Bouyer J, Hémon D
INSERM U292, Hôpital de Bicêtre, Le Kremlin-Bicêtre.
Rev Epidemiol Sante Publique. 1994;42(3):235-45.
During the last years, the use of Job Exposure Matrices (JEMs) for the evaluation of past occupational exposures has grown. This approach is described in this paper. The definition of a JEM is provided. The development process of a JEM is discussed. It 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 should provide more information than the oversimplified exposed/non exposed dichotomy. When comparing JEMs and experts' evaluation of exposure, all aspects of both methods have to be looked at and a balance struck between the advantages and shortcomings of each of them. The problem should not be reduced to a single choice between the precision provided by experts, and the cost savings and standardization offered by JEMs. Statistical analysis with a JEM must be adapted to the job classified information it provided. When an appropriate method is used, the loss of power with a JEM compared to experts' evaluation is rather small or even null. Finally, it is important to avoid a systematic opposition between JEMs and expert assessments, as one positive result of their comparison may be the improvement of both methods of exposure evaluation.
在过去几年中，用于评估既往职业暴露的工作暴露矩阵（JEMs）的使用有所增加。本文描述了这种方法。给出了JEM的定义，讨论了JEM的开发过程。这包括工作分类系统的选择，该选择会影响矩阵在其他研究中的可用程度、暴露的精确定义以及条目的选择，这些条目应提供比过于简化的暴露/未暴露二分法更多的信息。在比较JEMs和专家对暴露的评估时，必须审视两种方法的所有方面，并在它们各自的优缺点之间取得平衡。问题不应简化为在专家提供的精确性与JEMs提供的成本节约和标准化之间进行单一选择。使用JEM进行的统计分析必须适应其提供的工作分类信息。当使用适当的方法时，与专家评估相比，JEM的效能损失相当小甚至为零。最后，重要的是要避免JEMs与专家评估之间的系统性对立，因为它们比较的一个积极结果可能是两种暴露评估方法的改进。
