Healthy worker effect in a longitudinal study of one-second forced expiratory volume (FEV1) and chronic exposure to Granite Dust

Ellen A. Eisen, David H. Wegman, Thomas A. Louis, Thomas J. Smith, John M. Peters

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Low level effects of granite dust on one-second forced expiratory volume (FEV1) are estimated in 618 Vermont granite workers followed for 5 years with annual pulmonary function tests. Reduced pulmonary function has already been reported for the subset of subjects lost to follow-up (dropouts) suggesting possible bias in analyses based only on survivors. Method: Healthy worker selection bias is directly assessed by comparing the dose-response associations between survivors who remained in the study for the full 5-year observation period and the dropouts. Results: The 353 survivors had an FEV1 of 96% of predicted at baseline and were losing FEV1 at an average rate of 44 ml/yr. No association was found in this group between the rate of FEV1 decline and lifetime dust exposure. However, the 265 workers with incomplete follow-up, 'dropouts', had a lower FEV1 at baseline (94%) and were losing FEV1 at an average rate of 69 ml/yr. The dose-response parameter in this group was estimated to be 4 ml/yr loss per mg/m3-year and was statistically significant. Conclusions: These results provide an illustration of bias due to the healthy worker effect and an example of the failure to detect a true work-related health effect in a study based only on a 'survivor' population.

Original languageEnglish (US)
Pages (from-to)1154-1162
Number of pages9
JournalInternational journal of epidemiology
Volume24
Issue number6
DOIs
StatePublished - Dec 1995
Externally publishedYes

Keywords

  • Epidemiology
  • Healthy worker effect
  • Longitudinal study
  • Occupational exposure

ASJC Scopus subject areas

  • Epidemiology

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