Burnett C A, Silverman D T, Lalich N R
National Institute for Occupational Safety and Health, Cincinnati, Ohio.
Am J Ind Med. 1994 May;25(5):677-88. doi: 10.1002/ajim.4700250507.
The authors examined the utility of death certificate data for occupational health surveillance by comparing the ability of the data to identify high-risk occupations for bladder cancer with that of a population-based case-control study. Death certificate data for white males from 23 states for 1979-1987 were analyzed using proportionate mortality ratios. The case-control study used cancer registry cases for 1977-1978. Results were compared for 21 a priori suspect occupations. A broad definition of agreement resulted in agreement for 62% of the occupations; the death certificate study identified eight of 15 occupations identified by the case-control study and neither study identified five of the categories. While death certificate data have many limitations, our results indicate that death certificate data can provide clues to some potential occupational health problems. With the advantages of inexpensive data, large sample size, and industrial coverage, more refined analyses of the data should prove useful for occupational mortality surveillance and hypothesis generation.
作者通过比较死亡证明数据与基于人群的病例对照研究在识别膀胱癌高危职业方面的能力，研究了死亡证明数据在职业健康监测中的效用。使用比例死亡率对1979 - 1987年来自23个州的白人男性的死亡证明数据进行了分析。病例对照研究使用了1977 - 1978年癌症登记病例。对21种先验可疑职业的结果进行了比较。宽泛的一致性定义导致62%的职业达成一致；死亡证明研究识别出了病例对照研究确定的15种职业中的8种，且两项研究均未识别出5个类别。虽然死亡证明数据有许多局限性，但我们的结果表明，死亡证明数据可为一些潜在的职业健康问题提供线索。鉴于数据成本低、样本量大和行业覆盖范围广等优势，对这些数据进行更精细的分析应有助于职业死亡率监测和假设生成。
