石棉暴露的回顾性评估——I. 肺癌研究中的病例对照分析:特定工作问卷和工作暴露矩阵的有效性

Retrospective assessment of asbestos exposure--I. Case-control analysis in a study of lung cancer: efficiency of job-specific questionnaires and job exposure matrices.

作者信息

Ahrens W, Jöckel K H, Brochard P, Bolm-Audorff U, Grossgarten K, Iwatsubo Y, Orlowski E, Pohlabeln H, Berrino F

机构信息

Bremer Institut für Präventionsforschung und Sozialmedizin, Bremen, Germany.

出版信息

Int J Epidemiol. 1993;22 Suppl 2:S83-95. doi: 10.1093/ije/22.supplement_2.s83.

Abstract

Retrospective assessment of asbestos exposure--I. Case-control analysis in a study of lung cancer: efficiency of job-specific questionnaires and job exposure matrices. International Journal of Epidemiology 1993; 22 (Suppl. 2): S83-S95. In a lung cancer study in Northern Germany the asbestos exposure assessment obtained from detailed supplementary questionnaires (SQ) was compared to the assessment obtained by the application of two job exposure matrices (JEM) to the job history. The study includes 391 incident male cases and the same number of controls from the general population, matched by sex, age, and region. Almost 16% of the subjects are considered as never having been exposed to asbestos and 24% are classified as certainly exposed according to both of the JEM, the corresponding percentages of the SQ-method being 68% and 32%. Sixty percent are considered by the JEM as having an intermediate probability of exposure. In general, the agreement between the different methods is better when the exposure definition is restricted to definite exposures, the corresponding Kappa statistic being 0.67 for the comparison between both JEM and 0.44/0.39 between the JEM and the SQ. The positive agreement between SQ and JEM (reference) increases from 12% and 17% for subjects with low probability of exposure to 61% and 69% for those with definite exposures. A ranking according to cumulative exposure shows some dose-response relationship for each of the three methods with a smoking-adjusted OR in the highest category of 1.85 (95% CI: 1.01-3.38) for the SQ method and 2.47 (95% CI: 1.40-4.37) and 2.94 (95% CI: 1.73-4.99) for the two JEM. The results are discussed with reference to the conceptual differences between the methods and their potential scope in future studies.

摘要

石棉暴露的回顾性评估——I. 肺癌研究中的病例对照分析:特定工作问卷和工作暴露矩阵的效率。《国际流行病学杂志》1993年;22(增刊2):S83 - S95。在德国北部的一项肺癌研究中,将通过详细补充问卷(SQ)获得的石棉暴露评估与将两种工作暴露矩阵(JEM)应用于工作经历所获得的评估进行了比较。该研究包括391例男性新发病例以及相同数量来自普通人群的对照,按性别、年龄和地区进行匹配。几乎16%的受试者被认为从未接触过石棉,根据两种JEM,24%的受试者被归类为肯定接触过石棉,SQ方法对应的百分比分别为68%和32%。JEM认为60%的受试者有中等接触可能性。总体而言,当暴露定义限于明确暴露时,不同方法之间的一致性更好,两种JEM之间比较的相应Kappa统计量为0.67,JEM与SQ之间为0.44/0.39。SQ与JEM(参考)之间的阳性一致性从低接触可能性受试者的12%和17%增加到明确暴露受试者的61%和69%。根据累积暴露进行的排序显示,三种方法中的每一种都有一些剂量反应关系,SQ方法在最高类别中的吸烟调整优势比为1.85(95%可信区间:1.01 - 3.38),两种JEM分别为2.47(95%可信区间:1.40 - 4.37)和2.94(95%可信区间:1.73 - 4.99)。结合方法之间的概念差异及其在未来研究中的潜在范围对结果进行了讨论。

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