The Positive Known Association DesignA Quality Assurance Method for Occupational Health Surveillance Data

Quality control must be an integral component of an occupational health surveillance program. The positive known association design offers the occupational health physician a method to test, on a population basis (ie, high periodic medical surveillance examination participation rates by the employees), the quality of periodic medical surveillance data. Several well-established biological associations were evaluated and observed in this study, including a dramatic relation between white blood cell counts and smoking. We highly recommend that the positive known association design be incorporated in the quality assurance procedures of occupational health surveillance programs.