0103   Racial and Gender Differences in the Risk of XXXX and the Healthy Worker Survivor Effect among Autoworkers.

@entity1 @entity299
OBJECTIVES: To examine gender and racial disparities in @entity299 mortality related to metalworking fluid exposures and in the healthy worker survivor effect. METHOD: We examined @entity299 ( @entity299 ) mortality from 1941 to 1995 in a cohort of autoworkers with quantitative exposure to cumulative respirable particulate matter from water-based metalworking fluids. Cox models were used to estimate the exposure-response to soluble and synthetic fluids separately in white @entity1 , black @entity1 , and white @entity1 . In separate analyses, we used g-estimation to adjust for the healthy worker survivor effect. RESULTS: The risk of @entity299 was increased among black @entity1 (295 deaths) exposed to synthetic fluid with a hazard ratio (HR) of 3.47 (95% CI: 1.52, 7.92) in the highest cumulative exposure category. White @entity1 (119 deaths) had increased risk of @entity299 with increased soluble fluid (HR: 2.44 (0.93, 6.38)) in the second to highest category. However, Cox models show no increased risk in white @entity1 (2246 deaths). In contrast, g-estimation results indicate that if white @entity1 had been always unexposed to soluble and synthetic fluid, then on average for each case, 2.99 and 2.77 years of life would have been saved, respectively. CONCLUSIONS: We found increased risk of @entity299 for black @entity1 and white @entity1 exposed to metalworking fluids using Cox regression. After adjusting for the healthy worker survivor effect, increased risk was observed for white @entity1 . The ability to leave work for health related reasons may be an option more available to white male workers.
