Application of Standardized Proportional Mortality Ratio to the Assessment of Health Risk in Relatively Healthy Populations

When a study population is relatively healthy, such as an occupational population, epidemiological studies are likely to underestimate risk. We used a case study on the cancer risk of workers with exposure to acid mists, a well-documented carcinogen, to demonstrate that using proportional mortality ratios (PMRs) is more appropriate than mortality ratios in assessing risk in terms of mortality. The study included 10,229 employees of a telecommunication company who worked in buildings with battery rooms. In these buildings, the battery rooms had the highest levels of sulfuric acid in the air (geometric mean = 10.7 μg/m 3 ). With the general population in Taiwan as a reference, a decreased standardized mortality ratio (0.42, p p = 0.01) and cancers of the digestive organs and peritoneum (1.61, p = 0.02), especially stomach cancer (2.94, p = 0.01). The results showed that PMR can detect increases in mortality when a study population is generally healthier than the comparison population and call for further studies on the possible carcinogenic effects of low-level acid mist exposures on the stomach

Cancer · Environmental health · Population · Standardized mortality ratio · Stomach cancer · Air Quality and Health Impacts · Demography · Injury Epidemiology and Prevention · Medicine · Occupational and environmental lung diseases · Epidemiology · Internal Medicine

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