OCCUPATIONAL CASE-CONTROL STUDIES .2. RECOMMENDATIONS FOR EXPOSURE ASSESSMENT
OCCUPATIONAL CASE-CONTROL STUDIES .2. RECOMMENDATIONS FOR EXPOSURE ASSESSMENT
复制标题
DOI：
10.1002/ajim.4700260305
复制
发表时间：
1994-09-01
影响因子：
3.5
通讯作者：
STEWART, WF
中科院分区：
文献类型：
--
作者：
STEWART, PA;STEWART, WF
在基于社区的病例对照研究中，获得有效且可靠的定量暴露估计是一个重大挑战，部分原因是工业卫生监测数据通常无法获得，并且通常无法系统地获取或评估有关工作和工作环境的详细信息。为了提高从职业病例对照研究中获得的疾病风险信息的质量和可信度，我们建议使用标准化暴露评估方法来得出定量暴露估计。我们确定评估过程中固有的变异来源，包括： 报告的有关工作、行业、活动和材料的信息的质量；工业卫生员对所报告的工作/行业的熟悉程度；工作/行业暴露的可能性，这取决于工厂对特定物质的偏好、工艺技术和客户规格；以及工作场所特征的可变性。为了提高研究内部和研究之间与工作相关的暴露估计的可靠性，我们建议在有或没有被评定为质量较差的数据的情况下进行流行病学分析；当研究工业卫生员不熟悉相关制造过程时，应与专家联系；使用现有数据库来估计接触概率；开发一个描述制造过程的数据库；并使用基于工业卫生原则的明确标准来评估工作场所特征。此外，还描述了一种通过使用经常监控的工作及其相关平均暴露水平的参考范围来得出定量暴露估计的程序。确定了研究领域以改进基于社区的病例对照研究中的暴露评估。 (C) 1994 年 Wiley-Liss 公司
Obtaining valid and reliable quantitative exposure estimates is a significant challenge in community-based case-control studies in part, because industrial hygiene monitoring data are usually not available and detailed information on the job and work environment is usually not systematically obtained or assessed. To improve the quality and credibility of disease risk information obtained from occupational case-control studies, we recommend that standardized exposure assessment methods be used to derive quantitative exposure estimates. We identify sources of variation inherent to the assessment process, including: the quality of the information reported on the job, industry, activities, and materials; the industrial hygienist's familiarity with the reported job/industry; the probability that the job/industry was exposed, which depends on plant preferences for particular substances, on process technology, and on customer specifications; and variability in workplace characteristics. To improve the reliability of estimating job-related exposures both within and between studies, we recommend that the epidemiologic analyses be conducted with and without data rated to be of poor quality; that contact be made with experts when the study industrial hygienist is unfamiliar with the manufacturing process in question; that existing data bases be used to estimate the probability of exposure; that a data base be developed that describes manufacturing processes; and that explicit criteria based on industrial hygiene principles be used to evaluate workplace characteristics. In addition, a procedure is described for deriving quantitative exposure estimates by using a reference scale of frequently monitored jobs with their associated mean exposure levels. Areas of research are identified to improve exposure assessment in community-based case-control studies. (C) 1994 Wiley-Liss, Inc.