Stewart Patricia A, Coble Joseph B, Vermeulen Roel, Schleiff Patricia, Blair Aaron, Lubin Jay, Attfield Michael, Silverman Debra T
Division of Cancer Epidemiology and Genetics, US National Cancer Institute, Bethesda, MD 20892, USA.
Ann Occup Hyg. 2010 Oct;54(7):728-46. doi: 10.1093/annhyg/meq022. Epub 2010 Sep 27.
This report provides an overview of the exposure assessment process for an epidemiologic study that investigated mortality, with a special focus on lung cancer, associated with diesel exhaust (DE) exposure among miners. Details of several components are provided in four other reports. A major challenge for this study was the development of quantitative estimates of historical exposures to DE. There is no single standard method for assessing the totality of DE, so respirable elemental carbon (REC), a component of DE, was selected as the primary surrogate in this study. Air monitoring surveys at seven of the eight study mining facilities were conducted between 1998 and 2001 and provided reference personal REC exposure levels and measurements for other agents and DE components in the mining environment. (The eighth facility had closed permanently prior to the surveys.) Exposure estimates were developed for mining facility/department/job/year combinations. A hierarchical grouping strategy was developed for assigning exposure levels to underground jobs [based on job titles, on the amount of time spent in various areas of the underground mine, and on similar carbon monoxide (CO, another DE component) concentrations] and to surface jobs (based on the use of, or proximity to, diesel-powered equipment). Time trends in air concentrations for underground jobs were estimated from mining facility-specific prediction models using diesel equipment horsepower, total air flow rates exhausted from the underground mines, and, because there were no historical REC measurements, historical measurements of CO. Exposures to potentially confounding agents, i.e. respirable dust, silica, radon, asbestos, and non-diesel sources of polycyclic aromatic hydrocarbons, also were assessed. Accuracy and reliability of the estimated REC exposures levels were evaluated by comparison with several smaller datasets and by development of alternative time trend models. During 1998-2001, the average measured REC exposure level by facility ranged from 40 to 384 μg m⁻³ for the underground workers and from 2 to 6 μg m⁻³ for the surface workers. For one prevalent underground job, 'miner operator', the maximum annual REC exposure estimate by facility ranged up to 685% greater than the corresponding 1998-2001 value. A comparison of the historical CO estimates from the time trend models with 1976-1977 CO measurements not used in the modeling found an overall median relative difference of 29%. Other comparisons showed similar levels of agreement. The assessment process indicated large differences in REC exposure levels over time and across the underground operations. Method evaluations indicated that the final estimates were consistent with those from alternative time trend models and demonstrated moderate to high agreement with external data.
本报告概述了一项流行病学研究的暴露评估过程,该研究调查了矿工中与接触柴油机尾气(DE)相关的死亡率,尤其关注肺癌死亡率。其他四份报告提供了几个组成部分的详细信息。本研究的一个主要挑战是对历史DE暴露进行定量估计。目前尚无评估DE总量的单一标准方法,因此本研究选择将DE的一个成分——可吸入元素碳(REC)作为主要替代指标。在1998年至2001年期间,对八个研究采矿设施中的七个进行了空气监测调查,提供了参考个人REC暴露水平以及采矿环境中其他污染物和DE成分的测量数据。(第八个设施在调查之前已永久关闭。)针对采矿设施/部门/工作/年份的组合制定了暴露估计值。制定了一种分层分组策略,用于为地下工作(根据工作岗位名称、在地下矿井各个区域花费的时间以及类似的一氧化碳(CO,DE的另一种成分)浓度)和地面工作(根据柴油动力设备的使用情况或与之的接近程度)分配暴露水平。利用柴油设备马力、从地下矿井排出的总空气流量,以及由于没有历史REC测量数据而使用的CO历史测量数据,通过特定于采矿设施的预测模型估算地下工作的空气浓度随时间的变化趋势。还评估了对潜在混杂因素的暴露情况,即可吸入粉尘、二氧化硅、氡、石棉以及多环芳烃的非柴油来源。通过与几个较小的数据集进行比较以及开发替代时间趋势模型,评估了估计的REC暴露水平的准确性和可靠性。在1998 - 2001年期间,各设施测量的地下工人平均REC暴露水平为40至384μg m⁻³,地面工人为2至6μg m⁻³。对于一种常见的地下工作“矿工操作员”,各设施的年度最大REC暴露估计值比1998 - 2001年的相应值高出685%。将时间趋势模型得出的历史CO估计值与建模中未使用的1976 - 1977年CO测量值进行比较,发现总体中位数相对差异为29%。其他比较显示出类似的一致程度。评估过程表明,REC暴露水平随时间以及在不同地下作业之间存在很大差异。方法评估表明,最终估计值与替代时间趋势模型的估计值一致,并与外部数据显示出中度至高一致性。