ArticleAmerican journal of epidemiology2015
Healthy worker survivor bias in the Colorado Plateau uranium miners cohort.
Article in American journal of epidemiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Evaluation of Confounding and Selection Bias in Epidemiological Studies of Populations Exposed to Low-Dose, High-Energy Photon Radiation.Journal of the National Cancer Institute. Monographs · 2020Pooled it
- Article
- Inverse probability weighting to estimate impacts of hypothetical occupational limits on radon exposure to reduce lung cancer.American journal of epidemiology · 2025Article
- Re: Adjustment for duration of employment in occupational epidemiology.Annals of epidemiology · 2024Article
- Healthy worker hire and survivor effects in a cohort of medical radiation workers.International journal of epidemiology · 2024Article
- Estimating impacts of reducing acrylonitrile exposure on lung cancer mortality in an occupational cohort with the parametric g-formula.Occupational and environmental medicine · 2024Article
- Updated risk models for lung cancer due to radon exposure in the German Wismut cohort of uranium miners, 1946-2018.Radiation and environmental biophysics · 2023Article
- Radon and lung cancer in the pooled uranium miners analysis (PUMA): highly exposed early miners and all miners.Occupational and environmental medicine · 2023Article
- Nonmalignant respiratory disease mortality in male Colorado Plateau uranium miners, 1960-2016.American journal of industrial medicine · 2022Article
- Effects of chronic intermittent hypobaric hypoxia on prostate-specific antigen (PSA) in Chilean miners.Occupational and environmental medicine · 2021Article
- Lung Cancer Mortality and Styrene Exposure in the Reinforced-Plastics Boatbuilding Industry: Evaluation of Healthy Worker Survivor Bias.American journal of epidemiology · 2021Article
- Ionizing radiation induces epithelial-mesenchymal transition in human bronchial epithelial cells.Bioscience reports · 2020Article
- A Bayesian hierarchical approach to account for left-censored and missing radiation doses prone to classical measurement error when analyzing lung cancer mortality due to γ-ray exposure in the French cohort of uranium miners.Radiation and environmental biophysics · 2020Article
- Methodological considerations when analysing and interpreting real-world data.Rheumatology (Oxford, England) · 2020Article
- Extended Mortality Follow-up of a Cohort of 25,460 Workers Exposed to Acrylonitrile.American journal of epidemiology · 2019Article
- Health Effects of Radon Exposure.Yonsei medical journal · 2019Review
- 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
- Estimating the Impact of Changes to Occupational Standards for Silica Exposure on Lung Cancer Mortality.Epidemiology (Cambridge, Mass.) · 2018Article
- Low-dose ionizing radiation increases the mortality risk of solid cancers in nuclear industry workers: A meta-analysis.Molecular and clinical oncology · 2018Article
- The Healthy Worker Survivor Effect: Target Parameters and Target Populations.Current environmental health reports · 2017Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
Cohort mortality studies of underground miners have been used to estimate the number of lung cancer deaths attributable to radon exposure. However, previous studies of the radon-lung cancer association among underground miners may have been subject to healthy worker survivor bias, a type of time-varying confounding by employment status. We examined radon-mortality associations in a study of 4,124 male uranium miners from the Colorado Plateau who were followed from 1950 through 2005. We estimated the time ratio (relative change in median survival time) per 100 working level months (radon exposure averaging 130,000 mega-electron volts of potential α energy per liter of air, per working month) using G-estimation of structural nested models. After controlling for healthy worker survivor bias, the time ratio for lung cancer per 100 working level months was 1.168 (95% confidence interval: 1.152, 1.174). In an unadjusted model, the estimate was 1.102 (95% confidence interval: 1.099, 1.112)-39% lower. Controlling for this bias, we estimated that among 617 lung cancer deaths, 6,071 person-years of life were lost due to occupational radon exposure during follow-up. Our analysis suggests that healthy worker survivor bias in miner cohort studies can be substantial, warranting reexamination of current estimates of radon's estimated impact on lung cancer mortality.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.