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Impact of the specificity of the exposure metric on exposure-response relationships.

AbstractBACKGROUND:
Exposure misclassification may occur when nonspecific exposure indicators are used. Developing estimates of more specific measures may be difficult due to sampling limitations or a paucity of historical measurements and, thus, often requires substantial effort. We examine the impact on exposure-response relationships of moving from 2 measures of exposure mixtures (dust, chlorophenols) to more specific exposure indicators (wood dust, pentachlorophenol, tetrachlorophenol) in a retrospective cohort.
METHODS:
The study population consisted of 26,847 male sawmill workers (> or =1 year employment between 1950 and 1995) with linkage to national cancer registries. A subcohort (n = 11,273 employed more than 1 day between 1985 and 1995) was linked to hospital discharge records. We evaluated the shape (log-linear vs log-log models), goodness of fit, precision, and expected versus observed attenuation of the exposure-response relationships.
RESULTS:
The correlation between the cumulative exposure indices was moderately high (dust/wood dust, r = 0.68; total chlorophenol/pentachlorophenol, r = 0.88; total chlorophenol/tetrachlorophenol, r = 0.78). An increase in chronic obstructive pulmonary disease hospitalizations was found with wood dust but not with total dust. Stronger associations for non-Hodgkin lymphoma and kidney cancer incidence were observed with pentachlorophenol than with total chlorophenol; no association was observed with tetrachlorophenol. We observed greater attenuation than expected using total dust, but less than expected using total chlorophenol.
CONCLUSIONS:
The relationships between health outcomes were substantially attenuated when nonspecific exposure indicators were used. This study demonstrates the importance of developing exposure metrics as specific to the disease-causing agent as possible, particularly when the composition of mixed exposures varies by work areas.
AuthorsMelissa C Friesen, Hugh W Davies, Kay Teschke, Aleck S Ostry, Clyde Hertzman, Paul A Demers
JournalEpidemiology (Cambridge, Mass.) (Epidemiology) Vol. 18 Issue 1 Pg. 88-94 (Jan 2007) ISSN: 1044-3983 [Print] United States
PMID17130686 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Chlorophenols
  • Dust
  • tetrachlorophenol
  • Pentachlorophenol
Topics
  • British Columbia (epidemiology)
  • Chlorophenols (adverse effects)
  • Cohort Studies
  • Confounding Factors, Epidemiologic
  • Data Interpretation, Statistical
  • Dose-Response Relationship, Drug
  • Dust (analysis)
  • Humans
  • Kidney Neoplasms (epidemiology)
  • Lymphoma, Non-Hodgkin (epidemiology)
  • Male
  • Occupational Diseases (epidemiology)
  • Occupational Exposure (adverse effects, statistics & numerical data)
  • Pentachlorophenol (adverse effects, analysis)
  • Pulmonary Disease, Chronic Obstructive (epidemiology)
  • Retrospective Studies
  • Wood (adverse effects)

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