School of Engineering and Physical Sciences, Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot-Watt University, Edinburgh EH14 4AS, UK.
Maxwell Institute for Mathematical Sciences, School of Mathematical and Computer Sciences, Heriot-Watt University, Edinburgh EH14 4AS, UK.
Int J Environ Res Public Health. 2020 Jul 8;17(14):4919. doi: 10.3390/ijerph17144919.
Many epidemiological studies have shown an association between outdoor particulate air pollutants and increased morbidity and mortality. Inhalation of ambient aerosols can exacerbate or promote the development of cardiovascular and pulmonary diseases as well as other diseases, such as type 2 diabetes mellitus (T2DM) and neurodegenerative diseases. Occupational exposure to dust, fumes and diesel exhaust particulates can also cause adverse health outcomes and there are numerous occupations where workers are exposed to airborne particles that are similar to ambient air pollution. An individual's job title has normally been identified as a major determinant of workplace exposure in epidemiological studies. This has led to the development of Job-Exposure Matrices (JEMs) as a way of characterising specific workplace exposures. One JEM for airborne chemical exposures is the Airborne Chemical Exposure Job-Exposure Matrix (ACE JEM), developed specifically for the UK Biobank cohort. The objective of this paper is to evaluate the suitability of the ACE JEM in assessing occupational aerosol exposure of participants in the UK Biobank. We searched the scientific literature to identify exposure data linked to selected jobs in the ACE JEM and compared these data with the JEM assessments. Additionally, we carried out an independent expert-based assessment of exposure to compare with the JEM estimates. There is good published evidence to substantiate the high dust and biological dust assignments in the JEM and more limited evidence for diesel exhaust particulates. There is limited evidence in the published literature to substantiate moderate or low exposure assignments in the JEM. The independent expert-based assessment found good agreement at the two extremes of exposure in the JEM (high and no exposure), with uncertainty in all other classifications. The ACE JEM assignments are probably reliable for highly exposed jobs and for jobs assigned as unexposed. However, the assignments for medium and low exposures are less reliable. The ACE JEM is likely to be a good tool to examine associations between occupational exposures to particulates and chronic disease, although it should be used with caution. Further efforts should be made to improve the reliability of the ACE JEM.
许多流行病学研究表明，室外颗粒物空气污染物与发病率和死亡率的增加有关。吸入环境气溶胶会加重或促进心血管和肺部疾病以及其他疾病（如 2 型糖尿病（T2DM）和神经退行性疾病）的发展。职业接触粉尘、烟雾和柴油废气颗粒也会导致不良健康后果，许多职业的工人会接触到类似于环境空气污染的空气传播颗粒。在流行病学研究中，个体的工作岗位通常被确定为工作场所暴露的主要决定因素。这导致了职业暴露矩阵（JEM）的发展，作为一种描述特定工作场所暴露的方法。一种用于空气传播化学暴露的 JEM 是空气传播化学暴露职业暴露矩阵（ACE JEM），专门为英国生物库队列开发。本文的目的是评估 ACE JEM 在评估英国生物库参与者的职业气溶胶暴露中的适用性。我们搜索了科学文献，以确定与 ACE JEM 中选定工作相关的暴露数据，并将这些数据与 JEM 评估进行了比较。此外，我们进行了独立的基于专家的暴露评估，以与 JEM 估计值进行比较。有充分的已发表证据证实 JEM 中高粉尘和生物粉尘的赋值，而对柴油废气颗粒的证据则更为有限。发表的文献中对 JEM 中中等或低暴露赋值的证据有限。基于专家的独立评估发现，JEM 中暴露的两个极端（高暴露和无暴露）之间存在良好的一致性，所有其他分类都存在不确定性。ACE JEM 分配对于高度暴露的工作和未暴露的工作可能是可靠的。然而，中低暴露的分配则不太可靠。ACE JEM 可能是研究颗粒物职业暴露与慢性病之间关联的一个很好的工具，尽管应谨慎使用。应进一步努力提高 ACE JEM 的可靠性。
