title: Choice of rating method for assessing occupational asbestos exposure: study for compensation purposes in France.
abstract: BACKGROUND
  In the course of setting up the National Mesothelioma Surveillance Program (PNSM), established in France in 1998, the question arose as to the most suitable method of assessing occupational exposure. The aim of this study was to define the most suitable rating method for assessing occupational asbestos exposure in order to assess medico-social care.
  
  
  METHODS
  The study included 100 subjects-50 cases of mesothelioma and 50 controls-randomly selected and representing 457 jobs held. Job asbestos exposure was assessed by a six-expert panel using two methods: "by job" rating, where all the jobs in were assessed regardless of the subjects; and "by subject" rating, where all the jobs of a subject were assessed at the same time. Consensus was obtained and subjects' exposure was calculated for each rating. Then, two internal experts assessed job asbestos exposure with the "by subject" rating. Kappa coefficients were used to measure agreement between the ratings.
  
  
  RESULTS
  Agreement between "by job" and "by subject" ratings was very good for subject probability of exposure (kappa = 0.84) and cumulative exposure index (kappa = 0.80). Agreement between the six-expert panel and the two internal experts was good for subject exposure (kappa for probability = 0.71; kappa for cumulative exposure index= 0.68).
  
  
  CONCLUSIONS
  This study shows that the two rating systems have good or very good agreement. These results validate the routine use in the PNSM of the "by subject" rating, with the advantage of being convenient and quick to provide feedback on occupational asbestos exposure to mesothelioma cases for compensation.
authors.affiliation: Universite Bordeaux Segalen, Institut de Sante Publique d'Epidemiologie et de Developpement, Laboratoire Sante Travail Environnement, Centre INSERM U, Equipe Associee en Sante Travail, Bordeaux, France. celine.gramond@isped.u-bordeaux2.fr
authors.forename: Celine
authors.initials: C
authors.lastname: Gramond
authors.forename: Patrick
authors.initials: P
authors.lastname: Rolland
authors.forename: Aude
authors.initials: A
authors.lastname: Lacourt
authors.forename: Stephane
authors.initials: S
authors.lastname: Ducamp
authors.forename: Soizick
authors.initials: S
authors.lastname: Chamming's
authors.forename: Yvon
authors.initials: Y
authors.lastname: Creau
authors.forename: Michel
authors.initials: M
authors.lastname: Hery
authors.forename: Jacques
authors.initials: J
authors.lastname: Laureillard
authors.forename: Brahim
authors.initials: B
authors.lastname: Mohammed-Brahim
authors.forename: Ewa
authors.initials: E
authors.lastname: Orlowski
authors.forename: Christophe
authors.initials: C
authors.lastname: Paris
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Pairon
authors.forename: Marcel
authors.initials: M
authors.lastname: Goldberg
authors.forename: Patrick
authors.initials: P
authors.lastname: Brochard
mesh_terms: D001194:Asbestos / Q000032:analysis; D016022:Case-Control Studies; D035881:Compensation and Redress; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008654:Mesothelioma / Q000453:epidemiology*; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure / Q000032:analysis / Q000145:classification*; D009790:Occupations / Q000706:statistics & numerical data; D011336:Probability; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D011795:Surveys and Questionnaires
chemical_list: D001194:Asbestos