Task 3.2: Evaluate Cohort Study Results and Make Recommendations


You and your colleagues have been asked to evaluate the cohort study results so as to determine the relative risk of the workers at the plant. You have also been asked to communicate any relevant recommendations for the plant’s future safety from this type of outbreak. The steps below will walk you through this process.

1. Review the email from Dr. Lyons to confirm your understanding of the task.
   
   
2. Download and review the document attached to Dr. Lyons’ email (Cohort Study Results) both to see what is there and to get a feel for what resources you have available to you in this task.
   • Each team member should download a copy and keep his/her own notes.Each of you may notice different things, which will be helpful to share with each other and discuss.

Analyze Cohort Study Results

1. Review resources available on relative risk.
   
   
2. Using the template, calculate the relative risk for working in each area of the plant compared to not working in that area of the plant as well as compared to living in Arizona, an endemic area.
   • Use what you know from the Statistics Track and the information you have available in the Resources (above) to make the calculations and interpret the results.
     
     
3. Include both the numeric results and a statement about what the numeric results mean.

Make Recommendations


Now that you have determined the risk to the workers in different areas of the plant you can make some educated recommendations to the plant representative regarding what needs to be done immediately to minimize risk to the workers and for ways to safeguard the plant from future outbreaks.

1. Review the literature that you have used in past tasks to remind yourself of the forms of transmission.
   
   
2. Based on this literature review, brainstorm some ways that the plant might protect itself now and in the future. (This might be a good opportunity to work alone, and then bring your individual ideas to your team to engender more fruitful brainstorming.)
   • Make recommendations for both immediate actions (e.g., decontaminate the entire plant) and long-term prevention with a short justification for each point. Mr. Mayer may need some basic information to provide to management to justify expenses.
     
     
   • Keep cost and effort in mind, prioritizing any less expensive methods of protection. In your recommendation make it clear which steps are necessary or highly recommended and which are suggestions that Toyco might consider depending on how much time and resources they’ve allocated to deal with this outbreak and prevent future outbreaks.
     
     
   • Be creative! Even more off-beat ideas can spark a conversation and lead to more practical ideas.
     
     
3. Check the Resources link (above) for additional guidance or links in this area.
   
   
4. When you have recorded your thoughts, prepare them for submission to the mentor.

Review and submit your work.

1. Review your work.
   • Did you conduct a detailed analysis of the data that was provided, including a comparison with the background rate in Arizona?
     
     
   • Did you conduct a thorough review of the literature to remind yourself of the transmission properties of cocci?
     
     
   • Did you meet with your team to brainstorm ideas about how the plant can protect itself both immediately and in the future?
     
     
2. Submit your work.
   • Review the checklist located in the Submit Your Work section of this task to ensure completion of the task before submitting your deliverables to your mentor.
     

Task 3.2 Resources

While Wikipedia is a valuable resource, unlike some other websites anyone can contribute to or modify the site (whether they're knowledgeable about the topic or not). As a result, the site is subject to constant change by questionable sources. Be sure to cross-check information on Wikipedia with other reputable sites to ensure accuracy.

Ask the Expert

What steps are taken at the conclusion of an outbreak investigation?

Case-Control and Cohort Study FAQ
Frequently Asked Questions about Case-control and Cohort studies including the steps involved in each study, the advantages and disadvantages to each, how to calculate Odd Ratios and Relative Risk, and how to interpret the results.

Coccidioidomycosis (cocci)

Cocci Overview from CDC
Information from the Centers for Disease Control and Prevention (CDC) on cocci clinical features, transmission, risk groups, challenges, and other important info.

Cocci Overview 1
Includes common symptoms as well as tests and exams to detect the disease.

Cocci Overview 2
Includes x-rays of a cocci patient.

Cocci Overview 3
Includes a map of endemic areas (from Wikipedia).

Cocci Overview 4
Includes incubation periods, clinical signs, and communicability in both humans and animals from The Center for Food Security and Public Health at Iowa State University.

Prevention Strategies

Mold Prevention Strategies
Information from the Centers for Disease Control and Prevention on how humans are exposed to mold (which is classified as fungi) and steps for cleanup and prevention including decontamination and personal protective equipment. While the document addresses mold growth after hurricanes and floods much of the information relates to fungi contamination generally.

Molds and Fungi: Hazard Recognition
A compilation of links on the sources and effects of mold as well as prevention strategies from The U.S. Department of Labor, Occupational Health and Safety Administration.

Cocci Investigation 1
A description of an investigation into a cocci outbreak including the steps that were recommended to help prevent further illness. Note: the recommendations may be concise so look closely including at the editorial note.

Cocci Investigation 2
A description of an investigation into a cocci outbreak including the steps that were recommended to help prevent further illness. Note: the recommendations may be concise so look closely including at the editorial note.

Cocci Investigation 3
A description of an investigation into a case of cocci including the steps that were recommended to help prevent further illness. Note: the recommendations may be concise or not seem explicit so look closely.

Cocci Investigation 4
A description of an investigation into a cocci outbreak including the steps that were recommended to help prevent further illness. Note: the recommendations may be concise so look closely including at the editorial note.