Adjustment for smoking, alcohol consumption, and socioeconomic status in the California Occupational Mortality Study.

This paper presents methods for adjusting for smoking, alcohol, and socioeconomic status in death certificate-based occupational mortality surveillance. The methods were applied in the California Occupational Mortality Study, a statewide study of rates based on 180,000 deaths and census estimates of occupations. For each occupation, levels of smoking, alcohol consumption, and socioeconomic status were estimated using National Health Interview Survey and U.S. Census data, and an empirical Bayes procedure was used to improve the stability of smoking and alcohol estimates for small occupations. Expected death rates for occupations were calculated by modeling rates as a function of age, smoking, alcohol, and socioeconomic status with Poisson regression. The effect of adjustment was usually moderate and in the expected direction, and the adjusted mortality ratios were generally closer to 1.0. Full data on agricultural occupations are presented for illustration.

Occupational mortality of California women, 1979-1981.

A review of California's mortality data for 1979 through 1981, encompassing 61,561 female and 111,877 male deaths, shows differential female mortality risk by labor force status and by occupation. High patterns of risk were found for women in a number of occupations, including waitresses, licensed vocational nurses and health aides, cosmetologists, telephone operators, housekeepers and janitors, and launderers and dry cleaners. Patterns of mortality risk were similar for each race within these occupational groups. The mortality risks for women were generally higher than those for men. The association of mortality with certain occupational does not necessarily imply a causal relationship but is certainly a signal that further research is required and that physicians need to consider work-related factors in evaluating the health of women.