COMPONENTS AND MODIFIERS OF THE HEALTHY WORKER EFFECT - EVIDENCE FROM 3 OCCUPATIONAL COHORTS AND IMPLICATIONS FOR INDUSTRIAL COMPENSATION
COMPONENTS AND MODIFIERS OF THE HEALTHY WORKER EFFECT - EVIDENCE FROM 3 OCCUPATIONAL COHORTS AND IMPLICATIONS FOR INDUSTRIAL COMPENSATION
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DOI：
10.1093/oxfordjournals.aje.a115089
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发表时间：
1988-12-01
影响因子：
5
通讯作者：
LINDSAY, JP
中科院分区：
文献类型：
--
作者：
HOWE, GR;CHIARELLI, AM;LINDSAY, JP
作者使用三个职业群体的死亡率数据研究了健康工人效应的组成部分和修正因素：加拿大原子能有限公司的员工在 1950 年至 1981 年间进行了跟踪，加拿大劳动力 110% 的样本在 1965 年至 1979 年间进行了跟踪，埃尔多拉多资源有限公司 Beaverlodge 铀矿的工人在 1950 年至 1980 年间进行了跟踪。健康工人效应的两个重要组成部分是在这些群体中确定的，即健康个体的初始选择和持续就业。与一般人群相比，较少证据表明就业个体中存在差异风险因素。然而，健康工人的影响会受到就业时间、性别、年龄、具体死因和具体职业的影响。由于这种变化，用单一参数来解释健康工人的影响是不合适的，在任何适当的分析中都必须考虑到上述所有因素。当职业队列唯一可用的比较组是一般人群时，健康工人效应不太可能对评估个别案例中任何观察到的关联或归因原因的因果关系的过程产生重大影响。对于癌症来说尤其如此，对于肺癌来说更是如此，这种疾病通常与工业赔偿案件相关。
The authors examined the components and modifiers of the healthy worker effect using mortality data form three occupational cohorts: the employees of Atomic Energy of Canada Limited followed between 1950 and 1981, a 110% sample of the Canadian labor force followed between 1965 and 1979, and workers at the Eldorado Resources Limited Beaverlodge uranium mine followed between 1950 and 1980. Two important components of the healthy worker effect have been identified in these cohorts, namely, initial selection of and continuing employment of healthy individuals. There is less evidence for a contribution from the existence of differential risk factors among employed individuals as compared with the general population. The healthy worker effect is, however, substantially modified by time since employment, sex, age, specific cause of death, and specific occupation. Because of this variation, it is inappropriate to account for the healthy worker effect by a single parameter, and all of the above factors must be taken into account in any appropriate analysis. When the only available comparison group for an occupational cohort is the general population, the healthy worker effect is unlikely to have substantial influence on the process of assessing causality for any observed association or atrributing cause in an individual case. This would be particularly true for cancer, and even more so for lung cancer, a disease often associated with industrial compensation cases.