Lamm S H, Levine M S, Starr J A, Tirey S L
Epidemiology and Occupational Health, Inc., Washington, DC 20007.
Am J Epidemiol. 1988 Jun;127(6):1202-9. doi: 10.1093/oxfordjournals.aje.a114913.
An excess of lung cancer found in a cohort of 741 New York State tremolitic talc workers observed from 1947 through 1978 has been shown paradoxically to be concentrated in short-term workers. Review of past work histories suggests that the excess of lung cancer in these short-term workers may be accounted for by prior exposures rather than by exposures at the employment under investigation. This finding has significant implications in view of the developing practice of including short-term workers in occupational cohort studies in contrast to the more traditional practice of excluding short-term workers. The traditional practice was based on the assumption that the inclusion of short-term workers with little exposure, and thus little risk, might dilute an otherwise apparent association between mortality and exposure. This study suggests that in certain instances the inclusion of short-term workers may magnify rather than dilute the estimation of risk, reflecting the presence of confounding variables.
在1947年至1978年观察的741名纽约州透闪石滑石工人队列中发现的肺癌过量情况,矛盾的是,集中在短期工人身上。对过去工作经历的回顾表明,这些短期工人中肺癌过量可能是由先前的暴露所致,而非正在调查的就业期间的暴露。鉴于与排除短期工人这种更为传统的做法相比,目前将短期工人纳入职业队列研究的做法不断发展,这一发现具有重要意义。传统做法基于这样一种假设,即纳入几乎没有暴露、因而几乎没有风险的短期工人,可能会冲淡原本明显的死亡率与暴露之间的关联。本研究表明,在某些情况下,纳入短期工人可能会放大而非冲淡风险估计,这反映了混杂变量的存在。