Mester Birte, Schmeisser Nils, Lünzmann Hauke, Pohlabeln Hermann, Langner Ingo, Behrens Thomas, Ahrens Wolfgang
Department of Epidemiological Methods and Etiologic Research, Bremen University, Germany.
Ann Occup Hyg. 2011 Aug;55(7):736-51. doi: 10.1093/annhyg/mer023.
A system for retrospective occupational exposure assessment combining the efficiency of a job exposure matrix (JEM) and the precision of a subsequent individual expert exposure assessment (IEEA) was developed. All steps of the exposure assessment were performed by an interdisciplinary expert panel in the context of a case-control study on male germ cell cancer nested in the car manufacturing industries.
An industry-specific JEM was developed and automatic exposure estimation was performed based on this JEM. A subsample of exposure ratings was done by IEEA to identify determinants of disagreement between the JEM and the individual review. Possible determinants were analyzed by calculating odds ratios (ORs) of disagreement between ratings with regard to different dimensions (e.g. high versus low intensity of exposure). Disagreement in ≥20% of the sampled exposure ratings with a statistically significant OR was chosen as a threshold for inclusion of the exposure ratings into a final IEEA.
The most important determinants of disagreement between JEM and individual review were working outside of the production line (disagreement 80%), low probability of exposure (disagreement 25%), and exposure depending on specific activities like usage of specific lacquers (disagreement 32%) for jobs within the production line. These determinants were the selection criteria of exposure ratings for the subsequent final IEEA.
Combining a JEM and a subsequent final IEEA for a selected subset of exposure ratings is a feasible and labor-saving approach for exposure assessment in large occupational epidemiological studies.
开发一种回顾性职业暴露评估系统,该系统结合了工作暴露矩阵(JEM)的效率和后续个体专家暴露评估(IEEA)的精确性。暴露评估的所有步骤均由一个跨学科专家小组在汽车制造业男性生殖细胞癌病例对照研究的背景下进行。
开发了一个特定行业的JEM,并基于此JEM进行自动暴露估计。通过IEEA对暴露评级的一个子样本进行评估,以确定JEM与个体评估之间存在分歧的决定因素。通过计算不同维度(例如高暴露强度与低暴露强度)评级之间分歧的优势比(OR)来分析可能的决定因素。将抽样暴露评级中≥20%且OR具有统计学意义的分歧作为将暴露评级纳入最终IEEA的阈值。
JEM与个体评估之间存在分歧的最重要决定因素是在生产线外工作(分歧率80%)、暴露可能性低(分歧率25%)以及生产线内工作的暴露取决于特定活动(如使用特定漆料,分歧率32%)。这些决定因素是后续最终IEEA暴露评级的选择标准。
对于选定的暴露评级子集,将JEM与后续最终IEEA相结合是大型职业流行病学研究中进行暴露评估的一种可行且省力的方法。