Comparison of asbestos exposure assessments by next-of-kin respondents, by an occupational hygienist, and by a job-exposure matrix from the national occupational hazard survey
Comparison of asbestos exposure assessments by next-of-kin respondents, by an occupational hygienist, and by a job-exposure matrix from the national occupational hazard survey
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DOI：
10.1002/ajim.20168
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发表时间：
2005-05-01
影响因子：
3.5
通讯作者：
Gail, MH
中科院分区：
文献类型：
--
作者：
Nam, JM;Rice, C;Gail, MH
背景评估职业暴露的病例对照研究中的快速致命疾病往往依赖于数据从近亲受访者，这可能是不准确的。方法三个评估暴露于石棉间皮瘤病例对照数据，包括近亲评估，专家评估，并使用一个通用的工作暴露矩阵（JEM）。由一名职业卫生学家（C.R.）审查访谈数据[Spirtas等人（1994年）：Occup Environ Med 51：804-811]，以确定接触状况。不知道自己的病情暴露比值比计算使用标准的方法，和协议的措施，包括卡帕统计和条件和边际odds ratios.Results专家评估检测到较高比例的暴露对象比近亲的受访者或JEM方法。疾病暴露的比值比最高的受访者，也许是因为回忆偏见，和最低的JEM方法。受访者和专家评估之间的一致性最高。将被调查者的评价与JEM的评价相结合，可以得到对专家评价的最佳预测。配偶受访者的结果是类似的其他“近亲”的responders.Conclusions专家评估是最合理的，但数据表明，疾病协会也可以检测到与其他暴露评估方法。使用代理受访者的评估和正义与平等运动的评估的某种组合，可以预测专家的评估。与专家对所有问题的评估相比，如果战略依赖于被调查者的评估，如果评估是肯定的，则可以获得专家的评估，这样可以减少成本，而且误差很小。2005年出版Wiley-Liss，Inc.
Background Assessments of occupational exposures in case-control studies of rapidly fatal illnesses often rely on data from next-of-kin respondents, which may be inaccurate.Methods Three methods for assessing exposure to asbestos from case-control data on mesothelioma, including next-of-kin assessment, expert assessment, and use of a generic job-exposure matrix (JEM). Interview data [Spirtas et al. (1994): Occup Environ Med 51:804-811] were reviewed to determine exposure status by an occupational hygienist (C.R.) who was unaware of disease status. Exposure odds ratios were calculated using standard methods, and measures of agreement included the kappa statistic and conditional and marginal odds ratios.Results Expert assessment detected higher proportions of exposed subjects than the next-of-kin respondents or JEM methods. The disease-exposure odds ratios were highest for respondents, perhaps because of recall bias, and lowest for the JEM method. The agreement was highest between the respondent and expert assessments. A combination of respondent′ s assessment and JEM assessment led to the best prediction of the expert′ s assessment. Results for spouse respondents were similar to those for other "next-of-kin" respondents.Conclusions Expert assessments were the most plausible, but the data indicate that disease associations could also be detected with the other exposure assessment methods. Using some combination of the proxy respondent's assessment and the JEM assessment, one can predict the expert's assessment. A strategy that relied on the respondent's assessment when it was positive and otherwise obtained an expert assessment could reduce costs with little error compared to expert assessment on all subjects. Published 2005 Wiley-Liss, Inc.