title: Bayesian Approach to "Healthy Worker Hire Effect" in Standardized Mortality Ratio Analysis.
abstract: OBJECTIVE
  In this study, we address the healthy worker hire effect that arises when people with greater than average health are recruited to work in industrial jobs.
  
  
  METHODS
  Epidemiologists have used both general and working population reference rates to gauge influence of healthy worker hire effect on the standardized mortality ratio. We propose a Bayesian procedure that uses information derived from general and working population reference rates to calculate standardized mortality ratio.
  
  
  RESULTS
  The procedure is illustrated in the context of heart disease and lung cancer mortality analyses of a cohort of workers from a fluoropolymer production facility.
  
  
  CONCLUSIONS
  Application of our method should allow for fuller discussions of the healthy worker effect when one of its components, the healthy worker hire effect, is evaluated quantitatively. Our method can be utilized to improve risk estimates for a cohort with occupational exposure.
authors.affiliation: Department of Environmental and Occupational Health (Drs Burstyn, Hamra); Department of Epidemiology and Biostatistics (Dr Burstyn), School of Public Health, Drexel University, Philadelphia, Pennsylvania; and DuPont Epidemiology Program-Integrated Health Services (Dr Symons), Newark, Delaware.
authors.forename: Igor
authors.initials: I
authors.lastname: Burstyn
authors.forename: Ghassan B
authors.initials: GB
authors.lastname: Hamra
authors.forename: J Morel
authors.initials: JM
authors.lastname: Symons
mesh_terms: D000328:Adult; D001499:Bayes Theorem; D002617:Chemical Industry; D005260:Female; D015989:Healthy Worker Effect; D006331:Heart Diseases / Q000401:mortality*; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009784:Occupational Diseases / Q000401:mortality*; D016273:Occupational Exposure / Q000009:adverse effects*; D014903:West Virginia / Q000453:epidemiology