Incident Ischemic Heart Disease After Long-Term Occupational Exposure to Fine Particulate Matter: Accounting for 2 Forms of Survivor Bias

Details

• Personal Author:
  Brown DM ; Costello S ; Cullen MR ; Eisen EA ; Hammond SK ; Neophytou AM ; Noth EM
• Description:
  Little is known about the heart disease risks associated with occupational, rather than traffic-related, exposure to particulate matter with aerodynamic diameter of 2.5 µm or less (PM2.5). We examined long-term exposure to PM2.5 in cohorts of aluminum smelters and fabrication workers in the United States who were followed for incident ischemic heart disease from 1998 to 2012, and we addressed 2 forms of survivor bias. Left truncation bias was addressed by restricting analyses to the subcohort hired after the start of follow up. Healthy worker survivor bias, which is characterized by time-varying confounding that is affected by prior exposure, was documented only in the smelters and required the use of marginal structural Cox models. When comparing always-exposed participants above the 10th percentile of annual exposure with those below, the hazard ratios were 1.67 (95% confidence interval (CI): 1.11, 2.52) and 3.95 (95% CI: 0.87, 18.00) in the full and restricted subcohorts of smelter workers, respectively. In the fabrication stratum, hazard ratios based on conditional Cox models were 0.98 (95% CI: 0.94, 1.02) and 1.17 (95% CI: 1.00, 1.37) per 1 mg/m(3)-year in the full and restricted subcohorts, respectively. Long-term exposure to occupational PM2.5 was associated with a higher risk of ischemic heart disease among aluminum manufacturing workers, particularly in smelters, after adjustment for survivor bias. [Description provided by NIOSH]
• Subjects:
  Aluminum Compounds Cardiovascular Diseases Cardiovascular System Epidemiology Metals Metal Workers Occupational Exposure Occupational Health Particulate Matter Safety
• Keywords:
  Aluminum Industry Author Keywords: Epidemiologic Methods Cardiovascular Disease Heart Disease Long Term Exposure Occupational Epidemiology Occupational Exposure Particle Size Particulates Smelters Survivor Bias

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• 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:
  9
• NIOSHTIC Number:
  nn:20049935
• Citation:
  Am J Epidemiol 2016 May; 183(9):861-868
• Contact Point Address:
  Dr. Sadie Costello, Environmental Health Science, School of Public Health, University of California, Berkeley, 50 University Hall #7360, Berkeley, CA 94720
• Email:
  sadie@berkeley.edu
• Federal Fiscal Year:
  2016
• Performing Organization:
  Stanford University
• Peer Reviewed:
  True
• Start Date:
  20110901
• Source Full Name:
  American Journal of Epidemiology
• End Date:
  20200831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:169dd8527c38f0de4c9e89e8680c1af79e8bd3eb4e47e22593556e423f7d988a8d98708aa3c49f400f0cc8b2229c5ee09db16d961ced489957365d0df8c43fbd
• Download URL:
  https://stacks.cdc.gov/view/cdc/210523/cdc_210523_DS1.pdf
• File Type:
  [PDF - 305.07 KB ]