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April 28, 1989

Nagging Doubt, Public Opinion Offer Obstacles to Ending `Cluster' Studies

JAMA. 1989;261(16):2297-2298. doi:10.1001/jama.1989.03420160013002

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BIRTH DEFECTS reported by users of video display terminals at the Toronto Star. Cancers in football players practicing and playing in the Meadowlands Stadium in New Jersey. Leukemias in children living near some drinking wells in Woburn, Mass.

Health departments have invested large sums of time and energy investigating these so-called clusters, epidemiologists countless hours calculating risk ratios, attorneys endless weeks litigating civil suits. Now, say investigators in Atlanta, Ga, at the Centers for Disease Control, it's time the public health community calls a halt to many of those investigations.

In the last 5 years, the Centers for Disease Control has pretty much gotten out of the business of cluster investigation itself, turning over the work to state health departments, says Glyn G. Caldwell, MD, formerly at the Atlanta facility and now deputy director of the Arizona Department of Health Services, Phoenix: "We just weren't getting anywhere. They weren't productive