哮喘特异性工作暴露矩阵在美国的开发。
Development of an Asthma-Specific Job Exposure Matrix for Use in the United States.
机构信息
Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA.
Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
出版信息
Ann Work Expo Health. 2020 Jan 1;64(1):82-95. doi: 10.1093/annweh/wxz089.
INTRODUCTION
Existing asthma-specific job-exposure matrices (JEMs) do not necessarily reflect current working conditions in the USA and do not directly function with occupational coding systems commonly used in the USA. We initiated a project to modify an existing JEM to address these limitations, and to apply the new JEM to the entire US employed population to estimate quantitatively the extent of probable work-related asthma exposures nationwide.
METHODS
We started with an asthma-specific JEM that was developed for northern Europe (the N-JEM) and modified it to function with the 2010 US Standard Occupational Classification (SOC-2010) codes and to reflect working conditions in the USA during the post-2000 period. This involved cross walking from the 1988 International Standard Classification of Occupations (ISCO-88) codes used in the N-JEM to the SOC-2010 codes, transferring the N-JEM exposure assignments to the SOC-2010 codes, and modifying those assignments to reflect working conditions in the USA. The new US asthma JEM (USA-JEM) assigns exposures to 19 agents organized into five categories. The USA-JEM and N-JEM were applied to the same sample of working adults with asthma to compare how they performed, and the USA-JEM was also applied to the entire 2015 US working population to estimate the extent of occupational asthma exposures nationally.
RESULTS
The USA-JEM assigns at least one asthma-related probable exposure to 47.5% and at least one possible exposure to 14.9% of the 840 SOC-2010 detailed occupations, and 9.0% of the occupations have both probable exposure to at least one agent and possible exposure to at least one other agent. The USA-JEM has greater sensitivity for cleaning products, highly reactive disinfectants and sterilants, and irritant peak exposures than the N-JEM. When applied to the entire 2015 US working population, the USA-JEM determined that 42.6% of workers had probable exposure to at least one type of occupational asthma agent.
DISCUSSION
A new asthma-specific JEM for application in the USA was developed. Additional work is needed to compare its performance to similar JEMs and, if possible, to exposure assessments generated on a case-by-case basis.
简介
现有的哮喘特异性职业暴露矩阵（JEM）不一定反映美国当前的工作条件，也不能直接与美国常用的职业编码系统配合使用。我们启动了一个项目，旨在修改现有的 JEM 以解决这些限制，并将新的 JEM 应用于整个美国就业人群，以定量估计全国范围内可能与工作相关的哮喘暴露程度。
方法
我们从一个专为北欧开发的哮喘特异性 JEM（N-JEM）开始，对其进行修改，使其能够与 2010 年美国标准职业分类（SOC-2010）代码配合使用，并反映 2000 年后美国的工作条件。这涉及从 N-JEM 中使用的 1988 年国际标准职业分类（ISCO-88）代码交叉映射到 SOC-2010 代码，将 N-JEM 的暴露分配转移到 SOC-2010 代码，并修改这些分配以反映美国的工作条件。新的美国哮喘 JEM（USA-JEM）将暴露分配给 19 种分为五类的制剂。将 USA-JEM 和 N-JEM 应用于相同的患有哮喘的成年工作人群样本，以比较它们的性能，并且还将 USA-JEM 应用于整个 2015 年美国工作人群，以估计全国范围内职业性哮喘暴露的程度。
结果
USA-JEM 将至少一种与哮喘相关的可能暴露分配给 840 个 SOC-2010 详细职业中的 47.5%，并将至少一种可能暴露分配给 14.9%，并且 9.0%的职业既有至少一种制剂的可能暴露，也有至少另一种制剂的可能暴露。与 N-JEM 相比，USA-JEM 对清洁产品、高反应性消毒剂和杀菌剂以及刺激性峰值暴露的敏感性更高。当应用于整个 2015 年美国工作人群时，USA-JEM 确定 42.6%的工人有至少一种职业性哮喘制剂的可能暴露。
讨论
为在美国应用开发了一种新的哮喘特异性 JEM。需要进一步的工作来比较其性能与类似的 JEM，如果可能的话，还需要与基于个案的暴露评估进行比较。
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