Symptom reports and mortality in an occupational cohort.

: The relationship between baseline symptom reports and subsequent mortality over a 24-year period was examined in a group of 1,224 white male nonsupervisory paper workers. Symptom reports were measured via the Cornell Medical Index, and the vital status of each participant was ascertained by reviewing company personnel records and death certificates. Analyses based on proportional hazards models suggest that symptom reports are predictive of mortality (RR = 1.24; P = .0002), independent of the participant's age and biologic risk status at intake. Analyses based upon age-specific and age-standardized mortality ratios confirm that the paper workers were subject to a "healthy worker effect" (standardized mortality ratio [SMR] = 0.66), and that the healthy worker effect is attenuated (SMR = 0.77) among those participants reporting ten or more symptoms at the beginning of the follow-up period.