Epidemiology in occupational medicine

Each of the research strategies employed in epidemiology has distinctive advantages and disadvantages related to costs, time required, sources of bias, kinds of risk assessments produced, and limitations on causal inference. Therefore each must be evaluated in the light of the needs and opportunities that characterize the disease problem addressed and the environment within which it occurs. Epidemiology has the major disadvantage that it requires illness and death as a base for research. However, many health and disease problems cannot be anticipated before illnesses have occurred, and epidemiological studies then represent the most efficient means of identifying hazardous substances and situations. Epidemiological analysis should be a routine responsibility of every major corporate medical department, including, at a minimum, a system of surveillance for morbidity and mortality that will draw attention to significant problems as they arise, so that more intensive research may be initiated and preventive measures taken as early as possible. Epidemiology should, therefore, be integrated with industrial hygiene, safety engineering, and toxicology as the bases of occupational health.