Exposure to vapors, gas, dust, or fumes: assessment by a single survey item compared to a detailed exposure battery and a job exposure matrix.
BACKGROUND
Occupational exposure assessment often relies upon subject report. We examined the characteristics of self-reported exposure in respondents' longest held job to vapors, gas, dust, or fumes (VGDF) compared to other measures of exposure risk.


METHODS
We analyzed data from 1,876 respondents from a national US population-based telephone survey designed to estimate the association between occupational factors and chronic disease of the airways. We tested a single VGDF item against responses to a 16-item battery assessing specific inhalation exposures and against a job exposure matrix (JEM). We analyzed all of these measures for their association with adult-onset asthma after excluding subjects with COPD or asthma with onset before age 18.


RESULTS
VDGF (single item) was reported by 744 (40%) subjects; any of the 16 exposures by 899 (48%); and an intermediate or high exposure likelihood job by JEM was assigned to 682 (36%). The sensitivity of the VGDF item measured against the 16-item battery was 69%; the specificity was 88%; (classification agreement kappa=0.58); against the JEM classification the sensitivity was 64% and specificity 74% (kappa=0.37). The relative odds (OR) for adult-onset asthma associated with various measures of exposure were: VGDF, 1.7 (95% Confidence Interval [CI] 1.0-2.8; P=0.04); any of the 16 exposures, 1.6 (95% CI 1.0-2.7; P=0.06), and intermediate or high by JEM, 1.2 (0.7-2.1; P>0.50).


CONCLUSIONS
A single VGDF survey item appears to delineate exposure risk at least as well as a multiple-item battery assessing such exposures; it has modest agreement with a JEM-based exposure categorization.
Blanc
Paul D
PD
Department of Medicine, The Division of Occupational and Environmental Medicine, University of California San Francisco, San Francisco, California 94117, USA. blancp@itsa.ucsf.edu
Eisner
Mark D
MD
Balmes
John R
JR
Trupin
Laura
L
Yelin
Edward H
EH
Katz
Patricia P
PP
D000368:Aged; D001249:Asthma / Q000453:epidemiology* / Q000209:etiology; D015982:Bias; D004391:Dust / Q000032:analysis; D005260:Female; D005740:Gases / Q000032:analysis / Q000633:toxicity; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis* / Q000706:statistics & numerical data; D009790:Occupations / Q000145:classification; D018570:Risk Assessment / Q000379:methods*; D012650:Self Disclosure; D014481:United States
D004391:Dust; D005740:Gases