A comparison of exposure assessment approaches: lung cancer and occupational asbestos exposure in a population-based case-control study.

Abstract

OBJECTIVES:

In attempts to overcome the limitations of self-reported data in occupational health research, job-exposure matrices, which assign exposure by occupation, have emerged as an objective approach for assessing occupational exposures. On the basis of a lung cancer case-control study conducted in the Greater Toronto Area, 1997-2002, assessment of occupational exposure to asbestos was compared using self-reports and a general population job-exposure matrix (DOM-JEM).

METHODS:

Cases and frequency matched controls provided life-time job histories and self-reported exposures to potential lung carcinogens including asbestos through a detailed questionnaire. Exposure to asbestos was also assigned to each job by linking occupational histories with DOM-JEM. Agreement in classification of exposed and unexposed jobs according to self-reports and DOM-JEM was evaluated using Cohen's κ. Risks for lung cancer were estimated using unconditional logistic regression for each exposure assessment approach.

RESULTS:

The prevalence of occupational asbestos exposure was greater when based on DOM-JEM than when based on self-reports. Agreement in classifying exposure to jobs between the two assessment approaches was poor. The risk of lung cancer was not elevated among workers who self-reported asbestos exposure, whereas workers considered exposed on the basis of DOM-JEM were almost twice as likely as unexposed workers to be diagnosed with lung cancer (OR 1.9, 95% CI 1.3 to 2.7).

CONCLUSIONS:

It is generally assumed by epidemiologists that self-reported exposure assessments result in inflated risk estimates. In this study, self-reports found no association with a well-established risk factor, whereas a high-quality job-exposure matrix revealed relative risk estimates that are more consistent with previous findings.

• Authors: Jill S Hardt, Roel Vermeulen, Susan Peters, Hans Kromhout, John R McLaughlin, Paul A Demers
• Journal: Occupational and environmental medicine (Occup Environ Med) Vol. 71 Issue 4 Pg. 282-8 (Apr 2014) ISSN: 1470-7926 [Electronic] England
• PMID: 24334241 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Asbestos

Topics

• Adult
• Aged
• Asbestos (adverse effects)
• Case-Control Studies
• Female
• Humans
• Logistic Models
• Lung Neoplasms (chemically induced)
• Male
• Middle Aged
• Occupational Diseases (chemically induced)
• Occupational Exposure (analysis, classification)
• Prevalence
• Risk Factors
• Self Report