Koskela R S, Kolari P J, Järvinen E, Korhonen H
Scand J Work Environ Health. 1984 Dec;10(6 Spec No):455-9. doi: 10.5271/sjweh.2298.
The lack of complete occupational histories causes underestimates or overestimates of occupational mortality and morbidity. The problem is emphasized in cohorts with high turnover and in cross-sectional study designs. In the study of the effect of selective turnover on occupational mortality and morbidity complete occupational histories were acquired via questionnaire. The sample comprised 1 200 current and 1 800 alive former workers and the closest relatives of 450 deceased workers and was formed from three exposure-level cohorts (defined primarily according to the physical demands of the work) of 15 714 metal workers hired in 1950-1976. The occupational histories reported in the questionnaires were compared with those collected from employers' personnel records. The coverage of occupational histories was the most accurate for current and former workers with the longest duration of exposure and the least accurate for dead workers and the oldest age groups. The use of complete occupational histories and the combining of the similar levels of exposure through the lifetime produced clear differences in the occurrences of musculoskeletal, respiratory, and cardiovascular diseases between the three levels of exposure. The errors in person-years were smaller than the errors in the duration of exposure; the coverage varied from 51 to 94%. However, misclassification clearly caused cancer cases to be located in classes with too short a period of latency. About 30% of the deceased workers had reportedly entered the industry before the first follow-up year.
缺乏完整的职业史会导致对职业死亡率和发病率的低估或高估。在人员流动率高的队列研究和横断面研究设计中，这个问题尤为突出。在一项关于选择性流动对职业死亡率和发病率影响的研究中，通过问卷调查获取了完整的职业史。样本包括1200名在职工人、1800名健在的离职工人以及450名已故工人的近亲，该样本取自1950年至1976年受雇的15714名金属工人组成的三个暴露水平队列（主要根据工作的体力要求定义）。将问卷调查中报告的职业史与从雇主人事记录中收集的职业史进行比较。职业史的覆盖情况对于暴露时间最长的在职和离职工人最为准确，而对于已故工人和年龄最大的年龄组最不准确。使用完整的职业史并将一生中相似的暴露水平合并，使得三个暴露水平之间肌肉骨骼疾病、呼吸系统疾病和心血管疾病的发生率产生了明显差异。人年误差小于暴露持续时间的误差；覆盖范围从51%到94%不等。然而，错误分类显然导致癌症病例被归入潜伏期过短的类别。据报告，约30%的已故工人在第一次随访年份之前就已进入该行业。
