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Occupational mortality studies. Principles of validity

J D Wang, O S Miettinen

    Scandinavian Journal of Work, Environment & Health
    |September 1, 1982
    PubMed
    Summary
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    Occupational mortality studies require comparable reference populations to ensure valid results. Using a general population or total deaths can lead to inaccurate conclusions, including the "healthy worker effect".

    Area of Science:

    • Epidemiology
    • Occupational Health
    • Biostatistics

    Background:

    • Occupational mortality studies often lack experimental rigor.
    • Two common practices, using the general population as a reference and total deaths for population-time, are problematic.

    Purpose of the Study:

    • To highlight the methodological flaws in common occupational mortality study practices.
    • To propose the use of carefully selected occupational reference populations for enhanced validity.

    Main Methods:

    • Critique of the "general population" as a reference group.
    • Analysis of using total deaths as a surrogate for population-time.
    • Emphasis on the need for comparability in effects, populations, and information.

    Main Results:

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    • The use of general populations compromises comparability of effects, populations, and death certification.
    • Failure to use comparable reference populations results in the "healthy worker effect".

    Conclusions:

    • A carefully selected occupational reference population is essential for valid occupational mortality studies.
    • Comparability must be ensured for both the disease of interest and auxiliary causes of death.