荷兰基于人群的职业与环境卫生前瞻性队列研究(AMIGO)。

The population-based Occupational and Environmental Health Prospective Cohort Study (AMIGO) in The Netherlands.

作者信息

Slottje Pauline, Yzermans C Joris, Korevaar Joke C, Hooiveld Mariëtte, Vermeulen Roel C H

机构信息

Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands.

Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.

出版信息

BMJ Open. 2014 Nov 26;4(11):e005858. doi: 10.1136/bmjopen-2014-005858.

Abstract

PURPOSE

Occupational and environmental exposures remain important modifiable risk factors of public health. Existing cohort studies are often limited by the level of detail of data collected on these factors and health. It is also often assumed that the more healthy group is over-represented in cohort studies, which is of concern for their external validity. In this cohort profile, we describe how we set up the population-based Occupational and Environmental Health Cohort Study (AMIGO) to longitudinally study occupational and environmental determinants of diseases and well-being from a multidisciplinary and life course point of view. Reviewed by the Medical Ethics Research Committee of the University Medical Center Utrecht (protocol 10-268/C). All cohort members participate voluntarily and gave informed consent prior to their inclusion.

PARTICIPANTS

14,829 adult cohort members (16% of those invited) consented and filled in the online baseline questionnaire. Determinants include chemical, biological, physical (eg, electromagnetic fields), and psychosocial factors. Priority health outcomes include cancer, neurological, cardiovascular and respiratory diseases and non-specific symptoms. Owing to the recruitment strategy via general practitioners of an established network, we also collect longitudinal data registered in their electronic medical records including symptoms, diagnosis and treatments. Besides the advantage of health outcomes that cannot be easily captured longitudinally by other means, this created a unique opportunity to assess health-related participation bias by comparing general practitioner-registered prevalence rates in the cohort and its source population.

FINDINGS TO DATE

We found no indications of such a systematic bias. The major assets of the AMIGO approach are its detailed occupational and environmental determinants in combination with the longitudinal health data registered in general practice besides linkage to cancer and mortality registries and self-reported health.

FUTURE PLANS

We are now in the phase of prospective follow-up, with the aim of continuing this for as long as possible (20+ years), pending future funding. Findings will be disseminated through scientific conferences and peer-reviewed journals, and through newsletters and the project website to participants, stakeholders and the wider public.

摘要

目的

职业和环境暴露仍然是公共卫生领域重要的可改变风险因素。现有的队列研究往往受到这些因素和健康状况数据收集细节程度的限制。人们还常常认为,在队列研究中健康状况较好的人群占比过高,这对研究的外部效度构成了担忧。在本队列研究简介中,我们描述了如何建立基于人群的职业与环境健康队列研究(AMIGO),以便从多学科和生命历程的角度纵向研究疾病和健康状况的职业与环境决定因素。该研究经乌得勒支大学医学中心医学伦理研究委员会审核(方案10 - 268/C)。所有队列成员均自愿参与,并在纳入研究前签署了知情同意书。

参与者

14829名成年队列成员(占受邀者的16%)同意并填写了在线基线调查问卷。决定因素包括化学、生物、物理(如电磁场)和社会心理因素。重点健康结局包括癌症、神经、心血管和呼吸系统疾病以及非特异性症状。由于通过一个既定网络的全科医生进行招募,我们还收集了他们电子病历中记录的纵向数据,包括症状、诊断和治疗情况。除了具有其他方法难以纵向获取的健康结局这一优势外,这还创造了一个独特的机会,通过比较队列及其源人群中全科医生记录的患病率来评估与健康相关的参与偏倚。

迄今的发现

我们未发现此类系统偏倚的迹象。AMIGO方法的主要优点在于其详细的职业和环境决定因素,以及全科医疗中记录的纵向健康数据,此外还与癌症和死亡率登记处以及自我报告的健康状况相联系。

未来计划

我们目前正处于前瞻性随访阶段,目标是在未来获得资金的情况下尽可能长时间地持续进行(20多年)。研究结果将通过科学会议、同行评审期刊以及时事通讯和项目网站向参与者、利益相关者及更广泛的公众传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b850/4248092/49d30ebcfa43/bmjopen2014005858f01.jpg

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