Assessment of Lifetime Occupational Exposure in an Epidemiologic Study of COPD

Abstract

Ascertainment of lifetime occupational exposures in an epidemiological study of chronic obstructive pulmonary disease (COPD) is important in order to investigate its effect on the disease and develop prevention strategies. The aim of our paper is to describe and evaluate a methodology used to assign lifetime occupational exposure to participants in a case-control study of COPD where lifetime occupational history was ascertained through telephone questionnaire interviews.The methodology involved assigning to each individual a qualitative index of potential exposure to eight occupational hazards, summarized individually overall the job categories reported by the individual, and an overall qualitative index of lifetime exposure to all eight hazards. The eight occupational hazards scored were mineral dusts, metal dusts/fumes, organic dusts, irritant gases/vapors, sensitizers, organic solvents, diesel exhaust, and environmental tobacco smoke (ETS). Two industrial hygienists independently assigned the above indices based on: their expert opinion, a priori knowledge based on literature review, and study participants' responses to interviewer questions regarding types and duration of exposure. To evaluate agreement of the assigned scores, we used the Kappa statistic to test the agreement between the two scorers on each of the indices. The Kappa statistic generally indicated good agreement between the industrial hygienists' scores but varied by exposure from 0.42 to 0.86. Although the exposure scoring is somewhat subjective, it is based on experience of experts and review of the literature. This method, with subject interviews providing qualitative lifetime exposure data when air monitoring has not been conducted, is useful for reconstructing lifetime exposures.

Occupational exposure and airflow obstruction and self‐reported COPD among ever‐employed US adults using a COPD‐job exposure matrix

“…The combined dust category takes into consideration both organic dust and mineral dust (plus metal dust) and uses the highest exposure level of either the organic dust or the mineral dust exposure level. Sensitizers included respiratory hazards associated with COPD such as welding operations, glues, isocyanates, and animal dander . The overall NIOSH COPD‐JEM occupational exposure level considers the above exposure categories and environmental tobacco smoke and assigns one exposure level for each self‐reported, longest held NHANES occupation.…”

Occupational Risk Factors for COPD Phenotypes in the Multi-Ethnic Study of Atherosclerosis (MESA) Lung Study

“…An industrial hygienist then constructed the NIOSH JEM by assigning an exposure score (1, 2, or 3) representing the likelihood of the presence and severity of the VGDF exposure (low, medium, and high) for each Census occupation code based on expert opinion. In addition, the method of exposure coding applied in the Weinmann et al (14) study was adopted for assigning the exposure scores in this study (19). The hygienist similarly created separate scores representing the likelihood and severity of exposure to vapor-gas, fumes, dust, and subcategories of dust (mineral; organic).…”

Occupational exposures and chronic obstructive pulmonary disease (COPD): comparison of a COPD-specific job exposure matrix and expert-evaluated occupational exposures

“…1 Epidemiological studies of COPD use a variety of methods to assign estimates of occupational exposure levels. [1][2][3] These methods include a National Institute for Occupational Safety and Health COPD-specific job exposure matrix (NIOSH COPD JEM) previously constructed by three NIOSH industrial hygienists (IHs). 2 3 The NIOSH COPD JEM was developed to be a generalisable tool to assess COPD risk by assigning exposure levels to all US Census 2000 Occupations regardless of disease status.…”