健康勞工效應的定義、來源、大小、影響因素及其防止之策略

Healthy Worker Effect - Its Definition, Sources, Magnitude, Contributory Factors and Control Strategies

吳聰能(Trong-Neng Wu)

《中華職業醫學雜誌》 2卷1期 (1995/01) Pp. 220-228

摘要

「健康勞工效應」在職業流行病學研究中是一個重要的問題。這是一種在職業性世代中觀察到比一般人口有較低的死亡率或罹病率的情形。其來源可分成：真實效應、選擇偏差、資料偏差、干擾偏差等四類，其影響的大小，在死亡率方面可出現10%-30%的偏差；對於可能之影響因子，如雇用時間、特定死因、職業型態、社經地位、年齡、性別等，可在研究設計或資料分析時加以控制，以防止或降低其影響。在職業流行病學研究中，不論是世代追溯或是橫斷性調查，不論是死亡、罹病率或是健康效應，都必須注意「健康勞工效應」的存在，避免影響研究之結論。

關鍵字

健康勞工效應 ； 職業流行病學研究 ； 偏差

並列摘要

The healthy worker effect (HWE) is an important issue in occupational epidemiological studies. It refers to an observed decrease in mortality or morbidity in workers when compared with the general population. Sources of HWE can be classified into four categories: true effect and selection, information, and confounding biases. The magnitude of HWE is estimated to bias the mortality of the workers by 10% to 30%. Employment duration, specific cause of death, type of occupation, socio-economic status, age and sex were identified as contributory factors of HWE. These factors could be controlled in the process of research design or data analysis to minimize the HWE. No matter what type of studies and what kind of data to be collected, HWE should be kept in mind while conducting occupational epidemiological studies, and strategies should be taken to reduce its interference with the interpretation of research finding.

並列關鍵字

Healthy worker effect ； Occupational epidemiology ； Bias