Traditional epidemiological approaches based on biomedical models may
be limited with respect to their response to ''outbreaks of concern''
among work-force or community populations. Three published Canadian ''
outbreaks'' were reviewed in this study. In all three instances, resea
rch was initiated because lay persons were concerned about either nons
pecific symptoms or hazardous exposures, and individuals publicly call
ed for a response. Epidemiologic analyses were inconclusive as to the
reasons for the outbreaks, and they contributed little toward the reso
lution of concerns. There is a need for a fuller recognition of the ro
le of social context and of the action-oriented nature of such researc
h. The elucidation of multifactorial and culturally mediated causation
, as well as the development of remedial actions, require a rethinking
of research methods. We specifically call for (a) an expansion of the
disciplinary base of research teams to include social scientists, and
(b) the adoption of combined qualitative and quantitative research ap
proaches.