Social disparities in heart disease risk and survivor bias among autoworkers: an examination based on survival models and g-estimation.
Social disparities in heart disease risk and survivor bias among autoworkers: an examination based on survival models and g-estimation.
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DOI：
10.1136/oemed-2014-102168
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发表时间：
2015-02
影响因子：
4.9
通讯作者：
Eisen EA
中科院分区：
文献类型：
--
作者：
Costello S;Picciotto S;Rehkopf DH;Eisen EA
研究与金属加工液暴露相关的缺血性心脏病（IHD）死亡率的性别和种族差异以及健康工人的存活效应。从1941年到1995年，对美国一组白色和黑人男性和女性汽车工人进行了跟踪调查，定量暴露于水基金属加工液中的可吸入颗粒物。单独分析使用比例风险模型和g-估计。在累积合成液体暴露的最高类别中，黑人男性中IHD的HR为3.29（95% CI 1.49至7.31）。暴露于可溶性液体的白色女性中IHD的HR达到2.44（95% CI 0.96至6.22）。然而，在我们校正健康工人幸存者效应之前，没有观察到白色男性的风险增加。g-估计的结果表明，如果暴露于可溶性或合成液体的白色男性病例未暴露于该液体类型，则平均分别可以挽救1.59年和1.20年的生命。 我们利用两种不同分析方法的优势来检查金属加工液的IHD风险。所有工人可能有相同的病因风险，但是，黑人和女性工人可能会遇到更多的IHD从水基金属加工液暴露，因为陡峭的反应或较弱的健康工人幸存者的影响。
To examine gender and racial disparities in ischaemic heart disease (IHD) mortality related to metalworking fluid exposures and in the healthy worker survivor effect. A cohort of white and black men and women autoworkers in the USA was followed from 1941 to 1995 with quantitative exposure to respirable particulate matter from water-based metalworking fluids. Separate analyses used proportional hazards models and g-estimation. The HR for IHD among black men was 3.29 (95% CI 1.49 to 7.31) in the highest category of cumulative synthetic fluid exposure. The HR for IHD among white women exposed to soluble fluid reached 2.44 (95% CI 0.96 to 6.22). However, no increased risk was observed among white men until we corrected for the healthy worker survivor effect. Results from g-estimation indicate that if white male cases exposed to soluble or synthetic fluid had been unexposed to that fluid type, then 1.59 and 1.20 years of life would have been saved on average, respectively. We leveraged the strengths of two different analytic approaches to examine the IHD risks of metalworking fluids. All workers may have the same aetiological risk; however, black and female workers may experience more IHD from water-based metalworking fluid exposure because of a steeper exposure–response or weaker healthy worker survivor effect.
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影响因子：
3.5
作者：
Friesen, Melissa C.;Costello, Sadie;Eisen, Ellen A.
通讯作者：
Eisen, Ellen A.
影响因子：
3.5
作者：
Costello, Sadie;Garcia, Erika;Eisen, Ellen A.
通讯作者：
Eisen, Ellen A.
影响因子：
5.4
作者：
Burstyn, I;Kromhout, H;Boffetta, P
通讯作者：
Boffetta, P
影响因子：
6.3
作者：
Mehta, Amar J.;Malloy, Elizabeth J.;Eisen, Ellen A.
通讯作者：
Eisen, Ellen A.
影响因子：
2.1
作者：
Ghio, AJ;Hall, A;Devlin, RB
通讯作者：
Devlin, RB