• Journal of Environmental Health Sciences
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• v.37 no.5
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• pp.342-347
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• 2011

Healthy worker effect (HWE) refers to the consistent tendency for actively employed individuals to have a more favorable mortality experience than the population at large. Although HWE has been well known since the 1970s, only a few studies in occupational epidemiology have attempted to fully define and evaluate HWE. HWE can be separated into effects on the initial hiring into the workforce (healthy worker hire effect) and those on continuing employment (healthy worker survival effect). In this review, we summarize the methods for minimizingor adjusting for the healthy worker effect available in occupational epidemiology. It is noteworthy that healthy worker survival effect appears complicated, considering that employment status plays simultaneous roles as a counfounding variable and intermediate variable, whereas healthy worker hire effect may be adjusted by incorporating health status at baseline into the statistical model. In addition, two retrospective cohort studies for workers in the semiconductor industry and Vietnam veterans in Korea, respectively, were introduced, and their results were explained in terms of healthy worker effect.

• Korean Journal of Occupational Health Nursing
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• v.12 no.2
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• pp.146-155
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• 2003

This study was conducted for investigating the status of management of preemployment health examination and to have an effect on the worker's employment. Health managers of 103 companies in Incheon metropolitan city and Gyeonggi were interviewed by telephone. Of 103 companies, 67(65.1%) said they don't hire the applicants who have an active pulmonary tuberculosis, 80(77.7%) companies said they health HBV carrier is acceptable but active HBV carrier is not 29(28.2%) companies said they don't hire the applicants who have a hypertension or diabetes mellitus, 42(40.8%) companies said they don't hire the applicants who have a hearing disturbance. If HIVD is suspicious in X-ray lumbar-sacral region, 37(78.7% of 47 companies) said they do not hire the applicants. 29(35% of 83 companies) said they cancel the employment of the applicants who are suspicious of noise induced hearing loss on preplacement health examination. From our survey, preemployment health examination was utilizing mainly as a tool for the selection of health employees who don't have a disease. Furthermore, in many companies, additional test items are being included and getting more strict the selection criteria for preemployment health examination. For the right use of preemployment health examination, author suggested that further studies were needed to select the adequate test items and establish the reasonable criteria for preemployment health examination.

• Journal of Environmental Health Sciences
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• v.40 no.5
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• pp.385-396
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• 2014

Objectives: By conducting a meta-analysis of cohort studies reporting standardized mortality ratios (SMRs) for workers exposed to trichloroethylene, we attempted to adjust for healthy hired effect by applying the same methods as described in a recent report from the Agricultural Health Study. Methods: Among all cohort studies that evaluated the association between all cancer, non-Hodgkin's lymphoma (NHL), kidney cancer, liver cancer and occupational exposure to trichloroethylene, a total of 10 studies reporting SMR values were selected. A random-effects model was used to estimate the summary SMRs or rSMRs and 95% confidence intervals. Relative SMR ($rSMR=SMR_x/SMR_{not\;x}$) was calculated comparing observed and expected counts for all cancer, NHL, kidney cancer, and liver cancer with an independent referent set of values consisting of the observed and expected counts for other causes. Results: The SMR values for all causes ranged from 0.68 to 1.03, suggesting moderate to weak healthy worker effect for the selected studies. When the healthy worker hire effect was taken into account, the summarized risk became statistically significant; the summary SMR of all cancer was 0.95 (0.91-1.00) and the summary rSMR of all cancer was 1.10 (1.04-1.15). The summary SMR of NHL was 1.04 (0.93-1.14) and the summary rSMR of NHL was 1.23 (1.04-1.46). The summary SMR of kidney cancer was 1.08 (0.88-1.33) and the summary rSMR of kidney cancer was 1.23 (1.02-1.49). The summary SMR of liver cancer was 0.88 (0.78-0.99), and the summary rSMR of liver cancer was 0.95 (0.84-1.07). Conclusion: The rSMR method is useful to determine summary risk adjusted for healthy worker effect through meta-analysis.