Related Experiment Videos
Does arsenic exposure increase the risk for circulatory disease?
I Hertz-Picciotto1, H M Arrighi, S W Hu
1Department of Epidemiology, University of North Carolina, Chapel Hill 27599-7400, USA.
American Journal of Epidemiology
|January 25, 2000
Summary
Arsenic exposure may harm circulatory health, but the healthy worker survivor effect can mask this risk. Controlling for this effect in occupational studies is crucial for accurate public health assessments.
Area of Science:
- Occupational Epidemiology
- Environmental Health
- Toxicology
Background:
- Community studies link high arsenic in drinking water to circulatory issues.
- Occupational studies often show weak or no arsenic-circulatory disease associations.
- The healthy worker effect (HWE) may explain discrepancies, particularly the healthy worker survivor effect (HWSE).
Purpose of the Study:
- To investigate arsenic exposure and circulatory disease mortality in smelter workers.
- To control for HWE, including healthy hire and HWSE, in arsenic exposure analyses.
- To determine if HWSE obscures a true association between arsenic and circulatory disease.
Main Methods:
- Analysis of mortality data for 2,802 Tacoma smelter workers.
- Internal comparisons to control for healthy hire effect.
- Lagging method, work status adjustment, and G-null test to control for HWSE.
Main Results:
- Lagging and work status adjustment increased circulatory mortality rate ratios.
- Excess mortality was specific to cardiovascular disease, not cerebrovascular disease.
- G-null analyses showed no adverse effect, but lacked statistical power.
Conclusions:
- The healthy worker survivor effect may obscure the association between arsenic exposure and circulatory disease.
- Cardiovascular disease mortality is a significant concern, with potential public health implications.
- Future occupational cohort studies must account for HWSE when examining arsenic's effects.