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首页> 外文学位 >Disease clustering and episodic environmental releases: Development and testing of a GIS-based spatial study design for epidemiologic analysis.
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Disease clustering and episodic environmental releases: Development and testing of a GIS-based spatial study design for epidemiologic analysis.

机译：疾病聚集和突发环境释放：用于流行病学分析的基于GIS的空间研究设计的开发和测试。

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摘要

Public health investigators are often called upon to address community concerns over emerging patterns or "clusters" of disease in local areas. Traditional epidemiological study designs are labor intensive and often inadequate for investigations of small local areas.; Under an ATSDR grant for the development of methods for small areas (ATPM TS1067), I explored a simple but realistic situation: a single-incident exposure of a population (e.g. railway tanker accident) resulting in an acute disease outbreak. I developed study methods using software available to community investigators, including GIS technology to facilitate spatial data handling and visualization.; This spatial study design uses matched analysis of actual case or health event data paired with counterfactual referent data. The study method compares each case's observed exposure to a counterfactual referent exposure derived from the exposure prevalence in that case's local area. Simulation testing under highly controlled theoretical conditions and with realistic census-based populations demonstrates that this spatial study design controls or mitigates several types of spatial confounding present in many real-world study situations.; I conducted field testing with two very different scenarios. The first involved hydrogen sulfide plumes from a large slaughterhouse waste pool in Nebraska, previously linked to rises in hospital visits for respiratory distress. Feasibility investigation involved all the steps necessary to set up a field study. The second scenario analyzed self reports of smoke exposure from New York City area women who were pregnant at the time of the World Trade Center attack. Maps of respondent locations and responses were compared with a model for smoke emanating from the site in the first few days after the attack.; Data analyzed using three levels of geographic areas for referent exposure assignment (full area, zip code, and neighborhood) showed divergent results, from a null finding at the zip code level, to a matched odds ratio (MOR) of 18.7 for the full study area referents. After rigorous simulation testing, pilot study, and field study, the generalized matched spatial study methods developed in this dissertation add to existing options for the study of disease clusters and environmental exposures.
机译：人们经常要求公共卫生研究人员解决社区对当地新出现的疾病模式或“集群”的关注。传统的流行病学研究设计是劳动密集型的，通常不足以进行小区域的调查。在ATSDR拨款用于开发小区域方法（ATPM TS1067）的情况下，我探索了一种简单而现实的情况：一次人群的一次事件暴露（例如铁路油轮事故）导致了急性疾病暴发。我使用社区调查员可用的软件开发了研究方法，包括GIS技术，以促进空间数据处理和可视化。此空间研究设计使用对实际病例或健康事件数据与反事实参考数据配对的匹配分析。该研究方法将每个案例的观察到的暴露与由该案例所在地区的暴露流行率得出的反事实参照暴露进行比较。在严格控制的理论条件下以及基于实际人口普查的人口中的模拟测试表明，这种空间研究设计可以控制或减轻许多现实世界研究情况中存在的几种类型的空间混淆。我在两种截然不同的场景下进行了现场测试。第一个涉及内布拉斯加州一个大型屠宰场废物池中的硫化氢羽流，以前与医院因呼吸窘迫而就诊的人数增加有关。可行性研究涉及建立现场研究的所有必要步骤。第二种情况分析了在世界贸易中心袭击时怀孕的纽约市地区妇女吸烟的自我报告。在袭击发生后的头几天，将被调查者的位置和反应地图与从该地点发出的烟雾模型进行比较。使用三个地理区域级别进行参照暴露分配（完整区域，邮政编码和邻域）进行分析的数据显示出不同的结果，从邮政编码级别的零发现到完整研究的匹配比值比（MOR）为18.7地区对象。经过严格的模拟测试，初步研究和现场研究，本文开发的广义匹配空间研究方法为研究疾病群和环境暴露提供了现有的选择。

著录项

  • 作者

    Adams, Kathryn E.;

  • 作者单位

    University of Massachusetts Lowell.;

  • 授予单位 University of Massachusetts Lowell.;
  • 学科 Biology Biostatistics.; Health Sciences Occupational Health and Safety.; Health Sciences Public Health.; Health Sciences Epidemiology.
  • 学位 Sc.D.
  • 年度 2006
  • 页码 169 p.
  • 总页数 169
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类 生物数学方法;职业性疾病预防;预防医学、卫生学;
  • 关键词

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