A comprehensive review of the healthy worker effect in occupational epidemiological studies

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dc.contributor.authorAlgarni, Fahad Saaden_US
dc.date.accessioned2020-11-18T10:02:33Z
dc.date.available2020-11-18T10:02:33Z
dc.date.issued2020-09
dc.description.abstractThe reduction of mortality and morbidity rates among occupational cohort studies may be attributed to the presence of the healthy worker effect (HWE). Occupational epidemiologic studies investigating worker’s health are prone to the risk of having the HWE phenomenon and this special form of bias has been debated over the years. Hence, it’s imperative to explore in-depth the magnitude and sources of HWE, and further, elucidate the factors that may affect HWE and strategies reducing HWE. The HWE should be considered as a mixed bias between selection and confounding bias. The validity threats due to the HWE among morbidity studies are the same as the mortality studies. The consequent reduction due to the HWE in the association between the exposure and outcome may lead to underestimating some harmful exposures in the workplace or occupational settings. Healthy hire effect and healthy worker survivor effect are the main sources of HWE. Several factors can increase or decrease the probability of HWE; therefore, the investigators should consider them among future occupational epidemiological studies. Many strategies can help in reducing the impact of HWE, but each strategy has its weaknesses and strengths. Not all strategies can be applied among all occupational epidemiological studies. Mathematical procedures still need further investigations to be validated. HWE is a consequence of inappropriate comparison groups in nature. The usage of the general population as a reference group is not an appropriate choice. By considering the HWE sources and factors and using appropriate strategies, the impact of HWE may be reduced.en_US
dc.identifier.affiliationsDepartment of Rehabilitation Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabiaen_US
dc.identifier.citationAlgarni Fahad Saad. A comprehensive review of the healthy worker effect in occupational epidemiological studies. International Journal of Research in Medical Sciences. 2020 Sep; 8(9): 3394-3400en_US
dc.identifier.issn2320-6071
dc.identifier.issn2320-6012
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/212610
dc.languageenen_US
dc.publisherMedip Academyen_US
dc.relation.issuenumber9en_US
dc.relation.volume8en_US
dc.source.urihttps://dx.doi.org/10.18203/2320-6012.ijrms20203702en_US
dc.subjectConfounding biasen_US
dc.subjectHealthy worker effecten_US
dc.subjectHealthy worker survivor effecten_US
dc.subjectOccupational epidemiologyen_US
dc.subjectSelection biasen_US
dc.titleA comprehensive review of the healthy worker effect in occupational epidemiological studiesen_US
dc.typeJournal Articleen_US
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