工作暴露矩阵与针对甲醛和木屑职业暴露的逐案专家评估之间差异的来源。

Sources of discrepancies between a job exposure matrix and a case by case expert assessment for occupational exposure to formaldehyde and wood-dust.

作者信息

Luce D, Gérin M, Berrino F, Pisani P, Leclerc A

机构信息

INSERM U.88, Paris, France.

出版信息

Int J Epidemiol. 1993;22 Suppl 2:S113-20. doi: 10.1093/ije/22.supplement_2.s113.

Abstract

Two methods used for retrospective evaluation of occupational exposures, a case by case assessment by expert and the application of a job exposure matrix (JEM), are compared using occupational histories collected for a case-control study on sinonasal cancer. The objective was to identify the main sources of discrepancies and to contribute to an optimal use of a JEM for population-based case-control studies. Comparisons were based on job periods, and were performed separately for two substances: formaldehyde and wood-dust. Job periods were classified according to the category of exposure assigned by the matrix, and to the probability and level of exposure assessed by the study expert. The sources of discrepancies were examined for job periods probably or definitely exposed according to the JEM and unexposed for the expert, or unexposed in the JEM and probably or definitely exposed to medium or high level for the expert. Such discrepancies were observed for 8% of the job periods for formaldehyde and 3% of the job periods for wood-dust. The agreement between the two approaches was better for wood-dust than for formaldehyde. The relative importance of different sources of discrepancies was not the same for formaldehyde and wood-dust. For formaldehyde a substantial part of the discrepancies was due to disagreements between the study expert and the matrix experts, which were mostly differences in threshold limits between 'not exposed' and 'definitely exposed at a low level'. Differences between experts' opinions did not explain the discordances observed for wood-dust. The presence of additional information in the questionnaire was an important source of discrepancy for the two substances.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

利用为一项关于鼻窦癌的病例对照研究收集的职业史,比较了用于职业暴露回顾性评估的两种方法,即专家逐案评估和工作暴露矩阵(JEM)的应用。目的是确定差异的主要来源,并有助于在基于人群的病例对照研究中优化使用JEM。比较基于工作时间段,分别针对两种物质进行:甲醛和木尘。工作时间段根据矩阵分配的暴露类别以及研究专家评估的暴露概率和水平进行分类。对于根据JEM可能或肯定暴露但专家认为未暴露的工作时间段,以及在JEM中未暴露但专家认为可能或肯定暴露于中高水平的工作时间段,检查差异来源。甲醛工作时间段中有8%、木尘工作时间段中有3%观察到此类差异。两种方法之间对木尘的一致性比对甲醛的更好。甲醛和木尘不同差异来源的相对重要性不同。对于甲醛,相当一部分差异是由于研究专家和矩阵专家之间的分歧,主要是“未暴露”和“肯定低水平暴露”之间阈值限制的差异。专家意见之间的差异并不能解释木尘中观察到的不一致。问卷中额外信息的存在是两种物质差异的一个重要来源。(摘要截断于250字)

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