Use of multiple-cause mortality data in epidemiologic analyses: US rate and proportion files developed by the National Institute for Occupational Safety and Health and the National Cancer Institute.
United States (US) mortality rates and proportions for the entire US population were created using multiple cause of death data for the years 1960 through 1989. The data included the usual underlying cause of death listed on the death certificate as well as contributory causes and other significant conditions. The rate and proportion files, which were age, sex, race, and calendar time specific, allowed for the calculation of the expected occurrences of disease on the death certificates of the cohort under study. Two examples were presented to illustrate the use of this data with occupational cohorts; one case involved the deaths of granite cutters while the other involved workers exposed to dioxin (1746016). Multiple cause analyses revealed twofold significant excesses of renal disease and arthritis among granite cutters, but no excess of diabetes in dioxin exposed subjects. The authors conclude that multiple cause of death data can provide a useful tool for epidemiologic analyses of mortality data; the best candidates for multiple cause analysis appear to be those diseases with a long time course that are not necessarily fatal but are serious enough to be noted on the death certificate.
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