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职业性致癌物暴露的回顾性评估:一种流行病学方法及其在健康监测中的应用

[Retrospective assessment of occupational exposure to carcinogens: an epidemiological approach and application to health surveillance].

作者信息

Ribeiro Fátima Sueli Neto, Wünsch Filho Victor

机构信息

Programa de Saúde do Trabalhador, Secretaria de Saúde do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.

出版信息

Cad Saude Publica. 2004 Jul-Aug;20(4):881-90. doi: 10.1590/s0102-311x2004000400002. Epub 2004 Jul 29.

Abstract

The proportion of cancer attributed to occupation varies, and estimates are partially dependent on the characteristics of exposed populations, type of tumor, and methodology. The main difficulty for estimating these proportions is the reconstruction of past individual occupational exposure. Appropriate methods for retrospective occupational exposure assessment are essential in epidemiological studies in order to avoid misclassification. In this review, qualitative and quantitative methods are discussed, considering that such evaluations require progressive approaches without a previously established hierarchy. Methods to evaluate exposure through environmental and biological measurements, questionnaires, interviews, expert panels, and job-exposure matrices are compared as to their advantages, limitations, accuracy, and validity. In health surveillance, all the above-mentioned methods can be applied, but the use of job-exposure matrices is emphasized, especially using secondary databases.

摘要

归因于职业的癌症比例各不相同,估计部分取决于暴露人群的特征、肿瘤类型和方法。估计这些比例的主要困难在于重建过去个体的职业暴露情况。在流行病学研究中,适当的回顾性职业暴露评估方法对于避免错误分类至关重要。在本综述中,讨论了定性和定量方法,因为此类评估需要循序渐进的方法,而无需预先建立层次结构。通过环境和生物测量、问卷、访谈、专家小组和工作暴露矩阵来评估暴露的方法,就其优点、局限性、准确性和有效性进行了比较。在健康监测中,可以应用上述所有方法,但强调使用工作暴露矩阵,尤其是使用二级数据库。

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