A structural approach to address the healthy-worker survivor effect in occupational cohorts: an application in the trucking industry cohort.

ABSTRACT:

Background

Occupational cohort studies are often challenged by the Healthy Worker Survivor Effect, which may bias standard methods of analysis. G-estimation of structural failure time models is an approach for reducing this type of bias. Accelerated failure time models have recently been applied in an occupational cohort but cumulative failure time models have not.

Methods

We used g-estimation of a cumulative failure time model to assess the effect of working as a long-haul driver on ischaemic heart disease mortality in a cohort of 30 448 men employed in the unionised US trucking industry in 1985. Exposure was defined by job title and based on work records. We also applied g-estimation of an accelerated failure time model as a sensitivity analysis and approximated HRs from b

SUBMITTER: Neophytou AM 

PROVIDER: S-EPMC4051133 | biostudies-literature | 2014 Jun

REPOSITORIES: biostudies-literature