ArticleEpidemiology (Cambridge, Mass.)2014
Estimating the effect of cumulative occupational asbestos exposure on time to lung cancer mortality: using structural nested failure-time models to account for healthy-worker survivor bias.
Article in Epidemiology (Cambridge, Mass.), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
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Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Methodological approaches, challenges, and opportunities in the application of Mendelian randomisation to lifecourse epidemiology: A systematic literature review.European journal of epidemiology · 2024Pooled it
- A comparison of meta-analysis results with and without adjustment for the healthy worker effect: cancer mortality among workers in the semiconductor industry.Epidemiology and health · 2021Pooled it
- Revisiting the hazards of hazard ratios through simulations and case studies.European journal of epidemiology · 2025Article
- Healthy worker hire and survivor effects in a cohort of medical radiation workers.International journal of epidemiology · 2024Article
- Exploring the Relationship Between Anticipated Stigma and Community Shared Concerns about HIV on Defaulting from HIV Care in Rural South Africa.Stigma and health · 2024Article
- Modeling Cash Plus Other Psychosocial and Structural Interventions to Prevent HIV Among Adolescent Girls and Young Women in South Africa (HPTN 068).AIDS and behavior · 2021Article
- Modeling Combination Interventions to Prevent Human Immunodeficiency Virus in Adolescent Girls and Young Women in South Africa (HIV Prevention Trials Network 068).Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Lung Cancer Mortality and Styrene Exposure in the Reinforced-Plastics Boatbuilding Industry: Evaluation of Healthy Worker Survivor Bias.American journal of epidemiology · 2021Article
- Extended Mortality Follow-up of a Cohort of 25,460 Workers Exposed to Acrylonitrile.American journal of epidemiology · 2019Article
- Occupational silica exposure and mortality from lung cancer and nonmalignant respiratory disease: G-estimation of structural nested accelerated failure time models.Environmental epidemiology (Philadelphia, Pa.) · 2018Article
- Does Partner Selection Mediate the Relationship Between School Attendance and HIV/Herpes Simplex Virus-2 Among Adolescent Girls and Young Women in South Africa: An Analysis of HIV Prevention Trials Network 068 Data.Journal of acquired immune deficiency syndromes (1999) · 2018Article
- Estimating long-term treatment effects in observational data: A comparison of the performance of different methods under real-world uncertainty.Statistics in medicine · 2018Article
- Assessment of the healthy worker survivor effect in cancer studies of the United Autoworkers-General Motors cohort.Occupational and environmental medicine · 2017Article
- Induction of GOncology letters · 2016Article
- Drinking water: a risk factor for high incidence of esophageal cancer in Anyang, China.Environmental geochemistry and health · 2016Article
- Are all biases missing data problems?Current epidemiology reports · 2015Article
- Healthy worker survivor bias in the Colorado Plateau uranium miners cohort.American journal of epidemiology · 2015Article
- Lung cancer incidence and mortality in China, 2010.Thoracic cancer · 2014Article
- Causal inference in occupational epidemiology: accounting for the healthy worker effect by using structural nested models.American journal of epidemiology · 2013Article
- Healthy Worker Effect Phenomenon: Revisited with Emphasis on Statistical Methods - A Review.Indian journal of occupational and environmental medicineReview
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundPrevious estimates of the effect of occupational asbestos on lung cancer mortality have been obtained by using methods that are subject to the healthy-worker survivor bias. G-estimation of a structural nested model provides consistent exposure effect estimates under this bias.
methodsWe estimated the effect of cumulative asbestos exposure on lung cancer mortality in a cohort comprising 2564 textile factory workers who were followed from January 1940 to December 2001.
resultsAt entry, median age was 23 years, with 42% of the cohort being women and 20% nonwhite. During the follow-up period, 15% of person-years were classified as occurring while employed and 13% as occupationally exposed to asbestos. For a 100 fiber-year/ml increase in cumulative asbestos, a Weibull model adjusting for sex, race, birth year, baseline exposure, and age at study entry yielded a survival time ratio of 0.88 (95% confidence interval = 0.83 to 0.93). Further adjustment for work status yielded no practical change. The corresponding survival time ratio obtained using g-estimation of a structural nested model was 0.57 (0.33 to 0.96).
conclusionsAccounting for the healthy-worker survivor bias resulted in a 35% stronger effect estimate. However, this estimate was considerably less precise. When healthy-worker survivor bias is suspected, methods that account for it should be used.
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