Developments in occupational cohort studies

  • Checkoway H
  • Eisen E
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Abstract

Many occupational health risks were first identified by case-series reports of apparent disease excesses or clusters, often recognized by clinicians. Discoveries of fatal silicosis among underground metal miners (1) and scrotal cancer in young chimney sweeps (2) pro- vide dramatic examples of the importance of case- series reporting in hazard identification. Causal infer- ences may also be drawn from reviews of routinely collected population statistics that include data on occupation and cause of death. For example, review of mortality and recorded occupational classification in the United Kingdom by Kennaway and Kennaway (3) in the 1920s and 1930s led to the recognition of the association between mineral oil mists and laryngeal cancer. More generally, however, linking the inci- dence of disease and injury with occupational expo- sure requires formal epidemiologic study designs, es- pecially in instances where associations are not exceptionally strong and the health outcomes of con- cern can be caused by multiple factors. In this presen- tation, we review recent developments in occupational cohort study design applications, with particular em- phasis on the increasingly broadened spectrum of health outcomes that can be investigated. Application of the cohort study design has been instrumental in the identification of numerous occupa- tional hazards and quantification of associated risks. During the past 50 years, occupational cohort studies have been the cornerstone of investigation of chronic fatal diseases. Landmark studies in the United King- dom of cancer risks in the gas works (4), dyestuff (5), and asbestos (6) industries made dual contributions of identifying specific occupational carcinogens and ad- vancing the methodology of the historical cohort design.

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