Hypothetical Exposure Limits for Oil-Based Metalworking Fluids and Cardiovascular Mortality in a Cohort of Autoworkers: Structural Accelerated Failure Time Models in a Public Health Framework

Hypothetical Exposure Limits for Oil-Based Metalworking Fluids and Cardiovascular Mortality in a Cohort of Autoworkers: Structural Accelerated Failure Time Models in a Public Health Framework

Occupational exposure to aerosolized particles of oil-based metalworking fluid was recently linked to deaths from ischemic heart disease. The current recommended exposure limits might be insufficient. Studying cardiovascular mortality is challenging because symptoms can induce sicker workers to redu...

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Main Authors: Picciotto, Sally, Peters, Annette, Eisen, Ellen A.
Format: Online
Language:English
Published: Oxford University Press 2015
Online Access:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4388016/
id pubmed-4388016
recordtype oai_dc
spelling pubmed-43880162015-04-09 Hypothetical Exposure Limits for Oil-Based Metalworking Fluids and Cardiovascular Mortality in a Cohort of Autoworkers: Structural Accelerated Failure Time Models in a Public Health Framework Picciotto, Sally Peters, Annette Eisen, Ellen A. ORIGINAL CONTRIBUTIONS Occupational exposure to aerosolized particles of oil-based metalworking fluid was recently linked to deaths from ischemic heart disease. The current recommended exposure limits might be insufficient. Studying cardiovascular mortality is challenging because symptoms can induce sicker workers to reduce their exposure, causing healthy-worker survivor bias. G-estimation of accelerated failure time models reduces this bias and permits comparison of multiple exposure interventions. Michigan autoworkers from the United AutoWorkers–General Motors cohort (n = 38,666) were followed from 1941 through 1994. Separate binary variables indicated whether annual exposure exceeded a series of potential limits. Separate g-estimation analyses for each limit yielded the total number of life-years that could have been saved among persons who died from specific cardiovascular causes by enforcing that exposure limit. Banning oil-based fluids would have saved an estimated 4,003 (95% confidence interval: 2,200, 5,807) life-years among those who died of ischemic heart disease. Estimates for cardiovascular disease overall, acute myocardial infarction, and cerebrovascular disease were 3,500 (95% confidence interval: 1,350, 5,651), 2,932 (95% confidence interval: 1,587, 4,277), and 917 (95% confidence interval: −80, 1,913) life-years, respectively. A limit of 0.01 mg/m3 would have had a similar impact on cerebrovascular disease but one only half as great on ischemic heart disease. Analyses suggest that limiting exposure to metalworking fluids could have saved many life-years lost to cardiovascular diseases in this cohort. Oxford University Press 2015-04-15 2015-03-27 /pmc/articles/PMC4388016/ /pubmed/25816818 http://dx.doi.org/10.1093/aje/kwu484 Text en © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
repository_type Open Access Journal
institution_category Foreign Institution
institution US National Center for Biotechnology Information
building NCBI PubMed
collection Online Access
language English
format Online
author Picciotto, Sally
Peters, Annette
Eisen, Ellen A.
spellingShingle Picciotto, Sally
Peters, Annette
Eisen, Ellen A.
Hypothetical Exposure Limits for Oil-Based Metalworking Fluids and Cardiovascular Mortality in a Cohort of Autoworkers: Structural Accelerated Failure Time Models in a Public Health Framework
author_facet Picciotto, Sally
Peters, Annette
Eisen, Ellen A.
author_sort Picciotto, Sally
title Hypothetical Exposure Limits for Oil-Based Metalworking Fluids and Cardiovascular Mortality in a Cohort of Autoworkers: Structural Accelerated Failure Time Models in a Public Health Framework
title_short Hypothetical Exposure Limits for Oil-Based Metalworking Fluids and Cardiovascular Mortality in a Cohort of Autoworkers: Structural Accelerated Failure Time Models in a Public Health Framework
title_full Hypothetical Exposure Limits for Oil-Based Metalworking Fluids and Cardiovascular Mortality in a Cohort of Autoworkers: Structural Accelerated Failure Time Models in a Public Health Framework
title_fullStr Hypothetical Exposure Limits for Oil-Based Metalworking Fluids and Cardiovascular Mortality in a Cohort of Autoworkers: Structural Accelerated Failure Time Models in a Public Health Framework
title_full_unstemmed Hypothetical Exposure Limits for Oil-Based Metalworking Fluids and Cardiovascular Mortality in a Cohort of Autoworkers: Structural Accelerated Failure Time Models in a Public Health Framework
title_sort hypothetical exposure limits for oil-based metalworking fluids and cardiovascular mortality in a cohort of autoworkers: structural accelerated failure time models in a public health framework
description Occupational exposure to aerosolized particles of oil-based metalworking fluid was recently linked to deaths from ischemic heart disease. The current recommended exposure limits might be insufficient. Studying cardiovascular mortality is challenging because symptoms can induce sicker workers to reduce their exposure, causing healthy-worker survivor bias. G-estimation of accelerated failure time models reduces this bias and permits comparison of multiple exposure interventions. Michigan autoworkers from the United AutoWorkers–General Motors cohort (n = 38,666) were followed from 1941 through 1994. Separate binary variables indicated whether annual exposure exceeded a series of potential limits. Separate g-estimation analyses for each limit yielded the total number of life-years that could have been saved among persons who died from specific cardiovascular causes by enforcing that exposure limit. Banning oil-based fluids would have saved an estimated 4,003 (95% confidence interval: 2,200, 5,807) life-years among those who died of ischemic heart disease. Estimates for cardiovascular disease overall, acute myocardial infarction, and cerebrovascular disease were 3,500 (95% confidence interval: 1,350, 5,651), 2,932 (95% confidence interval: 1,587, 4,277), and 917 (95% confidence interval: −80, 1,913) life-years, respectively. A limit of 0.01 mg/m3 would have had a similar impact on cerebrovascular disease but one only half as great on ischemic heart disease. Analyses suggest that limiting exposure to metalworking fluids could have saved many life-years lost to cardiovascular diseases in this cohort.
publisher Oxford University Press
publishDate 2015
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4388016/
_version_ 1613208483200499712

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