Reducing healthy worker survivor bias by restricting date of hire in a cohort study of Vermont granite workers

Abstract

Despite loss in power and restricted exposure range, decreasing the relative proportion of prevalent to incident hires reduced HWSE bias, resulting in stronger evidence for a dose-response between silica exposure and lung cancer mortality.

A critical review of the relationship between occupational exposure to diesel emissions and lung cancer risk

“…Several strategies have been developed in order to deal with this kind of bias (Arrighi & Hertz-Picciotto 1994;Arrighi & Hertz-Picciotto 1995;Steenland et al 1996;Li & Sung 1999;Baillargeon 2001;Richardson et al 2004;Applebaum et al 2007Applebaum et al , 2011Chevrier et al 2012;Joffe 2012;Naimi et al 2013;Picciotto et al 2013;Buckley et al 2015), but as recently formulated: the HWSE is a still-evolving concept (Picciotto & Hertz-Picciotto 2015). Some of the strategies referenced above do not take into account the primary aim of occupational epidemiology, which is to investigate the relationship between exposure and the first diagnosis (incidence) of a disease.…”

Importance of Occupational Selection in Prevalence of Hypertension: Effects of Healthy and Unhealthy Worker

“…Профессиональный отбор опосредован воздействи-ем профессиональных факторов и является одной из особенностей взаимодействия человека с профессией [11,49,50]. Несмотря на то, что устранить эффект про-фессионального отбора не всегда удается по ряду при-чин, установить сам факт его наличия и определить его особенности в профессиональной когорте необходимо для объяснения нелогичной причинно-следственной связи.…”

With long hours of work, might depression then lurk? A nationwide prospective follow-up study among Danish senior medical consultants

“…Three explanations should help to understand this finding. Firstly, it is a known phenomenon in occupational epidemiology that, against all expectations, the risk of an undesired outcome tends to decline at high levels of exposure in exposure-response curves because of the healthy worker effect (29,30). Senior medical consultants with mental health problems might have reduced their work hours, withdrawn from their position as a consultant, or been excluded by the criteria of no redemption of AD drug prescription at study entry.…”

“…It is important that future studies address the healthy worker effect and reverse causation, for example by means of restriction to incident hires (29).…”