Cluster Investigations in Non-Infectious Disease (FOCUS, Volume 5.4)
Length: 40 minutes
This issue of FOCUS describes the basic steps involved in investigating non-infectious disease clusters, including how to decide whether to investigate at all.
These trainings are applicable to all public health, medical, veterinary, pharmacy, emergency management, hospital, and other professionals interested in public health preparedness and field epidemiology. The periodicals and supplemental material are created by doctoral students and graduates of the UNC-CH Department of Epidemiology and reviewed by UNC-CH School of Public Health faculty and topic experts.
- Describe the basic steps involved in investigating non-infectious disease clusters, including the initial ascertainment of the cluster, assessment of excess occurrence, determining the feasibility of an etiologic investigation, and conducting an etiologic study.
- Describe how to decide whether to proceed with the investigation at each step.
- Provide an overview of ways to communicate your findings with the public.
Competencies and Capability Functions Addressed
This training addresses selected applied epidemiology, core public health, and public health preparedness and response competencies and public health preparedness capability functions as noted below. (Please note: The following training does not provide comprehensive or in-depth treatment of specified competencies or capability functions, it provides basic knowledge of the competencies or capability functions listed below.)
|Applied Epidemiology Competencies Tier 1|
|Characterize investigative processes (I.C.3)|
|Applied Epidemiology Competencies Tier 2|
|Select investigative processes (I.C.3)|
|Core Competencies for Public Health Professionals|
|2) Describes the characteristics of a population-based health problem (e.g. equity, social determinants, environment) (1: Analytic/Assessment Skills)|
|4) Uses methods and instruments for collecting valid and reliable quantitative and qualitative data (1: Analytic/Assessment Skills)|
|4) Applies the basic public health sciences (including, but not limited to biostatistics, epidemiology, environmental health sciences, health services administration, and social and behavioral health sciences) to public health policies and programs (6: Basic Public Health Sciences Skills)|
|Public Health Preparedness Capabilities|
|Capability 13, Function 2: Conduct public health and epidemiological investigations|
|Public Health Preparedness & Response Core Competencies|
|2.5. Manage the recording and/or transcription of data according to protocol.|
McBride WG. Thalidomide and congenital abnormalities. Lancet 1961;2:1388.
Cartwright RA. Cluster investigations: are they worth it? Med J Aust. 1999;171:172. http://www.mja.com.au/public/issues/171_4_160899/cartwright/cartwright.html
CDC. Guidelines for investigating clusters of health events. MMWR Morb Mortal Wkly Rep. 1990;39(RR-11):1-16. http://www.cdc.gov/mmwr/preview/mmwrhtml/00001797.htm
New Jersey Department of Health and Senior Services and ATSDR. Childhood Cancer Incidence Health Consultation: A Review and Analysis of Cancer Registry Data, 1979-1995 for Dover Township (Ocean County), New Jersey. 1997. http://www.state.nj.us/health/eoh/hhazweb/cansumm.pdf
Bender AP, Williams AN, Johnson RA, Jagger HG. Appropriate public health responses to clusters: the art of being responsibly responsive. Am J Epidemiol 1990;132:S48-S52.
Rothman KJ. A sobering start for the cluster busters' conference. Am J Epidemiol 1990;132:S6-S13.
Fischoff B, Lichtenstein S, Slovic P, et al. Acceptable Risk. Cambridge, UK: Cambridge Univ Press; 1981.
Greenberg MR, Wartenberg D. Understanding mass media coverage of disease clusters. Am J Epidemiol 1990;132:S192-5.
Covello VT, Allen F. Seven Cardinal Rules of Risk Communication. Washington, DC: US Environmental Protection Agency, Office of Policy Analysis; 1988. OPA publication 87-020.
Jeanette K. Stehr-Green, MD
Paul A. Stehr-Green, DrPH, MPH
The author(s) and reviewer(s) of this training have no personal financial relationships with commercial interests relevant to this presentation to disclose.
Continuing Education Credit:
The UNC Center for Public Health Preparedness offers the following continuing education credit/s on this training. Eligibility for all continuing education credit is determined on an annual basis.
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