Overview of occupational epidemiology: issues/dilemmas.

Occupational epidemiology is an essential discipline in the practice of occupational medicine. Many issues/dilemmas that plague the success of the practice in this field such as absence of complete and integrated company records, loss-to-follow-up, use of records for a purpose other than that for which they were intended, variations in exposure with calendar time and arising from within plant movement, the broad ranges of response with their resultant advantages and disadvantages, the magnitude of the probability of response and its relationship to the size of the study population, have been discussed. The current approach to solving these many issues/dilemmas is by the development of health information systems that prospectively gather employee medical surveillance data, tracking of employee work history and exposure monitoring data and have the built-in ability to relate these data for health studies. Care needs to be taken to assure that comparable data are gathered at different geographic sites within a company and possibly across an industry so that small but real probabilities of response can be identified.