The Healthy Worker Effect in Asthma: Work May Cause Asthma, but Asthma May Also Influence Work

Details

• Personal Author:
  Eisen EA ; Kauffmann F ; Kennedy SM ; Le Moual N
• Description:
  Despite the increasing attention to the relationship between asthma and work exposures, occupational asthma remains underrecognized and its population burden underestimated. This may be due, in part, to the fact that traditional approaches to studying asthma in populations cannot adequately take into account the healthy worker effect (HWE). The HWE is the potential bias caused by the phenomenon that sicker individuals may choose work environments in which exposures are low; they may be excluded from being hired; or once hired, they may seek transfer to less exposed jobs or leave work. This article demonstrates that population- and workplace-based asthma studies are particularly subject to HWE bias, which leads to underestimates of relative risks. Our objective is to describe the HWE as it relates to asthma research, and to discuss the significance of taking HWE bias into account in designing and interpreting asthma studies. We also discuss the importance of understanding HWE bias for public health practitioners and for clinicians. Finally, we emphasize the timeliness of this review in light of the many longitudinal "child to young adult" asthma cohort studies currently underway. These prospective studies will soon provide an ideal opportunity to examine the impact of early workplace environments on asthma in young adults. We urge occupational and childhood asthma epidemiologists collaborate to ensure that this opportunity is not lost. [Description provided by NIOSH]
• Subjects:
  Asthma Environmental Exposure Epidemiology Men Occupational Health Respiratory System Respiratory Tract Diseases Risk Assessment Risk Factors Safety Women Workplace

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• Keywords:
  Asthma Author Keywords: Epidemiology Bronchial Asthma Environmental Exposure Exposure Levels Health Effects Healthy Worker Effect Humans Occupational Exposure Risk Factors Work Environment Worker Health Workers

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• ISSN:
  1073-449X
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; Massachusetts ; OSHA Region 1 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  4-10
• Volume:
  177
• Issue:
  1
• NIOSHTIC Number:
  nn:20057475
• Citation:
  Am J Respir Crit Care Med 2008 Jan; 177(1):4-10
• Contact Point Address:
  Nicole Le Moual, Ph.D., INSERM U780, Recherche en Epide´miologie et Biostatistique, 16 avenue Paul Vaillant Couturier, 94807 Villejuif Cedex, France
• Email:
  lemoual@vjf.inserm.fr
• Federal Fiscal Year:
  2008
• Performing Organization:
  Harvard School of Public Health
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• End Date:
  20280630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:4286097852458c2e539a4b264291873c8f1016b34c52db7d6bcb4480cc55d473321e9dc43566e0b1ac37364b75aff7cfe235402d4f0892dc54b97681ac85c942
• Download URL:
  https://stacks.cdc.gov/view/cdc/214818/cdc_214818_DS1.pdf
• File Type:
  [PDF - 160.57 KB ]