Disease clusters: a central and ongoing role in occupational health

The workplace provides a special source of information that aids in the identification and evaluation of disease clusters. These are: natural denominator boundaries (the population at risk is defined), shared exposures, the ability to form intermediate hypotheses, and the possibility of locating comparable study populations. A total of 87 original disease clusters were identified in a literature review from the year 1775 to 1990, which established occupational-related disease toxin connections. Cluster disease data appeared early in the history of occupational health; arsenic and lead intoxication data were among the earliest. Today, the employee, along with the physician, is a responsible source of information and is frequently the initiator of cluster investigations. The literature and methodology of cluster data collection are reviewed. An extensive appended bibliography is also included. (Consumer Summary produced by Reliance Medical Information, Inc.)