A comparison of meta-Analysis results with and without adjustment for the healthy worker effect: Cancer mortality among workers in the semiconductor industry

Sung Ho Hwang, Moon Young Park, Won Jin Lee, Inho Park, Kimyong Hong, Donguk Park, Kyoung Mu Lee

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

OBJECTIVES: This study compared the results of meta-Analysis with and without adjustment for the healthy worker effect on the association between working in the semiconductor industry and cancer mortality. METHODS: Six studies that reported standardized mortality ratios (SMRs) for cancers were selected for meta-Analysis. Using a random-effects model, the SMR results from each study were combined for all cancers and leukemias to estimate the summary SMRs (95% confidence interval, CI). To adjust for the healthy worker effect, the relative standardized mortality ratio (rSMR=SMRx/SMRnot x) were calculated using observed and expected counts for the specific cause of interest (i.e., all cancers and leukemias) and the observed and expected counts for all other causes of mortality. Then, the rSMR results were combined to estimate the summary rSMRs (95% CIs). RESULTS: The SMRs for all causes of mortality among semiconductor industry workers ranged from 0.25 to 0.80, which reflects a significant healthy worker effect. A remarkable difference was found between the summary SMRs and the summary rSMRs. The summary SMR for all cancers was 0.70 (95% CI, 0.63 to 0.79) whereas the summary rSMR was 1.38 (95% CI, 1.20 to 1.59). The summary SMR for leukemia was 0.88 (95% CI, 0.72 to 1.07), and the summary rSMR was 1.88 (95% CI, 1.20 to 2.95). CONCLUSIONS: Our results suggest that adjustment for the healthy worker effect (i.e., rSMR) may be useful in meta-Analyses of cohort studies reporting SMRs.

Original languageEnglish
Article numbere2021057
JournalEpidemiology and health
Volume43
DOIs
Publication statusPublished - 2021

Keywords

  • Healthy worker effect
  • Meta-Analysis
  • Mortality
  • Semiconductor

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

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