Random left censoring: a second look at bone lead concentration measurements.

Bone lead concentrations measured in vivo by x-ray fluorescence (XRF) are subjected to left censoring due to limited precision of the technique at very low concentrations. In the analysis of bone lead measurements, inverse variance weighting (IVW) of measurements is commonly used to estimate the mean of a data set and its standard error. Student's t-test is used to compare the IVW means of two sets, testing the hypothesis that the two sets are from the same population. This analysis was undertaken to assess the adequacy of IVW in the analysis of bone lead measurements or to confirm the results of IVW using an independent approach. The rationale is provided for the use of methods of survival data analysis in the study of XRF bone lead measurements. The procedure is provided for bone lead data analysis using the Kaplan-Meier and Nelson-Aalen estimators. The methodology is also outlined for the rank tests that are used to determine whether two censored sets are from the same population. The methods are applied on six data sets acquired in epidemiological studies. The estimated parameters and test statistics were compared with the results of the IVW approach. It is concluded that the proposed methods of statistical analysis can provide valid inference about bone lead concentrations, but the computed parameters do not differ substantially from those derived by the more widely used method of IVW.