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Feasibility of using a brief self-administered questionnaire to assess occupational silica exposure in a rheumatology patient population.

Parks-CG; Cooper-GS; Callanah-LF
Arthritis Rheum 2006 Sep; 54(9)(S):S773-S774
Purpose: Occupational silica exposure has been associated with several systemic autoimmune diseases, and is an important environmental risk factor in studies of rheumatic diseases. Assessing silica exposure in population and clinic-based studies typically involves connecting and evaluating a detailed lifetime job history, which can be time consuming and expensive. We evaluated the feasibility of assessing silica exposure by self-administered questionnaire in an ongoing study of patients from university and community rheumatology practices. Methods: Patients (N=1759; 834 rheumatoid arthritis, 456 osteoarthritis, and 469 fibromyalgia) were mailed questionnaires that included a one page checklist of ten types of silica-related jobs or tasks. For positive responses, patients were asked to provide a brief written description of what they did or made at that job. Responses were evaluated and scored by expert review to determine the accuracy of individual responses and impact of this additional information on the classification of patient's likelihood of silica exposures. Results: Questionnaires were returned by 741 patients (overall response rate of 42%), 92% of whom completed the checklist (t01al=680; 78% female). Based on completed checked responses, 23% of patients indicated a possible history of silica exposure (9% from trades or construction, 10% from farm work, 4% from both). Job descriptions, provided on 273 (73%) of 376 checked responses, revealed a false-positive rate of 18% (48 responses rated as either unexposed or non-occupational exposures) and yielded positive confirmation of exposure in 162 responses (59%). The remaining 166 checked responses with incomplete or ambiguous job descriptions were considered to have possible exposure. In sum, after expert review only 8% of patients were classified as having likely history of high or moderate silica exposure while 6% had possible but unconfirmed high or moderate exposures. Conclusions: History of occupational silica exposure is not uncommon in rheumatotogy patients. This method (checklist+ review) provides a feasible and efficient alternative to collecting an extensive job history to assess silica exposure in clinical populations. Checklist completion rates were high and, when provided, job descriptions were of sufficient quality to reduce the number of false-positives. Response rates and data quality may be optimized by administering this instrument to patients in a clinical setting. This approach may be useful for other types of occupational exposures of interest in rheumatology populations.
Silica-dusts; Silicosis; Questionnaires; Rheumatoid-disorders; Exposure-assessment; Exposure-levels; Exposure-methods
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Arthritis and Rheumatism
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division