Straight metalworking fluids and all-cause and cardiovascular mortality analyzed by using g-estimation of an accelerated failure time model with quantitative exposure: methods and interpretations

Details

• Personal Author:
  Eisen EA ; Ljungman PL ; Picciotto S
• Description:
  Straight metalworking fluids have been linked to cardiovascular mortality in analyses using binary exposure metrics, accounting for healthy worker survivor bias by using g-estimation of accelerated failure time models. A cohort of 38,666 Michigan autoworkers was followed (1941-1994) for mortality from all causes and ischemic heart disease. The structural model chosen here, using continuous exposure, assumes that increasing exposure from 0 to 1 mg/m(3) in any single year would decrease survival time by a fixed amount. Under that assumption, banning the fluids would have saved an estimated total of 8,468 (slope-based 95% confidence interval: 2,262, 28,563) person-years of life in this cohort. On average, 3.04 (slope-based 95% confidence interval: 0.02, 25.98) years of life could have been saved for each exposed worker who died from ischemic heart disease. Estimates were sensitive to both model specification for predicting exposure (multinomial or logistic regression) and characterization of exposure as binary or continuous in the structural model. Our results provide evidence supporting the hypothesis of a detrimental relationship between straight metalworking fluids and mortality, particularly from ischemic heart disease, as well as an instructive example of the challenges in obtaining and interpreting results from accelerated failure time models using a continuous exposure in the presence of competing risks. [Description provided by NIOSH]
• Subjects:
  Cardiovascular Diseases Cardiovascular System Environmental Exposure Occupational Health Particulate Matter Risk Assessment Risk Factors Safety
• Keywords:
  Author Keywords: Cardiovascular Outcomes Cardiovascular System Cardiovascular System Disease Cardiovascular System Disorders Epidemiologic Methods Exposure Levels Healthy Worker Effect Heart Heart Disease Metalworking Fluids Models Mortality MWFs Occupational Exposures Particulate Matter Particulates Risk Factors Statistical Analysis Workers

  More +
• ISSN:
  0002-9262
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  183
• Issue:
  7
• NIOSHTIC Number:
  nn:20048387
• Citation:
  Am J Epidemiol 2016 Apr; 183(7):680-688
• Contact Point Address:
  Sally Picciotto, UC Berkeley School of Public Health, Environmental Health Sciences, 50 University Hall, Berkeley, CA 94720-7360
• Email:
  sallypicciotto@berkeley.edu
• Federal Fiscal Year:
  2016
• Performing Organization:
  University of California - Berkeley
• Peer Reviewed:
  True
• Start Date:
  20120701
• Source Full Name:
  American Journal of Epidemiology
• End Date:
  20141231
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:5266bdfbebcd3094105b20bf0b847c81f2a61e2efac4c7d21a446a5020ab0222fe6ae7de1ce49e3ae256ff40998e15b834b239437bca9bbc1376bd72aa38d751
• Download URL:
  https://stacks.cdc.gov/view/cdc/203148/cdc_203148_DS1.pdf
• File Type:
  [PDF - 256.40 KB ]