A standardized approach to non-infectious disease cluster investigations in the U.S. Department of the Air Force.

Abstract

The U.S. Air Force School of Aerospace Medicine (USAFSAM) developed a systematic, multi-phased process for receiving, evaluating, and responding to inquiries about potential non-infectious disease clusters, particularly cancer, within the Department of the Air Force. Created in response to a rise in cluster concerns, this process provides a validated, transparent, and objective evaluation framework with 4 distinct phases: 1) establishing lines of communication, 2) feasibility assessment, 3) epidemiological evaluation, and 4) epidemiological investigation. This framework allows a merit-based evaluation for determining if a full epidemiological study is warranted. The framework emphasizes robust risk communication and partnerships to manage expectations and address all concerns with scientific rigor. In 2023 and 2024 this process evinced savings of $6.25 million and 102 months of person-time for the USAFSAM team, ensuring responsible use of public health resources. The process enables a timely, evidence-based response to potential health threats. It ensures public health resources are used responsibly, for scientifically valid investigations, and builds trust within the Air Force community to directly support the health, fitness, and readiness of U.S. Air Force service members.