Evaluation of the Suitability of an Existing Job–Exposure Matrix for the Assessment of Exposure of UK Biobank Participants to Dust, Fumes, and Diesel Exhaust Particulates

Abstract

<jats:p>Many epidemiological studies have shown an association between outdoor particulate air pollutants and increased morbidity and mortality. Inhalation of ambient aerosols can exacerbate or promote the development of cardiovascular and pulmonary diseases as well as other diseases, such as type 2 diabetes mellitus (T2DM) and neurodegenerative diseases. Occupational exposure to dust, fumes and diesel exhaust particulates can also cause adverse health outcomes and there are numerous occupations where workers are exposed to airborne particles that are similar to ambient air pollution. An individual’s job title has normally been identified as a major determinant of workplace exposure in epidemiological studies. This has led to the development of Job–Exposure Matrices (JEMs) as a way of characterising specific workplace exposures. One JEM for airborne chemical exposures is the Airborne Chemical Exposure Job–Exposure Matrix (ACE JEM), developed specifically for the UK Biobank cohort. The objective of this paper is to evaluate the suitability of the ACE JEM in assessing occupational aerosol exposure of participants in the UK Biobank. We searched the scientific literature to identify exposure data linked to selected jobs in the ACE JEM and compared these data with the JEM assessments. Additionally, we carried out an independent expert-based assessment of exposure to compare with the JEM estimates. There is good published evidence to substantiate the high dust and biological dust assignments in the JEM and more limited evidence for diesel exhaust particulates. There is limited evidence in the published literature to substantiate moderate or low exposure assignments in the JEM. The independent expert-based assessment found good agreement at the two extremes of exposure in the JEM (high and no exposure), with uncertainty in all other classifications. The ACE JEM assignments are probably reliable for highly exposed jobs and for jobs assigned as unexposed. However, the assignments for medium and low exposures are less reliable. The ACE JEM is likely to be a good tool to examine associations between occupational exposures to particulates and chronic disease, although it should be used with caution. Further efforts should be made to improve the reliability of the ACE JEM.</jats:p>

Is Environmental and Occupational Particulate Air Pollution Exposure Related to Type-2 Diabetes and Dementia? A Cross-Sectional Analysis of the UK Biobank

“…To the best of our knowledge, although there are many studies that examine the relationship between occupational exposures such as night-shift work, job strain, or specific substances such as solvents and diabetes [ 48 , 49 , 50 ] or dementia [ 51 , 52 , 53 , 54 , 55 ], this is the first study to investigate an association between occupational exposure to PM that are similar to environmental air pollution exposure and both health outcomes. We relied on the ACE JEM to assign exposure probability and intensity to jobs, although from our earlier work it is likely that these assignments were most reliable for highly exposed jobs and for jobs assigned as unexposed [ 23 ]. We chose to recategorise into exposed and unexposed to attempt to minimise the potential for misclassification in the analysis.…”

“…JEMs are also generally not good at identifying small effects, especially JEMs like the ACE JEM that are generated from subjective information rather than objective measurements [ 59 ]. From our earlier evaluation of the ACE JEM it was observed that the assignments for medium and low exposed jobs were less reliable than for high and unexposed jobs [ 23 ]. Moreover, there may be problems in the JEM’s coding for men and women, as it seems there is inconsistency between the assessments for the two gender.…”

“…The occupational variable (P × L) was recategorised into two levels, with level 1 representing no exposure and level 2 representing some exposure. This recategorisation was chosen because the ACE JEM assignments are probably reliable for highly exposed jobs and for jobs assigned as unexposed, while the assignments for medium exposed and low exposed are less reliable [ 23 ]. This is a complete case analysis, as participants with missing data were excluded ( Table S2 ) and only participants with full data records were included in the analysis.…”

“…This is a population cohort of over 500,000 participants from all over the UK. As an individual’s job title has commonly been identified as a major determinant of workplace exposure in epidemiological studies, the development of Job–Exposure Matrices (JEMs) provides a way of characterising specific workplace exposures [ 23 ]. The ACE JEM (Airborne Chemical Exposure–Job Exposure Matrix) was originally developed to investigate workplace causes of COPD amongst participants in the UK Biobank.…”