Effect of follow-up time on risk estimates: A longitudinal examination of the relative risks of leukemia and multiple myeloma in a rubber hydrochloride cohort
Effect of follow-up time on risk estimates: A longitudinal examination of the relative risks of leukemia and multiple myeloma in a rubber hydrochloride cohort
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DOI：
10.1002/ajim.10139
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发表时间：
2002-12-01
影响因子：
3.5
通讯作者：
Lai, D
中科院分区：
文献类型：
--
作者：
Silver, SR;Rinsky, RA;Lai, D
背景职业队列随访时间的选择会影响风险估计。我们在1,845名盐酸橡胶工人队列中检验了随访时间对白血病和多发性骨髓瘤相对风险估计的影响。材料和方法我们为每年的随访生成标准化死亡率(SMR)，从1940年开始每项研究，并从1950年到1996年递增研究结束日期。结果1961年白血病的SMR上升到13.55，到1996年几乎单调下降到2.47。COX模型表明，累积暴露与暴露开始的时间之间存在交互作用。多发性骨髓瘤的风险达到峰值的时间更长。结论由于风险概括性估计随着随访时间的变化而变化，使用这些估计设置的暴露限值可能不能充分保护工人。考虑适当的后续行动时间和使用更复杂的时间模型对风险评估过程至关重要。2002年出版，Wiley-Liss，Inc.(Dagger)
Background Choice of follow-up time for an occupational cohort can influence risk estimates. We examined the effects of follow-up time on relative risk estimates for leukemia and multiple myeloma in a cohort of 1,845 rubber hydrochloride workers.Materials and Methods We generated standardized mortality ratios (SMRs) for yearly follow-ups, beginning each study in 1940 and increasing study end dates from 1950 through 1996. We used Cox proportional hazards modeling to explore the effects of follow-up time on the exposure-response relationship.Results The SMR for leukemia rose to 13.55 in 1961 and fell nearly monotonically to 2.47 by 1996. Cox modeling suggested interaction between cumulative exposure and time since exposure. A longer time to peak risk was seen for multiple myeloma.Conclusions Because summary risk estimates change with follow-up time, exposure limits set using these estimates may not adequately protect workers. Consideration of appropriate follow-up time and use of more complex temporal models are critical to the risk assessment process. Published 2002 Wiley-Liss, Inc.(dagger)