Evolving methods for inference in the presence of healthy worker survivor bias

Details

• Personal Author:
  Buckley JP ; Edwards JK ; Keil AP ; McGrath LJ
• Description:
  Healthy worker survivor bias may occur in occupational studies due to the tendency for unhealthy individuals to leave work earlier, and consequently accrue less exposure, compared with their healthier counterparts. If occupational data are not analyzed using appropriate methods, this bias can result in attenuation or even reversal of the estimated effects of exposures on health outcomes. Recent advances in computing power, coupled with state-of-the-art statistical methods, have greatly increased the ability of analysts to control healthy worker survivor bias. However, these methods have not been widely adopted by occupational epidemiologists. We update the seminal review by Arrighi and Hertz-Picciotto (Epidemiology.1994; 5: 186-196) of the sources and methods to control healthy worker survivor bias. In our update, we discuss methodologic advances since the publication of that review, notably with a consideration of how directed acyclic graphs can inform the choice of appropriate analytic methods. We summarize and discuss methods for addressing this bias, including recent work applying g-methods to account for employment status as a time-varying covariate affected by prior exposure. In the presence of healthy worker survivor bias, g-methods have advantages for estimating less biased parameters that have direct policy implications and are clearly communicated to decision-makers. [Description provided by NIOSH]
• Subjects:
  Decision Making Environmental Monitoring Epidemiology Occupational Health Quality Control Risk Assessment Risk Factors Safety
• Keywords:
  Analytical-methods Analytical-processes Data-processing Decision-making Employees Exposure-assessment Mathematical-models Quality-control Risk-analysis Risk-factors Statistical-analysis Statistical-quality-control Survival-rate Worker-health Workers

  More +
• ISSN:
  1044-3983
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  North Carolina ; OSHA Region 4
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  204-212
• Volume:
  26
• Issue:
  2
• NIOSHTIC Number:
  nn:20046871
• Citation:
  Epidemiology 2015 Mar; 26(2):204-212
• Contact Point Address:
  Jessie P. Buckley, Department of Epidemiology, University of North Carolina, CB #7435, Chapel Hill, NC 27599
• Email:
  jessbuck@unc.edu
• Federal Fiscal Year:
  2015
• Performing Organization:
  University of North Carolina, Chapel Hill
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Epidemiology
• End Date:
  20270630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:50c506eb44bba1da088a29a1ebc15e094371c39da64f20b38a02c8b20eb1e5a587604e32c29faeeec9e66b12ead9183e09ec2a99bc528084116de31a5c2a2eac
• Download URL:
  https://stacks.cdc.gov/view/cdc/202150/cdc_202150_DS1.pdf
• File Type:
  [PDF - 394.85 KB ]