Active surveillance of birth defects among US Department of Defense beneficiaries: A feasibility study

Since the Vietnam War, concern regarding the association of military exposu res and birth defects has grown. The possibility of such associations remai ns a source of unease. To determine if such an association exists, birth de fects surveillance among military families must be conducted. This project compared health record abstraction (active surveillance) with screening of Department of Defense electronic medical data (passive surveillance) to det ect birth defects among San Diego County military families during the perio d January 1, 1997, through June 30, 1998. A total of 171 of 5,351 infants ( 3.2%) were identified as having a major defect, consistent with national ci vilian rates. There was approximately 80% concurrence between passive and a ctive surveillance birth defect data, suggesting that a hybrid system of el ectronic data, supplemented with active surveillance in a specific region, represents a feasible and cost-effective surveillance program for the geogr aphically dispersed military population.