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Methods of Cohort Analysis: Appraisal by Application to Asbestos Mining

F. D. K. Liddell, J. C. McDonald, D. C. Thomas and Stella V. Cunliffe
Journal of the Royal Statistical Society. Series A (General)
Vol. 140, No. 4 (1977), pp. 469-491
Published by: Wiley for the Royal Statistical Society
DOI: 10.2307/2345280
Stable URL: http://www.jstor.org/stable/2345280
Page Count: 23
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Methods of Cohort Analysis: Appraisal by Application to Asbestos Mining
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Abstract

Longitudinal studies of occupational mortality have usually been analysed a priori: the cohort is subdivided in terms of potential stimuli and comparisons made between sub-cohorts in their patterns of mortality. The alternative a posteriori argument compares the dead with the living, searching for differences in the potential stimuli. We selected the following methods for appraisal: (a) comparative composite cohort analysis (Case and Lea, 1955), against external and internal standards; (b) the use of a fixed number of controls for each death (following Miettinen, 1969); and (c) that of Cox (1972) based on regression models. Method (a) argues a priori, the others a posteriori. These three methods have been applied to a large cohort study of mortality in the Quebec chrysotile asbestos-producing industry, focusing on lung cancer. The methods agreed in demonstrating a clear direct relationship, which may well be linear, between excess lung cancer mortality and total dust exposure. Method (a), with an external standard, is useful for placing the cohort in demographic context. In method (b), only three or four controls should suffice for each case, leading to possibilities of improved quality of data. Similar advantages might be achieved for method (c) through some sampling of the living, but it would remain more complex; while it facilitates the study of interactions and, without sampling, can provide absolute risks, it was very expensive.

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