Comparison of expert and job-exposure matrix-based retrospective exposure assessment of occupational carcinogens in The Netherlands Cohort Study.
OBJECTIVE
Reliable retrospective exposure assessment continues to be a challenge in most population-based studies. Several methodologies exist for estimating exposures retrospectively, of which case-by-case expert assessment and job-exposure matrices (JEMs) are commonly used. This study evaluated the reliability of exposure estimates for selected carcinogens obtained through three JEMs by comparing the estimates with case-by-case expert assessment within the Netherlands Cohort Study (NLCS).


METHODS
The NLCS includes 58,279 men aged 55-69 years at enrolment in 1986. For a subcohort of these men (n=1630), expert assessment is available for exposure to asbestos, polycyclic aromatic hydrocarbons (PAHs) and welding fumes. Reliability of the different JEMs (DOMJEM (asbestos, PAHs), FINJEM (asbestos, PAHs and welding fumes) and Asbestos JEM (asbestos) was determined by assessing the agreement between these JEMs and the expert assessment.


RESULTS
Expert assessment revealed the lowest prevalence of exposure for all three exposures (asbestos 9.3%; PAHs 5.3%; welding fumes 11.7%). The DOMJEM showed the highest level of agreement with the expert assessment for asbestos and PAHs (κs=0.29 and 0.42, respectively), closely followed by the FINJEM. For welding fumes, concordance between the expert assessment and FINJEM was high (κ=0.70). The Asbestos JEM showed poor agreement with the expert asbestos assessment (κ=0.10).


CONCLUSIONS
This study shows case-by-case expert assessment to result in the lowest prevalence of occupational exposure in the NLCS. Furthermore, the DOMJEM and FINJEM proved to be rather similar in agreement when compared with the expert assessment. The Asbestos JEM appeared to be less appropriate for use in the NLCS.
Department of Epidemiology, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands. nadine.offermans@maastrichtuniversity.nl
Nadine S M
NS
Offermans
Roel
R
Vermeulen
Alex
A
Burdorf
Susan
S
Peters
R Alexandra
RA
Goldbohm
Tom
T
Koeman
Martie
M
van Tongeren
T
T
Kauppinen
Ijmert
I
Kant
Hans
H
Kromhout
Piet A
PA
van den Brandt
D000368:Aged; D001194:Asbestos / Q000032:analysis; D002274:Carcinogens, Environmental / Q000032:analysis*; D015331:Cohort Studies; D004784:Environmental Monitoring / Q000379:methods* / Q000706:statistics & numerical data; D005104:Expert Testimony; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009426:Netherlands; D016273:Occupational Exposure / Q000032:analysis* / Q000706:statistics & numerical data; D011084:Polycyclic Aromatic Hydrocarbons / Q000032:analysis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014896:Welding
D002274:Carcinogens, Environmental; D011084:Polycyclic Aromatic Hydrocarbons; D001194:Asbestos