Retrospective cohort mortality study of workers in a polymer production plant including a reference population of regional workers
Retrospective cohort mortality study of workers in a polymer production plant including a reference population of regional workers
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DOI：
10.1016/j.annepidem.2007.06.011
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发表时间：
2008-01-01
影响因子：
5.6
通讯作者：
Symons, J. Morel
中科院分区：
文献类型：
--
作者：
Leonard, Robin C.;Kreckmann, Kim H.;Symons, J. Morel
目的：基于先前关于美国一家聚合物制造工厂工人血脂水平升高的报道，本研究的目的是调查该工厂一个职业队列的缺血性心脏病（IHD）死亡率以及广泛的死亡原因。方法：该队列包括1948年至2002年间在该设施工作的6,027名男性和女性；这些年份划定了死亡率随访期。估计标准化死亡率（SMR）是为了将观察到的死亡人数与从3个参考人群的死亡率得出的预期死亡人数进行比较：美国人口、西弗吉尼亚州人口和来自同一公司的8个州的地区雇员人口。结果：大多数基于美国和各州人口的SMR估计低于100。与员工群体的比较也导致许多SMR估计值处于或接近无影响水平。相对于地区工人人群，IHD死亡率无显著升高（SMR = 109, 95%可信区间[Cl]: 96, 124）。与地区工人人群相比，与糖尿病相关的死亡率显著增加（SMR = 197, 95% Cl: 123, 298）。与两个普通人群相比，未发现IHD和糖尿病死亡率的SMR相应增加。结论：本文报告的结果显示，几乎没有证据表明工厂工人的死因特异性死亡风险增加。本研究表明，为了减少与健康工人效应相关的偏见，将职业队列与相似的工人参考人群进行比较的效用。
PURPOSE: Based on previous reports of increased serum lipid levels in workers at a U.S. polymer manufacturing facility, the study objective was to investigate ischemic heart disease (IHD) mortality as well as a broad range of mortality causes for an occupational cohort at the facility.METHODS: The cohort comprised 6,027 men and women who had worked at the facility between 1948 and 2002; these years delimit the mortality follow-up period. Standardized mortality ratios (SMR) were estimated to compare observed numbers of deaths to expected numbers derived from mortality rates for 3 reference populations: the U.S. population, the West Virginia state population, and an 8-state regional employee population from the same company.RESULTS: Most SMR estimates based on U.S. and state populations were below 100. Comparison to the employee population also resulted in many SMR estimates at or near a no-effect level. Relative to the regional worker population, a nonsignificant elevation for IHD mortality was observed (SMR = 109, 95% confidence interval [Cl]: 96, 124). Mortality associated with diabetes was significantly increased compared to the regional worker population (SMR = 197, 95% Cl: 123, 298). A corresponding increase in the SMR for IHD and diabetes mortality was not detected for comparisons with the two general populations.CONCLUSIONS: The results reported herein show little evidence of increased cause-specific mortality risks for workers at the plant. This study demonstrates the utility of comparing occupational cohorts with a similar worker reference population in order to reduce bias associated with the healthy worker effect.