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Journal Article

Citation

Busey A, Asfaw A, Applebaum KM, Leary PKO, Tripodis Y, Fox MP, Stokes AC, Boden LI. Ann. Epidemiol. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, American College of Epidemiology, Publisher Elsevier Publishing)

DOI

10.1016/j.annepidem.2021.09.015

PMID

34607011

Abstract

PURPOSE: Recent studies have shown increased all-cause mortality among workers following disabling workplace injury. These studies did not account for two potentially important confounders, smoking and obesity. We estimated injury-related mortality accounting for these factors.

METHODS: We followed workers receiving New Mexico workers' compensation benefits (1994-2000) through 2013. Using data from the Panel Study of Income Dynamics, we derived the joint distribution of smoking status and obesity for workers with and without lost-time injuries. We conducted a quantitative bias analysis (QBA) to determine the adjusted relationship of injury and mortality.

RESULTS: We observed hazard ratios after adjusting for smoking and obesity of 1.13 for women (95% simulation interval (SI) 0.97 to 1.31) and 1.12 for men (95% SI 1.00 to 1.27). The estimated fully adjusted excess hazard was about half the estimates not adjusted for these factors.

CONCLUSIONS: Using QBA to adjust for smoking and obesity reduced the estimated mortality hazard from lost-time injuries and widened the simulation interval. The adjusted estimate still showed more than a 10 percent increase for both women and men, although the 95% SI for women included 1.0. The change in estimates reveals the importance of accounting for these confounders. Of course, the results depend on the methods and assumptions used.


Language: en

Keywords

Excess Mortality; Confounding; Epidemiological bias; Occupational Safety; Quantitative Bias Analysis

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