Modelling Pathways for Outbreaks in Field Occupational Epidemiology
Modelling Pathways for Outbreaks in Field Occupational Epidemiology作者机构：Health Promotion and Occupational Epidemiology Department National Institute of Safety and Health at Work Madrid Spain Faculty of Medicine and Health Sciences Alcalá de Henares University Madrid Spain National School of Occupational Medicine Institute of Health Carlos III Madrid Spain
出 版 物：《Open Journal of Preventive Medicine》 (预防医学期刊（英文）)
年 卷 期：2021年第11卷第4期
页 面：91-112页
学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100402[医学-劳动卫生与环境卫生学] 10[医学]
主 题：Occupational Outbreak Occupational Diseases Working Exposure Field Epidemiology
摘 要：Background: The investigation of an occupational outbreak, once the index case has been identified, triggers a stress situation to epidemiologists. Modelling occupational outbreaks will be useful to guide the field investigation. Objective: To identify standard pathways for occupational epidemic outbreaks. Methods: In-depth critical appraisal of 57 occupational outbreaks. Standard pathways of occupational outbreaks were identified by analysing the similarity between out-breaks. The model’s accuracy and homogeneity were established through Fisher’s exact test and the Kappa Index. Results: The analysis allowed synthesizing the occupational outbreaks variability in 4 pathways. 92.98% of the analysed outbreaks could be allocated to one of those 4 types. The theoretical patterns showed a good adjustment with the analysed out-breaks: Type I (Kappa = 0.94 - 0.60), Type II (Kappa = 1.00), Type III (Kappa = 1.00 - 0.68) and Type IV (Kappa = 0.94 - 0.87). The probability of a given outbreak fitting with its three components in any of the theoretical pathways was 0.83. Conclusions: The incorporation of those pathways to the field occupational epidemiology will allow: 1) to provide early guidance to epidemiological, clinical and environmental studies focused on specific hypothesis of causality;2) to anticipate preventive measures;3) to contribute to an earlier and more efficient outbreak resolution.
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