Abstract
OBJECTIVES--This survey was conducted to determine the frequency with which different data analysis techniques are being used in occupational cohort studies. Of particular interest was the relative use of external and internal comparison groups, and the choice of multivariable model. METHODS--Occupational cohort studies published in 1990-91 were located with Medline and Index Medicus, and the contents of several relevant journals were systematically reviewed. Each study was categorised by the methods of external or internal comparisons performed. RESULTS--Of 200 occupational cohort studies identified, 104 (52%) conducted only external comparisons, 46 (23%) conducted only internal, and 50 (25%) presented both. Of those that used an external referent population, about two thirds used a national standard. 40 of the studies that performed internal comparisons fitted multivariable models, with use divided about equally between proportional hazards regression, Poisson regression, and logistic regression. DISCUSSION--The finding that logistic regression is used quite commonly, even though it does not directly model time dependent data of the type frequently encountered in occupational cohort studies, was suprising. The reasons why investigators choose from among the available statistical and modelling techniques are likely to include familiarity, ease of use, restrictions in study population characteristics, especially study size, and others. Authors should be encouraged to be more explicit about the statistical methods used in the analysis of occupational cohort studies, as well as whether important assumptions about their data have been evaluated.
Full text
PDFSelected References
These references are in PubMed. This may not be the complete list of references from this article.
- Abbott R. D. Logistic regression in survival analysis. Am J Epidemiol. 1985 Mar;121(3):465–471. doi: 10.1093/oxfordjournals.aje.a114019. [DOI] [PubMed] [Google Scholar]
- Battié M. C., Bigos S. J., Fisher L. D., Spengler D. M., Hansson T. H., Nachemson A. L., Wortley M. D. Anthropometric and clinical measures as predictors of back pain complaints in industry: a prospective study. J Spinal Disord. 1990 Sep;3(3):195–204. [PubMed] [Google Scholar]
- Battié M. C., Bigos S. J., Fisher L. D., Spengler D. M., Hansson T. H., Nachemson A. L., Wortley M. D. The role of spinal flexibility in back pain complaints within industry. A prospective study. Spine (Phila Pa 1976) 1990 Aug;15(8):768–773. [PubMed] [Google Scholar]
- Belli S., Comba P., De Santis M., Grignoli M., Sasco A. J. Cancer mortality patterns among laboratory workers. Lancet. 1990 Jun 30;335(8705):1597–1598. doi: 10.1016/0140-6736(90)91432-a. [DOI] [PubMed] [Google Scholar]
- Bigos S. J., Battié M. C., Fisher L. D. Methodology for evaluating predictive factors for the report of back injury. Spine (Phila Pa 1976) 1991 Jun;16(6):669–670. doi: 10.1097/00007632-199106000-00017. [DOI] [PubMed] [Google Scholar]
- Bonde J. P., Hansen K. S., Levine R. J. Fertility among Danish male welders. Scand J Work Environ Health. 1990 Oct;16(5):315–322. doi: 10.5271/sjweh.1778. [DOI] [PubMed] [Google Scholar]
- Boshuizen H. C., Hulshof C. T., Bongers P. M. Long-term sick leave and disability pensioning due to back disorders of tractor drivers exposed to whole-body vibration. Int Arch Occup Environ Health. 1990;62(2):117–122. doi: 10.1007/BF00383587. [DOI] [PubMed] [Google Scholar]
- Brenn T., Arnesen E. Selecting risk factors: a comparison of discriminant analysis, logistic regression and Cox's regression model using data from the Tromsø Heart Study. Stat Med. 1985 Oct-Dec;4(4):413–423. doi: 10.1002/sim.4780040403. [DOI] [PubMed] [Google Scholar]
- Breslow N. E., Storer B. E. General relative risk functions for case-control studies. Am J Epidemiol. 1985 Jul;122(1):149–162. doi: 10.1093/oxfordjournals.aje.a114074. [DOI] [PubMed] [Google Scholar]
- Breslow N. Multivariate cohort analysis. Natl Cancer Inst Monogr. 1985 May;67:149–156. [PubMed] [Google Scholar]
- Clayton D. The analysis of event history data: a review of progress and outstanding problems. Stat Med. 1988 Aug;7(8):819–841. doi: 10.1002/sim.4780070802. [DOI] [PubMed] [Google Scholar]
- Coste J., Mandereau L., Pessione F., Bregu M., Faye C., Hemon D., Spira A. Lead-exposed workmen and fertility: a cohort study on 354 subjects. Eur J Epidemiol. 1991 Mar;7(2):154–158. doi: 10.1007/BF00237359. [DOI] [PubMed] [Google Scholar]
- Cupples L. A., D'Agostino R. B., Anderson K., Kannel W. B. Comparison of baseline and repeated measure covariate techniques in the Framingham Heart Study. Stat Med. 1988 Jan-Feb;7(1-2):205–222. doi: 10.1002/sim.4780070122. [DOI] [PubMed] [Google Scholar]
- D'Agostino R. B., Lee M. L., Belanger A. J., Cupples L. A., Anderson K., Kannel W. B. Relation of pooled logistic regression to time dependent Cox regression analysis: the Framingham Heart Study. Stat Med. 1990 Dec;9(12):1501–1515. doi: 10.1002/sim.4780091214. [DOI] [PubMed] [Google Scholar]
- DAWBER T. R., MEADORS G. F., MOORE F. E., Jr Epidemiological approaches to heart disease: the Framingham Study. Am J Public Health Nations Health. 1951 Mar;41(3):279–281. doi: 10.2105/ajph.41.3.279. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Davies J. M., Easton D. F., Bidstrup P. L. Mortality from respiratory cancer and other causes in United Kingdom chromate production workers. Br J Ind Med. 1991 May;48(5):299–313. doi: 10.1136/oem.48.5.299. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fox A. J., Collier P. F. Low mortality rates in industrial cohort studies due to selection for work and survival in the industry. Br J Prev Soc Med. 1976 Dec;30(4):225–230. doi: 10.1136/jech.30.4.225. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Frome E. L., Checkoway H. Epidemiologic programs for computers and calculators. Use of Poisson regression models in estimating incidence rates and ratios. Am J Epidemiol. 1985 Feb;121(2):309–323. doi: 10.1093/oxfordjournals.aje.a114001. [DOI] [PubMed] [Google Scholar]
- Frome E. L., Cragle D. L., McLain R. W. Poisson regression analysis of the mortality among a cohort of World War II nuclear industry workers. Radiat Res. 1990 Aug;123(2):138–152. [PubMed] [Google Scholar]
- Frome E. L. The analysis of rates using Poisson regression models. Biometrics. 1983 Sep;39(3):665–674. [PubMed] [Google Scholar]
- Gilbert E. S., Fry S. A., Wiggs L. D., Voelz G. L., Cragle D. L., Petersen G. R. Methods for analyzing combined data from studies of workers exposed to low doses of radiation. Am J Epidemiol. 1990 May;131(5):917–927. doi: 10.1093/oxfordjournals.aje.a115581. [DOI] [PubMed] [Google Scholar]
- Green M. S., Symons M. J. A comparison of the logistic risk function and the proportional hazards model in prospective epidemiologic studies. J Chronic Dis. 1983;36(10):715–723. doi: 10.1016/0021-9681(83)90165-0. [DOI] [PubMed] [Google Scholar]
- Greenland S. Modeling and variable selection in epidemiologic analysis. Am J Public Health. 1989 Mar;79(3):340–349. doi: 10.2105/ajph.79.3.340. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hnizdo E., Sluis-Cremer G. K. Silica exposure, silicosis, and lung cancer: a mortality study of South African gold miners. Br J Ind Med. 1991 Jan;48(1):53–60. doi: 10.1136/oem.48.1.53. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hodgson J. T., Jones R. D. Mortality of a cohort of tin miners 1941-86. Br J Ind Med. 1990 Oct;47(10):665–676. doi: 10.1136/oem.47.10.665. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Hunting K. L., Matanoski G. M., Larson M., Wolford R. Solvent exposure and the risk of slips, trips, and falls among painters. Am J Ind Med. 1991;20(3):353–370. doi: 10.1002/ajim.4700200308. [DOI] [PubMed] [Google Scholar]
- Ingram D. D., Kleinman J. C. Empirical comparisons of proportional hazards and logistic regression models. Stat Med. 1989 May;8(5):525–538. doi: 10.1002/sim.4780080502. [DOI] [PubMed] [Google Scholar]
- Kongerud J., Samuelsen S. O. A longitudinal study of respiratory symptoms in aluminum potroom workers. Am Rev Respir Dis. 1991 Jul;144(1):10–16. doi: 10.1164/ajrccm/144.1.10. [DOI] [PubMed] [Google Scholar]
- Leaverton P. E., Sorlie P. D., Kleinman J. C., Dannenberg A. L., Ingster-Moore L., Kannel W. B., Cornoni-Huntley J. C. Representativeness of the Framingham risk model for coronary heart disease mortality: a comparison with a national cohort study. J Chronic Dis. 1987;40(8):775–784. doi: 10.1016/0021-9681(87)90129-9. [DOI] [PubMed] [Google Scholar]
- Liddell F. D. The development of cohort studies in epidemiology: a review. J Clin Epidemiol. 1988;41(12):1217–1237. doi: 10.1016/0895-4356(88)90027-3. [DOI] [PubMed] [Google Scholar]
- Macaluso M., Delzell E., Cole P., Wongsrichanalai C., Cowles S. Validity of a mortality study based on a corporate health surveillance system. J Occup Med. 1991 Nov;33(11):1180–1186. doi: 10.1097/00043764-199111000-00017. [DOI] [PubMed] [Google Scholar]
- Mazumdar S., Redmond C. K., Costantino J. P., Patwardhan R. N., Zhou S. Y. Recent developments in the multistage modeling of cohort data for carcinogenic risk assessment. Environ Health Perspect. 1991 Jan;90:271–277. doi: 10.1289/ehp.90-1519516. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McMichael A. J. Standardized mortality ratios and the "healthy worker effect": Scratching beneath the surface. J Occup Med. 1976 Mar;18(3):165–168. doi: 10.1097/00043764-197603000-00009. [DOI] [PubMed] [Google Scholar]
- Michaels D., Zoloth S. R., Stern F. B. Does low-level lead exposure increase risk of death? A mortality study of newspaper printers. Int J Epidemiol. 1991 Dec;20(4):978–983. doi: 10.1093/ije/20.4.978. [DOI] [PubMed] [Google Scholar]
- Mock P. Empirical comparisons of proportional hazards and logistic regression models. Stat Med. 1990 Apr;9(4):463–464. doi: 10.1002/sim.4780090417. [DOI] [PubMed] [Google Scholar]
- Moolgavkar S. H., Venzon D. J. General relative risk regression models for epidemiologic studies. Am J Epidemiol. 1987 Nov;126(5):949–961. doi: 10.1093/oxfordjournals.aje.a114733. [DOI] [PubMed] [Google Scholar]
- Moore D. E., Hayward M. D. Occupational careers and mortality of elderly men. Demography. 1990 Feb;27(1):31–53. [PubMed] [Google Scholar]
- Paddle G. M., Osborn A. J., Parker G. D. Mortality of employees in plants manufacturing 4,4'-bipyridyl. Scand J Work Environ Health. 1991 Jun;17(3):175–178. doi: 10.5271/sjweh.1714. [DOI] [PubMed] [Google Scholar]
- Piolatto G., Negri E., La Vecchia C., Pira E., Decarli A., Peto J. Bladder cancer mortality of workers exposed to aromatic amines: an updated analysis. Br J Cancer. 1991 Mar;63(3):457–459. doi: 10.1038/bjc.1991.106. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Steenland K., Beaumont J., Hornung R. The use of regression analyses in a cohort mortality study of welders. J Chronic Dis. 1986;39(4):287–294. doi: 10.1016/0021-9681(86)90050-0. [DOI] [PubMed] [Google Scholar]
- Stähelin H. B., Gey K. F., Eichholzer M., Lüdin E., Bernasconi F., Thurneysen J., Brubacher G. Plasma antioxidant vitamins and subsequent cancer mortality in the 12-year follow-up of the prospective Basel Study. Am J Epidemiol. 1991 Apr 15;133(8):766–775. doi: 10.1093/oxfordjournals.aje.a115955. [DOI] [PubMed] [Google Scholar]
- Thompson W. A., Jr On the treatment of grouped observations in life studies. Biometrics. 1977 Sep;33(3):463–470. [PubMed] [Google Scholar]
- Tsai S. P., Cowles S. R., Tackett D. L., Barclay M. T., Ross C. E. Morbidity prevalence study of workers with potential exposure to epichlorohydrin. Br J Ind Med. 1990 Jun;47(6):392–399. doi: 10.1136/oem.47.6.392. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Tüchsen F., Zebitz U. Work and "lifestyle" in occupational mortality in Denmark. Scand J Soc Med. 1990 Sep;18(3):179–183. doi: 10.1177/140349489001800305. [DOI] [PubMed] [Google Scholar]
- Vestbo J., Rasmussen F. V. Long-term exposure to cement dust and later hospitalization due to respiratory disease. Int Arch Occup Environ Health. 1990;62(3):217–220. doi: 10.1007/BF00379436. [DOI] [PubMed] [Google Scholar]
- Walker A. M., Cohen A. J., Loughlin J. E., Rothman K. J., DeFonso L. R. Mortality from cancer of the colon or rectum among workers exposed to ethyl acrylate and methyl methacrylate. Scand J Work Environ Health. 1991 Feb;17(1):7–19. doi: 10.5271/sjweh.1731. [DOI] [PubMed] [Google Scholar]
- Wigle D. T., Semenciw R. M., Wilkins K., Riedel D., Ritter L., Morrison H. I., Mao Y. Mortality study of Canadian male farm operators: non-Hodgkin's lymphoma mortality and agricultural practices in Saskatchewan. J Natl Cancer Inst. 1990 Apr 4;82(7):575–582. doi: 10.1093/jnci/82.7.575. [DOI] [PubMed] [Google Scholar]
- Wu M., Ware J. H. On the use of repeated measurements in regression analysis with dichotomous responses. Biometrics. 1979 Jun;35(2):513–521. [PubMed] [Google Scholar]
- You X. Y., Chen J. G., Hu Y. N. Studies on the relation between bladder cancer and benzidine or its derived dyes in Shanghai. Br J Ind Med. 1990 Aug;47(8):544–552. doi: 10.1136/oem.47.8.544. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Zober A., Messerer P., Huber P. Thirty-four-year mortality follow-up of BASF employees exposed to 2,3,7,8-TCDD after the 1953 accident. Int Arch Occup Environ Health. 1990;62(2):139–157. doi: 10.1007/BF00383591. [DOI] [PubMed] [Google Scholar]