Identification of Research Needs to Resolve the Carcinogenicity of High-priority IARC Carcinogens. Views and Expert Opinions of an IARC/NORA Expert Group Meeting, Lyon, France, 30 June - 2 July 2009. IARC Technical Publication No. 42. Lyon, France: International Agency for Research on Cancer, 2010 Jul; 42:219-220
For cross-sectional surveys, study participants may be recruited from numerous small workplaces (Calvert et al., 1998). Recruitment can be difficult because the shop or business owner may act as gatekeeper and effectively bar access to the workers (McKernan et al., 2008). One possible solution would be recruiting currently employed workers outside the workplace. If there were a good validated biomarker for recent exposure, such as end-exhaled breath levels of tetrachloroethylene (PCE) for dry cleaners, workplaces could be bypassed. Potential participants-for example, dry-cleaning operators and spotters--would be recruited through advertisements in the appropriate ethnic press/radio stations to come to a Saturday morning study site. PCE breath analysis would be used to determine eligibility (above a threshold for potentially exposed; nondetectable for potential referents). A half-day of tests and interviews would begin with a medical exam and, for example, for dry cleaners at increased risk of cervical cancer, a Pap test evaluated on site (so further tests could be offered the same day if dysplasia or other positive results were found). Blood would be drawn to test for PCE level and biomarkers of exposure, genetic susceptibility, and effect. Testing for possible neurological, renal, liver, and other health effects would be included in the exam, depending on costs and funding. An occupational history would be taken (including asking the number of workers at the current job), and questions relative to health and lifestyle would be included. Approaches could be made to some of the shops whose workers participated to do environmental sampling and pre- and post-shift testing of the workers. Shops would only be approached if the workforce was large enough so the participating workers could not be identified, and if the exposures (based on the workers' breath levels) were high enough to merit testing. Data based on volunteers should be interpreted in light of the potential selection bias.
Identification of Research Needs to Resolve the Carcinogenicity of High-priority IARC Carcinogens. Views and Expert Opinions of an IARC/NORA Expert Group Meeting, Lyon, France, 30 June - 2 July 2009, IARC Technical Publication No. 42