title: Evaluating Exposure-Response Associations for Non-Hodgkin Lymphoma with Varying Methods of Assigning Cumulative Benzene Exposure in the Shanghai Women's Health Study.
abstract: To provide insight into the contributions of exposure measurements to job exposure matrices (JEMs), we examined the robustness of an association between occupational benzene exposure and non-Hodgkin lymphoma (NHL) to varying exposure assessment methods.
  
  
  
  NHL risk was examined in a prospective population-based cohort of 73087 women in Shanghai. A mixed-effects model that combined a benzene JEM with >60000 short-term, area benzene inspection measurements was used to derive two sets of measurement-based benzene estimates: 'job/industry-specific' estimates (our presumed best approach) were derived from the model's fixed effects (year, JEM intensity rating) and random effects (occupation, industry); 'calibrated JEM' estimates were derived using only the fixed effects. 'Uncalibrated JEM' (using the ordinal JEM ratings) and exposure duration estimates were also calculated. Cumulative exposure for each subject was calculated for each approach based on varying exposure definitions defined using the JEM's probability ratings. We examined the agreement between the cumulative metrics and evaluated changes in the benzene-NHL associations.
  
  
  
  For our primary exposure definition, the job/industry-specific estimates were moderately to highly correlated with all other approaches (Pearson correlation 0.61-0.89; Spearman correlation > 0.99). All these metrics resulted in statistically significant exposure-response associations for NHL, with negligible gain in model fit from using measurement-based estimates. Using more sensitive or specific exposure definitions resulted in elevated but non-significant associations.
  
  
  
  The robust associations observed here with varying benzene assessment methods provide support for a benzene-NHL association. While incorporating exposure measurements did not improve model fit, the measurements allowed us to derive quantitative exposure-response curves.
authors.affiliation: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rm. 6E634, Rockville, MD 20850, USA.
authors.forename: Melissa C
authors.initials: MC
authors.lastname: Friesen
authors.affiliation: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rm. 6E634, Rockville, MD 20850, USA.
authors.forename: Bryan A
authors.initials: BA
authors.lastname: Bassig
authors.affiliation: Institute for Risk Assessment Sciences, Utrecht University, Yalelaan 2, Utrecht 3508 TD, The Netherlands.
authors.forename: Roel
authors.initials: R
authors.lastname: Vermeulen
authors.affiliation: Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, 2525 West End Avenue, Nashville, TN 37203, USA.
authors.forename: Xiao-Ou
authors.initials: XO
authors.lastname: Shu
authors.affiliation: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rm. 6E634, Rockville, MD 20850, USA.
authors.forename: Mark P
authors.initials: MP
authors.lastname: Purdue
authors.affiliation: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rm. 6E634, Rockville, MD 20850, USA.|Stewart Exposure Assessments, LLC, 6045 N 27th St, Arlington, VA 22207, USA.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Stewart
authors.affiliation: Department of Epidemiology, Shanghai Cancer Institute, 2200 Xietu Road, Xuhui, Shanghai 200032, China.
authors.forename: Yong-Bing
authors.initials: YB
authors.lastname: Xiang
authors.affiliation: Department of Epidemiology, The University of Texas MD Anderson Cancer Center, 1155 Pressler Street, Houston, TX 77030, USA.
authors.forename: Wong-Ho
authors.initials: WH
authors.lastname: Chow
authors.affiliation: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rm. 6E634, Rockville, MD 20850, USA.
authors.forename: Bu-Tian
authors.initials: BT
authors.lastname: Ji
authors.affiliation: Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, 2525 West End Avenue, Nashville, TN 37203, USA.
authors.forename: Gong
authors.initials: G
authors.lastname: Yang
authors.affiliation: Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, USA.
authors.forename: Martha S
authors.initials: MS
authors.lastname: Linet
authors.affiliation: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rm. 6E634, Rockville, MD 20850, USA.
authors.forename: Wei
authors.initials: W
authors.lastname: Hu
authors.affiliation: Department of Epidemiology, Shanghai Cancer Institute, 2200 Xietu Road, Xuhui, Shanghai 200032, China.
authors.forename: Yu-Tang
authors.initials: YT
authors.lastname: Gao
authors.affiliation: Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, 2525 West End Avenue, Nashville, TN 37203, USA.
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
authors.affiliation: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rm. 6E634, Rockville, MD 20850, USA.
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Rothman
authors.affiliation: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rm. 6E634, Rockville, MD 20850, USA.
authors.forename: Qing
authors.initials: Q
authors.lastname: Lan
mesh_terms: D000395:Air Pollutants, Occupational / Q000032:analysis; D001554:Benzene / Q000032:analysis*; D002681:China / Q000453:epidemiology; D006801:Humans; D007221:Industry / Q000145:classification; D008228:Lymphoma, Non-Hodgkin / Q000139:chemically induced* / Q000453:epidemiology; D015233:Models, Statistical; D016273:Occupational Exposure; D009790:Occupations / Q000145:classification / Q000706:statistics & numerical data; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D016387:Women's Health
chemical_list: D000395:Air Pollutants, Occupational; D001554:Benzene
keywords: benzene; exposure assessment methodology