Reversal of the Healthy-worker Effect.
The well-known healthy-worker effect (HWE) may become reversed at advanced ages. The HWE deficit of deaths at younger ages must be compensated for by extra deaths at advanced ages. A hypothesized distribution of these compensating deaths illustrates how they may increase age-specific mortality rates. This can probably produce spurious associations with occupational exposures when cohort follow-up is long. This point is illustrated for lung cancer by data from a reported study of beryllium workers.
Archer
VE
Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, 50 North Medical Drive, Salt Lake City, Utah 84112, USA.