title: Underestimation of risk due to exposure misclassification.
abstract: Exposure misclassification constitutes a major obstacle when developing dose-response relationships for risk assessment. A non-differentional error results in underestimation of the risk. If the degree of misclassification is known, adjustment may be achieved by sensitivity analysis. The purpose of this study was to examine the full magnitude of measurement error in determining the prenatal exposure to methylmercury. We used data from a prospective study of a Faroese birth cohort. Two biomarkers of methylmercury exposure were available, i.e., the mercury concentrations in cord blood and in maternal hair (sampled at the time of parturition). The laboratory imprecision on both chemical analyses was thought to be below 5% coefficient of variation (CV). As a third exposure parameter, we used the dietary questionnaire response on frequency of whale meat dinners. Factor analysis and structural equation analysis were applied to assess the full extent of the imprecision. The calculated total imprecision much exceeded the known laboratory variation: the CV was 28-30% for the cord-blood concentration and 52-55% for the maternal hair concentration. The dietary questionnaire response was even more imprecise. These findings illustrate that measurement error may be greatly underestimated if judged solely from reproducibility or laboratory quality data. Adjustment by sensitivity analysis is meaningful only if realistic measurement errors are applied. When exposure measurement errors are overlooked or underestimated, decisions based on the precautionary principle will not appropriately reflect the degree of precaution that was intended.
authors.affiliation: Institute of Public Health, University of Southern Denmark, Odense, Denmark. PGrandjean@health.sdu.dk
authors.forename: Philippe
authors.initials: P
authors.lastname: Grandjean
authors.forename: Esben
authors.initials: E
authors.lastname: Budtz-Jørgensen
authors.forename: Niels
authors.initials: N
authors.lastname: Keiding
authors.forename: Pal
authors.initials: P
authors.lastname: Weihe
mesh_terms: D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D004781:Environmental Exposure; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008431:Maternal-Fetal Exchange; D008767:Methylmercury Compounds / Q000097:blood*; D015233:Models, Statistical; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D018570:Risk Assessment; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D008767:Methylmercury Compounds