Background
For more than 50 years, the Department of Biostatistics (BIOS), home to the Center for Occupational Biostatistics and Epidemiology (COBE), has been one of the leading academic centers of occupational and environmental health research in the United States. BIOS faculty have been active in the development and application of biostatistical methods to study potential health effects of workplace exposures in a variety of industrial settings including: man-made vitreous fiber production, steel making, coal mining, refinery and petrochemical operations, copper and zinc smelting, pharmaceutical production, jet engine manufacturing and tungsten carbide production.
Current and former BIOS faculty members who have made significant contributions in occupational and environmental health research include (alpha order): Vincent Arena, Ph.D, Jeanine Buchanich, Ph.D, Laura Cassidy, Ph.D., Joseph Costantino, Dr.P.H., Richard Day, Ph.D., Philip Enterline, Ph.D., Gary Marsh, Ph.D., Sati Mazumdar, Ph.D., Carol Redmond, Sc.D., Howard Rockette, Ph.D., Roslyn Stone, Ph.D. and Ada Youk, Ph.D.
Faculty members in BIOS continue to make important contributions to the development of new statistical methodology and to provide the quantitative component to public health and biomedical research efforts that have had a major impact on the prevention and treatment of disease. BIOS faculty have also pioneered new and innovative statistical methods, computer software and data base systems to refine and facilitate the conduct of these investigations.
Gary M. Marsh, Ph.D., Professor of Biostatistics and Director and Founder of COBE has been active in occupational health research in BIOS for more than 40 years, and for many years has directed the Department's largest occupational health research unit. Dr. Marsh's research unit in COBE currently includes: a Ph.D. level epidemiologist (Dr. Jeanine Buchanich), a masters level biostatistician and PhD student (Mr. Adam Krutchen), an information/computer scientist (Mr. Charles Alcorn), and technical/clerical support staff including a professional interviewer.
COBE has conducted occupational studies to investigate the long-term health effects of exposure to such agents as man-made mineral fibers, formaldehyde, acrylamide, acrylonitrile, arsenic, petrochemicals, aromatic amines, tungsten carbide with cobalt binder and pharmaceuticals. They have also applied their expertise in occupational epidemiological research to environmental epidemiologic studies of communities exposed to industrial pollutants or to hazardous waste site materials. Following is a sample of recent publications in the occupational and environmental health areas:
- Marsh GM, Youk AO, Buchanich JM, Esmen NA. Mortality Patterns among Workers in a U.S. Pharmaceutical Production Plant. Annals of Epidemiology, 15:112-122, 2005.
- Marsh GM, Gula MJ. Employment as a Welder and Parkinson’s Disease among Heavy Equipment Manufacturing Workers. Journal of Occupational and Environmental Medicine, 48:1031-1045, 2006.
- Marsh GM, Youk AO, Buchanich JM, Cunningham M, Esmen NA, Hall TA, Phillips ML. Mortality Patterns among Industrial Workers Exposed to Chloroprene and Other Substances: I. General Mortality Patterns. Chemico-Biological Interactions 166:285-300, 2007.
- Marsh GM, Youk AO, Buchanich JM, Cunningham M, Esmen NA, Hall TA, Phillips ML. Mortality Patterns among Industrial Workers Exposed to Chloroprene and Other Substances: II. Mortality in Relation to Exposure. Chemico-Biological Interactions 166:301-316, 2007.
- Marsh GM, Youk AO, Buchanich JM, Kant IJ, Swaen G. Mortality among Workers Exposed to Acrylamide: Updated Follow-up. Occupational and Environmental Medicine, 49:82-95, 2007.
- Marsh GM, Youk AO, Buchanich JM, Erdal S, Esmen NA. Work in the Metal Industry and Nasopharyngeal Cancer Mortality among Formaldehyde-Exposed Workers. Regulatory Toxicology and Pharmacology 48:308-319, 2007.
- Walker R, Williams GW. Aspartame: A Safety Evaluation Based on Current Use Levels, Regulations, Toxicological and Epidemiological Studies. Critical Reviews in Toxicology 37:629-727, 2007.
- Lippert J, Lacey S, Esmen N, Kennedy K, Hancock R, Marsh GM, Buchanich J, Youk A, Cunningham M, Lieberman F, Magnetic field exposure in a non-destructive testing operation. Archives of Environmental and Occupational Health 62:187-193, 2007.
- Fong J, Marsh GM, Stokan L, Ruhl L, Vinson C. The Hospital Quality Performance Report: An Application of Composite Scoring. American Journal of Medical Quality 23:287-295, 2008.
- Kheifets L, Bowman J, Checkoway H, Feychting M, Harrington M, , Kavet R, Marsh GM, Mezei G, Renew J, van Wijngaarden E. Future Needs of Occupational ELF EMF Epidemiology. Occupational and Environmental Medicine 66:72-80, 2009, Online version September 19, 2008.
- Cassidy L, Buchanich J, Marsh GM. Proposed Sampling Plan for a National Trauma Registry for Children. Journal of Registry Management 35:113-119, 2008.
- Marsh GM, Buchanich J, Youk A, Cunningham M, Kennedy K, Lacey S, Hancock R, Esmen N. Long-Term Health Experience of Jet Engine Manufacturing Workers: I. Mortality from Central Nervous System Neoplasms. Journal of Occupational and Environmental Medicine 50:1099-1116, 2008.
- Marsh GM, Buchanich J, Youk A, Cunningham M, Kennedy K, Lacey S, Hancock R, Esmen N. Long-Term Health Experience of Jet Engine Manufacturing Workers: II. Total and Cause-Specific Mortality excluding Central Nervous System Neoplasms. Journal of Occupational and Environmental Medicine 50:1117-1129, 2008.
- Youk AO, Buchanich JM, Marsh GM, Esmen NA. Pharmaceutical Production Workers and the Risks of Mortality from Respiratory System Cancer and Lymphatic and Hematopoeitic Tissue Cancers. Journal of Occupational and Environmental Medicine 51:903-915, 2009.
- Buchanich JM, Youk AO, Marsh GM, Bornemann Z, Lacey SE, Kennedy KJ, Hancock RP, Esmen NA, Lieberman FL. Methodological Issues in United States Retrospective Cancer Incidence Studies. American Journal of Epidemiology 170:112-119, 2009.
- Marsh GM, Esmen NA, Buchanich JM, Youk AO. Mortality Patterns among Workers Exposed to Arsenic, Cadmium and Other Substances in a Copper Smelter. American Journal of Industrial Medicine 52:633-644, 2009.
- Summers W, Cunningham M, Marsh GM. Complex Antioxidant Blend Improves Memory in Community-Dwelling Seniors. Journal of Alzheimer's Disease 19:429-439, 2010.
- Marsh GM, Buchanich J, Youk A, Cunningham M, Kennedy K, Lacey S, Hancock R, Esmen N, Lieberman FL, Fleissner ML. Long-Term Health Experience of Jet Engine Manufacturing Workers: III. Incidence of Malignant Central Nervous System Neoplasms. Neuroepidemiology 35:123-141 2010.
- Marsh GM, Morfeld P, Youk AO, Collins JJ, Symons M. Incomplete follow-up in the National Cancer Institute's formaldehyde worker study and the impact on subsequent reanalyzes and causal evaluations. Regulatory Toxicology and Pharmacology 58:233-236, 2010.
- Buchanich J, Youk A, Marsh GM, Kennedy K, Lacey S, Hancock R, Esmen N, Cunningham M, Lieberman FL, Fleissner ML. Long-Term Health Experience of Jet Engine Manufacturing Workers: IV. Comparison of Incidence and Mortality Rates of Central Nervous System Neoplasm. Annals of Epidemiology 20:759-765, 2010.
- Shire J, Marsh GM, Talbott E, Sharma R. Recent Advances and Current Themes in Occupational Health and Environmental Public Health Surveillance. Invited Review in Annual Reviews of Public Health 32: 21;1-24, 2010.
- Cassidy LD, Marsh GM, Talbott EO, Kelsey SF. Initial and Continued Adherence with Bladder Cancer Screening in an Occupationally Exposed Cohort. Journal of Occupational and Environmental Medicine 53:455-460, 2011.
- Marsh GM, Buchanich JM, Youk AO. Fiber Glass and Human Respiratory Cancer Risk: Lack of Evidence Persists Since 2001 IARC Re-evaluation. Regulatory Toxicology and Pharmacology 60:84-92, 2011.
- Marsh GM, Youk AO, Roggli VL. Asbestos Fiber Concentrations in the Lungs of Brake Repair Workers: Commercial Amphiboles Levels are Predictive of Chrysotile Levels. Inhalation Toxicology 23:681-688, 2011.
- Buchanich JM, Youk AO, Marsh GM, Lacey SE, Kennedy KJ, Hancock RH, Esmen NA, Lieberman FS, Fleissner ML. Long-Term Health Experience of Jet Engine Manufacturing Workers: V. Issues with the Analysis of Non-Malignant Central Nervous System Neoplasms, Journal of Registry Management 38(3): 115-119, 2011.
- Hesterberg T, Bunn B, Chase J, Jankousky A, McClelland RO, Marsh GM. Product Stewardship and Science: Safe Manufacturers and Use of Fiber Glass. Regulatory Toxicology and Pharmacology Regulatory Toxicology and Pharmacology 62: 257-277, 2012.
- Youk AO, Buchanich JM, Marsh GM, Fryzek J. A Study of Cancer Mortality Rates in High Altitude Counties of the United States. High Altitude Medicine & Biology Journal 13:98-104, 2012.
- Liu Y, Chang, C H, Marsh GM, Wu F. Population Attributable Risk of Aflatoxin-Related Liver Cancer: Systematic Review and Meta-Analysis. European Journal of Cancer 48:2125-2136, 2012.
- Castle T, Cunningham M, Marsh GM. Antidepressant Medication Adherence via Interactive Voice Response Most Effective in Older Patients. American Journal of Managed Care 18(9):e346-e355, 2012.
- Marsh GM, Youk AO, Buchanich JM, Cunningham M, Xu H, Downing S, Kennedy KJ, Esmen NA, Hancock RH, Lacey SE, Fleissner ML. Long-Term Health Experience of Jet Engine Manufacturing Workers: VI. Incidence of Malignant Central Nervous System Neoplasms in Relation to Estimated Workplace Exposures. Journal of Occupational and Environmental Medicine 55:654-675, 2013.
- Kennedy KJ, Esmen NA, Hancock RH, Lacey SE, Marsh GM, Buchanich JM, Youk AO, Cunningham M,, Fleissner ML. Long-Term Health Experience of Jet Engine Manufacturing Workers: VII. Occupational Exposures. Journal of Occupational and Environmental Medicine 55:676-689, 2013.
- Marsh GM, Youk AO, Buchanich JM, Downing S, Kennedy KJ, Esmen NA, Hancock RH, Lacey SE, Fleissner ML. Long-Term Health Experience of Jet Engine Manufacturing Workers: VIII. Incidence of Malignant Central Nervous System Neoplasms in Relation to Workplace Experience with Parts and Processes. Journal of Occupational and Environmental Medicine 55:690-708, 2013.
- Youk AO, Marsh GM, Buchanich JM, Downing S, Kennedy KJ, Esmen NA, Hancock RH, Lacey SE. Long-Term Health Experience of Jet Engine Manufacturing Workers: IX. Further Investigation of General Mortality Patterns in Relation to Workplace Exposures. Journal of Occupational and Environmental Medicine 55:709-721, 2013.
- Marsh GM, Buchanich JM, Youk AO, Downing SC, Esmen NE, Kennedy KJ, Lacey SE, Hancock RP, Fleissner ML, Lieberman FS. Long-Term Health Experience of Jet Engine Manufacturing Workers: Results from a 10-Year Exploratory Investigation. Journal of Occupational and Environmental Medicine 55:652, 2013.
- Marsh GM, Morfeld P, Collins J, Symons M. Issues of Methods and Interpretation in the NCI Formaldehyde Worker Cohort Study. Commentary. Journal of Occupational Medicine and Toxicology 9:22 DOI: 10.1186/1745-6673-9-22, URL: http://www.occup-med.com/content/9/1/22, 2014.
- Marsh GM, Zimmerman SD. Mortality among Chemical Workers Exposed to Acrylonitrile: 2011 Follow-Up, Journal of Occupational and Environmental Medicine 57:134-145, 2015.
- Zimmerman SD, Marsh GM, Youk AO, Talbott EO. Adjustment for Confounding by Smoking in the Presence of Misclassified Smoking Data in a Cohort Study of Workers Exposed to Formaldehyde. Journal of Occupational and Environmental Medicine 57:146-151, 2015.
- Marsh GM, Morfeld P, Zimmerman S, Liu Y, Balmert L. An Updated Re-analysis of the Mortality Risk from Nasopharyngeal Cancer in the National Cancer Institute Formaldehyde Worker Cohort Study. Journal of Occupational Medicine and Toxicology 11:8 DOI 10.1186/s12995-016-0097-6, 2016.
- Hutter HP, Wallner P, Moshammer H, Marsh GM. Dust and cobalt levels in the Austrian tungsten industry: workplace and human biomonitoring data. International Journal of Environmental Research and Public Health 13:931, 2016.
- Starr T, Marsh GM. Commentary: Methodological Challenges in the Statistical Analysis of Epidemiology Studies: Use of Average Exposure Metrics in Historical Cohort Designs. Open Medicine Journal 3:238-242, 2016.
- Gathuru I, Dolan D, Buchanich J, Marsh GM. Health Hazards in the Pharmaceutical Industry: A Review of the Literature. Pharmaceutical Regulatory Affairs, 4(3), http://dx.doi.org/10.4172/2167-7689.1000145, 2015.
- McElvenny DM, MacCalman LA, Sleeuwenhoek A, Davis A, Miller BG, Alexander C, Cherrie JW, Kennedy KJ, Esmen NA, Zimmerman SD, Buchanich JM, Marsh GM. Mortality among hardmetal production workers: UK historical cohort and nested case-control studies. Journal of Occupational and Environmental Medicine 59:e275-e281, 2017.
- Westberg H, Bryngelsson IL, Marsh GM, Buchanich JM, Zimmerman SD, Kennedy KJ, Esmen NA, Svartengren M. Mortality among hardmetal production workers: the Swedish cohort. Journal of Occupational and Environmental Medicine 59:e263-e274, 2017.
- Morfeld P, Gross J, Erren T, Noll B, Wei M, Kennedy K, Esmen N, Zimmerman SD, Buchanich JM, Marsh GM. Mortality among hardmetal production workers: German historical cohort study. Journal of Occupational and Environmental Medicine 59:e288-e296, 2017.
- Kennedy KJ, Esmen NA, Zimmerman SD, Buchanich JM, Marsh GM. Mortality among hardmetal production workers: occupational exposures. Journal of Occupational and Environmental Medicine 59:e297-e305, 2017.
- Wallner P, Kundi M, Moshammer H, Zimmerman SD, Buchanich JB, Marsh GM. Mortality among hardmetal production workers: A retrospective cohort study in Austrian hardmetal industry. Journal of Occupational and Environmental Medicine 59:e282-e287, 2017.
- Marsh GM, Buchanich JM, Zimmerman SD, Liu Y, Balmert L, Esmen NA, Kennedy KJ. Mortality among hardmetal production workers: US Cohort and Nest Case-Control Studies. Journal of Occupational and Environmental Medicine 59:e306-e326, 2017.
- Westberg H, Bryngelsson I, Marsh GM, Kennedy K, Buchanich J, Zimmerman S, Esmen N, Svartengren M. Mortality among hardmetal production workers: Swedish measurement data and exposure assessment. Journal of Occupational and Environmental Medicine 59:e327-e341, 2017.
- Liu Y, Marsh GM, Roggli V. Asbestos Fiber Concentrations in The Lungs of Brake Repair Worker: An Updated Analysis Using Several Regression Methods to Handle Non-Detectable Measurements. Journal of Occupational and Environmental Medicine, Advance online publication, March 30, 2018. https://doi: 10.1097/JOM.0000000000001320. Vol. 60, No. 7, pps. 661-671, July, 2018.
- Marsh GM, Buchanich J, Graves J, Zimmerman S, Liu Y. Mortality among US Aerospace Materials Manufacturing Workers. American Journal of Industrial Medicine, https://doi.org/10.1002/ajim.22943, 2019.
- Mohner M, Liu Y, Marsh GM. New Insights into the Mortality Risk from Nasopharyngeal Cancer in the National Cancer Institute Formaldehyde Worker Cohort Study. Journal of Occupational Medicine and Toxicology, https://doi.org/10.1186/s12995-019-0224-2, 2019.
In 2013, COBE completed an historical cohort study of nearly a quarter million jet engine manufacturing workers for the Pratt & Whitney Company and published 9 papers on the final results of the study. The Pratt & Whitney study was a collaborative effort with the Department of Neuro-Oncology within UPMC and the University of Illinois at Chicago. In 2017, COBE completed an international historical cohort study of workers exposed to tungsten carbide with cobalt binder funded by the International Tungsten Industry Association. This study will include about 38,000 subjects from 20 sites in the US, UK, Germany, Austria and Sweden. This led to 10 published papers. COBE researchers have also completed:
- An update of an earlier historical cohort study of workers exposed to acrylonitrile funded by the INEOS corporation. The study involves about 2,200 workers at a chemical plant in the US.
- A pooled analysis of historical cohort data from two previous studies of workers exposed to acrylonitrile: the NCI cohort study and the DuPont Chemical Company cohort study.
- A reanalysis of data from the NCI's cohort study of workers exposed to formaldehyde.
- A mortality surveillance program for Owens Corning.
In addition, COBE is engaged in several ongoing studies including:
- An update of an international study of chloroprene production workers funded by the International Institute of Synthetic Rubber Producers.
- An update of an historical cohort mortality study and a new study of cohort incidence among pharmaceutical production workers funded by Eli Lilly and Company.
- A risk assessment of cobalt funded by the Cobalt Institute.
COBE is also involved in basic methodological research related to statistical computing, longitudinal data analysis and quantitative risk assessment. Some of the major contributions in these areas include:
- The development of the Occupational Cohort Mortality Analysis Program (OCMAP, OCMAP/PC, OCMAP-Plus®) for DOS and the latest OCMAP-Plus® for Windows), a specialized software tool for research in occupational epidemiology.
- Marsh GM, Youk AO, Stone RA, Sefcik S, Alcorn C: OCMAP-PLUS, A Program for the Comprehensive Analysis of Occupational Cohort Data. Journal of Occupational and Environmental Health 40:351-362, 1998.
- A standardized risk assessment protocol (SRAP) was developed for use with hazardous waste sites.
- Marsh GM and Day RD. A Model Standardized Risk Assessment Protocol for Use with Hazardous Waste Sites. Environmental Health Perspectives 1991; 90:199-208.
- A web-based computer software tool for the rapid assessment and characterization of environmental risks (RACER) developed as part of the CDC-funded Health Tracking Initiative in the Department of Epidemiology at the UPitt Graduate School of Public Health. This analytic tool is being designed for use by state and local health department officials as well as academic, governmental and private sector researchers. Publications are under preparation.
- A data repository and retrieval system for detailed mortality data provided by the National Center for Health Statistics and the U.S. Census Bureau. This system, called the Mortality and Population Data System (MPDS) is widely used by occupational and environmental health researchers throughout the U.S.
- Improved methods for conducting mortality follow-up in large-scale longitudinal studies.
- Schall LC, Buchanich JM, Marsh GM, Bittner G: Utilizing Multiple Vital Status Tracing Services Optimizes Mortality Follow-Up in Large Cohort Studies. Annals of Epidemiology , 11:292-296, 2001.
- Buchanich JM, Dolan DG, Marsh GM, Madrigano J. Under-Ascertainment of Deaths Using Social Security Records: A Recommended Solution to a Little-Known Problem. American Journal of Epidemiology, 162:193-194, 2005.
- Reanalysis of the National Cancer Institute cohort study of formaldehyde-exposed workers with focus on the adequacy of the exposure-response modeling.
- Marsh GM, Youk AO. Reevaluation of Mortality Risks from Leukemia in the Formaldehyde Cohort Study of the National Cancer Institute. Regulatory Toxicology and Pharmacology, 40:113-124, 2004.
- Marsh GM, Youk AO. Reevaluation of Mortality Risks from Nasopharyngeal Cancer in the Formaldehyde Cohort Study of the National Cancer Institute. Regulatory Toxicology and Pharmacology, 42:275-283, 2005.
- Marsh GM, Youk AO, Morfeld P. Mis-Specified and Non-Robust Mortality Risk Models for Naspharyngeal Cancer in the National Cancer Institute Formaldehyde Worker Cohort Study. Regulatory Toxicology and Pharmacology 47:59-67, 2007.
- A method for imputing missing racial data (persons and person-time) in a large cohort study was created using a model-based iterative allocation algorithm.
- Youk AO, Stone RA, Marsh GM. A Method for Imputing Missing Data in Longitudinal Studies. Annals of Epidemiology 2004; 14:354-361.
- A method to derive exposure profiles of residential exposure by linking estimated historical environmental exposures to smelter emissions with residential histories
- Marsh GM, Stone RA, Esmen NA, Gula MJ, Gause CK, Petersen NJ, Meaney FJ, Rodney S, Prybylski D: A Case-Control Study of Lung Cancer Mortality in Six Gila Basin, Arizona Smelter Towns. Environmental Research 75:56-72, 1997.
- Marsh GM, Stone RA, Esmen NA, Gula MJ, Gause CK, Petersen NJ, Meaney FJ, Rodney S, Prybylski D: A Case-Control Study of Lung Cancer Mortality in Four Rural Arizona Smelter Towns. Archives of Environmental Health 53:15-28, 1998.
- A method for estimating standardized risk ratios in cohort studies using data from proportional mortality studies.
- Marsh GM, Winwood J, and Rao BR: Prediction of the Standardized Risk Ratio Via Proportional Mortality Analysis. Biometrical Journal 29:355-368, 1987.
- Statistical methods for estimating variances of summary mortality measures accounting for multiple competing risk factors
- Rao BR and Marsh GM: Approximate Simultaneous Inferential Procedures for Overall Risk Assessment of Several Competing Risk Factors in Biomedical and Epidemiologic Studies. Journal of Statistical Inference and Planning 18:323-344, 1988.
- Rao BR and Marsh GM: Approximate Variance Formulas and Asymptotic Joint Sampling Distribution of Standardized Risk Ratios in the Presence of Competing Risks in Cohort Studies. Communications in Statistics-Theory and Methods 17:745-777, 1988.
- Rao BR, Marsh GM, and Winwood J: Asymptotic Interval Estimation of Some Cause-Specific Mortality Risk Measures in Epidemiologic Studies. Biometrical Journal 31:461-475, 1989.
- Rao BR, Marsh GM, and Winwood J: Asymptotic Interval Estimation of Some Cause-Specific Mortality Risk Measures in Epidemiologic Studies. Biometrical Journal 31:461-475, 1989.
- Rao BR, Day R, Marsh GM: Estimation of Relative Risks from Individual and Ecological Correlation Studies. Communications in Statistics-Theory and Methods 21:241-268, 1992.
Today, COBE enjoys a national and international reputation as a leading center of occupational health research. Since the early 1980s, the sponsored research projects conducted by COBE have generated more than 17 million dollars in sponsored research funds.