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You have been given the following table from a prospective study of deaths in tu

ID: 128121 • Letter: Y

Question

You have been given the following table from a prospective study of deaths in tunnel and bridge workers in New York City. NYC Tunnel Workers NYC Bridge Workers Age Person- #Deaths | Age-Specific | Age | Person-!#Deaths Age-Specific Category Years Observed Mortality Years Observed Mortality er er 11,000 1,000 3,500 1,500 7,500 3,500 32,000 2,000 14,000 2,000 20,000 7,500 4 16 12 32 32 Total Total Crude Mortality (Tunnel) Crude Mortality Ratio: Crude Mortality (Bridge) Calculate the crude mortality rates and the crude mortality ratio (reference group - bridge workers) Interpret these results a. b. Fill the age-specific mortality rates in the table and interpret these results c. Using the table below, calculate the age-adjusted mortality rates and the age-adjusted mortality ratio (reference - bridge workers) using the combined person-years for the two groups as the standard population Iplease show vour work in detaill. Briefly explain what vou did and briefly discuss what these results mean TUNNEL WORKERS BRIDGE WORKERS Combined Standard Population 43,000 3,000 17,500 3,500 27,500 11,000 105,500 Age Category Age-SpecificExpected Deaths ExpectedAge-Specific Mortality Age Category Mortality Deaths 2 2 4 4 6 6 Total Total

Explanation / Answer

a. NYC Tunnel workers

Age category

Person in years

Death observed

Age-specific Mortality

1

11000

11

2

1000

5

3

3500

5

4

1500

18

5

7500

9

6

3500

32

Total

28000

80

Crude Mortality Rate = Number of death/ Total population*10n

Crude Mortality Tunnel = 80/28000*100000

= 286 death per 100000 population.

NYC Bridge Work:

Age

Persons-years

Death observed

Age-specific Mortality

1

32000

15

2

2000

5

3

14000

11

4

2000

16

5

20000

12

6

7500

32

Total

77500

91

Crude Mortality Bridge = 91/77500*100000

= 117 deaths per 100000 population.

Crude Mortality Ratio: No of death/ total population *100

= 403/105500*100

Crude ratio= 0.38.

Interpretation:

The Mortality rate of tunnel group is more when compared to Bridge group in the given population.

b. Age-specific Mortality Rates:

Age-specific mortality rate = No of deaths in the age category/ Total no of population in that age group*100000

NYC Tunnel Workers:

Age category

Person in years

Death observed

Age-specific Mortality per 100000 population

1

11000

11

100

2

1000

5

500

3

3500

5

142

4

1500

18

1200

5

7500

9

120

6

3500

32

914

Total

28000

80

NYC Bridge workers:

Age

Persons-years

Death observed

Age-specific Mortality per 100000 population

1

32000

15

46

2

2000

5

250

3

14000

11

78

4

2000

16

800

5

20000

12

60

6

7500

32

426

Total

77500

91

Interpretation: In NYC bridge workers have the high age-specific mortality rate of 800 in the age group of 4 whereas the NYC tunnel workers have age-specific mortality rate 1200 in the age category of 4. This shows the age category 4 has the high age-specific mortality rate in both tunnel and bridge workers.

c. First, find the expected death.

Expected deaths = Age-specific death* combined standard population/ Total Standard population.

  Tunnel workers Bridge workers

Age category

Age-specific Mortality

Expected Deaths

Combined standard population

Expected Deaths

Age-specific Mortality

Age category

1

100

40

43000

18.7

46

1

2

500

14.2

3000

7.1

250

2

3

142

23

17500

12.9

78

3

4

1200

39.8

3500

26.5

800

4

5

120

31.2

27500

15.6

60

5

6

914

95

11000

44.4

426

6

Total

2976

243.2

105500

125.2

1660

Age-Standardized Mortality = Observed death/ Expected death

Age-Standarized Mortality(Tunnel) = 2976/243.2 = 12.23

Age-standardized Mortality (Bridge) = 1660/125.2 =13.2

d.

Tunnel Worker Bridge worker

Age category

Age-specific Mortality

Observed deaths

Expected death

Age category

1

100

18.7

1

2

500

7.1

2

3

142

12.9

3

4

1200

26.5

4

5

120

15.6

5

6

914

44.4

6

Total

2976

91

15.2

Indirect Standardized Death Rate the predefined values of ASRD in the standard population are used in the actual age category of the study population.

Standarized Mortality ratio = 195.

Age category

Person in years

Death observed

Age-specific Mortality

1

11000

11

2

1000

5

3

3500

5

4

1500

18

5

7500

9

6

3500

32

Total

28000

80

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