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Furthermore, a publication by the US National Institute of Occupational Safety and Health (NIOSH) also provides a warning. In their experience of occupational disease cluster investigations from 1978-84, of a 61 reported clusters, only 16 were confirmed (based on a definition of at least 1 young person with confirmed cancer and possible occupational exposure). Of these 16 confirmed clusters, only 5 had a plausible etiologic relationship while 8 were statistically significant.