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http://dx.doi.org/10.5668/JEHS.2011.37.5.342

Methods to Minimize or Adjust for Healthy Worker Effect in Occupational Epidemiology  

Lee, Kyoung-Mu (Department of Environmental Health, Korea National Open University)
Chun, Jae-Buhm (Department of Environmental Health, Korea National Open University)
Park, Dong-Uk (Department of Environmental Health, Korea National Open University)
Lee, Won-Jin (Department of Preventive Medicine, College of Medicine, Korea University)
Publication Information
Journal of Environmental Health Sciences / v.37, no.5, 2011 , pp. 342-347 More about this Journal
Abstract
Healthy worker effect (HWE) refers to the consistent tendency for actively employed individuals to have a more favorable mortality experience than the population at large. Although HWE has been well known since the 1970s, only a few studies in occupational epidemiology have attempted to fully define and evaluate HWE. HWE can be separated into effects on the initial hiring into the workforce (healthy worker hire effect) and those on continuing employment (healthy worker survival effect). In this review, we summarize the methods for minimizingor adjusting for the healthy worker effect available in occupational epidemiology. It is noteworthy that healthy worker survival effect appears complicated, considering that employment status plays simultaneous roles as a counfounding variable and intermediate variable, whereas healthy worker hire effect may be adjusted by incorporating health status at baseline into the statistical model. In addition, two retrospective cohort studies for workers in the semiconductor industry and Vietnam veterans in Korea, respectively, were introduced, and their results were explained in terms of healthy worker effect.
Keywords
Health worker effect; Health worker hire effect; Healthy worker survival effect;
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