Abstract
The investigation of disease risks in small areas is complicated by many issues including data quality, the retrospective nature of the statistical testing, the problems of boundary definitions in time and space around a putative disease cluster, and the lack of generally accepted definitions of the key terminology. Routine data systems have revolutionised the initial investigation of disease risks near sources of environmental pollution, although problems of data analysis and interpretation remain. This is especially true of unmeasured socioeconomic confounding, which could generate apparent positive results near a pollution source.
Full text
PDF




Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Alexander F. E., Williams J., McKinney P. A., Ricketts T. J., Cartwright R. A. A specialist leukaemia/lymphoma registry in the UK. Part 2: Clustering of Hodgkin's disease. Br J Cancer. 1989 Dec;60(6):948–952. doi: 10.1038/bjc.1989.396. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Doll R., Evans H. J., Darby S. C. Paternal exposure not to blame. Nature. 1994 Feb 24;367(6465):678–680. doi: 10.1038/367678a0. [DOI] [PubMed] [Google Scholar]
- Elliott P., Hills M., Beresford J., Kleinschmidt I., Jolley D., Pattenden S., Rodrigues L., Westlake A., Rose G. Incidence of cancers of the larynx and lung near incinerators of waste solvents and oils in Great Britain. Lancet. 1992 Apr 4;339(8797):854–858. doi: 10.1016/0140-6736(92)90290-j. [DOI] [PubMed] [Google Scholar]
- Elliott P., Westlake A. J., Hills M., Kleinschmidt I., Rodrigues L., McGale P., Marshall K., Rose G. The Small Area Health Statistics Unit: a national facility for investigating health around point sources of environmental pollution in the United Kingdom. J Epidemiol Community Health. 1992 Aug;46(4):345–349. doi: 10.1136/jech.46.4.345. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gardner M. J., Snee M. P., Hall A. J., Powell C. A., Downes S., Terrell J. D. Results of case-control study of leukaemia and lymphoma among young people near Sellafield nuclear plant in West Cumbria. BMJ. 1990 Feb 17;300(6722):423–429. doi: 10.1136/bmj.300.6722.423. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rothman K. J. A sobering start for the cluster busters' conference. Am J Epidemiol. 1990 Jul;132(1 Suppl):S6–13. doi: 10.1093/oxfordjournals.aje.a115790. [DOI] [PubMed] [Google Scholar]
- Sans S., Elliott P., Kleinschmidt I., Shaddick G., Pattenden S., Walls P., Grundy C., Dolk H. Cancer incidence and mortality near the Baglan Bay petrochemical works, South Wales. Occup Environ Med. 1995 Apr;52(4):217–224. doi: 10.1136/oem.52.4.217. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stone R. A. Investigations of excess environmental risks around putative sources: statistical problems and a proposed test. Stat Med. 1988 Jun;7(6):649–660. doi: 10.1002/sim.4780070604. [DOI] [PubMed] [Google Scholar]
