Modelling Pathways for Outbreaks in Field Occupational Epidemiology  

作　　者：Jerónimo Maqueda Agustín Silva Rosa-Ana Cortés María-Fe Gamo Jerónimo Maqueda;Agustín Silva;Rosa-Ana Cortés;María-Fe Gamo(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)

机构地区：[1]Health Promotion and Occupational Epidemiology Department, National Institute of Safety and Health at Work, Madrid, Spain [2]Faculty of Medicine and Health Sciences, Alcalá de Henares University, Madrid, Spain [3]National School of Occupational Medicine, Institute of Health Carlos III, Madrid, Spain

出　　处：《Open Journal of Preventive Medicine》2021年第4期91-112,共22页预防医学期刊（英文）

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.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.

关 键 词：Occupational Outbreak Occupational Diseases Working Exposure Field Epidemiology 

分 类 号：R13[医药卫生—劳动卫生]