Exposure assessment in epidemiologic studies of birth defects by industrial hygiene review of maternal interviews.

In epidemiologic studies of birth defects, occupational titles have frequently been used as surrogates for exposure. To avoid the error associated with such proxy exposure measures, we have designed a process in which an industrial hygienist systematically imputes exposures derived from maternal interviews. In response to a structured questionnaire, mothers of cases and controls recalled occupational and nonoccupational tasks performed or products used around the time of conception. Maternal exposures were then assigned to several a priori defined categories by an industrial hygienist. The central exposure category consists of 74 chemical families, e.g., alcohols, lead compounds. Other exposure categories are individual chemical compounds; nonchemical agents, e.g., ionizing radiation, infectious diseases; and product end-use categories, e.g., insecticides, combustion products. A detailed description of this approach and its exposure assessment potential is presented using exposure data from 220 maternal interviews.