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Boiano JM, Silver SR, Tsai RJ, Sanderson WT, Liu S, Whitehead LW. Development of Job Exposure Matrices to Estimate Occupational Exposure to Solar and Artificial Ultraviolet Radiation. Ann Work Expo Health 2020; 64:936-943. [PMID: 33009798 PMCID: PMC8802569 DOI: 10.1093/annweh/wxaa076] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 05/21/2020] [Accepted: 10/01/2020] [Indexed: 01/01/2023] Open
Abstract
Abstract
Objectives
Job exposure matrices (JEMs) are important tools for estimating occupational exposures in study populations where only information on industry and occupation (I&O) are available. JEMs The objective of this work was to create JEMs for solar and artificial ultraviolet radiation (UVR) using a US standardized coding scheme.
Methods
Using U.S. Census Bureau industry and occupation codes, separate lists of I&O pairs were developed for solar and artificial UVR by a panel of Certified Industrial Hygienists who assigned exposure ratings to I&O pairs with potential exposure. Parameters for exposure included prevalence (P) and frequency (F) for solar UVR and P, F, and intensity (I) for artificial UVR. Prevalence, or percent of all workers employed in an I&O pair who were exposed, was categorically rated: 0 to <1, 1 to <20; 20 to <80, and ≥80. Frequency of exposure, defined by the number of hours per week workers were exposed, was categorically rated: 0 to <5, 5 to <20, 20 to <35, and ≥35 h per week. For artificial UVR only, intensity of exposure was assigned three ratings: low, low with rare excursions, and >low under normal conditions. Discrepant ratings were resolved via consensus.
Results
After excluding I&O pairs assigned P and F ratings of 0 (solar UVR) and P, F, and I ratings of 0 (artificial UVR) from the JEM, 9206 I&O pairs were rated for solar UVR and 2010 I&O pairs for artificial UVR. For solar UVR, 723 (7.9% of all rated pairs) had ratings in the highest category for P and F; this group included 45 occupations in varied industries. Construction and extraction occupations represented most of the occupations (n = 20; 44%), followed by farming, fishing, and forestry occupations (n = 6; 13%). For artificial UVR, 87 I&O pairs (4.3% of all rated pairs) had maximum ratings for P, F, and I; these comprised a single occupation (welding, soldering, and brazing workers) in diverse industries.
Conclusions
JEMs for solar and artificial UVR were developed for a broad range of I&O pairs in the US population and are available for use by researchers conducting occupational epidemiological studies.
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Affiliation(s)
- James M Boiano
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | - Sharon R Silver
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | - Rebecca J Tsai
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | - Wayne T Sanderson
- Department of Biosystems and Agricultural Engineering, University of Kentucky, Lexington, KY, USA
| | - Sa Liu
- Department of Public Health, Purdue University, West Lafayette, IN, USA
| | - Lawrence W Whitehead
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, University of Texas, Houston, TX, USA
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Advances in Comprehensive Exposure Assessment: Opportunities for the US Military. J Occup Environ Med 2020; 61 Suppl 12:S5-S14. [PMID: 31800446 DOI: 10.1097/jom.0000000000001677] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Review advances in exposure assessment offered by the exposome concept and new -omics and sensor technologies. METHODS Narrative review of advances, including current efforts and potential future applications by the US military. RESULTS Exposure assessment methods from both bottom-up and top-down exposomics approaches are advancing at a rapid pace, and the US military is engaged in developing both approaches. Top-down approaches employ various -omics technologies to identify biomarkers of internal exposure and biological effect. Bottom-up approaches use new sensor technology to better measure external dose. Key challenges of both approaches are largely centered around how to integrate, analyze, and interpret large datasets that are multidimensional and disparate. CONCLUSIONS Advances in -omics and sensor technologies may dramatically enhance exposure assessment and improve our ability to characterize health risks related to occupational and environmental exposures, including for the US military.
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A new trajectory approach for investigating the association between an environmental or occupational exposure over lifetime and the risk of chronic disease: Application to smoking, asbestos, and lung cancer. PLoS One 2020; 15:e0236736. [PMID: 32785269 PMCID: PMC7423115 DOI: 10.1371/journal.pone.0236736] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 07/12/2020] [Indexed: 11/19/2022] Open
Abstract
Quantifying the association between lifetime exposures and the risk of developing a chronic disease is a recurrent challenge in epidemiology. Individual exposure trajectories are often heterogeneous and studying their associations with the risk of disease is not straightforward. We propose to use a latent class mixed model (LCMM) to identify profiles (latent classes) of exposure trajectories and estimate their association with the risk of disease. The methodology is applied to study the association between lifetime trajectories of smoking or occupational exposure to asbestos and the risk of lung cancer in males of the ICARE population-based case-control study. Asbestos exposure was assessed using a job exposure matrix. The classes of exposure trajectories were identified using two separate LCMM for smoking and asbestos, and the association between the identified classes and the risk of lung cancer was estimated in a second stage using weighted logistic regression and all subjects. A total of 2026/2610 cases/controls had complete information on both smoking and asbestos exposure, including 1938/1837 cases/controls ever smokers, and 1417/1520 cases/controls ever exposed to asbestos. The LCMM identified four latent classes of smoking trajectories which had different risks of lung cancer, all much stronger than never smokers. The most frequent class had moderate constant intensity over lifetime while the three others had either long-term, distant or recent high intensity. The latter had the strongest risk of lung cancer. We identified five classes of asbestos exposure trajectories which all had higher risk of lung cancer compared to men never occupationally exposed to asbestos, whatever the dose and the timing of exposure. The proposed approach opens new perspectives for the analyses of dose-time-response relationships between protracted exposures and the risk of developing a chronic disease, by providing a complete picture of exposure history in terms of intensity, duration, and timing of exposure.
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Scarselli A, Marinaccio A, Corfiati M, Di Marzio D, Iavicoli S. Occupational asbestos exposure after the ban: a job exposure matrix developed in Italy. Eur J Public Health 2020; 30:936-941. [DOI: 10.1093/eurpub/ckaa118] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Abstract
Background
Asbestos is a well-known carcinogen for humans. The aim of this study is to develop a tool to estimate occupational asbestos exposure in Italy after the ban using information collected in a national dataset.
Methods
Data were collected from firm registries of workers exposed to asbestos in the period 1996–2016. Descriptive statistics (arithmetic mean, standard deviation, geometric mean and geometric standard deviation) were calculated for the main exposure-related variables (activity sector, occupational group and exposure period). An estimate of workers potentially exposed to asbestos was also performed.
Results
A total of 19 704 airborne measurements of asbestos exposure was selected from the national database of occupational exposures in the sectors of asbestos abatement. Overall, a geometric mean of 7.93 f l−1 was found, and chrysotile was the asbestos type that had more exposures (41%). A total of 46 422 workers was estimated to be potentially at asbestos exposure risk. Exposure data were summarized by calendar period, activity sector and occupational group.
Conclusions
The construction of a job exposure matrix for different occupation/industry combinations may allow the assessment of occupational exposure to asbestos in several removal and disposal activities, and the estimate of the risks associated with asbestos-related diseases in epidemiological studies.
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Affiliation(s)
- Alberto Scarselli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers’ Compensation Authority (INAIL), Rome, Italy
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers’ Compensation Authority (INAIL), Rome, Italy
| | - Marisa Corfiati
- Department of Prevention, Occupational Health and Safety Unit (SPeSAL), Local Health Authority of Bari, Italy
| | - Davide Di Marzio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers’ Compensation Authority (INAIL), Rome, Italy
| | - Sergio Iavicoli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers’ Compensation Authority (INAIL), Rome, Italy
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55
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Ge C, Peters S, Olsson A, Portengen L, Schüz J, Almansa J, Ahrens W, Bencko V, Benhamou S, Boffetta P, Bueno-de-Mesquita B, Caporaso N, Consonni D, Demers P, Fabiánová E, Fernández-Tardón G, Field J, Forastiere F, Foretova L, Guénel P, Gustavsson P, Janout V, Jöckel KH, Karrasch S, Teresa Landi M, Lissowska J, Luce D, Mates D, McLaughlin J, Merletti F, Mirabelli D, Pándics T, Parent MÉ, Plato N, Pohlabeln H, Richiardi L, Siemiatycki J, Świątkowska B, Tardón A, Wichmann HE, Zaridze D, Straif K, Kromhout H, Vermeulen R. Diesel Engine Exhaust Exposure, Smoking, and Lung Cancer Subtype Risks. A Pooled Exposure-Response Analysis of 14 Case-Control Studies. Am J Respir Crit Care Med 2020; 202:402-411. [PMID: 32330395 PMCID: PMC7465091 DOI: 10.1164/rccm.201911-2101oc] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 04/24/2020] [Indexed: 11/16/2022] Open
Abstract
Rationale: Although the carcinogenicity of diesel engine exhaust has been demonstrated in multiple studies, little is known regarding exposure-response relationships associated with different exposure subgroups and different lung cancer subtypes.Objectives: We expanded on a previous pooled case-control analysis on diesel engine exhaust and lung cancer by including three additional studies and quantitative exposure assessment to evaluate lung cancer and subtype risks associated with occupational exposure to diesel exhaust characterized by elemental carbon (EC) concentrations.Methods: We used a quantitative EC job-exposure matrix for exposure assessment. Unconditional logistic regression models were used to calculate lung cancer odds ratios and 95% confidence intervals (CIs) associated with various metrics of EC exposure. Lung cancer excess lifetime risks (ELR) were calculated using life tables accounting for all-cause mortality. Additional stratified analyses by smoking history and lung cancer subtypes were performed in men.Measurements and Main Results: Our study included 16,901 lung cancer cases and 20,965 control subjects. In men, exposure response between EC and lung cancer was observed: odds ratios ranged from 1.09 (95% CI, 1.00-1.18) to 1.41 (95% CI, 1.30-1.52) for the lowest and highest cumulative exposure groups, respectively. EC-exposed men had elevated risks in all lung cancer subtypes investigated; associations were strongest for squamous and small cell carcinomas and weaker for adenocarcinoma. EC lung cancer exposure response was observed in men regardless of smoking history, including in never-smokers. ELR associated with 45 years of EC exposure at 50, 20, and 1 μg/m3 were 3.0%, 0.99%, and 0.04%, respectively, for both sexes combined.Conclusions: We observed a consistent exposure-response relationship between EC exposure and lung cancer in men. Reduction of workplace EC levels to background environmental levels will further reduce lung cancer ELR in exposed workers.
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Affiliation(s)
- Calvin Ge
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Susan Peters
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Ann Olsson
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Lützen Portengen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Joachim Schüz
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Josué Almansa
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Vladimir Bencko
- Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | - Paolo Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Bas Bueno-de-Mesquita
- The National Institute for Public Health and Environmental Protection, Bilthoven, the Netherlands
| | | | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Paul Demers
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Eleonóra Fabiánová
- Regional Authority of Public Health, Banská Bystrica, Slovakia
- Faculty of Health, Catholic University, Ružomberok, Slovakia
| | - Guillermo Fernández-Tardón
- Fundación para la Investigación e Innovación Biomédica en el Principado de Asturias – Instituto de Investigación Sanitaria del Principado (FINBA-ISPA), Faculty of Medicine, University of Oviedo and Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Oviedo, Spain
| | - John Field
- Roy Castle Lung Cancer Research Programme, Cancer Research Centre, University of Liverpool, Liverpool, United Kingdom
| | - Francesco Forastiere
- Consiglio Nazionale delle Ricerche-Istituto per la Ricerca e l’Innovazione Biomedica (CNR-Irib), Palermo, Italy
| | | | - Pascal Guénel
- Center for research in Epidemiology and Population Health (CESP), Cancer and Environment team, Inserm U1018, University Paris-Sud, University Paris-Saclay, Villejuif, France
| | - Per Gustavsson
- The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Vladimir Janout
- Faculty of Health Sciences, Palacky University, Olomouc, Czech Republic
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Stefan Karrasch
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Inner City Clinic, University Hospital of Munich, Ludwig-Maximilians-Universität, Munich, Germany
- Institute of Epidemiology, Helmholtz Zentrum München – German Research Center for Environmental Health, Neuherberg, Germany
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Neuherberg, Germany
| | | | - Jolanta Lissowska
- The M. Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Danièle Luce
- Univ Rennes, Inserm, Ecole des hautes études en santé publique (EHESP), Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Pointe-à-Pitre, France
| | - Dana Mates
- National Institute of Public Health, Bucharest, Romania
| | - John McLaughlin
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Franco Merletti
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and ll Centro di Riferimento per l’Epidemiologia e la Prevenzione Oncologica in Piemonte (CPO-Piemonte), Torino, Italy
| | - Dario Mirabelli
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and ll Centro di Riferimento per l’Epidemiologia e la Prevenzione Oncologica in Piemonte (CPO-Piemonte), Torino, Italy
| | | | - Marie-Élise Parent
- Institut national de la recherche scientifique, University of Quebec, Laval, Quebec, Canada
| | - Nils Plato
- The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Lorenzo Richiardi
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and ll Centro di Riferimento per l’Epidemiologia e la Prevenzione Oncologica in Piemonte (CPO-Piemonte), Torino, Italy
| | - Jack Siemiatycki
- University of Montreal Hospital Research Centre, University of Montreal, Montreal, Quebec, Canada
| | | | - Adonina Tardón
- Fundación para la Investigación e Innovación Biomédica en el Principado de Asturias – Instituto de Investigación Sanitaria del Principado (FINBA-ISPA), Faculty of Medicine, University of Oviedo and Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Oviedo, Spain
| | - Heinz-Erich Wichmann
- Institut für Medizinische Informatik Biometrie Epidemiologie, Ludwig Maximilians University, Munich, Germany
- Institut für Epidemiologie, Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg, Germany; and
| | | | - Kurt Straif
- International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Hans Kromhout
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
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Occupational exposures and genetic susceptibility to occupational exposures are related to sickness absence in the Lifelines cohort study. Sci Rep 2020; 10:12963. [PMID: 32737337 DOI: 10.1038/s41598-020-69372-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 06/17/2020] [Indexed: 11/09/2022] Open
Abstract
In this cross-sectional study, we investigated the association between occupational exposures and sickness absence (SA), the mediating role of respiratory symptoms, and whether genetic susceptibility to SA upon occupational exposures exists. Logistic regression was used to examine associations and structural equation modelling was used for mediation analyses. Genetic susceptibility was investigated by including interactions between occupational exposures and 11 candidate single nucleotide polymorphisms (SNPs). Biological dust, mineral dust, and pesticides exposure were associated with a lower prevalence of any SA (OR (95% CI) = 0.72 (0.58-0.89), 0.88 (0.78-0.99), and 0.70 (0.55-0.89), respectively) while gases/fumes exposure was associated with a higher prevalence of long-term SA (1.46 (1.11-1.91)). Subjects exposed to solvents and metals had a higher prevalence of any (1.14 (1.03-1.26) and 1.68 (1.26-2.24)) and long-term SA (1.26 (1.08-1.46) and 1.75 (1.15-2.67)). Chronic cough and chronic phlegm mediated the association between high gases/fumes exposure and long-term SA. Two of 11 SNPs investigated had a positive interaction with exposure on SA and one SNP negatively interacted with exposure on SA. Exposure to metals and gases/fumes showed a clear dose-response relationship with a higher prevalence of long-term SA; contrary, exposure to pesticides and biological/mineral dust showed a protective effect on any SA. Respiratory symptoms mediated the association between occupational exposures and SA. Moreover, gene-by-exposure interactions exist.
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57
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Canetti EFD, Schram B, Orr RM, Knapik J, Pope R. Risk factors for development of lower limb osteoarthritis in physically demanding occupations: A systematic review and meta-analysis. APPLIED ERGONOMICS 2020; 86:103097. [PMID: 32342888 DOI: 10.1016/j.apergo.2020.103097] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 02/05/2020] [Accepted: 03/06/2020] [Indexed: 06/11/2023]
Abstract
This systematic review and meta-analysis identified and critically reviewed the findings of recent studies (last 15 years) examining relationships between specific physically demanding occupations or occupational tasks and development of lower limb osteoarthritis (OA). Twenty-eight studies with 266,227 cases of lower limb OA were included. Occupational tasks contributing to OA included farming, floor laying, and brick laying. Activities significantly contributing to the risk of knee OA were lifting heavy loads (>10 kg/week) (odds ratio [OR] = 1.52, 95% confidence interval [95%CI] 1.29-1.79), squatting/kneeling (OR = 1.69, 95%CI 1.15-2.49), standing (>2 h/daily) (OR = 1.22 95%CI 1.02-1.46) and walking (OR = 1.40 95%CI 1.14-1.73). Lifting contributed significantly to the risk of hip OA (OR = 1.35, 95%CI 1.16-1.57). The effects of occupational exposures appear to be magnified by previous injury and BMI >25 kg/m2. Since specific occupational activities increase OA risk, ergonomist should encourage the use of existing tools, or oversee the design of new tools that may decrease exposure to such activities.
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Affiliation(s)
- Elisa F D Canetti
- Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD, 4226, Australia; Tactical Research Unit, Bond University, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Ben Schram
- Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD, 4226, Australia; Tactical Research Unit, Bond University, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Robin M Orr
- Faculty of Health Sciences and Medicine, Bond University, 14 University Drive, Robina, QLD, 4226, Australia; Tactical Research Unit, Bond University, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Joseph Knapik
- Tactical Research Unit, Bond University, 2 Promethean Way, Robina, QLD, 4226, Australia.
| | - Rodney Pope
- Tactical Research Unit, Bond University, 2 Promethean Way, Robina, QLD, 4226, Australia; School of Community Health, Charles Sturt University, Elizabeth Mitchell Dr, Thurgoona, NSW, 2640, Australia.
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Stokholm ZA, Erlandsen M, Schlünssen V, Basinas I, Bonde JP, Peters S, Brandt J, Vestergaard JM, Kolstad HA. A Quantitative General Population Job Exposure Matrix for Occupational Noise Exposure. Ann Work Expo Health 2020; 64:604-613. [DOI: 10.1093/annweh/wxaa034] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 03/11/2020] [Accepted: 03/16/2020] [Indexed: 11/12/2022] Open
Abstract
Abstract
Occupational noise exposure is a known risk factor for hearing loss and also adverse cardiovascular effects have been suggested. A job exposure matrix (JEM) would enable studies of noise and health on a large scale. The objective of this study was to create a quantitative JEM for occupational noise exposure assessment of the general working population. Between 2001–2003 and 2009–2010, we recruited workers from companies within the 10 industries with the highest reporting of noise-induced hearing loss according to the Danish Working Environment Authority and in addition workers of financial services and children day care to optimize the range in exposure levels. We obtained 1343 personal occupational noise dosimeter measurements among 1140 workers representing 100 different jobs according to the Danish version of the International Standard Classification of Occupations 1988 (DISCO 88). Four experts used 35 of these jobs as benchmarks and rated noise levels for the remaining 337 jobs within DISCO 88. To estimate noise levels for all 372 jobs, we included expert ratings together with sex, age, occupational class, and calendar year as fixed effects, while job and worker were included as random effects in a linear mixed regression model. The fixed effects explained 40% of the total variance: 72% of the between-jobs variance, −6% of the between-workers variance and 4% of the within-worker variance. Modelled noise levels showed a monotonic increase with increasing expert score and a 20 dB difference between the highest and lowest exposed jobs. Based on the JEM estimates, metal wheel-grinders were among the highest and finance and sales professionals among the lowest exposed. This JEM of occupational noise exposure can be used to prioritize preventive efforts of occupational noise exposure and to provide quantitative estimates of contemporary exposure levels in epidemiological studies of health effects potentially associated with noise exposure.
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Affiliation(s)
- Zara Ann Stokholm
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N, Denmark
| | - Mogens Erlandsen
- Section for Biostatistics, Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C, Denmark
| | - Vivi Schlünssen
- Environment, Occupation and Health, Department of Public Health, Danish Ramazzini Centre, Aarhus University, Bartholins Allé 2, Aarhus C, Denmark
- National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen Ø, Denmark
| | - Ioannis Basinas
- Institute of Occupational Medicine, Research Avenue North, Riccarton, Edinburgh, UK
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Bispebjerg Bakke 23F, Copenhagen NV, Denmark
| | - Susan Peters
- Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM Utrecht, the Netherlands
| | - Jens Brandt
- CRECEA, Kongsvang Alle 25, Aarhus C, Denmark
| | - Jesper Medom Vestergaard
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N, Denmark
| | - Henrik Albert Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N, Denmark
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Ohlander J, Fuhrimann S, Basinas I, Cherrie JW, Galea KS, Povey AC, van Tongeren M, Harding AH, Jones K, Vermeulen R, Kromhout H. Systematic review of methods used to assess exposure to pesticides in occupational epidemiology studies, 1993-2017. Occup Environ Med 2020; 77:357-367. [PMID: 32098789 PMCID: PMC7279185 DOI: 10.1136/oemed-2019-105880] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 11/01/2019] [Accepted: 11/29/2019] [Indexed: 12/28/2022]
Abstract
Objective Numerous exposure assessment methods (EAM) exist for investigating health effects of occupational exposure to pesticides. Direct (eg, biomonitoring) and indirect methods (eg, self-reported exposures) are however associated with degrees of exposure misclassification. We systematically reviewed EAM in studies of occupational pesticide exposure. Methods We searched for articles reporting observational epidemiological studies in MEDLINE and Embase published 1993 to 2017. The relative frequency of EAM was analysed according to EAM type (direct and indirect methods), health outcome, study design, study location (country) and specificity of assessment. Temporal trends in EAM were analysed. Results In 1298 included articles 1521 EAM occurrences were documented. Indirect EAM (78.3%), primarily self-reported exposures (39.3%) and job titles assessments (9.5%), were mainly applied in case-control studies (95.0%), in high-income countries (85.0%) and in studies of doctor-diagnosed health outcomes (>85%). Direct EAM (20.8%), primarily biomonitoring of blood (15.6%) or urine (4.7%), were predominantly applied in cross-sectional studies (29.8%), in lower middle-income countries (40.9%) and in studies of neurological (50.0%) outcomes. Between 1993 to 2017 no distinct time trends regarding the ratio indirect to direct methods was seen. Within the category of indirect methods use of self-reported exposures and job exposure matrices increased while assessments by job titles and registers decreased. The use of algorithms showed no trend. The specificity of pesticide assessment increased since studies assessing exposure by using job title as a proxy declined. Assessments of type of pesticide increased. Conclusion Over the last 25 years, the ratio (5:1) of indirect to direct EAM applied in articles on occupational pesticide epidemiology stayed relatively constant; changes were mainly attributable to increasing use of self-reported exposures and job exposure matrices. This review, combined with studies assessing EAM validity, will inform on magnitudes of exposure misclassification and help improve the quality of studies on occupational pesticides exposure.
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Affiliation(s)
- Johan Ohlander
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Samuel Fuhrimann
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Ioannis Basinas
- Institute of Occupational Medicine (IOM), Edinburgh, United Kingdom
| | - John W Cherrie
- Institute of Occupational Medicine (IOM), Edinburgh, United Kingdom.,Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot Watt University, Edinburgh, UK
| | - Karen S Galea
- Institute of Occupational Medicine (IOM), Edinburgh, United Kingdom
| | - Andrew C Povey
- Centre for Occupational and Environmental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Martie van Tongeren
- Centre for Occupational and Environmental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | | | - Kate Jones
- Health and Safety Executive, Harpur Hill, Buxton, UK
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Hans Kromhout
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
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Florath I, Glass DC, Rhazi MS, Parent ME, Fritschi L. Inter-rater Agreement Between Exposure Assessment Using Automatic Algorithms and Using Experts. Ann Work Expo Health 2020; 63:45-53. [PMID: 30304470 DOI: 10.1093/annweh/wxy084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 09/19/2018] [Indexed: 11/14/2022] Open
Abstract
Objectives To estimate the inter-rater agreement between exposure assessment to asthmagens in current jobs by algorithms based on task-based questionnaires (OccIDEAS) and by experts. Methods Participants in a cross-sectional national survey of exposure to asthmagens (AWES-Asthma) were randomly split into two subcohorts of equal size. Subcohort 1 was used to determine the most common asthmagen groups and occupational groups. From subcohort 2, a random sample of 200 participants was drawn and current occupational exposure (yes/no) was assessed in these by OccIDEAS and by two experts independently and then as a consensus. Inter-rater agreement was estimated using Cohen's Kappa coefficient. The null hypothesis was set at 0.4, because both the experts and the automatic algorithm assessed the exposure using the same task-based questionnaires and therefore an agreement better than by chance would be expected. Results The Kappa coefficients for the agreement between the experts and the algorithm-based assessments ranged from 0.37 to 1, while the agreement between the two experts ranged from 0.29 to 0.94, depending on the agent being assessed. After discussion by both experts the Kappa coefficients for the consensus decision and OccIDEAS were significantly larger than 0.4 for 7 of the 10 asthmagen groups, while overall the inter-rater agreement was greater than by chance (P < 0.0001). Conclusions The web-based application OccIDEAS is an appropriate tool for automated assessment of current exposure to asthmagens (yes/no), and requires less time-consuming work by highly-qualified research personnel than the traditional expert-based method. Further, it can learn and reuse expert determinations in future studies.
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Affiliation(s)
- Ines Florath
- School of Public Health, Curtin University, Perth, Australia
| | - Deborah C Glass
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | | | | | - Lin Fritschi
- School of Public Health, Curtin University, Perth, Australia
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Fritschi L, Sadkowsky T, Glass DC. OccIDEAS: web-based assessment of occupational agent exposure. Int J Epidemiol 2020; 49:376-379. [DOI: 10.1093/ije/dyaa022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 01/22/2020] [Indexed: 01/04/2023] Open
Abstract
Abstract
Most epidemiological studies of disease aetiology do not consider potential risk factors at work. This may be because work is a complex exposure: people usually have a series of different jobs over their working lifetime; within each job there may be a range of different tasks; and there may be a variety of exposures in each job. Because of this complexity, many epidemiologists do not have the expertise or training to assess occupational exposures accurately. Our web-based application, OccIDEAS, manages the process of occupational agent assessment in epidemiological studies. The epidemiologist chooses the agents of interest for the study and OccIDEAS provides an online set of questionnaires that are tailored to those agents. The participant is asked specific questions about their job and evidence-based algorithms provide an assessment of exposure to each agent. OccIDEAS puts the world’s best occupational epidemiological expertise within reach of any researcher.
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Affiliation(s)
- Lin Fritschi
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Troy Sadkowsky
- School of Public Health, Curtin University, Perth, WA, Australia
- Data Scientists Pty Ltd, Brisbane, Queensland, Australia
| | - Deborah C Glass
- Monash Centre for Occupational & Environmental Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Hall AL, Kromhout H, Schüz J, Peters S, Portengen L, Vermeulen R, Agudo A, Ahrens W, Boffetta P, Brennan P, Canova C, Conway DI, Curado MP, Daudt AW, Fernandez L, Hashibe M, Healy CM, Holcatova I, Kjaerheim K, Koifman R, Lagiou P, Luce D, Macfarlane GJ, Menezes A, Menvielle G, Polesel J, Ramroth H, Richiardi L, Stücker I, Thomson P, Vilensky M, Wunsch-Filho V, Yuan-Chin AL, Znaor A, Straif K, Olsson A. Laryngeal Cancer Risks in Workers Exposed to Lung Carcinogens: Exposure-Effect Analyses Using a Quantitative Job Exposure Matrix. Epidemiology 2020; 31:145-154. [PMID: 31577634 DOI: 10.1097/ede.0000000000001120] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Various established occupational lung carcinogens are also suspected risk factors for laryngeal cancer. However, individual studies are often inadequate in size to investigate this relatively rare outcome. Other limitations include imprecise exposure assessment and inadequate adjustment for confounders. METHODS This study applied a quantitative job exposure matrix (SYN-JEM) for four established occupational lung carcinogens to five case-control studies within the International Head and Neck Cancer Epidemiology Consortium. We used occupational histories for 2256 laryngeal cancer cases and 7857 controls recruited from 1989 to 2007. We assigned quantitative exposure levels for asbestos, respirable crystalline silica, chromium-VI, and chromium-VI and nickel combined (to address highly correlated exposures) via SYN-JEM. We assessed effects of occupational exposure on cancer risk for males (asbestos, respirable crystalline silica, chromium-VI, and chromium-VI and nickel combined) and females (asbestos and respirable crystalline silica), adjusting for age, study, tobacco smoking, alcohol consumption, and asbestos exposure where relevant. RESULTS Among females, odds ratios (ORs) were increased for ever versus never exposed. Among males, P values for linear trend were <0.05 for estimated cumulative exposure (all agents) and <0.05 for exposure duration (respirable crystalline silica, chromium-VI, and chromium-VI and nickel combined); strongest associations were for asbestos at >90th percentile cumulative exposure (OR = 1.3, 95% confidence interval [CI] = 1.0, 1.6), respirable crystalline silica at 30+ years duration (OR = 1.4, 95% CI = 1.2, 1.7) and 75th-90th percentile cumulative exposure (OR = 1.4, 95% CI = 1.1, 1.8), chromium-VI at >75th percentile cumulative exposure (OR = 1.9, 95% CI = 1.2, 3.0), and chromium-VI and nickel combined at 20-29 years duration (OR = 1.5, 95% CI = 1.1, 2.2). CONCLUSIONS These findings support hypotheses of causal links between four lung carcinogens (asbestos, respirable crystalline silica, chromium-VI, and nickel) and laryngeal cancer.
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Affiliation(s)
- Amy L Hall
- From the International Agency for Research on Cancer, Lyon, France
| | - Hans Kromhout
- Institute for Risk Assessment Sciences, Utrecht University, The Netherlands
| | - Joachim Schüz
- From the International Agency for Research on Cancer, Lyon, France
| | - Susan Peters
- Institute for Risk Assessment Sciences, Utrecht University, The Netherlands
| | - Lützen Portengen
- Institute for Risk Assessment Sciences, Utrecht University, The Netherlands
| | - Roel Vermeulen
- From the International Agency for Research on Cancer, Lyon, France
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
- Faculty of Mathematics/Computer Science, Institute of Statistics, University of Bremen, Bremen, Germany
| | - Paolo Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Paul Brennan
- From the International Agency for Research on Cancer, Lyon, France
| | | | - David I Conway
- School of Medicine, Dentistry, and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | | | | | | | | | - Claire M Healy
- Trinity College School of Dental Science, Dublin, Ireland
| | - Ivana Holcatova
- Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Kristina Kjaerheim
- Cancer Registry of Norway, Institute of Population-based Cancer Research, Oslo, Norway
| | - Rosalina Koifman
- Escola Nacional de Saude Publica, Fundacao Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Pagona Lagiou
- School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Danièle Luce
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Pointe-à-Pitre, France
| | - Gary J Macfarlane
- Epidemiology Group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, United Kingdom
| | - Ana Menezes
- Universidade Federal de Pelotas, Pelotas, Brazil
| | - Gwenn Menvielle
- INSERM, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique IPLESP, Paris, France
| | | | | | | | - Isabelle Stücker
- University Paris Sud, Paris Saclay University, UVSQ, CESP, INSERM, Environmental Epidemiology of Cancer Team, Villejuif, France
| | | | - Marta Vilensky
- Institute of Oncology Angel H. Roffo, University of Buenos Aires, Argentina
| | | | | | - Ariana Znaor
- From the International Agency for Research on Cancer, Lyon, France
| | - Kurt Straif
- From the International Agency for Research on Cancer, Lyon, France
| | - Ann Olsson
- From the International Agency for Research on Cancer, Lyon, France
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Henneberger PK, Kurth LM, Doney B, Liang X, Andersson E. Development of an Asthma-Specific Job Exposure Matrix for Use in the United States. Ann Work Expo Health 2020; 64:82-95. [PMID: 31746973 PMCID: PMC9990745 DOI: 10.1093/annweh/wxz089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 09/25/2019] [Accepted: 11/04/2019] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Existing asthma-specific job-exposure matrices (JEMs) do not necessarily reflect current working conditions in the USA and do not directly function with occupational coding systems commonly used in the USA. We initiated a project to modify an existing JEM to address these limitations, and to apply the new JEM to the entire US employed population to estimate quantitatively the extent of probable work-related asthma exposures nationwide. METHODS We started with an asthma-specific JEM that was developed for northern Europe (the N-JEM) and modified it to function with the 2010 US Standard Occupational Classification (SOC-2010) codes and to reflect working conditions in the USA during the post-2000 period. This involved cross walking from the 1988 International Standard Classification of Occupations (ISCO-88) codes used in the N-JEM to the SOC-2010 codes, transferring the N-JEM exposure assignments to the SOC-2010 codes, and modifying those assignments to reflect working conditions in the USA. The new US asthma JEM (USA-JEM) assigns exposures to 19 agents organized into five categories. The USA-JEM and N-JEM were applied to the same sample of working adults with asthma to compare how they performed, and the USA-JEM was also applied to the entire 2015 US working population to estimate the extent of occupational asthma exposures nationally. RESULTS The USA-JEM assigns at least one asthma-related probable exposure to 47.5% and at least one possible exposure to 14.9% of the 840 SOC-2010 detailed occupations, and 9.0% of the occupations have both probable exposure to at least one agent and possible exposure to at least one other agent. The USA-JEM has greater sensitivity for cleaning products, highly reactive disinfectants and sterilants, and irritant peak exposures than the N-JEM. When applied to the entire 2015 US working population, the USA-JEM determined that 42.6% of workers had probable exposure to at least one type of occupational asthma agent. DISCUSSION A new asthma-specific JEM for application in the USA was developed. Additional work is needed to compare its performance to similar JEMs and, if possible, to exposure assessments generated on a case-by-case basis.
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Affiliation(s)
- Paul K Henneberger
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Laura M Kurth
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Brent Doney
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Xiaoming Liang
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Eva Andersson
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
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Migault L, Bowman JD, Kromhout H, Figuerola J, Baldi I, Bouvier G, Turner MC, Cardis E, Vila J. Development of a Job-Exposure Matrix for Assessment of Occupational Exposure to High-Frequency Electromagnetic Fields (3 kHz-300 GHz). Ann Work Expo Health 2019; 63:1013-1028. [PMID: 31702767 PMCID: PMC6853656 DOI: 10.1093/annweh/wxz067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Revised: 06/18/2019] [Accepted: 07/26/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The aim of this work was to build a job-exposure matrix (JEM) using an international coding system and covering the non-thermal intermediate frequency (IF) (3-100 kHz, named IFELF), thermal IF (100 kHz-10 MHz, named IFRF), and radiofrequency (RF) (>10 MHz) bands. METHODS Detailed occupational data were collected in a large population-based case-control study, INTEROCC, with occupations coded into the International Standard Classification of Occupations system 1988 (ISCO88). The subjects' occupational source-based ancillary information was combined with an existing source-exposure matrix and the reference levels of the International Commission on Non-Ionizing Radiation Protection (ICNIRP) for occupational exposure to calculate estimates of level (L) of exposure to electric (E) and magnetic (H) fields by ISCO88 code and frequency band as ICNIRP ratios (IFELF) or squared ratios (IFRF and RF). Estimates of exposure probability (P) were obtained by dividing the number of exposed subjects by the total number of subjects available per job title. RESULTS With 36 011 job histories collected, 468 ISCO88 (four-digit) codes were included in the JEM, of which 62.4% are exposed to RF, IFRF, and/or IFELF. As a reference, P values for RF E-fields ranged from 0.3 to 65.0% with a median of 5.1%. L values for RF E-fields (ICNIRP squared ratio) ranged from 6.94 × 10-11 to 33.97 with a median of 0.61. CONCLUSIONS The methodology used allowed the development of a JEM for high-frequency electromagnetic fields containing exposure estimates for the largest number of occupations to date. Although the validity of this JEM is limited by the small number of available observations for some codes, this JEM may be useful for epidemiological studies and occupational health management programs assessing high-frequency electromagnetic field exposure in occupational settings.
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Affiliation(s)
- Lucile Migault
- University of Bordeaux, Inserm UMR 1219 EPICENE Team, Bordeaux Population Health Research Center, Bordeaux, France
| | | | - Hans Kromhout
- Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Nieuw Gildestein Yalelaan, Utrecht, The Netherlands
| | - Jordi Figuerola
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Plaça de la Mercè, Barcelona, Spain
| | - Isabelle Baldi
- University of Bordeaux, Inserm UMR 1219 EPICENE Team, Bordeaux Population Health Research Center, Bordeaux, France
- Bordeaux University Hospital, Service de Médecine du Travail et pathologie professionnelle, Pessac, France
| | - Ghislaine Bouvier
- University of Bordeaux, Inserm UMR 1219 EPICENE Team, Bordeaux Population Health Research Center, Bordeaux, France
| | - Michelle C Turner
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Plaça de la Mercè, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Av. Monforte de Lemos, Madrid, Spain
- McLaughlin Center for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada
| | - Elisabeth Cardis
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Plaça de la Mercè, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Av. Monforte de Lemos, Madrid, Spain
| | - Javier Vila
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Plaça de la Mercè, Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Av. Monforte de Lemos, Madrid, Spain
- Environmental Protection Agency (EPA), Office of Radiation Protection and Environmental Monitoring, McCumiskey House, Richview, Dublin, Ireland
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[Screening of occupational exposure to asbestos and silica by job-exposure matrix among patients with lung cancer and mesothelioma]. Rev Mal Respir 2019; 36:1088-1095. [PMID: 31727556 DOI: 10.1016/j.rmr.2019.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 08/01/2019] [Indexed: 11/22/2022]
Abstract
INTRODUCTION In the context of underreporting of occupational diseases, the aim was to study the validity of silica and asbestos job-exposure matrices in screening occupational exposure in the field of thoracic oncology. METHODS Fifty patients hospitalized with primitive lung cancer or mesothelioma in a university hospital center in the Hauts-de-Seine department of France were included between November 2016 and September 2017. For each patient 1/the job history was collected, from which data was entered single-blindly into the job-exposure matrices by a resident in occupational medicine, 2/a questionnaire (Q-SPLF) was completed similarly, and 3/the patients also had a consultation with a chief resident in occupational medicine, considered the gold standard. The main outcome was the diagnostic performance of the matrices. The Q-SPLF diagnostic performance was also studied. RESULTS The asbestos and silica matrices had sensitivities of 100%, specificities of respectively 76.1% and 87.8%, the positive likelihood ratios were at 4.19 [2.5-6] and 8.17 [3.8-10], and the negative likelihood ratios were at 0. The Q-SPLF diagnostic performance was comparable to that of the matrices. CONCLUSIONS The matrices and the questionnaire have a great diagnostic performance which seems interesting for a use as a screening tool for occupational exposures. These results have yet to be confirmed by large-scale studies.
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Deltour I, Massardier-Pilonchery A, Schlehofer B, Schlaefer K, Hours M, Schüz J. Validation of self-reported occupational noise exposure in participants of a French case-control study on acoustic neuroma. Int Arch Occup Environ Health 2019; 92:991-1001. [PMID: 31028471 DOI: 10.1007/s00420-019-01427-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 04/03/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To validate self-reported occupational loud noise exposure against expert evaluation of noise levels in a French case-control study on acoustic neuroma and to estimate the impact of exposure misclassification on risk estimation. METHODS Noise levels were evaluated in 1006 jobs held by 111 cases and 217 population controls by an expert. Case-control differences in self-reporting were analyzed with logistic models. Sensitivity, specificity, positive and negative predictive values, and observed agreement of the self-reports were computed relative to the expert evaluation. They were used to calibrate the odds ratio (OR) between lifetime ever occupational loud noise exposure and the risk of acoustic neuroma, without adjustment for measurement error of the expert assessments. RESULTS Cases reported noise levels in individual jobs closer to the expert assessment than controls, but the case-control difference was small for lifetime exposures. For expert-rated exposure of 80 dB(A), reporting of individual jobs by cases was more sensitive (54% in cases, 37% in controls), whereas specificity (91% in cases, 93% in controls) and observed agreement (82% in cases, 81% in controls) were similar. When lifetime exposure was considered, sensitivity increased (76% in cases, 65% in controls), while cases specificity decreased (84%). When these values were used to calibrate self-reports for exposure misclassification compared to expert evaluation at 80 dB(A), the crude OR of 1.7 was reduced to 1.3. CONCLUSIONS Despite the relatively accurate reporting of loud noise, the impact of the calibration on the OR was non-negligible.
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Affiliation(s)
- Isabelle Deltour
- Section of Environment and Radiation, International Agency for Research on Cancer, 150, Cours Albert Thomas, 69372, Lyon Cedex 08, France.
| | - Amélie Massardier-Pilonchery
- University Claude Bernard Lyon 1 and IFSTTAR, Transport Work and Environmental Epidemiology Research and Surveillance Unit, UMRESTTE (UMR 14T9405), 8 Avenue Rockefeller, 69373, Lyon Cedex 08, France
- Hospices Civils de Lyon, Lyon, France
| | - Brigitte Schlehofer
- Section of Environment and Radiation, International Agency for Research on Cancer, 150, Cours Albert Thomas, 69372, Lyon Cedex 08, France
- Unit of Environmental Epidemiology, German Cancer Research Centre, Heidelberg, Germany
| | - Klaus Schlaefer
- Unit of Environmental Epidemiology, German Cancer Research Centre, Heidelberg, Germany
| | - Martine Hours
- University Claude Bernard Lyon 1 and IFSTTAR, Transport Work and Environmental Epidemiology Research and Surveillance Unit, UMRESTTE (UMR 14T9405), 8 Avenue Rockefeller, 69373, Lyon Cedex 08, France
| | - Joachim Schüz
- Section of Environment and Radiation, International Agency for Research on Cancer, 150, Cours Albert Thomas, 69372, Lyon Cedex 08, France
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Ge CB, Friesen MC, Kromhout H, Peters S, Rothman N, Lan Q, Vermeulen R. Use and Reliability of Exposure Assessment Methods in Occupational Case-Control Studies in the General Population: Past, Present, and Future. Ann Work Expo Health 2019; 62:1047-1063. [PMID: 30239580 DOI: 10.1093/annweh/wxy080] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 08/22/2018] [Indexed: 11/14/2022] Open
Abstract
Introduction Retrospective occupational exposure assessment has been challenging in case-control studies in the general population. We aimed to review (i) trends of different assessment methods used in the last 40 years and (ii) evidence of reliability for various assessment methods. Methods Two separate literature reviews were conducted. We first reviewed all general population cancer case-control studies published from 1975 to 2016 to summarize the exposure assessment approach used. For the second review, we systematically reviewed evidence of reliability for all methods observed in the first review. Results Among the 299 studies included in the first review, the most frequently used assessment methods were self-report/assessment (n = 143 studies), case-by-case expert assessment (n = 139), and job-exposure matrices (JEMs; n = 82). Usage trends for these methods remained relatively stable throughout the last four decades. Other approaches, such as the application of algorithms linking questionnaire responses to expert-assigned exposure estimates and modelling of exposure with historical measurement data, appeared in 21 studies that were published after 2000. The second review retrieved 34 comparison studies examining methodological reliability. Overall, we observed slightly higher median kappa agreement between exposure estimates from different expert assessors (~0.6) than between expert estimates and exposure estimates from self-reports (~0.5) or JEMs (~0.4). However, reported reliability measures were highly variable for different methods and agents. Limited evidence also indicates newer methods, such as assessment using algorithms and measurement-calibrated quantitative JEMs, may be as reliable as traditional methods. Conclusion The majority of current research assesses exposures in the population with similar methods as studies did decades ago. Though there is evidence for the development of newer approaches, more concerted effort is needed to better adopt exposure assessment methods with more transparency, reliability, and efficiency.
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Affiliation(s)
- Calvin B Ge
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Melissa C Friesen
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Hans Kromhout
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Susan Peters
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.,Department of Neurology, University Medical Centre Utrecht, Universiteitsweg, Utrecht, The Netherlands
| | - Nathaniel Rothman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Qing Lan
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Matrat M, Radoï L, Févotte J, Guida F, Cénée S, Cyr D, Sanchez M, Menvielle G, Schmaus A, Marrer E, Luce D, Stücker I. Occupational exposure to wood dust and risk of lung cancer: the ICARE study. Occup Environ Med 2019; 76:901-907. [PMID: 31537717 DOI: 10.1136/oemed-2019-105802] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 07/22/2019] [Accepted: 08/25/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVES In a previous analysis of data from a French population-based case-control study (the Investigation of occupational and environmental CAuses of REspiratory cancers (ICARE) study), 'having ever worked' in wood-related occupations was associated with excess lung cancer risk after adjusting for smoking but not for occupational factors. The present study aimed to investigate the relationship between lung cancer risk and wood dust exposure after adjusting for occupational exposures. METHODS Data were obtained from 2276 cases and 2780 controls on smoking habits and lifelong occupational history, using a standardised questionnaire with a job-specific questionnaire for wood dust exposure. Logistic regression models were used to calculate ORs and 95% CIs adjusted for age, area of residence, tobacco smoking, the number of job periods and exposure to silica, asbestos and diesel motor exhaust (DME). RESULTS No significant association was found between lung cancer and wood dust exposure after adjustment for smoking, asbestos, silica and DME exposures. The risk of lung cancer was slightly increased among those who were exposed to wood dust more than 10 years, and had over 40 years since the first exposure. CONCLUSION Our findings do not provide a strong support to the hypothesis that wood dust exposure is a risk factor for lung cancer. This study showed the importance of taking into account smoking and occupational coexposures in studies on lung cancer and wood dust exposure. Further studies evaluating the level and frequency of exposure during various tasks in woodwork are needed.
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Affiliation(s)
- Mireille Matrat
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, U1018, Equipe Epidemiologie des Cancers, Gènes et Environnement, INSERM, Villejuif, France .,Faculty of Medicine IFR 10, University Paris-Est Créteil, Créteil, France
| | - Loredana Radoï
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, U1018, Equipe Epidemiologie des Cancers, Gènes et Environnement, INSERM, Villejuif, France.,Faculty of Dental Surgery, University Paris Descartes, Paris, France
| | - Joëlle Févotte
- Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE), Université Claude Bernard Lyon 1, Lyon, France
| | - Florence Guida
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, U1018, Equipe Epidemiologie des Cancers, Gènes et Environnement, INSERM, Villejuif, France
| | - Sylvie Cénée
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, U1018, Equipe Epidemiologie des Cancers, Gènes et Environnement, INSERM, Villejuif, France
| | - Diane Cyr
- Population-Based Epidemiological Cohorts Unit (UMS 011) INSERM-UVSQ, INSERM, Villejuif, France.,UMS 011, University of Versailles St-Quentin, Villejuif, France
| | - Marie Sanchez
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, U1018, Equipe Epidemiologie des Cancers, Gènes et Environnement, INSERM, Villejuif, France
| | - Gwenn Menvielle
- Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP, UMR1136), Sorbonne Universités, INSERM, Paris, France
| | - Annie Schmaus
- Population-Based Epidemiological Cohorts Unit (UMS 011) INSERM-UVSQ, INSERM, Villejuif, France.,UMS 011, University of Versailles St-Quentin, Villejuif, France
| | - Emilie Marrer
- Registre des tumeurs du Haut Rhin, Centre Hospitalier de Mulhouse ARER 68, Mulhouse, France
| | - Danièle Luce
- UMRS 1085 IRSET, INSERM, Pointe-à-Pitre, France.,Campus de Fouillole, University of Rennes 1, Pointe à Pitre, France
| | - Isabelle Stücker
- Université Paris-Saclay, Université Paris-Sud, UVSQ, CESP, U1018, Equipe Epidemiologie des Cancers, Gènes et Environnement, INSERM, Villejuif, France
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70
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Rémen T, Richardson L, Pilorget C, Palmer G, Siemiatycki J, Lavoué J. Development of a Coding and Crosswalk Tool for Occupations and Industries. Ann Work Expo Health 2019; 62:796-807. [PMID: 29912270 DOI: 10.1093/annweh/wxy052] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 05/28/2018] [Indexed: 11/14/2022] Open
Abstract
Introduction Job coding into a standard occupation or industry classification is commonly performed in occupational epidemiology and occupational health. Sometimes, it is necessary to code jobs into multiple classifications or to convert job codes from one classification to another. We developed a generic tool, called CAPS-Canada (http://www.caps-canada.ca/), that combines a computer-assisted coding tool covering seven International, Canadian and US occupation and industry classifications and an assistant facilitating crosswalks from one classification to another. The objectives of this paper are to present the different functions of the CAPS-Canada tool and to assess their contribution through an inter-rater reliability study. Method The crosswalk assistant was built based on a database of >30,000 jobs coded during a previous project. We evaluated to what extent it would allow automatic translation between pairs of classifications. The influence of CAPS-Canada on agreement between coders was assessed through an inter-rater reliability study comparing three approaches: manual coding, coding with CAPS-Canada without the crosswalk assistant, and coding with the complete tool. The material for this trial consisted of a random sample of 1000 jobs extracted from a case-control study and divided into three subgroups of equivalent size. Results Across the classification systems, the crosswalk assistant would provide useful information for 83-99% of jobs (median 95%) in a population similar to ours. Eighteen to eighty-one percent of jobs (median 56%) could be entirely automatically recoded. Based on our sample of 1000 jobs, inter-rater reliability in occupation coding ranged from 35.7 to 66.5% (median 53.7%) depending on the combination of classification/resolution. Compared with manual coding, the use of CAPS-Canada substantially improved inter-rater reliability. Conclusion CAPS-Canada is an attractive alternative to manual coding and is particularly relevant for coding a job into multiple classifications or for recoding jobs into other classifications.
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Affiliation(s)
- Thomas Rémen
- Health Innovation and Evaluation Hub Department, University of Montreal Hospital Research Center (CRCHUM), Rue Saint-Denis, Montréal, QC, Canada
| | - Lesley Richardson
- Health Innovation and Evaluation Hub Department, University of Montreal Hospital Research Center (CRCHUM), Rue Saint-Denis, Montréal, QC, Canada
| | - Corinne Pilorget
- The French Public Health Agency, rue du Val d'Osne Saint-Maurice, France.,UMRESTTE (UMR T), Université Claude Bernard Lyon, avenue Rockefeller, Lyon, France
| | - Gilles Palmer
- French Center for Research and Development in Medical Informatics (CREDIM), ISPED, Université de Bordeaux, Rue Léo Saignat, Bordeaux, France
| | - Jack Siemiatycki
- Health Innovation and Evaluation Hub Department, University of Montreal Hospital Research Center (CRCHUM), Rue Saint-Denis, Montréal, QC, Canada
| | - Jérôme Lavoué
- Health Innovation and Evaluation Hub Department, University of Montreal Hospital Research Center (CRCHUM), Rue Saint-Denis, Montréal, QC, Canada
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71
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Peters CE, Parent MÉ, Harris SA, Bogaert L, Latifovic L, Kachuri L, Villeneuve PJ. Occupational Exposure to Diesel and Gasoline Engine Exhausts and the Risk of Kidney Cancer in Canadian Men. Ann Work Expo Health 2019; 62:978-989. [PMID: 30059990 PMCID: PMC6188530 DOI: 10.1093/annweh/wxy059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 06/05/2018] [Indexed: 11/17/2022] Open
Abstract
Introduction Kidney cancer is the fifth most common incident cancer in Canadian men. Diesel and gasoline exhausts are common workplace exposures that have been examined as risk factors for non-lung cancer sites, including the kidney, but limitations in exposure assessment methods have contributed to inconsistent findings. The objective of this study was to assess the relationship between occupational gasoline and diesel engine exhausts and the risk of kidney cancer in men. Methods The National Enhanced Cancer Surveillance System (NECSS) is a Canadian population-based case–control study conducted in 1994–1997. Incident kidney cancer cases were identified using provincial registries, while the control series was identified through random-digit dialing, or provincial administrative databases. Self-reported questionnaires were used to obtain information on lifetime occupational history and cancer risk factors. Two hygienists, blinded to case status, coded occupational histories for diesel and gasoline exhaust exposures using concentration, frequency, duration, and reliability. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) separately by exhaust type. The separate and combined impacts of both engine exhausts were also examined. ORs were adjusted for age, province, body mass index, occupational secondhand smoke exposure, and education. Results Of the kidney cancer cases (n = 712), 372 (52%) had exposure to both exhausts at some point, and 984 (40%) of the controls (n = 2457) were ever exposed. Workers who had ever been exposed to engine exhausts were more likely to have kidney cancer than those who were never exposed (OR diesel = 1.23, 95% CI = 0.99–1.53; OR gasoline = 1.51, 95% CI = 1.23–1.86). Exposure to gasoline exhaust was consistently associated with kidney cancer in a dose–response manner (P value for trends in highest attained and cumulative exposure both <0.0001). Those men with high cumulative exposure to both gasoline and diesel exhaust had a 76% increased odds of kidney cancer (95% CI = 1.27–2.43). Conclusions This study provides evidence that occupational gasoline, and to a lesser extent, diesel exhaust exposure may increase the risk of kidney cancer.
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Affiliation(s)
- Cheryl E Peters
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada.,Institut Armand-Frappier, Institut national de la recherche scientifique (IAF-INRS), Laval, Quebec, Canada
| | - Marie-Élise Parent
- Institut Armand-Frappier, Institut national de la recherche scientifique (IAF-INRS), Laval, Quebec, Canada
| | - Shelley A Harris
- Cancer Care Ontario, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Laura Bogaert
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Linda Kachuri
- Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA
| | - Paul J Villeneuve
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
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Sauvé JF, Friesen MC. Using Decision Rules to Assess Occupational Exposure in Population-Based Studies. Curr Environ Health Rep 2019; 6:148-159. [PMID: 31297745 PMCID: PMC6698417 DOI: 10.1007/s40572-019-00240-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW Population-based studies increasingly link task-based occupational questionnaire responses collected from subjects to exposure estimates via transparent, programmable decision rules. We reviewed recent applications and methodological developments of rule-based approaches. RECENT FINDINGS Agent-specific decision rules require interviews incorporating work-task-based questions. Some studies have developed rules before the interviews took place, while others developed rules after the interviews were completed. Agreement between rule-based estimates and exposures assigned using job-by-job expert review were generally moderate to good (Kappa = 0.4-0.8). Rules providing quantitative intensity levels using measurement data or that integrate multiple independent exposure sources for the same job represent further advances to improve the characterization of occupational exposures in population studies. Decision rules have provided transparent and reproducible assessments, reduce job-by-job review, and facilitate sensitivity analyses in epidemiologic studies. Future studies should consider the development of decision rules concurrent with the questionnaire design to facilitate occupational exposure assessment efforts.
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Affiliation(s)
- Jean-François Sauvé
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA.
| | - Melissa C Friesen
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
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73
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Sauvé JF, Ramsay JM, Locke SJ, Dopart PJ, Josse PR, Zaebst DD, Albert PS, Cantor KP, Baris D, Jackson BP, Karagas MR, Hosain GMM, Schwenn M, Johnson A, Purdue MP, Koutros S, Silverman DT, Friesen MC. Validity of retrospective occupational exposure estimates of lead and manganese in a case-control study. Occup Environ Med 2019; 76:680-687. [PMID: 31308155 PMCID: PMC6767614 DOI: 10.1136/oemed-2019-105744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 05/06/2019] [Accepted: 06/16/2019] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The validity of surrogate measures of retrospective occupational exposure in population-based epidemiological studies has rarely been evaluated. Using toenail samples as bioindicators of exposure, we assessed whether work tasks and expert assessments of occupational metal exposure obtained from personal interviews were associated with lead and manganese concentrations. METHODS We selected 609 controls from a case-control study of bladder cancer in New England who had held a job for ≥1 year 8-24 months prior to toenail collection. We evaluated associations between toenail metal concentrations and five tasks extracted from occupational questionnaires (grinding, painting, soldering, welding, working near engines) using linear regression models. For 139 subjects, we also evaluated associations between the toenail concentrations and exposure estimates from three experts. RESULTS We observed a 1.9-fold increase (95% CI 1.4 to 2.5) in toenail lead concentrations with painting and 1.4-fold increase (95% CI 1.1 to 1.7) in manganese concentrations with working around engines and handling fuel. We observed significant trends with increasing frequency of both activities. For lead, significant trends were observed with the ratings from all three experts. Their average ratings showed the strongest association, with subjects rated as possibly or probably exposed to lead having concentrations that were 2.0 and 2.5 times higher, respectively, than in unexposed subjects (ptrend <0.001). Expert estimates were only weakly associated with manganese toenail concentrations. CONCLUSIONS Our findings support the ability of experts to identify broad contrasts in previous occupational exposure to lead. The stronger associations with task frequency and expert assessments support using refined exposure characterisation whenever possible.
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Affiliation(s)
- Jean-François Sauvé
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Joemy M. Ramsay
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
- Rocky Mountain Center for Occupational and Environmental Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Sarah J. Locke
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Pamela J. Dopart
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Pabitra R. Josse
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | | | - Paul S. Albert
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Kenneth P. Cantor
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Dalsu Baris
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Brian P. Jackson
- Department of Earth Sciences, Dartmouth College, Hanover, NH, USA
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - GM Monawar Hosain
- Bureau of Public Health Statistics and Informatics, Department of Health and Human Services, Concord, NH, USA
| | | | | | - Mark P. Purdue
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Stella Koutros
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Debra T. Silverman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Melissa C. Friesen
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
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Visser AE, D'Ovidio F, Peters S, Vermeulen RC, Beghi E, Chiò A, Veldink JH, Logroscino G, Hardiman O, van den Berg LH. Multicentre, population-based, case-control study of particulates, combustion products and amyotrophic lateral sclerosis risk. J Neurol Neurosurg Psychiatry 2019; 90:854-860. [PMID: 30850472 DOI: 10.1136/jnnp-2018-319779] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 12/01/2018] [Accepted: 01/21/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To investigate whether exposure to particulates and combustion products may explain the association between certain occupations and amyotrophic lateral sclerosis (ALS) risk in a large, multicentre, population-based, case-control study, based on full job histories, using job-exposure matrices, with detailed information on possible confounders. METHODS Population-based patients with ALS and controls were recruited from five registries in the Netherlands, Ireland and Italy. Demographics and data regarding educational level, smoking, alcohol habits and lifetime occupational history were obtained using a validated questionnaire. Using job-exposure matrices, we assessed occupational exposure to silica, asbestos, organic dust, contact with animals or fresh animal products, endotoxins, polycyclic aromatic hydrocarbons and diesel motor exhaust. Multivariate logistic regression models adjusting for confounding factors were used to determine the association between these exposures and ALS risk. RESULTS We included 1557 patients and 2922 controls. Associations were positive for all seven occupational exposures (ORs ranging from 1.13 to 1.73 for high vs never exposed), and significant on the continuous scale for silica, organic dust and diesel motor exhaust (p values for trend ≤0.03). Additional analyses, adding an exposure (one at a time) to the model in the single exposure analysis, revealed a stable OR for silica. We found similar results when patients with a C9orf72 mutation were excluded. CONCLUSION In a large, multicentre study, using harmonised methodology to objectively quantify occupational exposure to particulates and combustion products, we found an association between ALS risk and exposure to silica, independent of the other occupational exposures studied.
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Affiliation(s)
- Anne E Visser
- Department of Neurology, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Fabrizio D'Ovidio
- Rita Levi Montalcini Department of Neuroscience, University of Torino, Torino, Italy
| | - Susan Peters
- Department of Neurology, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands.,Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Roel Ch Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Ettore Beghi
- Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Adriano Chiò
- Rita Levi Montalcini Department of Neuroscience, University of Torino, Torino, Italy
| | - Jan H Veldink
- Department of Neurology, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Giancarlo Logroscino
- Unit of Neurodegenerative Diseases, Department of Clinical Research in Neurology, University of Bari 'Aldo Moro', Pia Fondazione Cardinale G Panico, Lecce, Italy.,Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College, Dublin, Ireland
| | - Leonard H van den Berg
- Department of Neurology, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
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Garzia NA, Spinelli JJ, Gotay CC, Teschke K. Literature review: dermal monitoring data for pesticide exposure assessment of farm workers. J Agromedicine 2019; 23:187-214. [PMID: 30047858 DOI: 10.1080/1059924x.2018.1448734] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To conduct a literature review to determine the types of information that existing dermal pesticide monitoring data could provide for future pesticide exposure assessment in occupational epidemiology. METHODS A systematic literature search was performed on eight online databases. Two screening phases with predetermined criteria identified the qualifying literature. Standard information and dermal pesticide monitoring data were recorded and summarized from each qualifying study to assess its usefulness for future pesticide exposure assessment. RESULTS A total of 31 farm studies qualified for review; task information was used to standardize all farm job(s) evaluated into 5 job groups: operators, applicators, mixer-loaders, field workers, and flaggers. When attempting to compare dermal exposure levels between studies, two types of variation were identified: (1) variation in study focus and reporting and 2) variation in exposure levels. The former variation type prevented exposure level comparisons between studies. Within studies, exposure levels were compared across body parts to identify that which had the highest measured exposure and to determine if results were similar in other studies that evaluated the same farm job. Using studies that measured exposure for multiple farm jobs, within study comparisons of total body exposure were performed to evaluate work factors. CONCLUSION Future dermal pesticide exposure monitoring studies should standardize reporting procedures, as suggested in this review, to allow for more extensive dermal data comparisons. Body parts with highest measured levels of dermal exposure were identified by farm job, along with work factors to be further investigated as potential dermal pesticide exposure determinants for farm workers.
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Affiliation(s)
- Nichole A Garzia
- a School of Population and Public Health , University of British Columbia , Vancouver , Canada
| | - John J Spinelli
- a School of Population and Public Health , University of British Columbia , Vancouver , Canada.,b Population Oncology, BC Cancer , Vancouver , Canada
| | - Carolyn C Gotay
- a School of Population and Public Health , University of British Columbia , Vancouver , Canada
| | - Kay Teschke
- a School of Population and Public Health , University of British Columbia , Vancouver , Canada
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McCanlies EC, Ma CC, Gu JK, Fekedulegn D, Sanderson WT, Ludeña-Rodriguez YJ, Hertz-Picciotto I. The CHARGE study: an assessment of parental occupational exposures and autism spectrum disorder. Occup Environ Med 2019; 76:644-651. [PMID: 31248991 DOI: 10.1136/oemed-2018-105395] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 04/09/2019] [Accepted: 04/16/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The aim of this study is to determine if parental occupational exposure to 16 agents is associated with autism spectrum disorder (ASD). METHODS Demographic, health and parental occupational data were collected as part of the CHildhood Autism Risks from Genetics and Environment study. The workplace exposure assessment was conducted by two experienced industrial hygienists for the parents of 537 children with ASD and 414 typically developing (TD) children. For each job, frequency and intensity of 16 agents were assessed and both binary and semi-quantitative cumulative exposure variables were derived. Logistic regression models were used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI) to assess associations between parental occupational exposures 3 months pre-pregnancy until birth. RESULTS The OR of ASD in the children of mothers exposed to any solvents was 1.5 times higher than the mothers of TD children (95% CI=1.01-2.23). Cumulative exposure indicated that the OR associated with a moderate level of solvent exposure in mothers was 1.85 (95% CI=1.09, 3.15) for children with ASD compared with TD children. No other exposures were associated with ASD in mothers, fathers or the parents combined. CONCLUSION Maternal occupational exposure to solvents may increase the risk for ASD. These results are consistent with a growing body of evidence indicating that environmental and occupational exposures may be associated with ASD. Future research should consider specific types of solvents, larger samples and/or different study designs to evaluate other exposures for potential associations with ASD.
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Affiliation(s)
- Erin C McCanlies
- Health Effects Laboratory, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Claudia C Ma
- Health Effects Laboratory, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Ja Kook Gu
- Health Effects Laboratory, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Desta Fekedulegn
- Health Effects Laboratory, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Wayne T Sanderson
- University of Kentucky Chandler Medical Center, Lexington, Kentucky, USA
| | - Yunin J Ludeña-Rodriguez
- Division of Environmental and Occupational Health, Public Health Sciences, University of California, Davis, California, USA
| | - Irva Hertz-Picciotto
- Division of Environmental and Occupational Health, Public Health Sciences, University of California, Davis, California, USA
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78
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DeMatteo R, DeMatteo D. Workers' Fight for Justice: A Retrospective Exposure Profile Study of the GE Factory in Peterborough, Ontario. New Solut 2019; 29:138-166. [PMID: 31142206 DOI: 10.1177/1048291119850779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Occupational disease recognition is often hampered by lack of historical exposure data. This paper describes research documenting major chemical exposures of Canadian General Electric workers in a plant in Peterborough between 1945 and 2000. Workers’ experiences with diseases over forty years, and their frustration with the continual denial that these were work-related, drove this study. Researchers used qualitative methods, participatory action research, hazard mapping, and risk assessment. A report that incorporates this study’s findings documents extremely toxic exposures that placed Canadian General Electric workers at a disproportionate risk of occupational diseases. Since the report’s release, the Ontario Workplace Safety and Insurance Board reconsidered 233 previously denied claims in the light of “new evidence” and overturned one half of those it reviewed. The retrospective exposure profile methods used in this study may serve as a useful model for workers and their organization when plants close.
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Affiliation(s)
- Robert DeMatteo
- 1 Occupational Health Clinic for Ontario Workers, Toronto, ON, Canada
| | - Dale DeMatteo
- 1 Occupational Health Clinic for Ontario Workers, Toronto, ON, Canada
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79
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Fritschi L. OccIDEAS – occupational exposure assessment in community-based studies. Occup Med (Lond) 2019; 69:156-157. [DOI: 10.1093/occmed/kqy126] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Lin Fritschi
- School of Public Health, Curtin University, Perth, Western Australia, Australia
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80
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Stenehjem JS, Babigumira R, Friesen MC, Grimsrud TK. Harmonizing work history data in epidemiologic studies with overlapping employment records. Am J Ind Med 2019; 62:422-429. [PMID: 30919995 DOI: 10.1002/ajim.22965] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 01/22/2019] [Accepted: 02/13/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND Work history data often require major data management including handling of overlapping jobs to avoid overestimating exposure before linkage to job-exposure matrices (JEMs) is possible. METHODS In a case-cohort study of 1825 male Norwegian offshore petroleum workers, 3979 jobs were reported (mean duration 2417 days/job; maximum 8 jobs/worker). Each job was assigned to one of 27 occupation categories. Overlapping jobs of the same category (1142 jobs) were collapsed and overlapping jobs of different categories (1013 jobs) were split. The resulting durations were weighted by a factor accounting for the number of overlapping jobs. RESULTS Collapsing overlapping jobs within the same category resulted in 3295 jobs (mean 2629 days/job). Splitting overlapping jobs of different categories increased the number to 4239 jobs (mean 2043 days/job), while the total duration in days dropped by 10%. CONCLUSIONS We demonstrated that overlapping employment data structures can be harmonized in a systematic and unbiased way, preparing work history data for linkage to several JEMs.
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Affiliation(s)
- Jo Steinson Stenehjem
- Department of Research, Cancer Registry of NorwayOslo Norway
- Department of BiostatisticsOslo Centre for Biostatistics and Epidemiology, University of OsloOslo Norway
| | | | - Melissa C Friesen
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesda Maryland
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Bulka CM, Daviglus ML, Persky VW, Durazo-Arvizu RA, Lash JP, Elfassy T, Lee DJ, Ramos AR, Tarraf W, Argos M. Association of occupational exposures with cardiovascular disease among US Hispanics/Latinos. Heart 2019; 105:439-448. [PMID: 30538094 PMCID: PMC6580877 DOI: 10.1136/heartjnl-2018-313463] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 09/06/2018] [Accepted: 09/09/2018] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Cardiovascular disease (CVD) is a leading cause of mortality and morbidity in the USA. The role of occupational exposures to chemicals in the development of CVD has rarely been studied even though many agents possess cardiotoxic properties. We therefore evaluated associations of self-reported exposures to organic solvents, metals and pesticides in relation to CVD prevalence among diverse Hispanic/Latino workers. METHODS Cross-sectional data from 7404 employed individuals, aged 18-74 years, enrolled in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) were analysed. Participants from four US cities provided questionnaire data and underwent clinical examinations, including ECGs. CVD was defined as the presence of at least one of the following: coronary heart disease, atrial fibrillation, heart failure or cerebrovascular disease. Prevalence ratios reflecting the relationship between each occupational exposure and CVD as well as CVD subtypes were calculated using Poisson regression models. RESULTS Hispanic/Latino workers reported exposures to organic solvents (6.5%), metals (8.5%) and pesticides (4.7%) at their current jobs. Overall, 6.1% of participants had some form of CVD, with coronary heart disease as the most common (4.3%) followed by cerebrovascular disease (1.0%), heart failure (0.8%) and atrial fibrillation (0.7%). For individuals who reported working with pesticides, the prevalence ratios for any CVD were 2.18 (95% CI 1.34 to 3.55), coronary heart disease 2.20 (95% CI 1.31 to 3.71), cerebrovascular disease 1.38 (95% CI 0.62 3.03), heart failure 0.91 (95% CI 0.23 to 3.54) and atrial fibrillation 5.92 (95% CI 1.89 to 18.61) after adjustment for sociodemographic, acculturation, lifestyle and occupational characteristics. Metal exposures were associated with an almost fourfold (3.78, 95% CI 1.24 to 11.46) greater prevalence of atrial fibrillation. Null associations were observed for organic solvent exposures. CONCLUSIONS Our results suggest that working with metals and pesticides could be risk factors for CVD among Hispanic/Latino workers. Further work is needed to evaluate these relationships prospectively.
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Affiliation(s)
- Catherine M Bulka
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA
- Division of Academic Internal Medicine, Department of Medicine, Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Martha L Daviglus
- Division of Academic Internal Medicine, Department of Medicine, Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Victoria W Persky
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Ramon A Durazo-Arvizu
- Division of Academic Internal Medicine, Department of Medicine, Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, USA
| | - James P Lash
- Division of Nephrology, Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Tali Elfassy
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - David J Lee
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Alberto R Ramos
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Wassim Tarraf
- Department of Healthcare Sciences, Wayne State University, Detroit, Michigan, USA
| | - Maria Argos
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA
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Sauvé JF, Lavoué J, Nadon L, Lakhani R, Senhaji Rhazi M, Bourbonnais R, Richard H, Parent MÉ. A hybrid expert approach for retrospective assessment of occupational exposures in a population-based case-control study of cancer. Environ Health 2019; 18:14. [PMID: 30770757 PMCID: PMC6377721 DOI: 10.1186/s12940-019-0451-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Accepted: 01/31/2019] [Indexed: 05/12/2023]
Abstract
BACKGROUND While the expert-based occupational exposure assessment approach has been considered the reference method for retrospective population-based studies, its implementation in large study samples has become prohibitive. To facilitate its application and improve upon it we developed, in the context of a Montreal population-based study of prostate cancer (PROtEuS), a hybrid approach combining job-exposure profiles (JEPs) summarizing expert evaluations from previous studies and expert review. We aim to describe the hybrid expert method and its impacts on the exposures assigned in PROtEuS compared to those from a previous study coded using the traditional expert method. METHODS Applying the hybrid approach, experts evaluated semi-quantitative levels of confidence, concentration and frequency of exposure to 313 agents for 16,065 jobs held by 4005 subjects in PROtEuS. These assessments were compared to those from a different set of jobs coded in an earlier study of lung cancer, conducted on the same study base, for 90 blue-collar occupations and 203 agents. Endpoints evaluated included differences in the number of exposures and in the distribution of ratings across jobs, and the within-occupation variability in exposure. RESULTS Compared to jobs from the lung cancer study, jobs in PROtEuS had on average 0.3 more exposures. PROtEuS exposures were more often assigned definite confidence ratings, but concentration and frequency levels tended to be lower. The within-occupation variability in ratings assigned to jobs were lower in PROtEuS jobs for all metrics. This was particularly evident for concentration, although considerable variability remained with over 40% of occupation/agent cells in PROtEuS exposed at different levels. The hybrid approach reduced coding time by half, compared to the traditional expert assessment. CONCLUSIONS The new hybrid expert approach improved on efficiency and transparency, and resulted in greater confidence in assessments, compared to the traditional expert method applied in an earlier study involving a similar set of jobs. Assigned ratings were more homogeneous with the hybrid approach, possibly reflecting clearer guidelines for coding, greater coherence between experts and/or reliance on summaries of past assessments. Nevertheless, significant within-occupation variability remained with the hybrid approach, suggesting that experts took into account job-specific factors in their assessments.
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Affiliation(s)
- Jean-François Sauvé
- Department of Environmental and Occupational Health, Université de Montréal, School of Public Health, Montréal, Québec Canada
- Centre de recherche du CHUM, Montréal, Québec Canada
- INRS-Institut Armand-Frappier, Université du Québec, 531 Boul. des Prairies, Laval, Quebec H7V 1B7 Canada
| | - Jérôme Lavoué
- Department of Environmental and Occupational Health, Université de Montréal, School of Public Health, Montréal, Québec Canada
- Centre de recherche du CHUM, Montréal, Québec Canada
| | - Louise Nadon
- INRS-Institut Armand-Frappier, Université du Québec, 531 Boul. des Prairies, Laval, Quebec H7V 1B7 Canada
| | - Ramzan Lakhani
- INRS-Institut Armand-Frappier, Université du Québec, 531 Boul. des Prairies, Laval, Quebec H7V 1B7 Canada
| | - Mounia Senhaji Rhazi
- INRS-Institut Armand-Frappier, Université du Québec, 531 Boul. des Prairies, Laval, Quebec H7V 1B7 Canada
| | - Robert Bourbonnais
- INRS-Institut Armand-Frappier, Université du Québec, 531 Boul. des Prairies, Laval, Quebec H7V 1B7 Canada
| | - Hugues Richard
- INRS-Institut Armand-Frappier, Université du Québec, 531 Boul. des Prairies, Laval, Quebec H7V 1B7 Canada
| | - Marie-Élise Parent
- Centre de recherche du CHUM, Montréal, Québec Canada
- INRS-Institut Armand-Frappier, Université du Québec, 531 Boul. des Prairies, Laval, Quebec H7V 1B7 Canada
- Department of Social and Preventive Medicine, Université de Montréal, School of Public Health, Montréal, Québec Canada
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83
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Lacourt A, Labrèche F, Goldberg MS, Siemiatycki J, Lavoué J. Agreement in Occupational Exposures Between Men and Women Using Retrospective Assessments by Expert Coders. Ann Work Expo Health 2018; 62:1159-1170. [PMID: 30124778 DOI: 10.1093/annweh/wxy074] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 07/27/2018] [Indexed: 11/14/2022] Open
Abstract
Objectives To estimate the level of agreement and identify notable differences in occupational exposures (agents) between men and women from retrospective assessments by expert coders. Methods Lifetime occupational histories of 1657 men and 2073 women from two case-control studies, were translated into exposure estimates to 243 agents, from data on 13882 jobs. Exposure estimates were summarized as proportions and frequency-weighted intensity of exposure for 59 occupational codes by sex. Agreement between metrics of exposure in men's and women's jobs was determined with intraclass correlation coefficients (ICC) and weighted Kappa coefficients, using as unit of analysis ('cell') a combination of occupational code and occupational agent. 'Notable' differences between men and women were identified for each cell, according to a Bayesian hierarchical model for both proportion and frequency-weighted intensity of exposure. Results For cells common to both men and women, the ICC for continuous probability of exposure was 0.84 (95% CI: 0.83-0.84) and 7.4% of cells showed notable differences with jobs held by men being more often exposed. A weighted kappa of 0.67 (95% CI: 0.61-0.73) was calculated for intensity of exposure, and an ICC of 0.67 (95% CI: 0.62-0.71) for frequency-weighted intensity of exposure, with a tendency of higher values of exposure metrics in jobs held by men. Conclusions Exposures were generally in agreement between men and women. Some notable differences were identified, most of them explained by differential sub-occupations or industries or dissimilar reported tasks within the studied occupations.
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Affiliation(s)
- Aude Lacourt
- University of Montreal Hospital Research Center (CRCHUM), Montreal, QC, Canada.,Univ. Bordeaux, INSERM, BPH U1219-EPICENE, ISPED, Bordeaux, France
| | - France Labrèche
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montreal, QC, Canada.,Department of Environmental and Occupational Health, School of Public Health, University of Montreal, Montreal, QC, Canada
| | - Mark S Goldberg
- Department of Medicine, McGill University, Montreal, QC, Canada.,Centre for Outcomes Research and Evaluation, Research Institute, McGill University Health Centre, Montreal, QC, Canada
| | - Jack Siemiatycki
- University of Montreal Hospital Research Center (CRCHUM), Montreal, QC, Canada.,Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada.,Guzzo-Cancer Research Society Chair on Environment and Cancer, School of Public Health, University of Montreal, Montreal, QC, Canada
| | - Jérôme Lavoué
- University of Montreal Hospital Research Center (CRCHUM), Montreal, QC, Canada.,Department of Environmental and Occupational Health, School of Public Health, University of Montreal, Montreal, QC, Canada
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84
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De Roos AJ, Spinelli J, Brown EB, Atanackovic D, Baris D, Bernstein L, Bhatti P, Camp NJ, Chiu BC, Clavel J, Cozen W, De Sanjosé S, Dosman JA, Hofmann JN, McLaughlin JR, Miligi L, Monnereau A, Orsi L, Purdue MP, Schinasi LH, Tricot GJ, Wang SS, Zhang Y, Birmann BM, Cocco P. Pooled study of occupational exposure to aromatic hydrocarbon solvents and risk of multiple myeloma. Occup Environ Med 2018; 75:798-806. [PMID: 30121582 PMCID: PMC9386620 DOI: 10.1136/oemed-2018-105154] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 06/27/2018] [Accepted: 07/07/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To investigate the association between occupational exposure to aromatic hydrocarbon solvents and risk of multiple myeloma (MM) in a large, consortium-based study. METHODS We pooled data on 2854 cases and 10 743 controls from nine studies participating in the InterLymph consortium. Occupational exposures to benzene, toluene and xylene were assigned by a job-exposure matrix, coupled with 'correction' of exposure probability by self-reported or expert-assessed exposure from the individual studies. Cumulative intensity was calculated as the job-specific exposure intensity multiplied by job duration, summed across jobs. Associations were estimated using logistic regression, with inclusion of covariates for study matching factors and other potential confounders. We repeated our main analysis using random-effects meta-analysis to evaluate heterogeneity of effect. RESULTS Benzene, toluene and xylene were each associated with MM. For the three solvents, the highest quartile of high-probability cumulative intensity exposure (vs unexposed) was associated with 42% to 63% increased risks of MM. Associations with toluene and xylene exposures were fairly consistent and robust to sensitivity analyses. The estimated effect for benzene was moderately heterogeneous between the studies. Each solvent's association with MM was stronger for exposure occurring within 20 years of diagnosis than with exposure lagged by more than 20 years. CONCLUSIONS Our study adds important evidence for a role of aromatic hydrocarbon solvents in causation of MM. The difficulty in disentangling individual compounds in this group and a lack of data on potential carcinogenicity of toluene and xylene, in widespread current use, underscore a need for further epidemiological evaluation.
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Affiliation(s)
- Anneclaire J De Roos
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - John Spinelli
- Population Oncology, BC Cancer Agency, Vancouver, British Columbia, Canada
- School of Population and Public Health, UBC, Vancouver, Canada
| | - Elizabeth B Brown
- Department of Pathology, University of Alabama, Birmingham, Alabama, USA
| | - Djordje Atanackovic
- Division of Hematology and Hematological Malignancies, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Dalsu Baris
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Leslie Bernstein
- Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, California, USA
| | - Parveen Bhatti
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Cancer Control Research, BC Cancer Agency, Vancouver, British Columbia, Canada
| | - Nicola J Camp
- Division of Hematology and Hematological Malignancies, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Brian C Chiu
- Department of Public Health Sciences, University of Chicago, Chicago, Illinois, USA
| | - Jacqueline Clavel
- INSERM U1153, Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS), Paris, France
- Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris-Descartes University, Villejuif, France
| | - Wendy Cozen
- Departments of Preventive Medicine and Pathology, USC Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Silvia De Sanjosé
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Barcelona, Spain
| | - James A Dosman
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
| | - Jonathan N Hofmann
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | | | - Lucia Miligi
- Unit of Environmental and Occupational Epidemiology, Oncological Network, Prevention, Research Institute, Florence, Italy
| | - Alain Monnereau
- INSERM U1153, Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS), Paris, France
- Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris-Descartes University, Villejuif, France
- Inserm Team EPICENE U1219, Hematological Malignancies Registry of Gironde, Bergonie Institute, Bordeaux, France
| | - Laurent Orsi
- INSERM U1153, Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS), Paris, France
- Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris-Descartes University, Villejuif, France
| | - Mark P Purdue
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Leah H Schinasi
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | | | - Sophia S Wang
- Department of Population Sciences, Beckman Research Institute, City of Hope, Duarte, California, USA
| | - Yawei Zhang
- School of Public Health, Yale University, New Haven, Connecticut, USA
- School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Brenda M Birmann
- Channing Division of Network Medicine, Division of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Pierluigi Cocco
- Department of Public Health and Clinical Molecular Medicine, University of Cagliari, Cagliari, Italy
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85
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Callahan CL, Locke SJ, Dopart PJ, Stewart PA, Schwartz K, Ruterbusch JJ, Graubard BI, Rothman N, Hofmann JN, Purdue MP, Friesen MC. Decision rule approach applied to estimate occupational lead exposure in a case-control study of kidney cancer. Am J Ind Med 2018; 61:901-910. [PMID: 30291640 DOI: 10.1002/ajim.22912] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND We developed a systematic, data-driven approach to estimate metrics of occupational exposure to lead to aid in epidemiologic analyses in a case-control study of kidney cancer. METHODS Probability of exposure to ten lead sources was assigned using decision rules developed from an extensive literature review and expert judgement. For jobs with >50% probability of exposure, we assigned source-specific frequency based on subjects' self-reported task frequencies or means of subjects' job-groups and source-specific intensity estimates of blood lead (μg/dL). RESULTS In our study, 18.7% of employed person-years were associated with high (≥80%) probability of exposure to any lead source. The most common medium (>50%) or high probability source of lead exposure was leaded gasoline (2.5% and 11.5% of employed person-years, respectively). The median blood lead attributed to occupational exposure was 3.1 μg/dL. CONCLUSIONS These rules can aid in future studies after population-specific adaption for geographic differences and different exposure scenarios.
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Affiliation(s)
- Catherine L. Callahan
- Occupational and Environmental Epidemiology Branch; Division of Cancer Epidemiology Genetics; National Cancer Institute; Bethesda Maryland
| | - Sarah J. Locke
- Occupational and Environmental Epidemiology Branch; Division of Cancer Epidemiology Genetics; National Cancer Institute; Bethesda Maryland
| | - Pamela J. Dopart
- Occupational and Environmental Epidemiology Branch; Division of Cancer Epidemiology Genetics; National Cancer Institute; Bethesda Maryland
| | | | - Kendra Schwartz
- Department of Family Medicine and Public Health Sciences; Karmanos Cancer Institute; Wayne State University; Detroit Michigan
| | - Julie J. Ruterbusch
- Department of Family Medicine and Public Health Sciences; Karmanos Cancer Institute; Wayne State University; Detroit Michigan
| | - Barry I. Graubard
- Biostatistics Branch; Division of Cancer Epidemiology and Genetics; National Cancer Institute; Bethesda Maryland
| | - Nathaniel Rothman
- Occupational and Environmental Epidemiology Branch; Division of Cancer Epidemiology Genetics; National Cancer Institute; Bethesda Maryland
| | - Jonathan N. Hofmann
- Occupational and Environmental Epidemiology Branch; Division of Cancer Epidemiology Genetics; National Cancer Institute; Bethesda Maryland
| | - Mark P. Purdue
- Occupational and Environmental Epidemiology Branch; Division of Cancer Epidemiology Genetics; National Cancer Institute; Bethesda Maryland
| | - Melissa C. Friesen
- Occupational and Environmental Epidemiology Branch; Division of Cancer Epidemiology Genetics; National Cancer Institute; Bethesda Maryland
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86
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Sauvé JF, Siemiatycki J, Labrèche F, Richardson L, Pintos J, Sylvestre MP, Gérin M, Bégin D, Lacourt A, Kirkham TL, Rémen T, Pasquet R, Goldberg MS, Rousseau MC, Parent MÉ, Lavoué J. Development of and Selected Performance Characteristics of CANJEM, a General Population Job-Exposure Matrix Based on Past Expert Assessments of Exposure. Ann Work Expo Health 2018; 62:783-795. [PMID: 29897403 DOI: 10.1093/annweh/wxy044] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 05/20/2018] [Indexed: 11/12/2022] Open
Abstract
Objectives We developed a job-exposure matrix called CANJEM using data generated in population-based case-control studies of cancer. This article describes some of the decisions in developing CANJEM, and some of its performance characteristics. Methods CANJEM is built from exposure information from 31673 jobs held by study subjects included in our past case-control studies. For each job, experts had evaluated the intensity, frequency, and likelihood of exposure to a predefined list of agents based on jobs histories and descriptions of tasks and workplaces. The creation of CANJEM involved a host of decisions regarding the structure of CANJEM, and operational decisions regarding which parameters to present. The goal was to produce an instrument that would provide great flexibility to the user. In addition to describing these decisions, we conducted analyses to assess how well CANJEM covered the range of occupations found in Canada. Results Even at quite a high level of resolution of the occupation classifications and time periods, over 90% of the recent Canadian working population would be covered by CANJEM. Prevalence of exposure of specific agents in specific occupations ranges from 0% to nearly 100%, thereby providing the user with basic information to discriminate exposed from unexposed workers. Furthermore, among exposed workers there is information that can be used to discriminate those with high exposure from those with low exposure. Conclusions CANJEM provides good coverage of the Canadian working population and possibly that of several other countries. Available in several occupation classification systems and including 258 agents, CANJEM can be used to support exposure assessment efforts in epidemiology and prevention of occupational diseases.
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Affiliation(s)
- Jean-François Sauvé
- Department of Environmental and Occupational Health, School of Public Health, Université de Montréal, chemin de la Côte Ste-Catherine, Montréal, Québec, Canada.,Centre de recherche du CHUM, rue St-Denis, Montréal, Québec, Canada
| | - Jack Siemiatycki
- Centre de recherche du CHUM, rue St-Denis, Montréal, Québec, Canada.,Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, avenue du Parc, Montréal, Québec, Canada
| | - France Labrèche
- Department of Environmental and Occupational Health, School of Public Health, Université de Montréal, chemin de la Côte Ste-Catherine, Montréal, Québec, Canada.,Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, avenue du Parc, Montréal, Québec, Canada.,Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail, Boul. de Maisonneuve Ouest, Montréal, Québec, Canada
| | | | - Javier Pintos
- Centre de recherche du CHUM, rue St-Denis, Montréal, Québec, Canada
| | - Marie-Pierre Sylvestre
- Centre de recherche du CHUM, rue St-Denis, Montréal, Québec, Canada.,Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, avenue du Parc, Montréal, Québec, Canada
| | - Michel Gérin
- Department of Environmental and Occupational Health, School of Public Health, Université de Montréal, chemin de la Côte Ste-Catherine, Montréal, Québec, Canada
| | - Denis Bégin
- Department of Environmental and Occupational Health, School of Public Health, Université de Montréal, chemin de la Côte Ste-Catherine, Montréal, Québec, Canada
| | - Aude Lacourt
- Bordeaux Population Health Research Center, Team EPICENE, Université de Bordeaux, UMR, rue Léo Saignat, Bordeaux Cedex, France
| | - Tracy L Kirkham
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Thomas Rémen
- Centre de recherche du CHUM, rue St-Denis, Montréal, Québec, Canada
| | - Romain Pasquet
- Centre de recherche du CHUM, rue St-Denis, Montréal, Québec, Canada.,Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, avenue du Parc, Montréal, Québec, Canada
| | - Mark S Goldberg
- Department of Medicine, McGill University, Montréal, Québec, Canada.,Division of Clinical Epidemiology, McGill University Health Centre, Montréal, Québec, Canada
| | - Marie-Claude Rousseau
- Centre de recherche du CHUM, rue St-Denis, Montréal, Québec, Canada.,Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, avenue du Parc, Montréal, Québec, Canada.,INRS-Institut Armand-Frappier, Université du Québec, Laval, Québec, Canada
| | - Marie-Élise Parent
- Centre de recherche du CHUM, rue St-Denis, Montréal, Québec, Canada.,Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, avenue du Parc, Montréal, Québec, Canada.,INRS-Institut Armand-Frappier, Université du Québec, Laval, Québec, Canada
| | - Jérôme Lavoué
- Department of Environmental and Occupational Health, School of Public Health, Université de Montréal, chemin de la Côte Ste-Catherine, Montréal, Québec, Canada.,Centre de recherche du CHUM, rue St-Denis, Montréal, Québec, Canada
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87
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Peters CE, Parent MÉ, Harris SA, Kachuri L, Latifovic L, Bogaert L, Villeneuve PJ. Workplace exposure to asbestos and the risk of kidney cancer in Canadian men. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2018; 109:464-472. [PMID: 30225576 PMCID: PMC6182333 DOI: 10.17269/s41997-018-0095-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 05/30/2018] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Previous studies considered the role of occupational causes in kidney cancer but were limited by small sample sizes and imprecise exposure assessment. This study examined the relationship between occupational exposure to asbestos and the risk of kidney cancer across a range of jobs in a large, population-based case-control study in Canada. METHODS Data were from the case-control component of the National Enhanced Cancer Surveillance System, a study conducted between 1994 and 1997 in eight Canadian provinces. Male kidney cancer cases, histologically confirmed, and controls completed questionnaires on socio-demographics, anthropometry, diet, smoking, secondhand smoke exposure, and physical activity. Occupational histories were also collected, including each job held for at least 1 year since the age of 18. Occupational hygienists, blinded to case status, assigned exposure to asbestos, considering intensity, frequency, and probability of exposure (each 3-point scales). Logistic regression was used to estimate the odds of kidney cancer in exposed participants (defined using three metrics) compared to those without asbestos exposure. RESULTS There were 712 cases and 2454 controls in these analyses. Ever-exposure to asbestos was associated with 20% increased odds of kidney cancer compared to unexposed workers (OR 1.2, 95% confidence interval 1.0-1.4 when including possibly exposed workers). A small increase in risk was observed with cumulative exposure, while increasing intensity of exposure was related to increased odds of kidney cancer. CONCLUSIONS This study found some evidence for an association between occupational exposure to asbestos and kidney cancer. Higher intensity of exposure to asbestos had the strongest relationship with kidney cancer risk.
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Affiliation(s)
- Cheryl E Peters
- Department of Health Sciences, Carleton University, 3rd Floor, Health Sciences Building, Ottawa, ON, K1S 5B6, Canada.
- Institut Armand Frappier-Institut National de la Recherche Scientifique, Laval, QC, Canada.
| | - Marie-Élise Parent
- Institut Armand Frappier-Institut National de la Recherche Scientifique, Laval, QC, Canada
| | - Shelley A Harris
- Cancer Care Ontario, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Linda Kachuri
- Cancer Care Ontario, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Lidija Latifovic
- Cancer Care Ontario, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Laura Bogaert
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Paul J Villeneuve
- Department of Health Sciences, Carleton University, 3rd Floor, Health Sciences Building, Ottawa, ON, K1S 5B6, Canada
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88
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Bello A, Woskie SR, Gore R, Sandler DP, Schmidt S, Kamel F. Retrospective Assessment of Occupational Exposures for the GENEVA Study of ALS among Military Veterans. Ann Work Expo Health 2018; 61:299-310. [PMID: 28355414 DOI: 10.1093/annweh/wxw028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 12/02/2016] [Indexed: 12/11/2022] Open
Abstract
Objective This paper describes the retrospective exposure assessment conducted to assess occupational exposures for the Genes and Environmental Exposures in Veterans (GENEVA) study, a case-control study investigating the joint contribution of genetics and environmental exposures to the risk of amyotrophic lateral sclerosis (ALS) among military veterans. Methods Occupational histories for 1597 study participants collected as part of the GENEVA study were the basis for this retrospective exposure assessment. The data set included 15528 jobs held from 1924 to 2010, representing 4539 unique industry and occupation (I&O) combinations. Three industrial hygiene experts were recruited to independently rate occupational exposures to specific agents previously associated with an increased risk of ALS. Utilizing information on industry, job title, tasks performed, and materials used for each job held, raters assigned exposures associated with each I&O for the 'current time' defined as the period after 1995 (post-1995). The exposure assessment targeted agents identified as potential occupational risk factors for ALS. Experts rated semi-quantitatively exposure intensity in five exposure categories (0-4) for Group A agents (lead, formaldehyde, hydrocarbon solvents, and chlorinated solvents) and qualitatively as yes/no (1/0) exposed for Group B agents (mercury, selenium, arsenic, polychlorinated biphenyls, electromagnetic field, pesticides, and viral agents). Confidence scores (0-3) were reported for every I&O rated based on raters' experience with that industry and/or job. Each I&O was assigned an average exposure score of the raters and an alternative exposure rating was developed for each I&O by excluding low confidence (<2) scores before averaging. Exposure reconstruction for jobs held pre-1995 was done by comparing exposure data extracted from the OSHA Chemical Exposure and Health Database (CEHD) during pre-1995 and post-1995. For agents with limited exposure data in the CEHD, pre-1995 exposures were determined based on raters' judgment. Results The proportion of I&O combinations determined to be 'exposed' ranged from 0.1 to 26% across different agents, with the highest values corresponding to hydrocarbon solvents and the lowest to selenium. Industries with the highest proportion of exposed records include manufacturing, utilities, healthcare, and military with non-combat jobs. Analyses for raters' reliability showed the best agreement between the raters when rating exposure to viral agents (kappa = 0.67), hydrocarbon solvents (kappa = 0.53), and lead (kappa = 0.50). The proportion of 'exposed' I&O combinations increased for hydrocarbon solvents, chlorinated solvents, and pesticides when exposure ratings were adjusted by raters' confidence. Compared to post-1995, exposures in the earlier period (pre-1995) were deemed higher or the same for most of the agents and lower for formaldehyde and electromagnetic field exposures. Conclusions Our results indicate that using raters' confidence assessment in determining exposure scores increases both the proportion of I&O combinations regarded as exposed and the intensity scores, suggesting raters tend to be conservative in their assessment when they lack detailed knowledge of an industry or job.
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Affiliation(s)
- Anila Bello
- Work Environment Department, University of Massachusetts Lowell, One University Avenue, Lowell, MA 01854, USA
| | - Susan R Woskie
- Work Environment Department, University of Massachusetts Lowell, One University Avenue, Lowell, MA 01854, USA
| | - Rebecca Gore
- Work Environment Department, University of Massachusetts Lowell, One University Avenue, Lowell, MA 01854, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive, Research Triangle Park, NC 27709, USA
| | - Silke Schmidt
- Department of Medicine, Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710, USA
| | - Freya Kamel
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive, Research Triangle Park, NC 27709, USA
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89
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Callahan CL, Stewart PA, Friesen MC, Locke S, De Roos AJ, Cerhan JR, Severson RK, Rothman N, Purdue MP. Case-control investigation of occupational exposure to chlorinated solvents and non-Hodgkin's lymphoma. Occup Environ Med 2018; 75:415-420. [PMID: 29588333 PMCID: PMC10364142 DOI: 10.1136/oemed-2017-104890] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 02/08/2018] [Accepted: 03/13/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Although many studies have investigated the association between trichloroethylene (TCE) exposure and non-Hodgkin's lymphoma (NHL), less is known about other chlorinated solvents. We extended our previous analysis of occupational TCE exposure in a multicentre population-based case-control study of NHL to investigate associations with five additional chlorinated solvents: 1,1,1,-trichloroethane, carbon tetrachloride, chloroform, methylene chloride and perchloroethylene. METHODS Cases (n=1189) and controls (n=982) provided detailed information on their occupational histories and workplace exposure to chlorinated solvents for selected occupations using job-specific interview modules. An industrial hygienist used this information and a review of the literature to assess occupational exposure to chlorinated solvents. We computed ORs and 95% CIs for different exposure metrics, with the unexposed group as the referent. We also computed ORs by NHL subtype. RESULTS High cumulative hours exposed to carbon tetrachloride was associated with NHL (>520 hours: OR 1.9; 95% CI 1.0 to 3.6; Ptrend=0.04). This association remained after restricting to jobs with high-intensity exposure (OR 2.0; 95% CI 1.1 to 3.8; P=0.03) and ≥90% exposure probability (OR 2.1; 95% CI 1.0 to 4.3; P=0.03), adjusting for TCE (OR 2.1; 95% CI 1.0- to 4.1; P=0.04) and incorporating a 15-year lag (OR 1.9; 95% CI 1.0 to 3.6; P=0.06). The other evaluated chlorinated solvents were not associated with NHL. CONCLUSIONS This is the first study using high-quality quantitative exposure assessment methods to identify a statistically significant elevated association between occupational exposure to carbon tetrachloride and NHL. Our findings, although limited by a small number of exposed cases, offer evidence that carbon tetrachloride may be a lymphomagen.
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Affiliation(s)
- Catherine L Callahan
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | | | - Melissa C Friesen
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Sarah Locke
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Anneclaire J De Roos
- Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| | - James R Cerhan
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Richard K Severson
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Nathaniel Rothman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Mark P Purdue
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
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90
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Lévêque E, Lacourt A, Luce D, Sylvestre MP, Guénel P, Stücker I, Leffondré K. Time-dependent effect of intensity of smoking and of occupational exposure to asbestos on the risk of lung cancer: results from the ICARE case-control study. Occup Environ Med 2018; 75:586-592. [PMID: 29777039 DOI: 10.1136/oemed-2017-104953] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 03/28/2018] [Accepted: 04/27/2018] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To estimate the impact of intensity of both smoking and occupational exposure to asbestos on the risk of lung cancer throughout the whole exposure history. METHODS Data on 2026 male cases and 2610 male controls came from the French ICARE (Investigation of occupational and environmental causes of respiratory cancers) population-based, case-control study. Lifetime smoking history and occupational history were collected from standardised questionnaires and face-to-face interviews. Occupational exposure to asbestos was assessed using a job exposure matrix. The effects of annual average daily intensity of smoking (reported average number of cigarettes smoked per day) and asbestos exposure (estimated average daily air concentration of asbestos fibres at work) were estimated using a flexible weighted cumulative index of exposure in logistic regression models. RESULTS Intensity of smoking in the 10 years preceding diagnosis had a much stronger association with the risk of lung cancer than more distant intensity. By contrast, intensity of asbestos exposure that occurred more than 40 years before diagnosis had a stronger association with the risk of lung cancer than more recent intensity, even if intensity in the 10 years preceding diagnosis also had a significant effect. CONCLUSION Our results illustrate the dynamic of the effect of intensity of both smoking and occupational exposure to asbestos on the risk of lung cancer. They confirm that the timing of exposure plays an important role, and suggest that standard analytical methods assuming equal weights of intensity over the whole exposure history may be questionable.
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Affiliation(s)
- Emilie Lévêque
- Université de Bordeaux, ISPED, INSERM, Bordeaux Population Health Research Center, Team Biostatistics, UMR 1219, Bordeaux, France.,Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, Team EPICENE, UMR 1219, Bordeaux, France
| | - Aude Lacourt
- Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, Team EPICENE, UMR 1219, Bordeaux, France
| | - Danièle Luce
- Université de Rennes, INSERM, EHESP, IRSET (Institut de recherche en santé, environnement et travail), UMR_S 1085, Pointe-à-Pitre, France
| | - Marie-Pierre Sylvestre
- Department of Social and Preventive Medicine, Montreal School of Public Health (ESPUM), University of Montreal, Montreal, Quebec, Canada.,Research Center, University of Montreal Health Center (CRCHUM), Montreal, Quebec, Canada
| | - Pascal Guénel
- INSERM, CESP, Cancer and Environment Team, Université Paris Saclay, Université de Paris-Sud, UVSQ, Villejuif, France
| | - Isabelle Stücker
- INSERM, CESP, Cancer and Environment Team, Université Paris Saclay, Université de Paris-Sud, UVSQ, Villejuif, France
| | - Karen Leffondré
- Université de Bordeaux, ISPED, INSERM, Bordeaux Population Health Research Center, Team Biostatistics, UMR 1219, Bordeaux, France
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91
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Denison HJ, Eng A, Barnes LA, Cheng S, ’t Mannetje A, Haddock K, Douwes J, Pearce N, Ellison-Loschmann L. Inequities in exposure to occupational risk factors between Māori and non-Māori workers in Aotearoa New Zealand. J Epidemiol Community Health 2018; 72:809-816. [DOI: 10.1136/jech-2018-210438] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 03/29/2018] [Accepted: 04/19/2018] [Indexed: 11/03/2022]
Abstract
BackgroundHealth inequities between indigenous and non-indigenous people are well documented. However, the contribution of differential exposure to risk factors in the occupational environment remains unclear. This study assessed differences in the prevalence of self-reported exposure to disease risk factors, including dust and chemicals, physical factors and organisational factors, between Māori and non-Māori workers in New Zealand.MethodsPotential participants were sampled from the New Zealand electoral rolls and invited to take part in a telephone interview, which included questions about current workplace exposures. Logistic regression, accounting for differences in age, socioeconomic status and occupational distribution between Māori and non-Māori, was used to assess differences in exposures.ResultsIn total, 2344 Māori and 2710 non-Māori participants were included in the analyses. Māori had greater exposure to occupational risk factors than non-Māori. For dust and chemical exposures, the main differences related to Māori working in occupations where these exposures are more common. However, even within the same job, Māori were more likely to be exposed to physical factors such as heavy lifting and loud noise, and organisational factors such as carrying out repetitive tasks and working to tight deadlines compared with non-Māori.ConclusionsThis is one of the first studies internationally to compare occupational risk factors between indigenous and non-indigenous people. These findings suggest that the contribution of the occupational environment to health inequities between Māori and non-Māori has been underestimated and that work tasks may be unequally distributed according to ethnicity.
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92
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Cheng W, Roberts B, Mukherjee B, Neitzel RL. Meta-analysis of job-exposure matrix data from multiple sources. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2018; 28:259-274. [PMID: 28975928 PMCID: PMC9936531 DOI: 10.1038/jes.2017.19] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 03/30/2017] [Indexed: 05/12/2023]
Abstract
The objectives of this study were to determine the heterogeneity of data sources used to construct a job-exposure matrix (JEM) for occupational noise, and to calculate pooled exposure estimates for different job titles using different sources. The JEM was populated with measurements from government databases, private industry, and the published literature. Data were organized by job title using the US standard occupational classification (SOC). Using data from the literature as prior information, adjusted mean exposure was calculated for both the government and industry data following a simple Bayesian approach. A meta-analysis was conducted to measure data heterogeneity across sources and to calculate a pooled exposure estimate for each SOC and SOC group. In total, 715,867 measurements across 259 SOCs were analyzed. Using the data from literature as a prior, 15 of 28 applicable SOCs in the government and industry data had adjusted mean exposures above the OSHA action level (85 dBA). The meta-analysis showed that 63% of SOCs, and 78% of SOC groups, had moderate to high heterogeneity. Fifty-one percent of SOCs and 43% of SOC groups had pooled estimated exposures >85 dBA. The pooled estimates suggested that workers in 131 of 259 SOCs (51%) were exposed beyond the threshold of 85 dBA.
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Affiliation(s)
- Wenting Cheng
- Department of Biostatistics, University of Michigan, School of Public Health, Ann Arbor, Michigan, USA
| | - Benjamin Roberts
- Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, Michigan, USA
| | - Bhramar Mukherjee
- Department of Biostatistics, University of Michigan, School of Public Health, Ann Arbor, Michigan, USA
| | - Richard L Neitzel
- Department of Environmental Health Sciences, University of Michigan, School of Public Health, Ann Arbor, Michigan, USA
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93
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Betansedi CO, Vaca Vasquez P, Counil E. A comprehensive approach of the gender bias in occupational cancer epidemiology: A systematic review of lung cancer studies (2003-2014). Am J Ind Med 2018; 61:372-382. [PMID: 29508431 DOI: 10.1002/ajim.22823] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND In occupational epidemiology, a male-centered perspective often predominates. We aimed to describe current research practices in terms of gender consideration at different stages of epidemiological studies. METHODS A systematic review of occupational lung cancer publications indexed in PubMed was conducted over the period 2003-2014. Articles were described according to the sex composition of their study sample. RESULTS In 243 studies, 7 (3%) were women-only, 101 (41%) were mixed, with a disproportionate men-to-women ratio (P50 = 3.5; P75 = 12.4). A shift was observed from mixed and unspecified source populations to men-only final samples. Our results also suggest implicit generalization of results from men-only studies, a lack of tests of interaction and often unjustified sex-adjustment for mixed studies. CONCLUSIONS The lower proportion of women in studies cannot be fully explained by their under-representation in the target populations, since there were large numbers of women among both potentially exposed workers and patients diagnosed with lung cancer.
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Affiliation(s)
- Charles-Olivier Betansedi
- Paris-Saclay University; Paris-Sud University; UVSQ; Villejuif France
- Giscop93; Paris 13 University; Bobigny France
| | | | - Emilie Counil
- Giscop93; Paris 13 University; Bobigny France
- EHESP School of Public Health; Rennes; France
- IRIS UMR8156-U997; Paris 13 University; Bobigny France
- INSERM, U1085, IRSET, ESTER Team; University of Angers; Angers France
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94
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Le Moual N, Zock JP, Dumas O, Lytras T, Andersson E, Lillienberg L, Schlünssen V, Benke G, Kromhout H. Update of an occupational asthma-specific job exposure matrix to assess exposure to 30 specific agents. Occup Environ Med 2018; 75:507-514. [PMID: 29650699 DOI: 10.1136/oemed-2017-104866] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 02/09/2018] [Accepted: 03/15/2018] [Indexed: 01/26/2023]
Abstract
OBJECTIVES We aimed to update an asthmagen job exposure matrix (JEM) developed in the late 1990s. Main reasons were: the number of suspected and recognised asthmagens has since tripled; understanding of the aetiological role of irritants in asthma and methodological insights in application of JEMs have emerged in the period. METHODS For each agent of the new occupational asthma-specific JEM (OAsJEM), a working group of three experts out of eight evaluated exposure for each International Standard Classification of Occupations, 1988 (ISCO-88) job code into three categories: 'high' (high probability of exposure and moderate-to-high intensity), 'medium' (low-to-moderate probability or low intensity) and 'unexposed'. Within a working group, experts evaluated exposures independently from each other. If expert assessments were inconsistent the final decision was taken by consensus. Specificity was favoured over sensitivity, that is, jobs were classified with high exposure only if the probability of exposure was high and the intensity moderate-to-high. In the final review, all experts checked assigned exposures and proposed/improved recommendations for expert re-evaluation after default application of the JEM. RESULTS The OAsJEM covers exposures to 30 sensitisers/irritants, including 12 newly recognised, classified into seven broad groups. Initial agreement between the three experts was mostly fair to moderate (κ values 0.2-0.5). Out of 506 ISCO-88 codes, the majority was classified as unexposed (from 82.6% (organic solvents) to 99.8% (persulfates)) and a minority as 'high-exposed' (0.2% (persulfates) to 2.6% (organic solvents)). CONCLUSIONS The OAsJEM developed to improve occupational exposure assessment may improve evaluations of associations with asthma in epidemiological studies and contribute to assessment of the burden of work-related asthma.
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Affiliation(s)
- Nicole Le Moual
- Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180, Montigny le Bretonneux, France
- Inserm, U1168, VIMA: Aging and chronic diseases. Epidemiological and public health approaches, Inserm, F-94807, Villejuif, France
| | - Jan-Paul Zock
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain
- University Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Orianne Dumas
- Univ Versailles St-Quentin-en-Yvelines, UMR-S 1168, F-78180, Montigny le Bretonneux, France
- Inserm, U1168, VIMA: Aging and chronic diseases. Epidemiological and public health approaches, Inserm, F-94807, Villejuif, France
| | - Theodore Lytras
- Barcelona Institute of Global Health (ISGlobal), Barcelona, Spain
- University Pompeu Fabra (UPF), Barcelona, Spain
| | - Eva Andersson
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Linnéa Lillienberg
- Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Vivi Schlünssen
- Department of Public Health, Danish Ramazzini Centre, Aarhus University and National Research Center for the Working Environment, Copenhagen, Denmark
| | - Geza Benke
- Monash Centre for Occupation and Environmental Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Hans Kromhout
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
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95
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Furu H, Sainio M, Hyvärinen HK, Kaukiainen A. Work ability score of solvent-exposed workers. Int Arch Occup Environ Health 2018; 91:559-569. [PMID: 29594340 DOI: 10.1007/s00420-018-1306-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 03/25/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE Occupational chronic solvent encephalopathy (CSE), characterized by neurocognitive dysfunction, often leads to early retirement. However, only the more severe cases are diagnosed with CSE, and little is known about the work ability of solvent-exposed workers in general. The aim was to study memory and concentration symptoms, work ability and the effect of both solvent-related and non-occupational factors on work ability, in an actively working solvent-exposed population. METHODS A questionnaire on exposure and health was sent to 3640 workers in four solvent-exposed fields, i.e. painters and floor-layers, boat builders, printers, and metal workers. The total number of responses was 1730. We determined the work ability score (WAS), a single question item of the Work Ability Index, and studied solvent exposure, demographic factors, Euroquest memory and concentration symptoms, chronic diseases, and employment status using univariate and multivariate analyses. The findings were compared to those of a corresponding national blue-collar reference population (n = 221), and a small cohort of workers with CSE (n = 18). RESULTS The proportion of workers with memory and concentration symptoms was significantly associated with solvent exposure. The WAS of solvent-exposed workers was lower than that of the national blue-collar reference group, and the difference was significant in the oldest age group (those aged over 60). Solvent-exposed worker's WAS were higher than those of workers diagnosed with CSE. The WAS were lowest among painters and floor-layers, followed by metal workers and printers, and highest among boat builders. The strongest explanatory factors for poor work ability were the number of chronic diseases, age and employment status. Solvent exposure was a weak independent risk factor for reduced WAS, comparable to a level of high alcohol consumption. CONCLUSIONS Even if memory and concentration symptoms were associated with higher solvent exposure, the effect of solvents on self-experienced work ability was relatively weak. This in line with the improved occupational hygiene and reduced solvent exposure levels in industrialized countries, thus the effect may be stronger in high-level exposure environments. As a single question, WAS is easily included, applicable, and recommendable in occupational screening questionnaires.
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Affiliation(s)
- Heidi Furu
- Finnish Institute of Occupational Health, Helsinki, Finland. .,Doctagon, Kaivokatu 6, 00100, Helsinki, Finland.
| | - Markku Sainio
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Ari Kaukiainen
- Finnish Institute of Occupational Health, Helsinki, Finland
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96
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Scarselli A, Corfiati M, Di Marzio D, Marinaccio A, Iavicoli S. Gender differences in occupational exposure to carcinogens among Italian workers. BMC Public Health 2018; 18:413. [PMID: 29587708 PMCID: PMC5870210 DOI: 10.1186/s12889-018-5332-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 03/18/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Many carcinogenic chemicals are still used or produced in several economic sectors. The aim of this study is to investigate differences in occupational exposure patterns to carcinogens by gender in Italy. METHODS Information about the most common carcinogens recorded in the Italian occupational exposures database (SIREP) for the period 1996-2015 was retrieved. Descriptive statistics were calculated for exposure-related variables (carcinogenic agent, occupational group, economic activity sector, and workforce size). The chi-square(χ2) test was used to verify differences between genders, and logistic regression analysis was performed to evaluate the association between gender and risk of having higher exposure levels, after adjusting for age. Concurrent exposures to multiple carcinogens were investigated using the two-step cluster analysis. RESULTS A total of 166,617 exposure measurements were selected for 40 different carcinogens. Exposed workers were only in a small proportion women (9%), and mostly aged 20-44 years (70%) in both genders. Women were more likely to be exposed than men to higher levels for several carcinogens even after correction for age at exposure, and the exposure level was significantly (p < 0.01) associated with occupation, economic sector and workforce size. The five main clusters of co-exposures identified in the entire dataset showed a differential distribution across economic sectors between genders. CONCLUSIONS The exposures to occupational carcinogens have distinguishing characteristics in women, that are explained in part by work and job segregation. Because of the presence of high-exposed groups of female workers in many industrial sectors, further research and prevention efforts are recommended.
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Affiliation(s)
- Alberto Scarselli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Rome, Italy.
| | - Marisa Corfiati
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Davide Di Marzio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Sergio Iavicoli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Rome, Italy
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97
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Paul KC, Jerrett M, Ritz B. Type 2 Diabetes Mellitus and Alzheimer's Disease: Overlapping Biologic Mechanisms and Environmental Risk Factors. Curr Environ Health Rep 2018; 5:44-58. [PMID: 29464502 PMCID: PMC5931378 DOI: 10.1007/s40572-018-0176-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW A number of studies over the past two decades have suggested that type 2 diabetes mellitus (T2DM) patients are at an increased risk of Alzheimer's disease (AD). Several common molecular pathways to cellular and metabolic dysfunction have been implicated in the etiology of both diseases. Here, we review the emerging evidence from observational studies that investigate the relationship between T2DM and AD, and of shared environmental risk factors, specifically air pollution and pesticides, associated with both chronic disorders. RECENT FINDINGS Particulate matter and traffic-related air pollution have been widely associated with T2DM, and multiple studies have associated exposures with AD or cognitive function. Organochlorine (OC) and organophosphate (OP) pesticides have been associated with T2DM in multiple independent populations. Two populations have observed increased risks for OC and OP exposures and AD. Other studies, limited in exposure assessment, have reported increased risk of AD with any pesticide exposure assessments. This may suggest shared pathogenic pathways between environmental risk factors, T2DM, and AD. Research focusing on exposures related to both T2DM and AD could provide new disease insights on shared mechanisms and help shape innovative preventative measures and policy decisions.
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Affiliation(s)
- Kimberly C Paul
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Michael Jerrett
- Department of Environmental Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Beate Ritz
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
- Department of Environmental Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
- Department of Neurology, David Geffen School of Medicine, Los Angeles, CA, USA.
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98
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Rodgers KM, Udesky JO, Rudel RA, Brody JG. Environmental chemicals and breast cancer: An updated review of epidemiological literature informed by biological mechanisms. ENVIRONMENTAL RESEARCH 2018; 160:152-182. [PMID: 28987728 DOI: 10.1016/j.envres.2017.08.045] [Citation(s) in RCA: 234] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/28/2017] [Accepted: 08/29/2017] [Indexed: 05/20/2023]
Abstract
BACKGROUND Many common environmental chemicals are mammary gland carcinogens in animal studies, activate relevant hormonal pathways, or enhance mammary gland susceptibility to carcinogenesis. Breast cancer's long latency and multifactorial etiology make evaluation of these chemicals in humans challenging. OBJECTIVE For chemicals previously identified as mammary gland toxicants, we evaluated epidemiologic studies published since our 2007 review. We assessed whether study designs captured relevant exposures and disease features suggested by toxicological and biological evidence of genotoxicity, endocrine disruption, tumor promotion, or disruption of mammary gland development. METHODS We systematically searched the PubMed database for articles with breast cancer outcomes published in 2006-2016 using terms for 134 environmental chemicals, sources, or biomarkers of exposure. We critically reviewed the articles. RESULTS We identified 158 articles. Consistent with experimental evidence, a few key studies suggested higher risk for exposures during breast development to dichlorodiphenyltrichloroethane (DDT), dioxins, perfluorooctane-sulfonamide (PFOSA), and air pollution (risk estimates ranged from 2.14 to 5.0), and for occupational exposure to solvents and other mammary carcinogens, such as gasoline components (risk estimates ranged from 1.42 to 3.31). Notably, one 50-year cohort study captured exposure to DDT during several critical windows for breast development (in utero, adolescence, pregnancy) and when this chemical was still in use. Most other studies did not assess exposure during a biologically relevant window or specify the timing of exposure. Few studies considered genetic variation, but the Long Island Breast Cancer Study Project reported higher breast cancer risk for polycyclic aromatic hydrocarbons (PAHs) in women with certain genetic variations, especially in DNA repair genes. CONCLUSIONS New studies that targeted toxicologically relevant chemicals and captured biological hypotheses about genetic variants or windows of breast susceptibility added to evidence of links between environmental chemicals and breast cancer. However, many biologically relevant chemicals, including current-use consumer product chemicals, have not been adequately studied in humans. Studies are challenged to reconstruct exposures that occurred decades before diagnosis or access biological samples stored that long. Other problems include measuring rapidly metabolized chemicals and evaluating exposure to mixtures.
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Affiliation(s)
- Kathryn M Rodgers
- Silent Spring Institute, 320 Nevada Street, Newton, MA 02460, United States.
| | - Julia O Udesky
- Silent Spring Institute, 320 Nevada Street, Newton, MA 02460, United States.
| | - Ruthann A Rudel
- Silent Spring Institute, 320 Nevada Street, Newton, MA 02460, United States.
| | - Julia Green Brody
- Silent Spring Institute, 320 Nevada Street, Newton, MA 02460, United States.
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99
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Xu M, Siemiatycki J, Lavoué J, Pasquet R, Pintos J, Rousseau MC, Richardson L, Ho V. Occupational exposures to leaded and unleaded gasoline engine emissions and lung cancer risk. Occup Environ Med 2017; 75:303-309. [PMID: 29269562 DOI: 10.1136/oemed-2017-104801] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 11/27/2017] [Accepted: 12/07/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To determine whether occupational exposure to gasoline engine emissions (GEE) increased the risk of lung cancer and more specifically whether leaded or unleaded GEE increased the risk. METHODS Two population-based case-control studies were conducted in Montreal, Canada. The first was conducted in the early 1980s and included many types of cancer including lung cancer. The second was conducted in the late 1990s and focused on lung cancer. Population controls were used in both studies. Altogether, there were 1595 cases and 1432 population controls. A comprehensive expert-based exposure assessment procedure was implemented and exposure was assessed for 294 agents, including unleaded GEE, leaded GEE and diesel engine emissions (DEE). Logistic regression analyses were conducted to estimate ORs between various metrics of GEE exposure and lung cancer, adjusting for smoking, DEE and other potential confounders. RESULTS About half of all controls were occupationally exposed to GEE. Irrespective of the metrics of exposure (any exposure, duration of exposure and cumulative exposure) and the type of lung cancer, and the covariates included in models, none of the point estimates of the ORs between occupational exposure to leaded or unleaded GEE and lung cancer were above 1.0. Pooling two studies, the OR for any exposure to leaded GEE was 0.82 (0.68-1.00). CONCLUSIONS Our results do not support the hypothesis that occupational exposure to GEE increases the risk of lung cancer.
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Affiliation(s)
- Mengting Xu
- Carrefour de l'innovation, Centre de recherche du CHUM (CRCHUM), Montréal, Québec, Canada.,Department of Social and Preventive Medicine, University of Montreal, Montréal, Québec, Canada
| | - Jack Siemiatycki
- Carrefour de l'innovation, Centre de recherche du CHUM (CRCHUM), Montréal, Québec, Canada.,Department of Social and Preventive Medicine, University of Montreal, Montréal, Québec, Canada
| | - Jérôme Lavoué
- Carrefour de l'innovation, Centre de recherche du CHUM (CRCHUM), Montréal, Québec, Canada.,Department of Environmental and Occupational Health, University of Montréal, Montréal, Québec, Canada
| | - Romain Pasquet
- Carrefour de l'innovation, Centre de recherche du CHUM (CRCHUM), Montréal, Québec, Canada.,Department of Social and Preventive Medicine, University of Montreal, Montréal, Québec, Canada
| | - Javier Pintos
- Carrefour de l'innovation, Centre de recherche du CHUM (CRCHUM), Montréal, Québec, Canada
| | - Marie-Claude Rousseau
- Carrefour de l'innovation, Centre de recherche du CHUM (CRCHUM), Montréal, Québec, Canada.,Epidemiology and Biostatistics Unit, Institut national de la recherche scientifique (INRS)-Institut Armand-Frappier, Laval, Québec, Canada
| | - Lesley Richardson
- Carrefour de l'innovation, Centre de recherche du CHUM (CRCHUM), Montréal, Québec, Canada
| | - Vikki Ho
- Carrefour de l'innovation, Centre de recherche du CHUM (CRCHUM), Montréal, Québec, Canada.,Department of Social and Preventive Medicine, University of Montreal, Montréal, Québec, Canada
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Doney BC, Henneberger PK, Humann MJ, Liang X, Kelly KM, Cox-Ganser JM. Occupational Exposure to Vapor-Gas, Dust, and Fumes in a Cohort of Rural Adults in Iowa Compared with a Cohort of Urban Adults. MMWR. SURVEILLANCE SUMMARIES : MORBIDITY AND MORTALITY WEEKLY REPORT. SURVEILLANCE SUMMARIES 2017; 66:1-5. [PMID: 29095802 PMCID: PMC5829718 DOI: 10.15585/mmwr.ss6621a1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Problem/Condition Many rural residents work in the field of agriculture; however, employment in nonagricultural jobs also is common. Because previous studies in rural communities often have focused on agricultural workers, much less is known about the occupational exposures in other types of jobs in rural settings. Characterizing airborne occupational exposures that can contribute to respiratory diseases is important so that differences between rural and urban working populations can be assessed. Reporting Period 1994–2011. Description of System This investigation used data from the baseline questionnaire completed by adult rural residents participating in the Keokuk County Rural Health Study (KCRHS). The distribution of jobs and occupational exposures to vapor-gas, dust, and fumes (VGDF) among all participants was analyzed and stratified by farming status (current, former, and never) then compared with a cohort of urban workers from the Multi-Ethnic Study of Atherosclerosis (MESA). Occupational exposure in the last job was assessed with a job-exposure matrix (JEM) developed for chronic obstructive pulmonary disease (COPD). The COPD JEM assesses VGDF exposure at levels of none or low, medium, and high. Results The 1,699 KCRHS (rural) participants were more likely to have medium or high occupational VGDF exposure (43.2%) at their last job than their urban MESA counterparts (15.0% of 3,667 participants). One fifth (20.8%) of the rural participants currently farmed, 43.1% were former farmers, and approximately one third (36.1%) had never farmed. These three farming groups differed in VGDF exposure at the last job, with the prevalence of medium or high exposure at 80.2% for current farmers, 38.7% for former farmers, and 27.4% for never farmers, and all three percentages were higher than the 15.0% medium or high level of VGDF exposure for urban workers. Interpretation Rural workers, including those who had never farmed, were more likely to experience occupational VGDF exposure than urban workers. Public Health Action The occupational exposures of rural adults assessed using the COPD JEM will be used to investigate their potential association with obstructive respiratory health problems (e.g., airflow limitation and chronic bronchitis). This assessment might highlight occupations in need of preventive interventions.
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Affiliation(s)
- Brent C Doney
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Paul K Henneberger
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Michael J Humann
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Xiaoming Liang
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
| | - Kevin M Kelly
- The University of Iowa, Department of Occupational and Environmental Health, Iowa City, Iowa
| | - Jean M Cox-Ganser
- Respiratory Health Division, National Institute for Occupational Safety and Health, CDC, Morgantown, West Virginia
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