title: Development of a computer-based survey instrument for organophosphate and N-methyl-carbamate exposure assessment among agricultural pesticide handlers.
abstract: BACKGROUND
  Assessment of occupational pesticide exposures based on self-reported information can be challenging, particularly with immigrant farm worker populations for whom specialized methods are needed to address language and cultural barriers and account for limited literacy. An audio computer-assisted self-interview (A-CASI) survey instrument was developed to collect information about organophosphate (OP) and N-methyl-carbamate (CB) exposures and other personal characteristics among male agricultural pesticide handlers for an ongoing cholinesterase biomonitoring study in Washington State.
  
  
  OBJECTIVE
  To assess the feasibility of collecting data using the A-CASI instrument and evaluate reliability for a subset of survey items.
  
  
  METHODS
  The survey consisted of 64 items administered in Spanish or English on a touch-screen tablet computer. Participants listened to digitally recorded questions on headphones and selected responses on the screen, most of which were displayed as images or icons to facilitate participation of low literacy respondents. From 2006-2008, a total of 195 participants completed the survey during the OP/CB application seasons on at least one occasion. Percent agreement and kappa coefficients were calculated to evaluate test-retest reliability for selected characteristics among 45 participants who completed the survey on two separate occasions within the same year.
  
  
  RESULTS
  Almost all participants self-identified as Hispanic or Latino (98%), and 97% completed the survey in Spanish. Most participants completed the survey in a half-hour or less, with minimal assistance from on-site research staff. Analyses of test-retest reliability showed substantial agreement for most demographic, work history, and health characteristics and at least moderate agreement for most variables related to personal protective equipment use during pesticide applications.
  
  
  CONCLUSIONS
  This A-CASI survey instrument is a novel method that has been used successfully to collect information about OP/CB exposures and other personal characteristics among Spanish-speaking agricultural pesticide handlers.
authors.affiliation: Department of Epidemiology, University of Washington, Seattle, 98195-7236, USA. hofmannjn@mail.nih.gov
authors.forename: Jonathan N
authors.initials: JN
authors.lastname: Hofmann
authors.forename: Harvey
authors.initials: H
authors.lastname: Checkoway
authors.forename: Ofelio
authors.initials: O
authors.lastname: Borges
authors.forename: Flor
authors.initials: F
authors.lastname: Servin
authors.forename: Richard A
authors.initials: RA
authors.lastname: Fenske
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Keifer
mesh_terms: D000328:Adult; D000382:Agricultural Workers' Diseases / Q000453:epidemiology; D000383:Agriculture / Q000706:statistics & numerical data*; D002219:Carbamates / Q000032:analysis*; D003201:Computers; D004522:Educational Status; D005240:Feasibility Studies; D006304:Health Status; D006306:Health Surveys; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007306:Insecticides / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000517:prevention & control / Q000706:statistics & numerical data*; D010755:Organophosphates / Q000032:analysis; D011482:Protective Devices; D015203:Reproducibility of Results; D014171:Transients and Migrants / Q000706:statistics & numerical data; D014861:Washington / Q000453:epidemiology; D055815:Young Adult
chemical_list: D002219:Carbamates; D007306:Insecticides; D010755:Organophosphates; C020401:N-methylcarbamate