A comparison of analyses of occupational bladder cancer: death certificate vs. population-based case-control...

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.