The overarching goal of the "Alcoa Study" is to explain the disparate health and work- capacity trajectories demonstrated in this cohort of 40,000+ men and women as they progress from work-life into retirement. Outcomes of focus are incident chronic disease, work-disability and mortality. Etiologic factors of interest include 1) pre-employment health trajectories;2) adult health behaviors;3) work status and economic rewards;3) workload, including physical demands, hours and shifts;5) physical environmental hazards of work;6) psychosocial characteristics of work and work organization;7) health care quality and utilization;and 8) impacts of extrinsic factors such as economic cycles, changes in work benefits and policy interventions. This application builds on 5 years of investment in infrastructure development and initial analyses across each of the relevant outcome domains. Key observations include: 1. Both physical and psychosocial environment in the workplace contribute to risk for development of chronic disease and disability. 2. Pre-employment and post-employment regional and personal selection factors confound associations between work factors and health outcomes;methods to manage this remain inadequate. 3. Physical and psychological work demands are more salient risks in this population than in well studied white-collar populations;work "control" is less so. 4. The industrial workplace appears to impact women more unfavorably than men in terms of both disease incidence and disability. 5. Despite uniform access to health services for the whole population in each area, health care quality is strongly associated with SES, and with better outcomes independent of SES and other (measurable) underlying risks. 6. Time-varying external events, such as down turns in the business cycle and changes in benefits impact health and work capacity in this population. We propose some additional data collection and new models that will ultimately 1) lead to identification of opportunities for intervention in the workplace or in policy, and 2) best exploit our relative advantages among ongoing studies of these issues such as Whitehall and the Health and Retirement Study.

Public Health Relevance

Most of the serious chronic diseases that afflict Americans, like diabetes and heart disease, start in mid-life. Many become serious enough to limit or curtail the ability to work, especially for poorer and middle class people. The overarching goal of this study is to better understand what aspects of their lives during that period contribute to diseases and disability- Something about work and the workplace? Something about personal behavior? Something about position in society? Something about doctors and healthcare? We are especially looking for those things about work and that could be fixed if we understood them better.

National Institute of Health (NIH)
National Institute on Aging (NIA)
Research Project (R01)
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Social Sciences and Population Studies Study Section (SSPS)
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Patmios, Georgeanne E
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Stanford University
Internal Medicine/Medicine
Schools of Medicine
United States
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Taiwo, Oyebode A; Slade, Martin D; Cantley, Linda F et al. (2015) Bladder cancer screening in aluminum smelter workers. J Occup Environ Med 57:421-7
Neitzel, R L; Galusha, D; Dixon-Ernst, C et al. (2014) Methods for evaluating temporal trends in noise exposure. Int J Audiol 53 Suppl 2:S76-83
Noth, Elizabeth M; Dixon-Ernst, Christine; Liu, Sa et al. (2014) Development of a job-exposure matrix for exposure to total and fine particulate matter in the aluminum industry. J Expo Sci Environ Epidemiol 24:89-99
Souza, Kerry; Cantley, Linda F; Slade, Martin D et al. (2014) Individual-level and plant-level predictors of acute, traumatic occupational injuries in a manufacturing cohort. Occup Environ Med 71:477-83
Cantley, Linda F; Taiwo, Oyebode A; Galusha, Deron et al. (2014) Effect of systematic ergonomic hazard identification and control implementation on musculoskeletal disorder and injury risk. Scand J Work Environ Health 40:57-65
Neophytou, Andreas M; Costello, Sadie; Brown, Daniel M et al. (2014) Marginal structural models in occupational epidemiology: application in a study of ischemic heart disease incidence and PM2.5 in the US aluminum industry. Am J Epidemiol 180:608-15
Costello, Sadie; Brown, Daniel M; Noth, Elizabeth M et al. (2014) Incident ischemic heart disease and recent occupational exposure to particulate matter in an aluminum cohort. J Expo Sci Environ Epidemiol 24:82-8
Kubo, Jessica; Goldstein, Benjamin A; Cantley, Linda F et al. (2014) Contribution of health status and prevalent chronic disease to individual risk for workplace injury in the manufacturing environment. Occup Environ Med 71:159-66
Tessier-Sherman, Baylah; Cantley, Linda F; Galusha, Deron et al. (2014) Occupational injury risk by sex in a manufacturing cohort. Occup Environ Med 71:605-10
Bayer, Felicia J; Galusha, Deron; Slade, Martin et al. (2014) Process of care compliance is associated with fewer diabetes complications. Am J Manag Care 20:41-52

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