Medical Insurance Claims and Surveillance for Occupational Disease: Analysis of Respiratory, Cardiac, and Cancer Outcomes in Auto Industry Tool Grinding Operations

Details

• Personal Author:
  Park RM
• Description:
  To evaluate medical insurance claims for chronic disease investigation, claims from eight automotive machining plants (1984 to 1993) were linked with work histories (1967 to 1993), and associations with respiratory, cardiac, and cancer conditions were investigated, in a case-control design analyzed with logistic regression. The primary focus was tool grinding, but other important processes examined were metal-working, welding, forging, heat treat, engine testing, and diverse-skilled trades work. Considerable variability in claim-derived incidence rates across plants was not explained by age or known exposure differences. Asthma incidence increased in tool grinding (at mean cumulative duration: odds ratio [OR], 3.0; 95% confidence interval [CI], 0.90 to 10.0), as did non-ischemic heart disease (cardiomyopathy, cor pulmonale, rheumatic heart disease, or hypertension; OR, 3.1; 95% CI, 1.26 to 7.6). These trends appeared in models with deficits (OR < 1.0) for those ever exposed to tool grinding because of exposure-response miss-specification, demographic confounding, or removal of high-risk workers from the exposed group. The apparent cancer rates identified from claims greatly exceeded the expected rates from a cancer registry, suggesting that diagnostic, "rule-out," and surveillance functions were contributing. This study supports the epidemiologic use of medical insurance records in surveillance and, possibly, etiologic investigation and identifies issues requiring special attention or resolution. [Description provided by NIOSH]
• Subjects:
  Automobiles Cardiovascular Diseases Cardiovascular System Chronic Disease Manufacturing And Industrial Facilities Metals Metal Workers Occupational Health Respiratory System Respiratory Tract Diseases Safety Welding

  More +
• Keywords:
  Automotive-industry Cardiopulmonary-system-disorders Cardiovascular-system-disorders Chronic-degenerative-diseases Etiology Machine-shop-workers Metalworking Pulmonary-system-disorders Respiratory-system-disorders
• ISSN:
  1076-2752
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Michigan ; Ohio ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  EID - Education and Information Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  335-346
• Volume:
  43
• Issue:
  4
• NIOSHTIC Number:
  nn:20021834
• Citation:
  J Occup Environ Med 2001 Apr; 43(4):335-346
• Contact Point Address:
  NIOSH, Risk Evaluat Branch, Educ & Informat Div, 4676 Columbia Pkwy, Cincinnati, OH 45226 USA
• Federal Fiscal Year:
  2001
• Peer Reviewed:
  True
• Source Full Name:
  Journal of Occupational and Environmental Medicine
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:c4b9dc29f1c48324c262bb484702db956601487430232f8a7b482e0846da8928c1f16ba2ccddb7ec3708a19756d504dc073c3fd0d3b5576bcd6a433a51e5013d
• Download URL:
  https://stacks.cdc.gov/view/cdc/198931/cdc_198931_DS1.pdf
• File Type:
  [PDF - 170.87 KB ]