Assessing the component associations of the healthy worker survivor bias: occupational asbestos exposure and lung cancer mortality.

ABSTRACT:

Background

The healthy worker survivor bias is well-recognized in occupational epidemiology. Three component associations are necessary for this bias to occur: i) prior exposure and employment status; ii) employment status and subsequent exposure; and iii) employment status and mortality. Together, these associations result in time-varying confounding affected by prior exposure. We illustrate how these associations can be assessed using standard regression methods.

Methods

We use data from 2975 asbestos textile factory workers hired between January 1940 and December 1965 and followed for lung cancer mortality through December 2001.

Results

At entry, median age was 24 years, with 42% female and 19% non-Caucasian. Over follow-up, 21% and 17% of person-years were classif

SUBMITTER: Naimi AI 

PROVIDER: S-EPMC3773512 | biostudies-literature | 2013 Jun

REPOSITORIES: biostudies-literature