Herdt-Losavio Michele L, Mauer Matthew P, Carlson G Anders
New York State Department of Health, Center for Environmental Health, 547 River Street, Troy, NY 12180, USA.
Ann Occup Hyg. 2008 Mar;52(2):83-93. doi: 10.1093/annhyg/mem065. Epub 2008 Feb 13.
An exposure assessment method was developed for use in assigning an exposure score to New York State personnel who responded to the World Trade Center disaster site after the 11 September 2001 terrorist attacks.
The method consists of an algorithm with two instantiations. Each represents a major component of the overall exposures at the site: dust and smoke. The algorithm uses US Environmental Protection Agency air monitoring data collected between 23 September 2001 and 28 February 2002, as well as information on duration, location and time period of work assignment and type and frequency of personal protective respiratory equipment (PPE) use, collected by a self-administered mailed questionnaire. These data were used to calculate an overall exposure score for each participant. For each time period/location combination, individuals provided average number of hours and number of days worked. This was multiplied by a weighting factor derived from the median of the air monitoring data for the time period/location. Calcium was chosen as a surrogate for the dust exposure, so the weighting factors for the dust instantiation were calculated from calcium air monitoring data. Total hepta-chlorinated dibenzo-p-dioxin was chosen as a surrogate for the smoke exposure and was similarly used in the smoke instantiation.
More individuals in the highest exposure score category performed tasks such as search/rescue and hand digging than those in the lowest exposure category. Also, those in the highest exposure category had a higher mean number of hours at the site than other exposure groups.
The exposure assessment method presented accounts for PPE use, amount of time at the site, proximity to the site and ambient air monitoring results taken in the immediate vicinity. The algorithm can be used to rank individuals in the same study with very different patterns of exposure, such as high-level, short-term exposures and low-level, long-term exposures. The concepts could be modified for use in other epidemiological studies where long-term chronic exposure is a concern.
开发一种暴露评估方法，用于为2001年9月11日恐怖袭击后响应世贸中心灾难现场的纽约州人员分配暴露分数。
该方法由一种有两种实例化形式的算法组成。每种实例化形式代表现场总体暴露的一个主要组成部分：灰尘和烟雾。该算法使用美国环境保护局在2001年9月23日至2002年2月28日期间收集的空气监测数据，以及通过自行填写的邮寄问卷收集的关于工作任务的持续时间、地点和时间段以及个人防护呼吸设备（PPE）使用类型和频率的信息。这些数据用于计算每个参与者的总体暴露分数。对于每个时间段/地点组合，个人提供平均工作小时数和工作天数。将其乘以从该时间段/地点的空气监测数据中位数得出的加权因子。选择钙作为灰尘暴露的替代物，因此灰尘实例化形式的加权因子根据钙空气监测数据计算得出。选择总七氯二苯并对二恶英作为烟雾暴露的替代物，并在烟雾实例化形式中类似地使用。
暴露分数最高类别中的个体比最低暴露类别中的个体执行更多诸如搜索/救援和徒手挖掘等任务。此外，暴露分数最高类别的个体在现场的平均工作小时数比其他暴露组更高。
所提出的暴露评估方法考虑了PPE的使用、在现场的时间量、与现场的接近程度以及紧邻现场进行的环境空气监测结果。该算法可用于对同一研究中具有非常不同暴露模式的个体进行排名排序，例如高水平短期暴露和低水平长期暴露。这些概念可进行修改，以用于其他关注长期慢性暴露的流行病学研究。
