Design and validation of a self-administered questionnaire as an aid to detection of occupational exposure to lung carcinogens.
OBJECTIVE
Ten to thirty percent of lung cancer is thought to be of occupational origin. Lung cancer is under-declared as an occupational disease in Europe, and most declarations of occupational disease concern asbestos. The purpose of this study was to design and validate a short, sensitive self-administered questionnaire, as an aid for physicians in detecting occupational exposure to asbestos and other lung carcinogens in order to remedy occupational lung cancer under-declaration.


METHODS
Cross-sectional study.


METHODS
A short (30-question) self-administered questionnaire was drawn up by oncologist-pneumologists and occupational physicians, covering situations of exposure to proven and probable lung carcinogens. Understanding and acceptability were assessed on 15 lung cancer patients. Validity and reliability were assessed on 70 lung cancer patients by comparison against a semi-directive questionnaire considered as gold standard. Sensitivity and specificity were assessed by comparing responses to items on the two questionnaires. Reliability was assessed by analysing the kappa concordance coefficient for items on the two questionnaires.


RESULTS
Sensitivity was 0.85 and specificity 0.875. Concordance between responses on the two questionnaires was 85.7%, with a kappa coefficient of 0.695 [0.52-0.87]. Mean self-administration time was 3.1 min (versus 8.12 min to administer the gold-standard questionnaire). In 16 patients, the self-administered questionnaire detected lung carcinogen exposure meeting the criteria for occupational disease.


CONCLUSIONS
The present short, easy-to-use self-administered questionnaire should facilitate detection of occupational exposure to lung carcinogens. It could be used in occupational lung cancer screening and increase the presently low rate of application for recognition of lung cancer as an occupational disease.
Service de Santé au Travail, CHU de Saint-Etienne, France; Faculté de Médecine Jacques Lisfranc, Saint-Etienne, France. Electronic address: carole.pelissier@chu-st-etienne.fr.
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Pélissier
Centre HYGÉE, Institut de Cancérologie de la Loire Lucien Neuwirth, CIC 1408 Inserm, Saint-Priest en Jarez, France.
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Dutertre
Département d'Oncologie Médicale, Institut de Cancérologie Lucien Neuwirth, Saint-Priest en Jarez, France.
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Fournel
Service de Santé au Travail, CHU de Saint-Etienne, France; Faculté de Médecine Jacques Lisfranc, Saint-Etienne, France.
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Gendre
Faculté de Médecine Jacques Lisfranc, Saint-Etienne, France; Service de Pneumologie et d'oncologie thoracique, CHU de Saint-Etienne, France.
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Michel Vergnon
Centre HYGÉE, Institut de Cancérologie de la Loire Lucien Neuwirth, CIC 1408 Inserm, Saint-Priest en Jarez, France.
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Kalecinski
Centre HYGÉE, Institut de Cancérologie de la Loire Lucien Neuwirth, CIC 1408 Inserm, Saint-Priest en Jarez, France.
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Tinquaut
Service de Santé au Travail, CHU de Saint-Etienne, France; Faculté de Médecine Jacques Lisfranc, Saint-Etienne, France.
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Fontana
Faculté de Médecine Jacques Lisfranc, Saint-Etienne, France; Centre HYGÉE, Institut de Cancérologie de la Loire Lucien Neuwirth, CIC 1408 Inserm, Saint-Priest en Jarez, France.
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Chauvin
D000368:Aged; D001194:Asbestos / Q000633:toxicity; D002273:Carcinogens / Q000633:toxicity; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000139:chemically induced / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced / Q000175:diagnosis; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
D002273:Carcinogens; D001194:Asbestos
Lung carcinogen detection; Occupational disease; Self-administered questionnaire