STATISTICAL METHOD TO CONTROL THE HEALTHY WORKER EFFECT

控制健康工人效应的统计方法

• 批准号: 3250663
• 负责人: JAMES M ROBINS
• 金额: $ 14.12万
• 依托单位: HARVARD MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 1984
• 资助国家: 美国
• 起止时间: 1984-07-01 至 1991-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3250663
• 关键词: arsenic; arteriosclerosis; asbestos; cobalt; copper; data collection methodology /evaluation; disabling disease; disease /disorder proneness /risk; epidemiology; formaldehyde; human mortality; industrial medicine; industry; lung disorder; lung neoplasms; metal poisoning; occupational disease /disorder; pneumoconiosis; radiobiology; retirement; rubber; solvents; statistics /biometry; tobacco abuse

Occupational mortality studies have traditionally been plagued by bias resulting from improper comparisons of working populations with the general population. For example, the mortality rate for ASCVD in working populations is usually 60%-90% of the general population rate. Thus, the general population cannot serve as an appropriate control group for detecting relative risks in the range 1.3-2.5. Since present day exposures are often lower than past exposures, detection of relative risks less than 2.5 has become Grant=R01ES03405 Occupational mortality studies have traditionally been plagued by bias resulting from improper comparisons of working populations with the general population. For example, the mortality rate for ASCVD in working populations is usually 60%-90% of the general population rate. Thus, the general population cannot serve as an appropriate control group for detecting relative risks in the range 1.3-2.5. Since present day exposures are often lower than past exposures, detection of relative risks less than 2.5 has become of increased concern. Therefore, epidemiologists have increasingly relied upon intracohort (i.e., internal) comparisons. Unfortunately, when workers at increased risk terminate employment early, date of termination of employment is both a risk factor for death and a determinate employment early, date of termination of employment is both a risk factor for death and a determinant of subsequent exposure. Therefore, standard intracohort methods that estimate mortality as a function of cumulative exposure can underestimate the true effect of exposure, whether or not one adjusts for time of termination of employment [1-7]. Thus, even in intracohort analyses, relative risks of 1.3-2.5 can be masked by the early termination of workers at elevated risk. A principal aim of this grant is further development and implementation of new methods to control this bias based on the "G-null test algorithm", the "Monte-Carlo G-computation algorithm" and the "G- estimation" algorithm. The "G-null test algorithm" is a distribution- free test of the null hypothesis of no casual effects of exposure. The other algorithms are new semiparametric procedures for estimating the magnitude of any exposure effect. The ASCVD, nonmalignant respiratory disease, and/or lung cancer mortality in cohorts of arsenic-exposed copper smelter workers, solvent-exposed rubber workers, formaldehyde- exposed chemical workers, cobalt-exposed hard metal workers. Canadian asbestos miners, U.S. uranium miners, cutting oil-exposed auto workers, and nitroglycerin-exposed munitions workers will be reanalized with the new methods and with standard methods, and the results compared. These analytic methods may be necessary to control bias in nonoccupational studies in which a risk factor for the outcome under study determines subsequent exposure to the study agent. These methods will be used to examine the effect of cigarette smoking on pulmonary function in the Harvard Six Cities study. These methods are necessary to control bias because current level of pulmonary function is a determinant of both subsequent lung function and smoking behavior (since subjects with poor pulmonary function are more likely to quit smoking).

职业死亡率研究历来受到偏见的困扰 这是由于工作人口与 一般人口。 例如， 劳动人口的就业率通常为总人口的60%-90%。 因此，一般人群不能作为适当的对照 检测相对风险在1.3-2.5范围内的组。 从现在起 日暴露量通常低于过去的暴露量， 低于2.5的风险已变为Grant= R 01 ES 03405 职业死亡率研究历来受到偏见的困扰 这是由于工作人口与 一般人口。 例如， 劳动人口的就业率通常为总人口的60%-90%。 因此，一般人群不能作为适当的对照 检测相对风险在1.3-2.5范围内的组。 从现在起 日暴露量通常低于过去的暴露量， 低于2.5的风险已经变得越来越令人担忧。 因此，我们认为， 流行病学家越来越多地依赖于股内（即， 内部）比较。 不幸的是，当工人面临更大的风险时， 提前终止雇佣关系，终止雇佣关系的日期 死亡风险因素和提前确定就业， 终止雇用既是死亡的一个风险因素， 后续曝光的决定因素。 因此，标准的内部电缆 估计死亡率作为累积暴露函数的方法可以 低估暴露的真实效果，无论是否调整 劳动合同终止时间[1-7]。 因此，即使在内部 分析，1.3-2.5的相对风险可以被早期的 解雇高风险工人。 这笔赠款的主要目的是进一步发展和实施 新的方法来控制这种偏见的基础上“G零测试 算法”、“蒙特-卡罗G-计算算法”和“G- 估计”算法。 “G-null测试算法”是一个分布- 暴露无因果效应的零假设的自由检验。 的 其他算法是新的半参数估计程序， 任何暴露效应的大小。 ASCVD，非恶性呼吸道疾病， 疾病和/或肺癌死亡率 炼铜工人，溶剂暴露橡胶工人，甲醛- 接触化学品的工人，接触钴的硬金属工人。 加拿大 石棉矿工人，美国铀矿工人，石油工人， 和硝化甘油暴露的军火工人将被重新分析， 并与标准方法进行比较。 这些分析方法可能是必要的，以控制偏差， 非职业性研究，其中一个危险因素的结果， 研究确定了研究药物的后续暴露。 这些方法 将被用来检查吸烟对肺功能的影响。 在哈佛六城研究中的作用。 这些方法是必要的 控制偏差，因为目前的肺功能水平是 决定随后的肺功能和吸烟行为（因为 肺功能差的受试者更可能戒烟）。