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Mortality following workplace injury: Quantitative bias analysis
Andrew Busey1, Abay Asfaw2, Katie M Applebaum3
1NERA Economic Consulting, Boston, MA, USA.
Annals of Epidemiology
|October 4, 2021
Summary
Disabling workplace injuries increase mortality risk in men and women. Accounting for smoking and obesity significantly reduces the estimated mortality hazard, highlighting the importance of these factors in injury-related death risk assessment.
Area of Science:
- Occupational Health
- Epidemiology
- Biostatistics
Background:
- Previous research indicates a link between disabling workplace injuries and increased all-cause mortality.
- However, these studies often overlook critical confounding factors such as smoking and obesity.
Purpose of the Study:
- To estimate injury-related mortality risk by accounting for smoking and obesity.
- To quantify the impact of these confounders on the association between workplace injuries and mortality.
Main Methods:
- A cohort of New Mexico workers receiving workers' compensation benefits (1994-2000) was followed through 2013.
- Data from the Panel Study of Income Dynamics was used to model the joint distribution of smoking and obesity.
- Quantitative bias analysis (QBA) was employed to adjust for these confounders.
Main Results:
- Adjusted hazard ratios for mortality were 1.13 for women and 1.12 for men.
- The fully adjusted excess hazard was approximately half the size of unadjusted estimates.
- Simulation intervals indicated a statistically significant increase in mortality risk for both sexes.
Conclusions:
- Adjusting for smoking and obesity significantly reduces the estimated mortality hazard associated with lost-time injuries.
- Despite adjustments, a notable increase in mortality risk persists for both men and women following disabling injuries.
- These findings underscore the critical importance of considering smoking and obesity as confounders in occupational injury mortality research.
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