Wang J D, Miettinen O S
Ann Acad Med Singap. 1984 Apr;13(2 Suppl):312-6.
In occupational mortality studies, the information on the population at risk is frequently not available. In these circumstances, the rate ratio of interest can be assessed through the mortality odds ratio (MOR), given appropriate selections of reference occupation(s) and reference disease(s). The reference occupation should be chosen with a view to three aspects of validity: (1) comparability of effects, i.e., identity of mortality effects between the index and the reference occupation apart from the effect of the exposure under study; (2) comparability of contrasted populations, i.e., same job entry and exit factors and similar health promotion programmes when related to the mortality under study; and (3) comparability of mortality information, i.e., same diagnostic and certification practices for the cause of death of interest between the contrasted populations. The reference causes of death must also satisfy these requirements with the additions that the exposure under study have no effect on the risk of reference causes of death, and that the accuracy of information about the compared occupations be the same as in the context of the index cause of death. Throughout the discussion, an example of exploring cancer risks among lens manufacturing workers is used.
在职业死亡率研究中，通常无法获取关于风险人群的信息。在这种情况下，在适当选择参考职业和参考疾病的前提下，可通过死亡率比值比（MOR）来评估感兴趣的率比。选择参考职业应从有效性的三个方面考虑：（1）效应的可比性，即除了所研究暴露的效应外，指数职业和参考职业之间死亡率效应的一致性；（2）对比人群的可比性，即在与所研究死亡率相关时，相同的工作入职和离职因素以及类似的健康促进计划；（3）死亡率信息的可比性，即对比人群之间对于感兴趣的死亡原因有相同的诊断和认证做法。参考死亡原因还必须满足这些要求，此外所研究的暴露对参考死亡原因的风险没有影响，并且关于所比较职业的信息准确性与指数死亡原因的情况相同。在整个讨论过程中，使用了一个探索镜片制造工人癌症风险的例子。
