Retrospective Cohort Mortality Study of Workers in a Polymer Production Plant Including a Reference Population of Regional Workers

• Published in: Annals of epidemiology Vol. 18; no. 1; pp. 15 - 22
• Main Authors: Leonard, Robin C., PhD, Kreckmann, Kim H., BS, Sakr, Carine J., MD, MPH, Symons, J. Morel, PhD, MPH
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2008
• Subjects: Adult; Chemical Industry - manpower; Cohort Studies; Diabetes Mellitus - mortality; Female; Healthy Worker Effect; Humans; Internal Medicine; Male; Middle Aged; Myocardial Ischemia - mortality; Occupational Diseases - chemically induced; Occupational Diseases - mortality; Occupational Exposure - adverse effects; Occupational Health; Retrospective Studies; Standardized Mortality Ratios; United States; United States; USA, West Virginia; USA, Washington; WW; Healthy Worker Effect; National Death Index; standardized mortality ratio; Occupational Health; APFO; CI; Washington Works plant facility in Parkersburg, WV; perfluorooctanoic acid; PFOA; OCMAP; NDI; Standardized Mortality Ratios; ammonium perfluorooctanoate; HWE; Occupational Mortality Analysis Program; SMR; confidence interval; Cohort Studies
• ISSN: 1047-2797; 1873-2585
• DOI: 10.1016/j.annepidem.2007.06.011

Purpose Based on previous reports of increased serum lipid levels in workers at a U.S. polymer manufacturing facility, the study objective was to investigate ischemic heart disease (IHD) mortality as well as a broad range of mortality causes for an occupational cohort at the facility. Methods The cohort comprised 6,027 men and women who had worked at the facility between 1948 and 2002; these years delimit the mortality follow-up period. Standardized mortality ratios (SMR) were estimated to compare observed numbers of deaths to expected numbers derived from mortality rates for 3 reference populations: the U.S. population, the West Virginia state population, and an 8-state regional employee population from the same company. Results Most SMR estimates based on U.S. and state populations were below 100. Comparison to the employee population also resulted in many SMR estimates at or near a no-effect level. Relative to the regional worker population, a nonsignificant elevation for IHD mortality was observed (SMR = 109, 95% confidence interval [CI]: 96, 124). Mortality associated with diabetes was significantly increased compared to the regional worker population (SMR = 197, 95% CI: 123, 298). A corresponding increase in the SMR for IHD and diabetes mortality was not detected for comparisons with the two general populations. Conclusions The results reported herein show little evidence of increased cause-specific mortality risks for workers at the plant. This study demonstrates the utility of comparing occupational cohorts with a similar worker reference population in order to reduce bias associated with the healthy worker effect.