McLaughlin J K, Mehl E S
National Cancer Institute, Division of Cancer Etiology, Bethesda, MD 20892.
Am J Ind Med. 1991;20(3):335-42. doi: 10.1002/ajim.4700200306.
A comparison was made of the occupational data reported on the death certificates of 586 men with their employment history obtained by interviews. Agreement was assessed for 19 occupational and 14 industrial categories of usual employment, with the highest levels of concordance (greater than or equal to 80%) found for agricultural, medical, and public administration activities. Between the two sources of information, there was overall agreement of 56% for usual occupation and 51% for usual industry of employment. Concordance was highest among the 68 self-respondents (usual occupation 66%; usual industry 53%). Among the 518 surrogates, spousal agreement was highest (58% for occupation and 51% for industry). For other surrogate types, agreement was 49% for both industry and occupation. Agreement varied by duration of employment and by level of education, with concordance tending to increase as length of employment and educational attainment rose. These relationships remained when examined by respondent type. Evaluation of agreement levels by age and other study subject characteristics showed little effect on concordance. Review of verbatim data from the interviews and death certificates revealed that most disagreements could be attributed to coding problems caused by vague or misleading information on the death certificates, although some disconcordance was due to uncodable and missing information in the interview history. Based on results from this and prior studies, the value of occupational data derived from death certificates in epidemiologic studies may be limited, although the addition of explicit instructions on the death certificate itself may aid in providing more useful and complete information for usual employment.
对586名男性死亡证明上报告的职业数据与通过访谈获得的就业史进行了比较。评估了19个职业类别和14个通常就业的行业类别的一致性，发现农业、医疗和公共管理活动的一致性水平最高（大于或等于80%）。在这两种信息来源之间，通常职业的总体一致性为56%，通常就业行业的总体一致性为51%。在68名自我受访者中一致性最高（通常职业为66%；通常行业为53%）。在518名替代受访者中，配偶的一致性最高（职业为58%，行业为51%）。对于其他替代受访者类型，行业和职业的一致性均为49%。一致性因就业时长和教育程度而异，随着就业时长和教育程度的提高，一致性往往会增加。按受访者类型进行检查时，这些关系依然存在。按年龄和其他研究对象特征评估一致性水平对一致性影响不大。对访谈和死亡证明的逐字数据审查表明，大多数不一致可归因于死亡证明上模糊或误导性信息导致的编码问题，尽管有些不一致是由于访谈记录中无法编码和缺失的信息。根据本研究及先前研究的结果，死亡证明中得出的职业数据在流行病学研究中的价值可能有限，尽管在死亡证明本身添加明确说明可能有助于为通常就业提供更有用和完整的信息。
