Dens Anne-Catherine, Celen Hannelore, Michiels Stijn, Doumen Michaël, Pazmino Sofia, Godderis Lode, Verschueren Patrick, Kromhout Hans, Ronsmans Steven, De Langhe Ellen
Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
Department of Rheumatology, AZ Herentals General Hospital, Herentals, Belgium.
Rheumatol Adv Pract. 2025 Feb 7;9(1):rkaf016. doi: 10.1093/rap/rkaf016. eCollection 2025.
Systemic autoimmune rheumatic diseases (SARDs) develop in genetically susceptible individuals when exposed to environmental factors such as respirable crystalline silica (RCS) particles. Assessing occupational exposure in population-based studies is critical but resource intensive, often requiring expert interviews. This study aimed to develop and validate a self-administered occupational history questionnaire that allows for International Standard Classification of Occupations 1968 (ISCO-68) coding and exposure assessment as a cost-effective alternative to traditional interviews.
Seventy RA patients participated by completing a standardized telephone interview and the newly developed self-administered questionnaire. Participants were also asked to recruit two gender- and age-matched family members for comparison. Independent observers assigned ISCO-68 codes to the reported jobs and a job exposure matrix was used to link each job to RCS exposure. Agreement between the interview and questionnaire was assessed by comparing reported working years, ISCO-68 job codes and RCS exposure. Cohen's κ and intraclass correlation were calculated to evaluate agreement and interobserver variability.
The patient response rate was 77%, but family member controls had a low response rate (6.45%), likely impacted by the COVID-19 pandemic. Agreement for reported working years was 91%, with a Cohen's κ of 0.87 for ever/never RCS exposure. Manual ISCO coding introduced variability, but interobserver reliability remained high (intraclass correlation coefficient = 0.91).
The self-administered occupational history questionnaire provides a valid, cost-effective and time-efficient alternative to telephone interviews for assessing occupational history and estimating RCS exposure in epidemiological research. Future studies should explore automated coding systems and improved strategies for control recruitment.
系统性自身免疫性风湿病（SARDs）在遗传易感个体暴露于可吸入结晶二氧化硅（RCS）颗粒等环境因素时会发生。在基于人群的研究中评估职业暴露至关重要，但资源密集，通常需要专家访谈。本研究旨在开发并验证一份自我管理的职业史问卷，该问卷允许进行1968年国际职业分类（ISCO - 68）编码和暴露评估，作为传统访谈的一种经济高效的替代方法。
70名类风湿关节炎（RA）患者通过完成标准化电话访谈和新开发的自我管理问卷参与研究。参与者还被要求招募两名性别和年龄匹配的家庭成员进行比较。独立观察员为报告的工作分配ISCO - 68编码，并使用工作暴露矩阵将每个工作与RCS暴露联系起来。通过比较报告的工作年限、ISCO - 68工作编码和RCS暴露来评估访谈和问卷之间的一致性。计算科恩κ系数和组内相关性以评估一致性和观察者间的变异性。
患者的回应率为77%，但家庭成员对照组的回应率较低（6.45%），可能受到2019冠状病毒病大流行的影响。报告工作年限的一致性为91%，对于曾经/从未接触RCS的情况，科恩κ系数为0.87。人工ISCO编码引入了变异性，但观察者间的可靠性仍然很高（组内相关系数 = 0.9）。
自我管理的职业史问卷为在流行病学研究中评估职业史和估计RCS暴露提供了一种有效、经济高效且省时的电话访谈替代方法。未来的研究应探索自动编码系统和改进的对照招募策略。
