Journal of the American Statistical Association · 1997 · 245 citations · 0 references
Public HealthBiostatisticsEnvironmental SciencesCancer EpidemiologyEpidemiologic MethodsEpidemiologyBayesian Disease MappingDisease MappingEnvironmental Cancer EpidemiologyEnvironmental EpidemiologyRisk MappingSpatial Disease MappingChildhood Cancer IncidenceDisease Cluster AnalysisDisease RiskDisease Risk MappingEcological StudiesEnvironmental PollutionPoint Source ExposurePoint Sources
The paper outlines the purpose and methods of small‑area geographical epidemiology, emphasizing the health impacts of chemicals and radiation and providing a historical perspective and guidelines for investigating adverse health event clusters. It describes the use of routine mortality, cancer, congenital anomaly, and population data, combined with exposure mapping and Bayesian spatial statistical techniques, to model disease risk and assess point‑source exposures in small areas. Case studies illustrate the application of these methods, linking childhood leukemia to Sellafield, respiratory cancer to erionite fibers, asthma to soy bean, laryngeal and lung cancer to Seveso incinerators, and broader geographical correlations in China.
Part 1 Introduction: geographihcal epidemiology and ecological studies small-area studies - purpose and methods health and the environment - the significance of chemicals and radiation. Part 2 Data, computational methods and mapping: mortality data cancer incidence data for adults cancer incidence data for children congenital anomalies specialized registers population counts in small areas use of routine data in studies of point sources of environmental pollution socio-economic confounding use of record linkage in small-area studies confidentiality practical approaches to disease mapping estimating environmental exposures mapping environmental exposure. Part 3 Statistical methods: statistical methods for geographical correlation studies Bayesian methods for mapping disease risk statistical methods for analyzing point-source exposures some comments on methods for investigating disease risk around a point source methods for the assessment of disease clusters. Part 4 Studies of health and the environment: environmental epidemiology - a historical perspective guidelines for the investigation of clusters of adverse health events studies of diseas clustering - problems of interpretation. Part 5 Case studies: childhood leukaemia around the Sellafield nuclear plant the epidemic of respiratory cancer associated with erionite fibres in the Cappadocian region of Turkey soya bean as a risk factor of epidemic asthma the Seveso accident cancer of the larynx and lung near incinerators of waste solvents and oils in Britain a study of geographical correlations in China.