Health Innovation and Evaluation Hub, CRCHUM (Centre de recherche du CHUM), University of Montreal, Montreal, QC, Canada.
Department of Social and Preventive Medicine, University of Montreal, Montreal, QC, Canada.
Ann Work Expo Health. 2022 Jul 2;66(6):728-740. doi: 10.1093/annweh/wxac008.
To compare the exposure data generated by using the Canadian job-exposure matrix (CANJEM) with data generated by expert assessment, for jobs held by women.
We selected 69 occupational agents that had been assessed by experts for each of 3403 jobs held by 998 women in a population-based case-control study of lung cancer. We then assessed the same agents among the same jobs by linking their occupation codes to CANJEM and thereby derived probability of exposure to each of the agents in each job. To create binary exposure variables, we dichotomized probability of exposure using two cutpoints: 25 and 50% (referred to as CANJEM-25% and CANJEM-50%). Using jobs as units of observation, we estimated the prevalence of exposure to each selected agent using CANJEM-25% and CANJEM-50%, and using expert assessment. Further, using expert assessment as the gold standard, for each agent, we estimated CANJEM's sensitivity, specificity, and kappa.
CANJEM-based prevalence estimates correlated well with the prevalences assessed by the experts. When comparing CANJEM-based exposure estimates with expert-based exposure estimates, sensitivity, specificity, and kappa varied greatly among agents, and between CANJEM-25% and CANJEM-50% probability of exposure. With CANJEM-25%, the median sensitivity, specificity, and kappa values were 0.49, 0.99, and 0.46, respectively. Analogously, with CANJEM-50%, the corresponding values were 0.26, 1.00, and 0.35, respectively. For the following agents, we observed high concordance between CANJEM- and expert-based assessments (sensitivity ≥0.70 and specificity ≥0.99): fabric dust, cotton dust, synthetic fibres, cooking fumes, soldering fumes, calcium carbonate, and tin compounds. We present concordance estimates for each of 69 agents.
Concordance between CANJEM and expert assessment varied greatly by agents. Our results indicate which agents provide data that mimic best those obtained with expert assessment.
比较使用加拿大职业暴露矩阵（CANJEM）和专家评估生成的数据，用于女性从事的工作。
我们选择了专家评估的 69 种职业暴露剂，用于研究肺癌的人群病例对照研究中 998 名女性从事的 3403 种职业。然后，我们通过将职业代码链接到 CANJEM，评估了相同工作中的相同暴露剂，并由此得出了每种职业中每种暴露剂的暴露概率。为了创建二进制暴露变量，我们使用两个截断点（25%和 50%）对暴露概率进行二分类（分别称为 CANJEM-25%和 CANJEM-50%）。以工作为观察单位，我们使用 CANJEM-25%和 CANJEM-50%以及专家评估来估计每种选定暴露剂的暴露率。此外，使用专家评估作为金标准，对于每种暴露剂，我们估计了 CANJEM 的敏感性、特异性和 kappa。
基于 CANJEM 的患病率估计与专家评估的患病率相关性良好。当将基于 CANJEM 的暴露估计与基于专家的暴露估计进行比较时，敏感性、特异性和 kappa 在暴露剂之间以及在 CANJEM-25%和 CANJEM-50%的暴露概率之间差异很大。使用 CANJEM-25%，中位敏感性、特异性和 kappa 值分别为 0.49、0.99 和 0.46。类似地，使用 CANJEM-50%，相应的值分别为 0.26、1.00 和 0.35。对于以下暴露剂，我们观察到 CANJEM 和专家评估之间存在高度一致性（敏感性≥0.70 和特异性≥0.99）：织物粉尘、棉花粉尘、合成纤维、烹饪烟雾、焊接烟雾、碳酸钙和锡化合物。我们呈现了 69 种暴露剂中的每一种的一致性估计。
CANJEM 和专家评估之间的一致性因暴露剂而异。我们的结果表明，哪些暴露剂提供的数据最能模拟专家评估获得的数据。
