ISSN:0271-3586    

DOI:10.1002/ajim.4700130102

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractData from the 1978–1980 National Health Interview Survey smoking questionnaire were used to analyze prevalence and levels of cigarette smoking among groups of US workers. This information is valuable for indirect adjustment in occupational epidemiology studies as well as for describing smoking patterns of workers in a wide range of job settings. Although there was a higher percentage of current smokers among men than women in the general population, there were few differences in prevalence of smoking among men and women for specific occupations. Also, race and employment status had an influence on prevalence of smoking, where both the currently unemployed and blacks generally had a higher proportion of current smokers, although blacks generally had a higher proportion of current smokers, although blacks smoked fewer cigarettes. Industry also played a major role in the variation of smoking habits. For instance, the percentage of current smokers of a given occupation had as much as a 25% difference depending on the industry they were employed, such as 52% vs 26% for managers and administrators. Detailed data will be made available as microcomputer files for interested researcher

ISSN:0271-3586    

DOI:10.1002/ajim.4700130103

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractThe distribution of cigarette smoking (as well as of cigar and pipe smoking in men) by occupation was examined in over 800,000 men and women age 45–70 who were enrolled in the American Cancer Society's prospective study in 1982. Striking variations were seen for men—less striking variations for women. Smoking rates were significantly higher in groups exposed to a number of occupational hazards, compared to groups not so exposed. A considerable amount of variation is related to social class, but some individual occupations exhibit notably high (law enforcement) or low (clergy) smoking rates.This information can be quite useful in planning morbidity or mortality studies of specific occupational groups or in analyzing data from existing stud

ISSN:0271-3586    

DOI:10.1002/ajim.4700130104

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractOccupational cohort studies are usually carried out without the benefit of information on smoking habits of cohort members. One common approach to avoid confounding bias related to smoking habits is to carry out an internal analysis, comparing workers with different degrees of occupational exposure. The premise behind this approach is that within a cohort there is unlikely to be correlation between degree of exposure and smoking habits. If this were untrue, smoking could confound the disease‐exposure relationships. Our purpose was to verify the premise. The study sample consisted of 857 French‐Canadian men born between 1910 and 1930, with 11 or fewer years of education, and interviewed around 1980 in the context of an occupational cancer case‐control study. For each man we had information on smoking habits, job history, and a history of the chemicals he was exposed to in each of his jobs. We computed two indices of the dirtiness of workers' job histories: one based on the job titles held by the man and a second based on the degree of exposures to workplace substances. There was no correlation between these indices of job dirtiness and smoking history. We also examined the smoking‐exposure relationship among the subsets of men who had been occupationally exposed to ten especially noticeable substances. Within the subsets, there was no indication of a consistent difference among the smoking subgroups in level or duration of exposure to these index substances. These findings do not support the view that nonsmokers sought out cleaner job environments than smokers; they imply that internal analyses of “dose‐response” in cohort studies are unlikely to be seriously confounded by s

ISSN:0271-3586    

DOI:10.1002/ajim.4700130105

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractMany occupational epidemiology studies require complete and accurate information on tobacco use to control for confounding by smoking and to assess interactions of smoking with workplace exposures. This paper reviews and evaluates the availability, reliability, validity, and efficiency of the various data sources and techniques for obtaining individual smoking data, including existing records, biological markers, and surveys. Emphasis is placed on the highly problematic issue of obtaining retrospective smoking histories. In general, the survey technique is currently deemed the most feasible approach for obtaining lifetime smoking histories. Both theoretical and practical aspects of smoking surveys are discussed in detail and are illustrated with a review of the recent literature and with data from two recent retrospective cohort studies conducted at the University of Pittsburgh. Several recommendations involving both the use of smoking data and areas for future methodologic research are presented. These include (1) justification for collecting smoking data in occupational studies based primarily on the potential for smoking to act as an effect modifier rather than solely as a confounder, (2) checks for reliability and validity in all studies which involve the collection of smoking data, (3) more methodologic research to better understand the impact that missing, unreliable, and invalid smoking data may have on the ability to detect and quantify important smoking‐exposure interactions, and (4) an assessment of the correlation between biological markers and cigarette carcinogen exposur

ISSN:0271-3586    

DOI:10.1002/ajim.4700130106

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractFor various reasons, data on smoking are frequently missing, or only partially available, in retrospective epidemiologic studies of occupational risk factors. In such situations, indirect methods may be used to evaluate the magnitude and direction of the potentially confounding effects of smoking. Such an evaluation can be made quantitatively or qualitatively. Here we describe both approaches. A specific problem relates to case‐referent studies, where sampling variation in referent selection may limit the possibility of controlling for confounding by smoking, even when smoking data are available. We present data showing that estimates of risk from occupational exposures which are not controlled for smoking may be as accurate as estimates derived after controlling for smoking, when the number of referents is relatively small. The problem of interaction is also discussed. In the absence of smoking data, the investigator has no indication of how smoking and occupation jointly affect disease risk (eg, additively or multiplicatively). The multiplicative model is usually assumed. However, if exposure and smoking act independently (additively), rate ratios are diminished. In such situations, in the presence of negative confounding by smoking, rate ratios may actually even be less than one—also when exposure and disease are strongly rela

ISSN:0271-3586    

DOI:10.1002/ajim.4700130107

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractWe define a multiplicative model and an additive model for the hazards associated jointly with exposure and with the presence of a confounder like smoking. Under the multiplicative model, the crude relative risk may be adjusted indirectly, by means of a factor proposed by Axelson [1978], and implicitly by Cornfield et al. [1959]and Schlesselman [1978]. We present corresponding indirect correction formulas under the additive risk model for the risk difference and for the excess relative risk. Conditions are established under which these corrections may be applied to age‐adjusted rates from composite study populations. We demonstrate that indirect corrections may be no better than crude measures of risk if one assumes the wrong model for the joint action of the exposure and confounding factors. These results are illustrated on an example of occupational exposure to vermiculite. The limitations of the techniques are discusse

ISSN:0271-3586    

DOI:10.1002/ajim.4700130108

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractVarious approaches to assessing the interaction between smoking and occupational exposures are described. The definition of interaction depends on the measure of association under consideration and can be expressed in terms of disease risk, time, or dose. Simple descriptive methods and maximum likelihood model fitting methods are presented for analyzing interactions in terms of joint effects on disease risk. Methods for assessing the influence of exposures on times to disease, using appropriate denominators, are also described. The various approaches are illustrated with published data on lung cancer in relation to asbestos, radon daughters, chloromethyl ethers, and arsenic. Some of the mechanisms that can be invoked to explain the observed patterns include initiation and promotion, lung clearance, transport across cell membranes, and mucous secretion.

ISSN:0271-3586    

DOI:10.1002/ajim.4700130109

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractA goal of analyses of occupational cohort data is the specification of how covariate information relates to age‐specific disease risks. In describing this relationship, certain assumptions or models must be defined. For example, the usual standardized mortality ratio assumes a constant multiplicative increase in the age and calendar period disease rates of an exposed cohort over rates in a unexposed referent group. For analyzing several exposures, some of which may be continuous, such as cumulative dose, dose rate, duration of employment, and smoking patterns, or for analyzing complex associations between disease rate and covariates, flexible regression procedures are required. Using a crossclassification of the data and a Poisson probability model, relative risk regression methods are outlined. Breslow and Storer [1985], Guerrero and Johnson [1982], and Thomas [1981] propose general models for the relative risk as alternatives to, but which include, the usual exponential form. We review these models, discuss some limitations (in particular when there is more than one covariate) and present alternatives. Methods and models are illustrated by examining the joint effects of radon exposure and tobacco use on lung cancer mortality among a group of uranium miner

ISSN:0271-3586    

DOI:10.1002/ajim.4700130110

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractCigarette smoking is a major cause of cancer and lung disease in the U.S. population. The biological processes that underlie the response of the lung to cigarette smoke are important considerations for designing analyses of the effects of occupational exposures. Interactions between cigarette smoking and occupational exposures may occur through a combined effect on the mechanism of disease production, through an effect on the dose of the toxic substances that reach the target issue, or through an effect on the response of the lung to the toxic agents. Disease due to occupational exposures can occur in a similar pattern in both smokers and nonsmokers; however, as more complex interactions are examined, different responses to the same occupational exposure may be identified for smokers and nonsmokers. It is only through the successful intermingling of biologic information with epidemiologic data that these interactions can be fully examined.

ISSN:0271-3586    

DOI:10.1002/ajim.4700130111

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY