Healthy survivor effect -Reply

[Charles Willis <CAW@nrc.gov>]

Bill,

Perhaps someone knows of  a good defense of the "healthy survivor" effect, but I
do not.  The expression is used regularly but so far as I know, it is only a "hand
waving" argument used to explain away observations that do not agree with prior
beliefs.  A "healthy worker" effect seems logical for many effects, especially for the
first years after employment, because personnel practices tend to exclude the ill
and the infirm.  This seems less logical for cancer because employment physicals
usually are not sophisticated enough to weed out the cancer-prone.  An A-bomb
blast seems even less likely to be selective; survival is likely to be determined by
essentially random factors such as distance from the epicenter, structural shielding,
location with respect to the resulting conflagration, etc.

Charlie Willis
caw@nrc.gov