Disease mapping and risk assessment for public health decision-making : report on a WHO workshop, Rome, Italy 2-4 October 1997

Abstract

Spatially referenced epidemiological data and analytical methods recently developed for geographical studies are becoming increasingly common. Although in-depth investigations can be carried out, problems remain with interpretation and with evaluation of the implications. The Workshop aimed at clarifying the relevance of geographical studies and their role in informing public health decision-making. Several issues of interest were discussed, including the ability of geographical studies to assess the causality of observed associations; to estimate their magnitude, uncertainty and dose6response relationship; to evaluate whether effects apply to individuals or populations; to communicate the findings from geographical studies in epidemiology between specialists, decision-makers, the media and the public; and to assess the need and effectiveness of public health action or further investigation following sporadic disease outbreaks. The Workshop also covered analytical methods for disease mapping, cluster investigation, ecological analyses, studies of risk near point sources of environmental pollution, and surveillance. The available methodology was reviewed and some original methods were presented and discussed in special sessions, where examples of applications were given