Healthy Workers and Healthy Users: Comparing Approaches to Mitigate Confounding and Selection Bias in Occupational and Pharmaco-Epidemiology

Healthy Workers and Healthy Users: Comparing Approaches to Mitigate Confounding and Selection Bias in Occupational and Pharmaco-Epidemiology

The healthy preventive drug user bias in pharmacoepidemiology and the healthy worker bias in occupational epidemiology arise through similar structural mechanisms, whereby the underlying health status of an individual is related to initial and continued exposure over time. Each sub-discipline has developed study design and analytic methods to mitigate bias; however, the similarities and differences between these approaches have not been thoroughly examined. In this symposium, we will review the historical foundations of the healthy worker and healthy user biases and discuss recent methodological advances to address these biases in the fields of occupational and pharmaco-epidemiology. Presentations will focus on contemporary examples that serve to motivate discussion of whether and how study design and methodological approaches can be tailored and translated between the two sub-disciplines.

Session Chair:
Jennifer Lund,
University of North Carolina, Chapel Hill

Presenters:
Til Sturmer, University of North Carolina, Chapel Hill
Sally Picciotto, University of California, Berkeley
Alexander Keil, University of North Carolina, Chapel Hill
Miguel Hernan, Harvard T.H. Chan School of Public Health