© 2004 BMJ Publishing Group Ltd
EDITORIAL
Study design
Case-crossover designs in occupational health
Correspondence to:
Correspondence to:
Professor H Checkoway
University of Washington, Department of Environmental and Occupational Health Sciences, Seattle, Washington 98195, USA, USA; checko@u.washington.edu
Commentary on the paper by Schwartz (p. 956)
Keywords: case-crossover design; epidemiologic methods; occupational health; study design
| The first 150 words of the full text of this article appear below. |
The case-crossover design has become an accepted method for investigating acute health consequences of transient exposures, or "triggers". This design, originally presented in 1991 by Maclure,1 can be thought of as a variant of the conventional case-control study with individual (pairwise) matching. The principal difference is that a case-crossover study only includes cases, where each serves as his own referent. This feature has a compelling methodological appeal in that it allows for efficient control of potential confounders that are fixed (for example, genetic traits) or change minimally or slowly over time (for example, socioeconomic status), and are difficult or impractical to measure. Who better to provide control for confounding than the case himself?
To date, the case-crossover design has been applied most often to investigate environmental exposure effects in studies of air pollution, as an alternative to time series analyses. The paper by Schwartz2 in this issue exemplifies
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