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Mortality odds ratio, proportionate mortality ratio, and healthy worker effect
Author(s) -
Stewart Walter,
Hunting Katherine
Publication year - 1988
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.4700140312
Subject(s) - medicine , standardized mortality ratio , odds ratio , demography , mortality rate , confidence interval , lung cancer , population , rate ratio , epidemiology , relative risk , environmental health , sociology
Abstract The standardized proportionate mortality ratio (PMR i ) and the mortality odds ratio (MOR i ) are two statistics used to approximate the cause specific standardized mortality ratio (SMR i ) when death data are available but the population at risk is not known. When there is a healthy worker effect, the MOR i will always overestimate the SMR i and will always be greater than the PMR i . The PMR i is influenced by the relative frequency of the cause of death. For rare causes, such as brain cancer or leukemia, the PMR i will overestimate the SMR i to essentially the same degree as the MOR i . For more common conditions, such as lung cancer, the PMR i will overestimate or underestimate the SMR i depending on the magnitude of the healthy worker effect. When the SMR i = 1 and there is a healthy worker effect, both the PMR i and MOR i are in excess of one (1) regardless of the disease rate. As the SMR i increases it is more likely to be bounded by the PMR i (lower) and the MOR i (upper). We therefore recommend that each statistic be derived when death certificates are the only source of data used to assess risk due to occupational exposures.