Healthy worker effect in a longitudinal study of one-second forced expiratory volume (FEV1) and chronic exposure to granite dust.
Low level effects of granite dust on one-second forced expiratory volume (FEV1) are estimated in 618 Vermont granite workers followed for 5 years with annual pulmonary function tests.
Reduced pulmonary function has already been reported for the subset of subjects lost to follow-up (dropouts) suggesting possible bias in analyses based only on survivors.
Healthy worker selection bias is directly assessed by comparing the dose-response associations between survivors who remained in the study for the full 5-year observation period and the dropouts.
The 353 survivors had an FEV1 of 96% of predicted at baseline and were losing FEV1 at an average rate of 44 ml/yr.
No association was found in this group between the rate of FEV1 decline and lifetime dust exposure.
However, the 265 workers with incomplete follow-up, dropouts'had a lower FEV1 at baseline (94%) and were losing FEV1 at an average rate of 69 ml/yr.
The dose-response parameter in this group was estimated to be 4 ml/yr loss per mg/m3-year and was statistically significant.
These results provide an illustration of bias due to the healthy worker effect and an example of the failure to detect a true work-related health effect in a study based only on a'survivor'population.
Mots-clés Pascal : Granite, Poussière, Toxicité, Long terme, Fonction respiratoire, Appareil respiratoire pathologie, Homme, Exposition professionnelle, Vermont, Etats Unis, Amérique du Nord, Amérique, Etude longitudinale, Epidémiologie, Adaptation, Poste travail, Condition travail, Biais méthodologique, Médecine travail, Effet du travailleur en bonne santé
Mots-clés Pascal anglais : Granite, Dust, Toxicity, Long term, Lung function, Respiratory disease, Human, Occupational exposure, Vermont, United States, North America, America, Follow up study, Epidemiology, Adaptation, Workplace layout, Working condition, Methodological bias, Occupational medicine
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0072360
Code Inist : 002B03L03. Création : 199608.