New Opportunities in Exposure Assessment of Occupational Epidemiology: Use of Measurements to Aid Exposure Reconstruction in Population-Based Studies

Dopart, Pamela J.; Friesen, Melissa C.

doi:10.1007/s40572-017-0153-0

Cited by 19 publications

(8 citation statements)

References 55 publications

(122 reference statements)

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“…A job exposure matrix (JEM) is a promising tool for assessing occupational exposures in large epidemiological studies, as well as in studies including job titles, but lacking information on individual exposures 27. In JEMs, the exposures within each occupation have typically been determined using expert evaluations or self-reports of the general population.…”

Section: Introductionmentioning

confidence: 99%

Physical heaviness of work and sitting at work as predictors of mortality: a 26-year follow-up of the Helsinki Birth Cohort Study

et al. 2019

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ObjectivesTo examine the relationships of late-career physical heaviness of work and sitting at work with mortality. A national-level job exposure matrix was used to determine the occupation-specific level of physical heaviness and sitting.DesignProspective cohort study between years 1990 and 2015.SettingCommunity.Participants5210 men and 4725 women from the Helsinki Birth Cohort Study with an occupational code at baseline (ages 45–57 years).Primary and secondary outcome measuresTotal, cardiovascular (International Classification of Diseases 10th Revision I00–I99), cancer (C00–C97) and external (S00–Y84) mortality.ResultsThe exposures, physical heaviness and sitting had a non-linear, inverse relationship. During the 26-year follow-up, 1536 men and 759 women died. Among men, physical heaviness of work was positively associated and sitting at work was negatively associated with all-cause, cardiovascular and external cause mortality but they were not associated with cancer mortality. The HRs for men in the highest quartile of physical heaviness of work compared with men in the lowest quartile were 1.54 (1.31–1.80) for all-cause mortality, 1.70 (1.30–2.23) for cardiovascular mortality and 3.18 (1.75–5.78) for external cause mortality (adjusted for age and years of education). Compared with the lowest quartile, the HRs for the highest quartile of sitting at work among men were 0.71 (0.61–0.82) for all-cause mortality, 0.59 (0.45–0.77) for cardiovascular mortality and 0.38 (0.22–0.66) for external cause mortality. In women, neither physical heaviness of work nor sitting at work was associated with mortality.ConclusionsMen in physically heavy work at their late-work career are at higher risk of death than men in physically light work.

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Section: Introductionmentioning

confidence: 99%

Physical heaviness of work and sitting at work as predictors of mortality: a 26-year follow-up of the Helsinki Birth Cohort Study

et al. 2019

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“…For the reasons reported above, future efforts should be made to incorporate exposure variability estimates into uncertainty analyses, as suggested by the literature [ 23 ].…”

Section: Resultsmentioning

confidence: 99%

Retrospective Exposure Assessment Methods Used in Occupational Human Health Risk Assessment: A Systematic Review

Borghi

Mazzucchelli

Campagnolo

et al. 2020

IJERPH

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As part of the assessment and management of chemical risk and occupational hygiene, retrospective exposure assessment (REA) to chemical agents can be defined as the estimate of exposure associated with a person’s work history. The fundamental problem underlying the reconstruction of the exposure is that of transforming this type of information in quantitative terms to obtain an accurate estimate. REA can follow various approaches, some of which are technically complicated and both time and resource consuming. The aim of this systematic review is to present the techniques mainly used for occupational REA. In order to carry out this evaluation, a systematic review of the scientific literature was conducted. Forty-four studies were identified (published from 2010 to date) and analyzed. In exposure reconstruction studies, quantitative approaches should be preferable, especially when estimates will be used in the context of health impact assessment or epidemiology, although it is important to stress how, ideally, the experimental data available for the considered scenario should be used whenever possible as the main starting information base for further processing. To date, there is no single approach capable of providing an accurate estimate of exposure for each reasonably foreseeable condition and situation and the best approach generally depends on the level of information available for the specific case. The use of a combination of different reconstruction techniques can, therefore, represent a powerful tool for weighting and integrating data obtained through qualitative and quantitative approaches, in order to obtain the best possible estimate.

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“…When deciding about causation, we should remember that epidemiological studies on the risk of cancer associated with any kind of environmental exposure are often limited by uncertainties regarding the extent of exposure, especially when direct measurements are not available or multiple environmental exposures occurred. 8,9 Uncertainties also regard the diagnosis, which is usually taken from death certificates. The accuracy of the declared cause of death may differ for different cancer types 10,11 and among different registers and countries.…”

Section: Introductionmentioning

confidence: 99%

Difficulties in establishing a causal link between chemical exposures and cancer cannot be overcome by court assessments

Dragani

2020

Hum Exp Toxicol

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Scientific data are often used in lawsuits to prove, or dismiss, causation by a claimed factor of a claimed disease. Recent media reports of million-dollar compensations awarded to some cancer patients who had been exposed to certain chemical substances motivated me to examine how solid the causal links really were. Here, I discuss the limitations of epidemiological research on cancer causation and highlight how new knowledge of cancer genetics makes it unrealistic to expect that cancer causation can be clearly demonstrated. I then present two exposure–cancer cases, namely talcum powder–ovarian cancer and glyphosate–non-Hodgkin lymphoma, that led to civil lawsuits decided, in the United States, in favor of the claimants. Both these cancers have several risk factors, among which the claimed exposure presents only a minor, if any, increased risk. Through these cases, I explain why the use of epidemiological data is inappropriate to define causal associations in complex diseases like cancer. I close by suggesting a fairer approach, called proportional liability, to resolving future cancer litigation cases.

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New Opportunities in Exposure Assessment of Occupational Epidemiology: Use of Measurements to Aid Exposure Reconstruction in Population-Based Studies

Cited by 19 publications

References 55 publications

Physical heaviness of work and sitting at work as predictors of mortality: a 26-year follow-up of the Helsinki Birth Cohort Study

Physical heaviness of work and sitting at work as predictors of mortality: a 26-year follow-up of the Helsinki Birth Cohort Study

Retrospective Exposure Assessment Methods Used in Occupational Human Health Risk Assessment: A Systematic Review

Difficulties in establishing a causal link between chemical exposures and cancer cannot be overcome by court assessments

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