[Development of a job-exposure matrix in the heavy-metal industry in France].

A job exposure matrix (JEM) was developed by a committee of experts using the DELPHI method, in the French hard metal industry, in order to assess occupational exposures to cobalt along with tungsten carbide resulting from the industrial process. This JEM is part of a nested case-control study, carried out within the historical cohort of workers ever employed in these factories, aimed at assessing lung cancer risk. The committee included 8 experts: hygienists, chemical engineers, occupational physicians and epidemiologists. The JEM was developed in four stages: (i) visit of factories, (ii) definition of lines (job-periods) and columns (exposures) of the JEM, (iii) definition of coding procedures, (iv) coding the cells of the JEM. This last stage used a method derived from the DELPHI method. Throughout the study period 1945-1994. 320 job-periods and 21 agents were defined. A quantitative assignment (level 0 to level 9) along with a frequency code (1 to 3) was attempted for 4 agents, whereas only a qualitative assignment (non exposed/exposed, i.e. 0/l) was done for the other agents. An additional probability code (1 to 3) was assigned to all agents. This procedure led to 46 columns and 14,720 cells in the JEM. When applying the DELPHI method, the consensus of the committee was obtained for 85% of all cells after the first individual assignment of experts, 88% after the second individual assignment and 100% after the third assignment by the experts all together. In order to validate the JEM, these expert assignments will be brought together with the results of exposure measurements that were performed in some workplaces of these factories. The JEM will also be linked with the data base of the case-control study for the exposure assessment of cases and controls.