A structural approach to address the healthy-worker survivor effect in occupational cohorts: an application in the trucking industry cohort.
A structural approach to address the healthy-worker survivor effect in occupational cohorts: an application in the trucking industry cohort.
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DOI：
10.1136/oemed-2013-102017
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发表时间：
2014-06
影响因子：
4.9
通讯作者：
Laden F
中科院分区：
文献类型：
--
作者：
Neophytou AM;Picciotto S;Hart JE;Garshick E;Eisen EA;Laden F
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. 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 males employed in the unionized 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 hazard ratios from both models to compare them. The Risk Ratio (RR) obtained from the cumulative failure time model, comparing the observed risk under no intervention to the risk had nobody ever been exposed as a long-haul driver, was 1.09 (95% CI: 1.02 – 1.16). The RR comparing the risk had everyone been exposed as long-haul driver for 8 years to the risk had nobody ever been exposed was 1.20 (95% CI: 1.04 – 1.46). After hazard ratio approximations, accelerated failure time model results were similar. The cumulative failure time model can effectively control time-varying confounding by Healthy Worker Survivor Effect, and provides an easily interpretable effect estimate. Risk ratios estimated from the cumulative failure time model indicate an elevated ischaemic heart disease mortality risk for long-haul drivers in the US trucking industry.
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影响因子：
37.8
作者：
Pope, CA;Burnett, RT;Godleski, JJ
通讯作者：
Godleski, JJ
影响因子：
5
作者：
GILBERT, ES
通讯作者：
GILBERT, ES
影响因子：
5
作者：
Hertz-Picciotto, I;Arrighi, HM;Hu, SW
通讯作者：
Hu, SW
影响因子：
4.9
作者：
Hannerz, H;Tüchsen, F
通讯作者：
Tüchsen, F
卡车行业工人的肺癌和车辆排气。
影响因子：
10.4
作者：
Garshick, Eric;Laden, Francine;Hart, Jaime E.;Rosner, Bernard;Davis, Mary E.;Eisen, Ellen A.;Smith, Thomas J.
通讯作者：
Smith, Thomas J.