Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
Department of preventive medicine, University of Oviedo, Health Research Institute of Asturias, ISPA and CIBERESP, Oviedo, Spain.
Ann Work Expo Health. 2022 Mar 15;66(3):392-401. doi: 10.1093/annweh/wxab084.
We adapted previously developed decision rules from the New England Bladder Cancer Study (NEBCS) to assign occupational exposure to straight, soluble, and synthetic metalworking fluids (MWFs) to participants of the Spanish Bladder Cancer Study (SBCS).
The SBCS and NEBCS are case-control studies that used the same lifetime occupational history and job module questionnaires. We adapted published decision rules from the NEBCS that linked questionnaire responses to estimates of the probability (<5, ≥5 to <50, ≥50 to <100, and 100%), frequency (in h week-1), and intensity (in mg m-3) of exposure to each of the three broad classes of MWFs to assign exposure to 10 182 reported jobs in the SBCS. The decision rules used the participant's module responses to MWF questions wherever possible. We then used these SBCS module responses to calculate job-, industry-, and time-specific patterns in the prevalence and frequency of MWF exposure. These estimates replaced the NEBCS-specific estimates in decision rules applied to jobs without MWF module responses. Intensity estimates were predicted using a previously developed statistical model that used the decade, industry (three categories), operation (grinding versus machining), and MWF type extracted from the SBCS questionnaire responses. We also developed new decision rules to assess mineral oil exposure from non-machining sources (possibly exposed versus not exposed). The decision rules for MWF and mineral oil identified questionnaire response patterns that required job-by-job expert review.
To assign MWF exposure, we applied decision rules that incorporated participant's responses and job group patterns for 99% of the jobs and conducted expert review of the remaining 1% (145) jobs. Overall, 14% of the jobs were assessed as having ≥5% probability of exposure to at least one of the three MWFs. Probability of exposure of ≥50% to soluble, straight, and synthetic MWFs was identified in 2.5, 1.7, and 0.5% of the jobs, respectively. To assign mineral oil from non-machining sources, we used module responses for 49% of jobs, a job-exposure matrix for 41% of jobs, and expert review for the remaining 10%. We identified 24% of jobs as possibly exposed to mineral oil from non-machining sources.
We demonstrated that we could adapt existing decision rules to assess exposure in a new population by deriving population-specific job group patterns.
我们借鉴了新英格兰膀胱癌研究（NEBCS）先前开发的决策规则，将职业暴露于直型、水溶性和合成金属加工液（MWF）分配给西班牙膀胱癌研究（SBCS）的参与者。
SBCS 和 NEBCS 都是病例对照研究，它们使用相同的终生职业史和工作模块问卷。我们借鉴了 NEBCS 中已发表的决策规则，这些规则将问卷回答与三种广泛的 MWF 暴露概率（<5、≥5 至<50、≥50 至<100 和 100%）、频率（每周 h 周-1）和强度（每立方米 mg m-3）联系起来，以分配暴露于 SBCS 中报告的 10182 个报告工作。决策规则尽可能地使用参与者的模块对 MWF 问题的回答。然后，我们使用这些 SBCS 模块响应来计算工作、行业和时间特定的 MWF 暴露的流行率和频率模式。这些估计值取代了应用于没有 MWF 模块响应的工作的决策规则中的 NEBCS 特定估计值。使用先前开发的统计模型预测强度估计值，该模型使用从 SBCS 问卷响应中提取的十年、行业（三类）、操作（研磨与加工）和 MWF 类型。我们还开发了新的决策规则来评估非加工源的矿物油暴露（可能暴露与未暴露）。MWF 和矿物油的决策规则确定了需要逐工作进行专家审查的问卷响应模式。
为了分配 MWF 暴露，我们应用了纳入参与者的响应和工作组模式的决策规则，其中 99%的工作适用，而其余 1%（145）的工作需要进行专家审查。总体而言，14%的工作被评估为至少有一种三种 MWF 暴露的概率≥5%。可溶性、直型和合成 MWF 暴露的概率≥50%分别在 2.5%、1.7%和 0.5%的工作中确定。为了分配来自非加工源的矿物油，我们对 49%的工作使用模块响应，对 41%的工作使用工作暴露矩阵，对其余 10%的工作使用专家审查。我们确定了 24%的工作可能接触过非加工源的矿物油。
我们证明，我们可以通过得出特定于人群的工作组模式，将现有的决策规则应用于新人群，以评估暴露情况。
