Abstract
In a population-based case–referent study of lung cancer we wanted to estimate the over-all influence on the lung cancer incidence from several occupational exposures. Standard methods to do this are based on addition of separately estimated attributable fractions (AFs) by rather complex formulas. Although a simple and valid method for direct estimation of summary effects was published in 1990, it is not well known and has rarely been used. We here describe the method and apply it to the data from the case–referent study. The AF for withdrawal of occupational exposure to both asbestos and combustion products were nearly identical regardless of if it was calculated by an algorithm for summation of AF for the exposure factors separately (6.90%), by a bootstrap method (6.89%, 95% confidence interval, CI: 3.69, 10.04), or by the simple ‘dichotomization’-method (6.88%, 95%CI: 3.81, 9.84). The method is very easy to apply to population-based case–referent studies analyzed by logistic regression.
This is a preview of subscription content, log in via an institution to check access.
References
Gustavsson P, Jakobsson R, Nyberg F, Pershagen G, Järup L, Schéele P. Occupational exposure and lung cancer risk - a population-based case-referent study in Sweden. Am J Epidemiol 2000; 152: 32–40.
Nyberg F, Gustavsson P, Järup L, et al. Urban air pollution and lung cancer in Stockholm. Epidemiology 2000; 11: 587–595.
Rothman KJ, Greenland S. Modern Epidemiology. 2nd ed. Philadelphia: Lippincott - Raven, 1998.
Gefeller O. An annotated bibliography on the attributable risk. Biom J 1992; 34: 1007–1012.
Olsen O. Unbiased vs. conservative estimators of etiological fractions; examples of missclassification from studies of occupational lung cancer. Am J Ind Med 1995; 27: 837–843.
Rockhill B, Newman B, Weinberg C. Use and misuse of population attributable fractions. Am J Public Health 1998; 88: 15–19.
Greenland S. Re: Confidence limits made easy: Interval estimations using a substitution method (letter to the editor). Am J Epidemiol 1999; 149: 884.
Greenland S. Attributable fractions: Bias from broad definition of exposure. Am J Epidemiol 2001; 12: 518–520.
Benichou J, Gail MH. A review of adjusted estimators of attributable risk. Stat Methods Med Res 2001; 10: 195–216.
Greenland S, Robins J. Conceptual problems in the definition and interpretation of attributable fractions. Am J Epidemiol 1988; 128: 1185–1197.
Gefeller O, Eide GE. The attributable fraction of the combined effect of two risk factors (letter to the editor). Int J Epidemiol 1992; 21: 819–820, 823-824.
Checkoway H, Hickey JLS. Estimating the potential disease rate reduction under varying conditions of combined effects. Int J Epidemiol 1988; 17: 666–672.
Kleinbaum DG, Kupper LK, Morgenstern H. Epidemiologic Research. Principles and Quantitative Methods. New York: Van Nostrand Reinhold Co., 1982.
Benichou J. Variance calculations and confidence intervals for estimates of the attributable risk based on logistic models. Biometrics 1990; 46: 991–1003.
Bruzzi P, Green SB, Byar DP, Brinton LA, Schairer C. Estimating the population attributable risk for multiple risk factors using case-control data. Am J Epidemiol 1985; 122: 904–914.
Hartge P, Harvey EB, Linehan WM, et al. Unexplained excess risk of bladder cancer in men. J Natl Cancer Inst 1990; 82: 1636–1640.
Wacholder S, Benichou J, Heineman EF, Hartge P, Hoover RN. Attributable risk: Advantages of a broad definition of exposure. Am J Epidemiol 1994; 140: 303–309.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Gustavsson, P., Ahlbom, A., Andersson, T. et al. Calculation of fractions of lung cancer incidence attributable to occupational exposure to asbestos and combustion products in Stockholm, Sweden. Eur J Epidemiol 18, 937–940 (2003). https://doi.org/10.1023/A:1025885925199
Issue Date:
DOI: https://doi.org/10.1023/A:1025885925199