Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Switzerland.
Vaud Cancer Registry, Unisanté, Lausanne, Switzerland.
Swiss Med Wkly. 2022 Feb 22;152:w30127. doi: 10.4414/smw.2022.w30127. eCollection 2022 Feb 14.
The contribution of occupation-related diseases to the global burden of disease is greatly underestimated, mainly due to a shortage of occupational exposure data. This problem is particularly salient in Switzerland, where no estimates of occupation-related disease burden exist, even for the well-recognised occupational cancers, such as malignant pleural mesothelioma and lung cancer. To overcome this situation, we launched a research project "Examining Cancers and Labour Indicators to assess the Burden" (ExCaLIBur). Within this project, we aimed to assess the need for and quality (i.e., completeness, accuracy and precision) of occupation registration in all cancer registries of Western Switzerland. We also aimed to find a relevant and feasible strategy to collect this information in the future. We applied a mixed research method. We observed that, independently of the level of precision (5-3-2-1-digit aggregation level), the accuracy was lesser in the registries that were able to actively search and verify occupational information. Overall, the distinction of occupations based on the 3-digit code presents an acceptable compromise in terms of precision. Having such occupations registered in all, or most, Swiss cancer registries routinely would obviously be valuable for epidemiological surveillance of occupational cancers in Switzerland. However, it seems less obvious how these data could fulfill the research objectives, since a better precision than 3-digit occupational coding is challenging to achieve. Currently, the collection of occupational data by the Swiss cancer registries remains feasible in the frame of specific research projects on occupational cancers. However, available data sources, as well as lack of financial and human resources, will continue to affect quality of the collected occupation data. Therefore, the usage of the standardised questionnaire retracing the individual occupational history to enable further assessment of individual exposure to potential occupational hazards is recommended. However, this approach will disable the Swiss registries to insuring their epidemiological surveillance mission with respect to occupational cancers in Switzerland, for which national statistics remain limited.
职业相关疾病对全球疾病负担的贡献被大大低估了，主要原因是职业暴露数据的缺乏。这一问题在瑞士尤为突出，因为瑞士没有职业相关疾病负担的估计数据，甚至对于恶性胸膜间皮瘤和肺癌等公认的职业癌也没有。为了解决这一问题，我们启动了一个名为“检查癌症和劳工指标以评估负担”（ExCaLIBur）的研究项目。在该项目中，我们旨在评估瑞士西部所有癌症登记处的职业登记的需求和质量（即完整性、准确性和精密度）。我们还旨在找到一种相关且可行的策略，以便在未来收集这些信息。我们应用了混合研究方法。我们观察到，无论精度水平（5-3-2-1 位数字聚合水平）如何，能够主动搜索和验证职业信息的登记处的准确性较低。总体而言，基于 3 位数字代码对职业进行区分在精度方面是一个可以接受的折衷方案。如果所有或大多数瑞士癌症登记处都常规地登记这些职业，这显然对瑞士职业癌的流行病学监测很有价值。然而，这些数据如何能够满足研究目标似乎不太明显，因为要实现比 3 位职业编码更高的精度是具有挑战性的。目前，瑞士癌症登记处收集职业数据的工作在职业癌症的具体研究项目框架内仍然可行。然而，可用的数据来源以及缺乏财务和人力资源将继续影响所收集职业数据的质量。因此，建议使用标准化问卷追溯个人职业史，以便进一步评估个人接触潜在职业危害的情况。然而，这种方法将使瑞士登记处无法完成其在瑞士职业癌方面的流行病学监测任务，因为国家统计数据仍然有限。
