Controlling the healthy worker survivor effect : an example of arsenic exposure and respiratory cancer.
This investigation sought to examine whether methods proposed to control the healthy worker survivor effect would influence the shape or magnitude of the dose-response curve for respiratory cancer induced by arsenic.
Methods-Results from an unadjusted analysis are compared with results obtained by applying four different methods for control of the healthy worker survivor effect to data on arsenic exposure and respiratory cancer.
The four methods are
Exposure lag, adjustment for work status, cohort restriction, and the G null test.
Cohort restriction gave erratic results depending upon the minimum years of follow up used.
Exposure lag substantially increased the rate ratios and a non-linear shape (decreasing slope) compared with an unlagged analysis.
Adjusting for work status (currently employed v retired or otherwise not employed) yielded slightly higher rate ratios than an unadjusted analysis, with an overall shape similar to the baseline analysis.
Results from the G null test procedure of Robins (1986), although not directly comparable with the baseline analysis, did show an adverse effect of exposure that seemed to reach a maximum when exposure was lagged between 10 and 20 years.
Conclusions-All results confirm an adverse effect of arsenic exposure on respiratory cancer.
In these data, it seems that the healthy worker survivor effect was not strong enough to mask the strong effect of arsenic exposure on respiratory cancer. (...)
Mots-clés Pascal : Arsenic, Métal, Exposition professionnelle, Toxicité, Homme, Tumeur maligne, Bronchopulmonaire, Méthode étude, Interférence, Médecine travail, Relation dose réponse, Adaptation, Condition travail, Poste travail, Appareil respiratoire pathologie, Poumon pathologie, Bronche pathologie, Effet du travailleur en bonne santé, Biais
Mots-clés Pascal anglais : Arsenic, Metal, Occupational exposure, Toxicity, Human, Malignant tumor, Bronchopulmonary, Investigation method, Interference, Occupational medicine, Dose activity relation, Adaptation, Working condition, Workplace layout, Respiratory disease, Lung disease, Bronchus disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0333066
Code Inist : 002B03L05. Création : 10/04/1997.