Med. Pr. 2008;59(1):49-53 |
DEFINITION, CHARACTERISTICS AND METHODS OF REDUCING THE HEALTHY WORKER EFFECT |
EFEKT ZDROWEGO ROBOTNIKA - DEFINICJA, CHARAKTERYSTYKA I METODY KONTROLI |
Wojciech Sobala |
Abstract
A cohort study is the most important study design
for analyzing industrial exposures. One of the sources of bias in
industrial cohort studies is healthy worker effect (HWE). HWE consists
of two selection processes: healthy worker hire and healthy worker
survivor. In this article, methods of reducing HWE presented in the
literature are compared and its limitations are discussed. The best
method of reducing healthy worker hire effect is an internal reference
group. But in the case of time related exposures (cumulative exposure)
time from hire have to be controlled in the regression model. To
minimize healthy worker survival effect internal reference group should
be used and time from hire should be controlled. Med Pr 2008;59(1):49-53
Key words
healthy worker effect, cohort studies, data analysis, epidemiology