Friesen M C, Demers P A, Spinelli J J, Le N D
Cancer Control Research, British Columbia Cancer Agencyand School of Occupational and Environmental Hygiene, University of Britsh Columbia, Vancouver, Canada.
Ann Occup Hyg. 2003 Aug;47(6):477-84. doi: 10.1093/annhyg/meg059.
We tested the validity of a job exposure matrix (JEM) for coal tar pitch volatiles (CTPV) at a Söderberg aluminum smelter. The JEM had been developed by a committee of company hygienists and union representatives for an earlier study of cancer incidence and mortality. Our aim was to test the validity and reliability of the expert-based assignments.
Personal CTPV exposure measurements (n = 1879) overlapped 11 yr of the JEM. The arithmetic mean was calculated for 35 job/time period combinations (35% of the exposed work history), categorized using the original exposure intervals, and compared with the expert-based assignments.
The expert-based and the measurement-based exposure assignments were only moderately correlated (Spearman's rho = 0.42; weighted kappa = 0.39, CI 0.10-0.69). Only 40% of the expert-based medium category assignments were correctly assigned, with better agreement in the low (84%) and high (100%) categories. Pot operation jobs exhibited better agreement (rho = 0.60) than the maintenance and pot shell repair jobs (rho = 0.25). The mid-point value of the medium category was overestimated by 0.3 mg/m(3).
The expert-based exposure assignments may be improved by better characterizing the transitions between exposure categories, by accounting for exposure differences between pot lines and by re-examining the category mid-point values used in calculating the cumulative exposure. Lack of historical exposure measurements often requires reliance on expert knowledge to assess exposure levels. Validating the experts' estimates against available exposure measurements may help to identify weaknesses in the exposure assessment where improvements may be possible, as was shown here.
我们在一座 Söderberg 铝冶炼厂测试了煤焦油沥青挥发物(CTPV)工作暴露矩阵(JEM)的有效性。该 JEM 由公司卫生学家和工会代表委员会为早期的癌症发病率和死亡率研究而制定。我们的目的是测试基于专家的暴露赋值的有效性和可靠性。
个人 CTPV 暴露测量值(n = 1879)覆盖了 JEM 的 11 年数据。计算了 35 个工作/时间段组合(占暴露工作史的 35%)的算术平均值,按照原始暴露区间进行分类,并与基于专家的赋值进行比较。
基于专家的暴露赋值与基于测量的暴露赋值之间仅存在中等程度的相关性(Spearman 相关系数 rho = 0.42;加权卡帕系数 = 0.39,95%置信区间 0.10 - 0.69)。基于专家的中等暴露类别赋值中只有 40%被正确分配,低暴露类别(84%)和高暴露类别(100%)的一致性更好。电解槽操作岗位的一致性(rho = 0.60)优于维护和电解槽外壳维修岗位(rho = 0.25)。中等暴露类别的中点值被高估了 0.3 mg/m³。
通过更好地描述暴露类别之间的转变、考虑电解槽生产线之间的暴露差异以及重新审视计算累积暴露时使用的类别中点值,可以改进基于专家的暴露赋值。由于缺乏历史暴露测量数据,通常需要依靠专家知识来评估暴露水平。正如本研究所示,根据现有的暴露测量数据验证专家的估计值可能有助于识别暴露评估中可能改进的薄弱环节。