年的长期研究提供了良好条件；63个行政区社区中可随机选取13个进行研究。1950年至1993年期间，记录了144例患白血病或其他淋巴和造血组织恶性肿瘤的患者（国际疾病分类第十版编码C81 - C96）。当绘制这些患者的住所分布图时，13个地区中有7个呈现出散发性、不明显的时空分布。然而，在13个社区中的6个，存在与上述村庄观察到的相同的有限局部病例集中情况，且这种集中情况持续了一段时间。这种在地图上明显的集中情况被称为“聚集”；在这些“聚集区”，当地人和长期居民都受到了影响。这些“聚集区”在地形上的共同之处在于它们明显位于潮湿地区。该研究清楚地表明，从统计学角度评估这些在地图上具有显著意义的“聚集”存在困难，即在人口较少且人口数据不足的情况下进行风险量化。因此，无法确定观察到的“聚集”是代表变化结果，还是白血病和造血组织病的一种流行病学即地方病基本模式；在较短观察期内，这种模式必然无法被发现——也就是说，可能被人口迁移所掩盖。
