title: Comparison of exposure assessment methods in a lung cancer case-control study: performance of a lifelong task-based questionnaire for asbestos and PAHs.
abstract: OBJECTIVE
  To describe the performance of a lifelong task-based questionnaire (TBQ) in estimating exposures compared with other approaches in the context of a case-control study.
  
  
  METHODS
  A sample of 93 subjects was randomly selected from a lung cancer case-control study corresponding to 497 jobs. For each job, exposure assessments for asbestos and polycyclic aromatic hydrocarbons (PAHs) were obtained by expertise (TBQ expertise) and by algorithm using the TBQ (TBQ algorithm) as well as by expert appraisals based on all available occupational data (REFERENCE expertise) considered to be the gold standard. Additionally, a Job Exposure Matrix (JEM)-based evaluation for asbestos was also obtained. On the 497 jobs, the various evaluations were contrasted using Cohen's κ coefficient of agreement. Additionally, on the total case-control population, the asbestos dose-response relationship based on the TBQ algorithm was compared with the JEM-based assessment.
  
  
  RESULTS
  Regarding asbestos, the TBQ-exposure estimates agreed well with the REFERENCE estimate (TBQ expertise: level-weighted κ (lwk)=0.68; TBQ algorithm: lwk=0.61) but less so with the JEM estimate (TBQ expertise: lwk=0.31; TBQ algorithm: lwk=0.26). Regarding PAHs, the agreements between REFERENCE expertise and TBQ were less good (TBQ expertise: lwk=0.43; TBQ algorithm: lwk=0.36). In the case-control study analysis, the dose-response relationship between lung cancer and cumulative asbestos based on the JEM is less steep than with the TBQ-algorithm exposure assessment and statistically non-significant.
  
  
  CONCLUSIONS
  Asbestos-exposure estimates based on the TBQ were consistent with the REFERENCE expertise and yielded a steeper dose-response relationship than the JEM. For PAHs, results were less clear.
authors.affiliation: Département Epidémiologie en Entreprise, Institut National de Recherche et de Sécurité (INRS), Vandœuvre-lès-Nancy, France.
authors.forename: Eve
authors.initials: E
authors.lastname: Bourgkard
authors.forename: Pascal
authors.initials: P
authors.lastname: Wild
authors.forename: Maria
authors.initials: M
authors.lastname: Gonzalez
authors.forename: Joëlle
authors.initials: J
authors.lastname: Févotte
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Penven
authors.forename: Christophe
authors.initials: C
authors.lastname: Paris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001194:Asbestos / Q000032:analysis / Q000633:toxicity*; D002273:Carcinogens / Q000633:toxicity*; D016022:Case-Control Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis*; D012015:Reference Standards; D011795:Surveys and Questionnaires / Q000592:standards
chemical_list: D002273:Carcinogens; D001194:Asbestos
keywords: Lung cancer < Organ system, disease, disease type; Task-based exposure assessment < Methodology, speciality