1
|
Koh DH, Choi S, Park JH, Lee SG, Kim HC, Kim I, Lim D, Seo H, Park DU. Development of occupation-based exposure matrix of lead for Korean workers: challenges and opportunities. Ann Work Expo Health 2024; 68:256-268. [PMID: 38377017 DOI: 10.1093/annweh/wxae006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 01/19/2024] [Indexed: 02/22/2024] Open
Abstract
OBJECTIVES Industry- and occupation-based carcinogen exposure matrices play a pivotal role in preventing occupational cancer. While the Korean CARcinogen EXposure (K-CAREX) has been developed in recent years to assess exposure prevalence and intensity by industry, the feasibility of constructing an occupation-based exposure matrix remains unexplored. Hence, the objective of this study is to explore the potential of combining the nationwide work environment measurement database (WEMD) and the special health examination database (SHED) to develop a comprehensive occupation-based exposure matrix. METHODS The WEMD provides information on airborne lead measurements, including industry codes, but it does not include data related to occupations. In contrast, the SHED contains information on both occupation and blood lead levels. By integrating these 2 databases, we attempted to assess airborne lead exposure levels by occupation. Additionally, we performed a rank correlation analysis to compare the airborne exposure levels with corresponding blood lead levels according to occupation. RESULTS A total of 35 425 workers who both wore air samplers for lead and underwent special health examinations for lead were extracted between 2019 and 2021. An occupation-based exposure matrix was developed to evaluate the intensity of lead exposure across a range of occupations, encompassing 51 minor occupations and 70-unit occupations. Rank correlation analyses showed strong positive correlations between airborne lead and blood lead measurements according to occupation. CONCLUSIONS Our study findings suggest that combining 2 nationwide surveillance databases can be an effective approach for creating an occupation-based exposure matrix. However, our results also highlight several limitations that need to be addressed in future studies to improve the accuracy and reliability of such matrices.
Collapse
Affiliation(s)
- Dong-Hee Koh
- Department of Occupational and Environmental Medicine, International St. Mary's Hospital, Catholic Kwandong University, 25, Simgok-ro 100beon-gil, Seo-gu, Incheon 22711, Korea
| | - Sangjun Choi
- Graduate School of Public Health and Healthcare Management, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul 06591, Korea
- Catholic Institute for Public Health and Healthcare Management, 222, Banpo-daero, Seocho-gu, Seoul 06591, Korea
| | - Ju-Hyun Park
- Department of Statistics, Dongguk University, 30 Phildong-ro 1-gil, Jung-gu, Seoul 04620, Korea
| | - Sang-Gil Lee
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, 400, Jongga-ro, Jung-gu, Ulsan 44429, Korea
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University College of Medicine, 27, Inhang-Ro, Jung-gu, Incheon 22332, Korea
| | - Inah Kim
- Department of Occupational and Environmental Medicine, College of Medicine, Hanyang University, 222, Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea
| | - Daesung Lim
- Hansung Health and Safety Technology Co., Ltd., 803, Yuseong-daero, Yuseong-gu, Daejeon 34165, Korea
| | - Hoekyeong Seo
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, 400, Jongga-ro, Jung-gu, Ulsan 44429, Korea
| | - Dong-Uk Park
- Department of Environmental Health, Korea National Open University, 86, Daehak-ro, Jongno-gu, Seoul, 03087, Korea
| |
Collapse
|
2
|
Koh DH, Park JH, Lee SG, Kim HC, Choi S, Jung H, Park JO, Park DU. Estimation of Lead Exposure Prevalence in Korean Population through Combining Multiple Experts' Judgment based on Objective Data Sources. Ann Work Expo Health 2019; 62:210-220. [PMID: 29342235 DOI: 10.1093/annweh/wxx106] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 12/03/2017] [Indexed: 11/13/2022] Open
Abstract
Objective Estimating carcinogen exposure prevalence is important for preventing occupational cancers. To develop the Korean version of CARcinogen EXposure (CAREX), a carcinogen surveillance system used in many countries, we estimated lead exposure prevalence in the Korean working population. Methods We used three Korean nationwide data sources to obtain objective database-derived prevalences of lead exposure across industries: airborne lead measurement data from the work environment measurement database (WEMD), blood lead measurement data from the special health examination database (SHED), and lead exposure prevalence computed using data from the work environment condition survey (WECS), which is a nationwide occupational exposure survey. We also asked a panel of 52 experts with ≥20 years of experience in industrial hygiene practice for their judgment about lead exposure prevalence across industries after they reviewed the database-derived prevalences computed from the three exposure databases. We developed and compared various estimation methods for combining the experts' judgments. The 2010 census was used as the reference population to estimate the number of lead-exposed workers in 228 industries by multiplying the exposure prevalence by the number of workers in each industry. Results The database-derived prevalences of lead exposure in the 228 industries were calculated using data collected between 2009 and 2011 from the WEMD and SHED and from the 2009 WECS. From the various estimation methods assessed, the median values of experts' responses were selected as our estimates of lead exposure prevalence in each industry. As a result, it was estimated that 129,250 Korean workers were exposed to lead in 2010. Conclusions Based on objective databases, we developed a method for estimating exposure prevalence for the CAREX system by combining experts' judgments. This work may offer an unbiased approach to the development process that accounts for the uncertainty in exposure.
Collapse
Affiliation(s)
- Dong-Hee Koh
- Department of Occupational and Environmental Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea
| | - Ju-Hyun Park
- Department of Statistics, Dongguk University, Seoul, Korea
| | - Sang-Gil Lee
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Ulsan, Korea
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University, Incheon, Korea
| | - Sangjun Choi
- Department of Occupational Health, Catholic University of Daegu, Daegu, Korea
| | - Hyejung Jung
- Department of Occupational and Environmental Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea
| | - Jae-Oh Park
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Ulsan, Korea
| | - Dong-Uk Park
- Department of Environmental Health, Korea National Open University, Seoul, Korea
| |
Collapse
|
3
|
Koh DH, Park JH, Lee SG, Kim HC, Choi S, Jung H, Park DU. Combining Lead Exposure Measurements and Experts' Judgment Through a Bayesian Framework. Ann Work Expo Health 2018; 61:1054-1075. [PMID: 29136412 DOI: 10.1093/annweh/wxx072] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 07/25/2017] [Indexed: 11/12/2022] Open
Abstract
Objectives CARcinogen EXposure (CAREX) is a carcinogen-surveillance system employed in many countries. To develop Korean CAREX, the intensity of exposure to lead, as an example, was estimated across industries. Methods Airborne-lead measurement records were extracted from the work-environment measurement database (WEMD), which is a nationwide workplace-monitoring database. Lead measurements were log-transformed; then, the log-transformed geometric means (LGMs) and log-transformed geometric standard deviations (LGSDs) were calculated for each industry. However, the data of many industries was limited. To address this shortcoming, experts' judgments of the lead exposure levels across industries were elicited. Experts provided their estimates of lead exposure levels as the boundary of the 5th and 95th percentiles, and it is assumed that these estimates are based on the log-normal distributions of exposure levels. Estimates of LGM and LGSD were extracted from each expert's response and then combined to quantify the experts' prior distribution. Then, the experts' prior distributions for each industry were updated with the corresponding LGMs and LGSDs calculated from the WEMD data through a Bayesian framework, yielding posterior distributions of the LGM and LGSD. Results The WEMD contains 83035 airborne-lead measurements that were collected between 2002 and 2007. A total of 17 occupational-hygiene professionals with >20 years of experience provided lead exposure estimates. In industries where measurement data were abundant, the measurement data dominated the posterior exposure estimates. For example, for one industry, 'Manufacture of Accumulator, Primary Cells, and Primary Batteries,' 1152 lead measurements [with a geometric mean (GM) of 14.42 µg m-3 and a geometric standard deviation (GSD) of 3.31] were available and 15 experts' responses (with a GM of 7.06 µg m-3 and a GSD of 4.15) were collected, resulting in a posterior exposure estimate of 14.41µg m-3 as the GM with a GSD of 3.31. For industries with a limited number of measurements available in the WEMD, experts' decisions played a significant role in determining the posterior exposure estimates. For example, for the 'Manufacture of Weapons and Ammunition' industry, 15 lead measurements (with a GM of 6.45 µg m-3 and a GSD of 3.37) were available and seven experts' responses (with a GM of 3.28 µg m-3 and a GSD of 4.54) were obtained, resulting in a posterior exposure estimate of 5.42 µg m-3 as the GM with a GSD of 3.73. Conclusions The proposed method for estimating the intensity of exposure to carcinogens may introduce an unbiased approach to the development process by simultaneously utilizing both prior knowledge of experts and measurement data. In addition, it supplies a framework for future updates.
Collapse
Affiliation(s)
- Dong-Hee Koh
- Department of Occupational and Environmental Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea
| | - Ju-Hyun Park
- Department of Statistics, Dongguk University, Seoul, Korea
| | - Sang-Gil Lee
- Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Ulsan, Korea
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University, Incheon, Korea
| | - Sangjun Choi
- Department of Occupational Health, Catholic University of Daegu, Daegu, Korea
| | - Hyejung Jung
- Department of Occupational and Environmental Medicine, International St. Mary's Hospital, Catholic Kwandong University, Incheon, Korea
| | - Dong-Uk Park
- Department of Environmental Health, Korea National Open University, Seoul, Korea
| |
Collapse
|
4
|
Hall AL, Demers PA, Astrakianakis G, Ge C, Peters CE. Estimating National-Level Exposure to Antineoplastic Agents in the Workplace: CAREX Canada Findings and Future Research Needs. Ann Work Expo Health 2017; 61:656-658. [PMID: 28595280 PMCID: PMC6824530 DOI: 10.1093/annweh/wxx042] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 04/29/2017] [Accepted: 05/11/2017] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES Occupational exposure to antineoplastic agents occurs in various environments and is associated with increased cancer risk and adverse reproductive outcomes. National-level information describing the location and extent of occupational exposure to antineoplastic agents is unavailable in Canada and most other countries. CAREX Canada aimed to estimate the prevalence and relative levels of occupational exposures to antineoplastic agents across work setting, occupation, and sex. METHODS 'Exposure' was defined as any potential for worker contact with antineoplastic agents. Baseline numbers of licensed workers were obtained from their respective professional bodies. For unlicensed workers, Census data or data extrapolated from human resources reports (e.g., staffing ratios) were used. Prevalence was estimated by combining population estimates with exposure proportions from peer-reviewed and grey literature. Exposure levels (classified as low, moderate, and high) by occupation and work setting were estimated qualitatively by combining estimates of contact frequency and exposure control practices. RESULTS Approximately 75000 Canadians (0.42% of the total workforce) are estimated as occupationally exposed to antineoplastic agents; over 75% are female. The largest occupational group exposed to antineoplastic agents is community pharmacy workers, with 30200 exposed. By work setting, 39000 workers (52% of all exposed) are located in non-hospital settings; the remaining 48% are exposed in hospitals. The majority (75%) of workers are in the moderate exposure category. CONCLUSIONS These estimates of the prevalence and location of occupational exposures to antineoplastic agents could be used to identify high-risk groups, estimate disease burden, and target new research and prevention activities. The limited secondary data available for developing these estimates highlights the need for increased quantitative measurement and documentation of antineoplastic agent contamination and exposure, particularly in work environments where use is emerging.
Collapse
Affiliation(s)
- Amy L. Hall
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia V6T 1Z3, Canada
| | - Paul A. Demers
- Occupational Cancer Research Centre, Cancer Care Ontario, B525 University Avenue, 3rd Floor, Toronto, Ontario M5G 2L3, Canada
| | - George Astrakianakis
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia V6T 1Z3, Canada
| | - Calvin Ge
- Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, 3584 CM, Utrecht, The Netherlands
| | - Cheryl E. Peters
- Department of Health Sciences, Carleton University, 1125 Colonel By Dr., 5411 Herzberg Building, Ottawa, Ontario K1S 5B6, Canada
- CAREX Canada, Simon Fraser University, 105 - 515 W. Hastings St., Downtown Campus, Vancouver, British Columbia V6B 5K3, Canada
| |
Collapse
|