Practical Considerations for Approximating Relative Risk by the Standardized Mortality Ratio

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Abstract
The standardized mortality ratio is a widely used, and often criticized summary statistic for studies of occupational mortality. Practical conditions under which relative risk can reasonably be approximated by the standardized mortality ratio were discussed. When the true relative risk was > 100%, the standardized mortality ratio overestimated relative risk no matter how small the mortality rates or how short the age bands utilized in the analysis. When excessive mortality was consistent across age bands, the standardized mortality ratio usefully approximated relative risk for some applications, such as those involving site-specific cancers, providing the age bands employed were not too large.

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