INDIRECT METHODS OF ASSESSING THE EFFECTS OF TOBACCO USE IN OCCUPATIONAL STUDIES
INDIRECT METHODS OF ASSESSING THE EFFECTS OF TOBACCO USE IN OCCUPATIONAL STUDIES
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DOI：
10.1002/ajim.4700130107
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发表时间：
1988-01-01
影响因子：
3.5
通讯作者：
STEENLAND, K
中科院分区：
文献类型：
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作者：
AXELSON, O;STEENLAND, K
由于各种原因，在职业危险因素的回顾性流行病学研究中，有关吸烟的数据经常缺失，或仅部分可用。在这种情况下，可以使用间接方法来评估吸烟的潜在混杂效应的大小和方向。这种评价可以定量或定性进行。在这里，我们描述这两种方法。一个具体的问题与病例参照研究有关，其中参照选择的抽样变化可能限制控制吸烟混杂的可能性，即使吸烟数据可用。我们目前的数据表明，估计的风险，不控制吸烟的职业暴露可能是准确的估计后，控制吸烟，当参考的数量相对较小。讨论了相互作用问题。在缺乏吸烟数据的情况下，研究者无法表明吸烟和职业如何共同影响疾病风险（例如，相加或相乘）。通常假设乘法模型。然而，如果暴露和吸烟独立作用（相加），率比减小。在这种情况下，在存在吸烟的负面混杂的情况下，率比实际上甚至可能小于1-当暴露和疾病密切相关时也是如此。
For various reasons, data on smoking are frequently missing, or only partially available, in retrospective epidemiologic studies of occupational risk factors. In such situations, indirect methods may be used to evaluate the magnitude and direction of the potentially confounding effects of smoking. Such an evaluation can be made quantitatively or qualitatively. Here we describe both approaches. A specific problem relates to case‐referent studies, where sampling variation in referent selection may limit the possibility of controlling for confounding by smoking, even when smoking data are available. We present data showing that estimates of risk from occupational exposures which are not controlled for smoking may be as accurate as estimates derived after controlling for smoking, when the number of referents is relatively small. The problem of interaction is also discussed. In the absence of smoking data, the investigator has no indication of how smoking and occupation jointly affect disease risk (eg, additively or multiplicatively). The multiplicative model is usually assumed. However, if exposure and smoking act independently (additively), rate ratios are diminished. In such situations, in the presence of negative confounding by smoking, rate ratios may actually even be less than one—also when exposure and disease are strongly related.