Bouyer J, Hémon D
Department of Epidemiological and Statistical Research on Environment and Health, INSERM U.170, Villejuif, France.
Int J Epidemiol. 1993;22 Suppl 2:S57-64. doi: 10.1093/ije/22.supplement_2.s57.
Different approaches may be considered in the evaluation of past occupational exposures: questionnaires only, questionnaires and experts (such as industrial hygienists or occupational physicians), questionnaires and job exposure matrices (JEM). These approaches are described in this paper and their use in the framework of population-based case-control studies is discussed. The use of experts to assess exposure from questionnaires is generally considered to be the reference method. Its major drawbacks are its cost and the shortage of experienced experts. On the other hand, JEM reduce the cost of the study and provide an objective way of evaluating exposures. The main drawback of JEM is the fact that they can produce misclassification. The development of a JEM includes the choice of the job classification system which influences the degree to which the matrix can be used in other studies, the precise definition of exposures, and the choice of entries which provide more information than the oversimplified exposed/non-exposed dichotomy. Recent results on JEM methodology (statistical methods of analysis and evaluation of JEM quality) should encourage both their development and their use in epidemiological studies.
在评估过去的职业暴露时,可以考虑不同的方法:仅使用问卷调查、问卷调查结合专家(如工业卫生学家或职业医生)、问卷调查结合工作暴露矩阵(JEM)。本文描述了这些方法,并讨论了它们在基于人群的病例对照研究框架中的应用。利用专家根据问卷调查评估暴露情况通常被视为参考方法。其主要缺点是成本高且缺乏经验丰富的专家。另一方面,工作暴露矩阵降低了研究成本,并提供了一种评估暴露的客观方法。工作暴露矩阵的主要缺点是它们可能会产生错误分类。工作暴露矩阵的开发包括工作分类系统的选择,这会影响该矩阵在其他研究中的使用程度、暴露的精确定义以及条目的选择,这些条目提供的信息比过于简化的暴露/未暴露二分法更多。关于工作暴露矩阵方法学(分析和评估工作暴露矩阵质量的统计方法)的最新结果应会促进其在流行病学研究中的开发和应用。
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