Occupational asbestos exposure and mesothelioma risk in Los Angeles county: application of an occupational hazard survey job-exposure matrix.
Cicioni C; London SJ; Garabrant DH; Bernstein L; Phillips K; Peters JM
Am J Ind Med 1991 Sep; 20(3):371-379
The newly available job exposure matrix (JEM) of the NIOSH National Occupational Hazard Survey (NOHS) was evaluated by comparing it with the Los Angeles County/University of Southern California Cancer Surveillance Program (CSP) for assessing the association between asbestos (1332214) exposure and malignant mesothelioma occurrence in Los Angeles County. The CSP data for the years 1972 to 1988 included 143 patients diagnosed with mesothelioma and a total of 46,644 cases of cancer diagnosed among men aged 18 to 64 years. The NOHS JEM data, based on a survey of 538,871 workers, were adapted to the CSP data. Exposure categories for industry and occupations were graded as none, low, and high. Estimates of the odds ratio of mesothelioma associated with a particular level of asbestos exposure were obtained by comparing the number of patients with mesothelioma in a particular exposure category with the number of other cancer patients in that particular category. The results were discussed under application of NOHS JEM to CSP data, mesothelioma risk based on NOHS JEM asbestos exposure categories, mesothelioma risk based on job title exposure levels, and comparison of the two methods. When the correlation was made between exposure assignments for cancer cases that could be assigned an exposure by both methods there was a weak correlation between the two methods, with a Spearman correlation of 0.28. Of the 4116 cancers in occupation/industry (OI) couplets with an exposure probability above zero according to NOHS JEM, 45% were in couplets assigned to the "none" exposure category. Of the 288 cancers in OI couplets classified as highly exposed, 62.5% were in couplets with an asbestos exposure probability equal to zero, and 20.5% were in couplets not included in NOHS JEM. Limitations on the application of the NOHS JEM and its shortcomings were discussed. The authors conclude that JEMs should not be considered the principal means of exposure assessment, but as part of the armamentarium available for exposure assignments in epidemiologic studies.
NIOSH-Publication; NIOSH-Grant; Training; Surveillance-programs; Occupational-exposure; Industrial-exposures; Malignant-neoplasms; Risk-analysis; Statistical-analysis; Biostatistics; Cancer-rates; Epidemiology;
Author Keywords: job exposure matrix; inferring occupational exposure; mesothelioma risk; surveillance programs
Dr. John M. Peters, Department of Preventive Medicine, University of Southern California School of Medicine, 1420 San Pablo Street, B-306, Los Angeles, CA 90033-9987
American Journal of Industrial Medicine
University of Southern California, Los Angeles, California