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Josse PR, Koutros S, Tardon A, Rothman N, Silverman DT, Friesen MC. Adapting Decision Rules to Estimate Occupational Metalworking Fluid Exposure in a Case-Control Study of Bladder Cancer in Spain. Ann Work Expo Health 2021; 66:392-401. [PMID: 34625802 DOI: 10.1093/annweh/wxab084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 08/27/2021] [Accepted: 09/16/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES We adapted previously developed decision rules from the New England Bladder Cancer Study (NEBCS) to assign occupational exposure to straight, soluble, and synthetic metalworking fluids (MWFs) to participants of the Spanish Bladder Cancer Study (SBCS). METHODS The SBCS and NEBCS are case-control studies that used the same lifetime occupational history and job module questionnaires. We adapted published decision rules from the NEBCS that linked questionnaire responses to estimates of the probability (<5, ≥5 to <50, ≥50 to <100, and 100%), frequency (in h week-1), and intensity (in mg m-3) of exposure to each of the three broad classes of MWFs to assign exposure to 10 182 reported jobs in the SBCS. The decision rules used the participant's module responses to MWF questions wherever possible. We then used these SBCS module responses to calculate job-, industry-, and time-specific patterns in the prevalence and frequency of MWF exposure. These estimates replaced the NEBCS-specific estimates in decision rules applied to jobs without MWF module responses. Intensity estimates were predicted using a previously developed statistical model that used the decade, industry (three categories), operation (grinding versus machining), and MWF type extracted from the SBCS questionnaire responses. We also developed new decision rules to assess mineral oil exposure from non-machining sources (possibly exposed versus not exposed). The decision rules for MWF and mineral oil identified questionnaire response patterns that required job-by-job expert review. RESULTS To assign MWF exposure, we applied decision rules that incorporated participant's responses and job group patterns for 99% of the jobs and conducted expert review of the remaining 1% (145) jobs. Overall, 14% of the jobs were assessed as having ≥5% probability of exposure to at least one of the three MWFs. Probability of exposure of ≥50% to soluble, straight, and synthetic MWFs was identified in 2.5, 1.7, and 0.5% of the jobs, respectively. To assign mineral oil from non-machining sources, we used module responses for 49% of jobs, a job-exposure matrix for 41% of jobs, and expert review for the remaining 10%. We identified 24% of jobs as possibly exposed to mineral oil from non-machining sources. CONCLUSIONS We demonstrated that we could adapt existing decision rules to assess exposure in a new population by deriving population-specific job group patterns.
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Affiliation(s)
- Pabitra R Josse
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Stella Koutros
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Adonina Tardon
- Department of preventive medicine, University of Oviedo, Health Research Institute of Asturias, ISPA and CIBERESP, Oviedo, Spain
| | - Nathaniel Rothman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Debra T Silverman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Melissa C Friesen
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
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Dopart PJ, Locke SJ, Cocco P, Bassig BA, Josse PR, Stewart PA, Purdue MP, Lan Q, Rothman N, Friesen MC. Estimation of Source-Specific Occupational Benzene Exposure in a Population-Based Case-Control Study of Non-Hodgkin Lymphoma. Ann Work Expo Health 2019; 63:842-855. [PMID: 31504127 PMCID: PMC6788340 DOI: 10.1093/annweh/wxz063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 05/21/2019] [Accepted: 07/22/2019] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES Occupational exposures in population-based case-control studies are increasingly being assessed using decision rules that link participants' responses to occupational questionnaires to exposure estimates. We used a hierarchical process that incorporated decision rules and job-by-job expert review to assign occupational benzene exposure estimates in a US population-based case-control study of non-Hodgkin lymphoma. METHODS We conducted a literature review to identify scenarios in which occupational benzene exposure has occurred, which we grouped into 12 categories of benzene exposure sources. For each source category, we then developed decision rules for assessing probability (ordinal scale based on the likelihood of exposure > 0.02 ppm), frequency (proportion of work time exposed), and intensity of exposure (in ppm). The rules used the participants' occupational history responses and, for a subset of jobs, responses to job- and industry-specific modules. For probability and frequency, we used a hierarchical assignment procedure that prioritized subject-specific module information when available. Next, we derived job-group medians from the module responses to assign estimates to jobs with only occupational history responses. Last, we used job-by-job expert review to assign estimates when job-group medians were not available or when the decision rules identified possible heterogeneous or rare exposure scenarios. For intensity, we developed separate estimates for each benzene source category that were based on published measurement data whenever possible. Frequency and intensity annual source-specific estimates were assigned only for those jobs assigned ≥75% probability of exposure. Annual source-specific concentrations (intensity × frequency) were summed to obtain a total annual benzene concentration for each job. RESULTS Of the 8827 jobs reported by participants, 8% required expert review for one or more source categories. Overall, 287 (3.3%) jobs were assigned ≥75% probability of exposure from any benzene source category. The source categories most commonly assigned ≥75% probability of exposure were gasoline and degreasing. The median total annual benzene concentration among jobs assigned ≥75% probability was 0.11 ppm (interquartile range: 0.06-0.55). The highest source-specific median annual concentrations were observed for ink and printing (2.3 and 1.2 ppm, respectively). CONCLUSIONS The applied framework captures some subject-specific variability in work tasks, provides transparency to the exposure decision process, and facilitates future sensitivity analyses. The developed decision rules can be used as a starting point by other researchers to assess occupational benzene exposure in future population-based studies.
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Affiliation(s)
- Pamela J Dopart
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Sarah J Locke
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Pierluigi Cocco
- Department of Public Health, Clinical and Molecular Medicine, Occupational Health Section, University of Cagliari, Monserrato, Italy
| | - Bryan A Bassig
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Pabitra R Josse
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology Genetics, National Cancer Institute, Bethesda, MD, USA
| | | | - Mark P Purdue
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Qing Lan
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Nathaniel Rothman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Melissa C Friesen
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology Genetics, National Cancer Institute, Bethesda, MD, USA
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Sauvé JF, Friesen MC. Using Decision Rules to Assess Occupational Exposure in Population-Based Studies. Curr Environ Health Rep 2019; 6:148-159. [PMID: 31297745 PMCID: PMC6698417 DOI: 10.1007/s40572-019-00240-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE OF REVIEW Population-based studies increasingly link task-based occupational questionnaire responses collected from subjects to exposure estimates via transparent, programmable decision rules. We reviewed recent applications and methodological developments of rule-based approaches. RECENT FINDINGS Agent-specific decision rules require interviews incorporating work-task-based questions. Some studies have developed rules before the interviews took place, while others developed rules after the interviews were completed. Agreement between rule-based estimates and exposures assigned using job-by-job expert review were generally moderate to good (Kappa = 0.4-0.8). Rules providing quantitative intensity levels using measurement data or that integrate multiple independent exposure sources for the same job represent further advances to improve the characterization of occupational exposures in population studies. Decision rules have provided transparent and reproducible assessments, reduce job-by-job review, and facilitate sensitivity analyses in epidemiologic studies. Future studies should consider the development of decision rules concurrent with the questionnaire design to facilitate occupational exposure assessment efforts.
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Affiliation(s)
- Jean-François Sauvé
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA.
| | - Melissa C Friesen
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
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Maternal Occupational Oil Mist Exposure and Birth Defects, National Birth Defects Prevention Study, 1997⁻2011. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16091560. [PMID: 31060207 PMCID: PMC6539329 DOI: 10.3390/ijerph16091560] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 04/19/2019] [Accepted: 05/03/2019] [Indexed: 12/31/2022]
Abstract
Workers in various industries can be exposed to oil mists when oil-based fluids are aerosolized during work processes. Oil mists can be inhaled or deposited on the skin. Little research exists on the reproductive effects of oil mist exposure in pregnant workers. We aimed to investigate associations between occupational oil mist exposure in early pregnancy and a spectrum of birth defects using data from 22,011 case mothers and 8140 control mothers in the National Birth Defects Prevention Study. In total, 150 mothers were rated as exposed. Manufacturing jobs, particularly apparel manufacturing, comprised the largest groups of exposed mothers. Mothers of infants with septal heart defects (odds ratio (OR): 1.8, 95% confidence interval (CI): 1.0-3.3), and especially perimembranous ventricular septal defects (OR: 2.5, CI: 1.2-5.2), were more likely to be occupationally exposed to oil mists in early pregnancy than control mothers; and their rater-estimated cumulative exposure was more likely to be higher. This was the first U.S. study evaluating associations between oil mist exposure and a broad spectrum of birth defects. Our results are consistent with previous European studies, supporting a potential association between oil-based exposures and congenital heart defects. Further research is needed to evaluate the reproductive effects of occupational oil mist exposure.
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Deziel NC, Beane Freeman LE, Hoppin JA, Thomas K, Lerro CC, Jones RR, Hines CJ, Blair A, Graubard BI, Lubin JH, Sandler DP, Chen H, Andreotti G, Alavanja MC, Friesen MC. An algorithm for quantitatively estimating non-occupational pesticide exposure intensity for spouses in the Agricultural Health Study. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2019; 29:344-357. [PMID: 30375516 PMCID: PMC6470005 DOI: 10.1038/s41370-018-0088-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 10/05/2018] [Indexed: 05/27/2023]
Abstract
Residents of agricultural areas experience pesticide exposures from sources other than direct agricultural work. We developed a quantitative, active ingredient-specific algorithm for cumulative (adult, married lifetime) non-occupational pesticide exposure intensity for spouses of farmers who applied pesticides in the Agricultural Health Study (AHS). The algorithm addressed three exposure pathways: take-home, agricultural drift, and residential pesticide use. Pathway-specific equations combined (i) weights derived from previous meta-analyses of published pesticide exposure data and (ii) information from the questionnaire on frequency and duration of pesticide use by applicators, home proximity to treated fields, residential pesticide usage (e.g., termite treatments), and spouse's off-farm employment (proxy for time at home). The residential use equation also incorporated a published probability matrix that documented the likelihood active ingredients were used in home pest treatment products. We illustrate use of these equations by calculating exposure intensities for the insecticide chlorpyrifos and herbicide atrazine for 19,959 spouses. Non-zero estimates for ≥1 pathway were found for 78% and 77% of spouses for chlorpyrifos and atrazine, respectively. Variability in exposed spouses' intensity estimates was observed for both pesticides, with 75th to 25th percentile ratios ranging from 7.1 to 7.3 for take-home, 6.5 to 8.5 for drift, 2.4 to 2.8 for residential use, and 3.8 to 7.0 for the summed pathways. Take-home and drift estimates were highly correlated (≥0.98), but were not correlated with residential use (0.01‒0.02). This algorithm represents an important advancement in quantifying non-occupational pesticide relative exposure differences and will facilitate improved etiologic analyses in the AHS spouses. The algorithm could be adapted to studies with similar information.
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Affiliation(s)
- Nicole C Deziel
- Yale School of Public Health, Yale University, New Haven, CT, USA.
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
| | - Laura E Beane Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jane A Hoppin
- Department of Biological Sciences, Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, USA
| | - Kent Thomas
- National Exposure Research Laboratory, U.S. Environmental Protection Agency, Research Triangle Park, Durham, NC, USA
| | - Catherine C Lerro
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Rena R Jones
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Cynthia J Hines
- Division of Surveillance, Hazard Evaluation and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Aaron Blair
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Barry I Graubard
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jay H Lubin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Dale P Sandler
- Department of Health and Human Services, Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA
| | - Honglei Chen
- Department of Health and Human Services, Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, Durham, NC, USA
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA
| | - Gabriella Andreotti
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Michael C Alavanja
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Melissa C Friesen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Callahan CL, Locke SJ, Dopart PJ, Stewart PA, Schwartz K, Ruterbusch JJ, Graubard BI, Rothman N, Hofmann JN, Purdue MP, Friesen MC. Decision rule approach applied to estimate occupational lead exposure in a case-control study of kidney cancer. Am J Ind Med 2018; 61:901-910. [PMID: 30291640 DOI: 10.1002/ajim.22912] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2018] [Indexed: 01/07/2023]
Abstract
BACKGROUND We developed a systematic, data-driven approach to estimate metrics of occupational exposure to lead to aid in epidemiologic analyses in a case-control study of kidney cancer. METHODS Probability of exposure to ten lead sources was assigned using decision rules developed from an extensive literature review and expert judgement. For jobs with >50% probability of exposure, we assigned source-specific frequency based on subjects' self-reported task frequencies or means of subjects' job-groups and source-specific intensity estimates of blood lead (μg/dL). RESULTS In our study, 18.7% of employed person-years were associated with high (≥80%) probability of exposure to any lead source. The most common medium (>50%) or high probability source of lead exposure was leaded gasoline (2.5% and 11.5% of employed person-years, respectively). The median blood lead attributed to occupational exposure was 3.1 μg/dL. CONCLUSIONS These rules can aid in future studies after population-specific adaption for geographic differences and different exposure scenarios.
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Affiliation(s)
- Catherine L. Callahan
- Occupational and Environmental Epidemiology Branch; Division of Cancer Epidemiology Genetics; National Cancer Institute; Bethesda Maryland
| | - Sarah J. Locke
- Occupational and Environmental Epidemiology Branch; Division of Cancer Epidemiology Genetics; National Cancer Institute; Bethesda Maryland
| | - Pamela J. Dopart
- Occupational and Environmental Epidemiology Branch; Division of Cancer Epidemiology Genetics; National Cancer Institute; Bethesda Maryland
| | | | - Kendra Schwartz
- Department of Family Medicine and Public Health Sciences; Karmanos Cancer Institute; Wayne State University; Detroit Michigan
| | - Julie J. Ruterbusch
- Department of Family Medicine and Public Health Sciences; Karmanos Cancer Institute; Wayne State University; Detroit Michigan
| | - Barry I. Graubard
- Biostatistics Branch; Division of Cancer Epidemiology and Genetics; National Cancer Institute; Bethesda Maryland
| | - Nathaniel Rothman
- Occupational and Environmental Epidemiology Branch; Division of Cancer Epidemiology Genetics; National Cancer Institute; Bethesda Maryland
| | - Jonathan N. Hofmann
- Occupational and Environmental Epidemiology Branch; Division of Cancer Epidemiology Genetics; National Cancer Institute; Bethesda Maryland
| | - Mark P. Purdue
- Occupational and Environmental Epidemiology Branch; Division of Cancer Epidemiology Genetics; National Cancer Institute; Bethesda Maryland
| | - Melissa C. Friesen
- Occupational and Environmental Epidemiology Branch; Division of Cancer Epidemiology Genetics; National Cancer Institute; Bethesda Maryland
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Dopart PJ, Friesen MC. New Opportunities in Exposure Assessment of Occupational Epidemiology: Use of Measurements to Aid Exposure Reconstruction in Population-Based Studies. Curr Environ Health Rep 2017; 4:355-363. [PMID: 28695485 PMCID: PMC5693667 DOI: 10.1007/s40572-017-0153-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Exposure assessment efforts in population-based studies are increasingly incorporating measurements. The published literature was reviewed to identify the measurement sources and the approaches used to incorporate measurements into these efforts. RECENT FINDINGS The variety of occupations and industries in these studies made collecting participant-specific measurements impractical. Thus, the starting point was often the compilation of large databases of measurements from inspections, published literature, and other exposure surveys. These measurements usually represented multiple occupations, industries, and worksites, and spanned multiple decades. Measurements were used both qualitatively and quantitatively, dependent on the coverage and quality of the data. Increasingly, statistical models were used to derive job-, industry-, time period-, and other determinant-specific exposure concentrations. Quantitative measurement-based approaches are increasingly replacing expert judgment, which facilitates the development of quantitative exposure-response associations. Evaluations of potential biases in these measurement sources, and their representativeness of typical exposure situations, warrant additional examination.
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Affiliation(s)
- Pamela J Dopart
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA
| | - Melissa C Friesen
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD, 20850, USA.
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Locke SJ, Deziel NC, Koh DH, Graubard BI, Purdue MP, Friesen MC. Evaluating predictors of lead exposure for activities disturbing materials painted with or containing lead using historic published data from U.S. workplaces. Am J Ind Med 2017; 60:189-197. [PMID: 28079279 DOI: 10.1002/ajim.22679] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVES We evaluated predictors of differences in published occupational lead concentrations for activities disturbing material painted with or containing lead in U.S. workplaces to aid historical exposure reconstruction. METHODS For the aforementioned tasks, 221 air and 113 blood lead summary results (1960-2010) were extracted from a previously developed database. Differences in the natural log-transformed geometric mean (GM) for year, industry, job, and other ancillary variables were evaluated in meta-regression models that weighted each summary result by its inverse variance and sample size. RESULTS Air and blood lead GMs declined 5%/year and 6%/year, respectively, in most industries. Exposure contrast in the GMs across the nine jobs and five industries was higher based on air versus blood concentrations. For welding activities, blood lead GMs were 1.7 times higher in worst-case versus non-worst case scenarios. CONCLUSIONS Job, industry, and time-specific exposure differences were identified; other determinants were too sparse or collinear to characterize. Am. J. Ind. Med. 60:189-197, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Sarah J. Locke
- Division of Cancer Epidemiology and Genetics; Occupational and Environmental Epidemiology Branch; National Cancer Institute; Bethesda Maryland
| | - Nicole C. Deziel
- Yale School of Public Health; Yale University; New Haven Connecticut
| | - Dong-Hee Koh
- Department of Occupational and Environmental Medicine; International St. Mary's Hospital; Catholic Kwandong University; Incheon Korea
| | - Barry I. Graubard
- Division of Cancer Epidemiology and Genetics; Biostatistics Branch; National Cancer Institute; Bethesda Maryland
| | - Mark P. Purdue
- Division of Cancer Epidemiology and Genetics; Occupational and Environmental Epidemiology Branch; National Cancer Institute; Bethesda Maryland
| | - Melissa C. Friesen
- Division of Cancer Epidemiology and Genetics; Occupational and Environmental Epidemiology Branch; National Cancer Institute; Bethesda Maryland
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Figueroa JD, Prokunina-Olsson L, Koutros S, Garcia-Closas M, Chanock S, Silverman DT, Rothman N. Response. J Natl Cancer Inst 2016; 108:djv441. [PMID: 26857138 DOI: 10.1093/jnci/djv441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jonine D Figueroa
- Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (JDF, LPO, SK, MGC, SC, DTS, NR); Usher Institute of Population Health Sciences and Informatics, Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh, UK (JDF).
| | - Ludmila Prokunina-Olsson
- Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (JDF, LPO, SK, MGC, SC, DTS, NR); Usher Institute of Population Health Sciences and Informatics, Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh, UK (JDF)
| | - Stella Koutros
- Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (JDF, LPO, SK, MGC, SC, DTS, NR); Usher Institute of Population Health Sciences and Informatics, Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh, UK (JDF)
| | - Montserrat Garcia-Closas
- Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (JDF, LPO, SK, MGC, SC, DTS, NR); Usher Institute of Population Health Sciences and Informatics, Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh, UK (JDF)
| | - Stephen Chanock
- Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (JDF, LPO, SK, MGC, SC, DTS, NR); Usher Institute of Population Health Sciences and Informatics, Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh, UK (JDF)
| | - Debra T Silverman
- Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (JDF, LPO, SK, MGC, SC, DTS, NR); Usher Institute of Population Health Sciences and Informatics, Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh, UK (JDF)
| | - Nathaniel Rothman
- Affiliations of authors: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (JDF, LPO, SK, MGC, SC, DTS, NR); Usher Institute of Population Health Sciences and Informatics, Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh, UK (JDF)
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Friesen MC, Shortreed SM, Wheeler DC, Burstyn I, Vermeulen R, Pronk A, Colt JS, Baris D, Karagas MR, Schwenn M, Johnson A, Armenti KR, Silverman DT, Yu K. Using hierarchical cluster models to systematically identify groups of jobs with similar occupational questionnaire response patterns to assist rule-based expert exposure assessment in population-based studies. ACTA ACUST UNITED AC 2014; 59:455-66. [PMID: 25477475 DOI: 10.1093/annhyg/meu101] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 10/27/2014] [Indexed: 11/14/2022]
Abstract
OBJECTIVES Rule-based expert exposure assessment based on questionnaire response patterns in population-based studies improves the transparency of the decisions. The number of unique response patterns, however, can be nearly equal to the number of jobs. An expert may reduce the number of patterns that need assessment using expert opinion, but each expert may identify different patterns of responses that identify an exposure scenario. Here, hierarchical clustering methods are proposed as a systematic data reduction step to reproducibly identify similar questionnaire response patterns prior to obtaining expert estimates. As a proof-of-concept, we used hierarchical clustering methods to identify groups of jobs (clusters) with similar responses to diesel exhaust-related questions and then evaluated whether the jobs within a cluster had similar (previously assessed) estimates of occupational diesel exhaust exposure. METHODS Using the New England Bladder Cancer Study as a case study, we applied hierarchical cluster models to the diesel-related variables extracted from the occupational history and job- and industry-specific questionnaires (modules). Cluster models were separately developed for two subsets: (i) 5395 jobs with ≥1 variable extracted from the occupational history indicating a potential diesel exposure scenario, but without a module with diesel-related questions; and (ii) 5929 jobs with both occupational history and module responses to diesel-relevant questions. For each subset, we varied the numbers of clusters extracted from the cluster tree developed for each model from 100 to 1000 groups of jobs. Using previously made estimates of the probability (ordinal), intensity (µg m(-3) respirable elemental carbon), and frequency (hours per week) of occupational exposure to diesel exhaust, we examined the similarity of the exposure estimates for jobs within the same cluster in two ways. First, the clusters' homogeneity (defined as >75% with the same estimate) was examined compared to a dichotomized probability estimate (<5 versus ≥5%; <50 versus ≥50%). Second, for the ordinal probability metric and continuous intensity and frequency metrics, we calculated the intraclass correlation coefficients (ICCs) between each job's estimate and the mean estimate for all jobs within the cluster. RESULTS Within-cluster homogeneity increased when more clusters were used. For example, ≥80% of the clusters were homogeneous when 500 clusters were used. Similarly, ICCs were generally above 0.7 when ≥200 clusters were used, indicating minimal within-cluster variability. The most within-cluster variability was observed for the frequency metric (ICCs from 0.4 to 0.8). We estimated that using an expert to assign exposure at the cluster-level assignment and then to review each job in non-homogeneous clusters would require ~2000 decisions per expert, in contrast to evaluating 4255 unique questionnaire patterns or 14983 individual jobs. CONCLUSIONS This proof-of-concept shows that using cluster models as a data reduction step to identify jobs with similar response patterns prior to obtaining expert ratings has the potential to aid rule-based assessment by systematically reducing the number of exposure decisions needed. While promising, additional research is needed to quantify the actual reduction in exposure decisions and the resulting homogeneity of exposure estimates within clusters for an exposure assessment effort that obtains cluster-level expert assessments as part of the assessment process.
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Affiliation(s)
- Melissa C Friesen
- 1.Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
| | - Susan M Shortreed
- 2.Biostatistics, Group Health Research Institute, Seattle, WA 98101-1448, USA
| | - David C Wheeler
- 1.Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA 3.Department of Biostatistics, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Igor Burstyn
- 4.Department of Environmental and Occupational Health, Drexel University, Philadelphia, PA 19104, USA
| | | | | | - Joanne S Colt
- 1.Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
| | - Dalsu Baris
- 1.Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
| | | | - Molly Schwenn
- 8.Maine Cancer Registry, Augusta, ME 04333-0011, USA
| | - Alison Johnson
- 9.Vermont Cancer Registry, Burlington, VT 05402-0070, USA
| | - Karla R Armenti
- 10.New Hampshire Department of Health and Human Services, Division of Public Health Services, Bureau of Public Health Statistics and Informatics, Concord, NH 03301, USA
| | - Debra T Silverman
- 1.Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
| | - Kai Yu
- 11.Biostatistics, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
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11
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Colt JS, Friesen MC, Stewart PA, Donguk P, Johnson A, Schwenn M, Karagas MR, Armenti K, Waddell R, Verrill C, Ward MH, Beane Freeman LE, Moore LE, Koutros S, Baris D, Silverman DT. A case-control study of occupational exposure to metalworking fluids and bladder cancer risk among men. Occup Environ Med 2014; 71:667-74. [PMID: 25201311 PMCID: PMC4690539 DOI: 10.1136/oemed-2013-102056] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Metalworking has been associated with an excess risk of bladder cancer in over 20 studies. Metalworking fluids (MWFs) are suspected as the responsible exposure, but epidemiological data are limited. We investigated this association among men in the New England Bladder Cancer Study using state-of-the-art, quantitative exposure assessment methods. METHODS Cases (n=895) and population controls (n=1031) provided occupational histories during personal interviews. For selected jobs, exposure-oriented modules were administered to collect information on use of three MWF types: (1) straight (mineral oil, additives), (2) soluble (mineral oil, water, additives) and (3) synthetic (water, organics, additives) or semisynthetic (hybrid of soluble and synthetic). We computed ORs and 95% CIs relating bladder cancer risk to a variety of exposure metrics, adjusting for smoking and other factors. Non-metalworkers who had held jobs with possible exposure to mineral oil were analysed separately. RESULTS Bladder cancer risk was elevated among men who reported using straight MWFs (OR=1.7, 95% CI 1.1 to 2.8); risk increased monotonically with increasing cumulative exposure (p=0.041). Use of soluble MWFs was associated with a 50% increased risk (95% CI 0.96 to 2.5). ORs were non-significantly elevated for synthetic/semisynthetic MWFs based on a small number of exposed men. Non-metalworkers holding jobs with possible exposure to mineral oil had a 40% increased risk (95% CI 1.1 to 1.8). CONCLUSIONS Exposure to straight MWFs was associated with a significantly increased bladder cancer risk, as was employment in non-metalworking jobs with possible exposure to mineral oil. These findings strengthen prior evidence for mineral oil as a bladder carcinogen.
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Affiliation(s)
- Joanne S. Colt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Melissa C. Friesen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Patricia A. Stewart
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
- Stewart Exposure Assessments, LLC, Arlington, VA
| | - Park Donguk
- Korea National Open University, Seoul, Korea
| | | | | | | | - Karla Armenti
- New Hampshire Department of Health and Human Services, Concord, NH
| | | | | | - Mary H. Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Laura E. Beane Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Lee E. Moore
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Dalsu Baris
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Debra T. Silverman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
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12
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Koh DH, Nam JM, Graubard BI, Chen YC, Locke SJ, Friesen MC. Evaluating temporal trends from occupational lead exposure data reported in the published literature using meta-regression. ACTA ACUST UNITED AC 2014; 58:1111-25. [PMID: 25193938 DOI: 10.1093/annhyg/meu061] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The published literature provides useful exposure measurements that can aid retrospective exposure assessment efforts, but the analysis of this data is challenging as it is usually reported as means, ranges, and measures of variability. We used mixed-effects meta-analysis regression models, which are commonly used to summarize health risks from multiple studies, to predict temporal trends of blood and air lead concentrations in multiple US industries from the published data while accounting for within- and between-study variability in exposure. METHODS We extracted the geometric mean (GM), geometric standard deviation (GSD), and number of measurements from journal articles reporting blood and personal air measurements from US worksites. When not reported, we derived the GM and GSD from other summary measures. Only industries with measurements in ≥2 time points and spanning ≥10 years were included in our analyses. Meta-regression models were developed separately for each industry and sample type. Each model used the log-transformed GM as the dependent variable and calendar year as the independent variable. It also incorporated a random intercept that weighted each study by a combination of the between- and within-study variances. The within-study variances were calculated as the squared log-transformed GSD divided by the number of measurements. Maximum likelihood estimation was used to obtain the regression parameters and between-study variances. RESULTS The blood measurement models predicted statistically significant declining trends of 2-11% per year in 8 of the 13 industries. The air measurement models predicted a statistically significant declining trend (3% per year) in only one of the seven industries; an increasing trend (7% per year) was also observed for one industry. Of the five industries that met our inclusion criteria for both air and blood, the exposure declines per year tended to be slightly greater based on blood measurements than on air measurements. CONCLUSIONS Meta-analysis provides a useful tool for synthesizing occupational exposure data to examine exposure trends that can aid future retrospective exposure assessment. Data remained too sparse to account for other exposure predictors, such as job category or sampling strategy, but this limitation may be overcome by using additional data sources.
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Affiliation(s)
- Dong-Hee Koh
- 1.Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA 3.National Cancer Control Institute, National Cancer Center, Goyang 410-769, Korea
| | - Jun-Mo Nam
- 1.Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
| | - Barry I Graubard
- 1.Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
| | - Yu-Cheng Chen
- 2.National Environmental Health Research Center, National Health Research Institutes, Taipei 11503, Taiwan
| | - Sarah J Locke
- 1.Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
| | - Melissa C Friesen
- 1.Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
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13
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Colt JS, Friesen MC, Stewart PA, Donguk P, Johnson A, Schwenn M, Karagas MR, Armenti K, Waddell R, Verrill C, Ward MH, Beane Freeman LE, Moore LE, Koutros S, Baris D, Silverman DT. 0084 A Case-Control Study of Occupational Exposure to Metalworking Fluids and Bladder Cancer Risk among Men. Occup Environ Med 2014; 71 Suppl 1:A71. [PMID: 25018457 PMCID: PMC4116153 DOI: 10.1136/oemed-2014-102362.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVES Metalworking has been associated with bladder cancer risk in many studies. Metalworking fluids (MWFs) are suspected as the putative exposure, but epidemiologic data are limited. Based on state-of-the-art, quantitative exposure assessment, we examined MWF exposure and bladder cancer risk in the New England Bladder Cancer Study. METHOD Male cases (n = 895) and population controls (n = 1031) provided occupational histories and information on use of each of three MWF types: (1) straight (mineral oil, additives), (2) soluble (mineral oil, water, additives), and (3) synthetic (water, organics, additives) or semi-synthetic (soluble/synthetic hybrid), in response to exposure-oriented modules administered during personal interviews. We estimated the probability, frequency, and intensity of exposure to each MWF type and, if probability exceeded 50%, cumulative exposure. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs), adjusting for smoking and other risk factors. RESULTS Risk was increased for men reporting use of straight MWFs (OR=1.7, 95% CI=1.1-2.8), with a significant trend with increasing cumulative exposure (p = 0.024). Use of soluble MWFs conferred a 50% elevated risk (95% CI=0.96-2.5). ORs were nonsignificantly elevated for synthetic MWFs, based on small numbers. Men who were never metalworkers, but held jobs with possible exposure to mineral oil, had a 40% increased risk (95% CI=1.1-1.8). CONCLUSIONS In the most comprehensive assessment of MWF exposure in a bladder cancer case-control study, exposure to straight MWFs significantly increased bladder cancer risk, as did employment in non-metalworking jobs with possible mineral oil exposure. Our results strengthen prior evidence for mineral oil as a bladder carcinogen.
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Affiliation(s)
- Joanne S. Colt
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Melissa C. Friesen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Patricia A. Stewart
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
- Stewart Exposure Assessments, LLC, Arlington, VA
| | - Park Donguk
- Korea National Open University, Seoul, Korea
| | | | | | | | - Karla Armenti
- New Hampshire Department of Health and Human Services, Concord, NH
| | | | | | - Mary H. Ward
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Laura E. Beane Freeman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Lee E. Moore
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Dalsu Baris
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
| | - Debra T. Silverman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD
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14
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Park DU, Colt JS, Baris D, Schwenn M, Karagas MR, Armenti KR, Johnson A, Silverman DT, Stewart PA. Estimation of the probability of exposure to machining fluids in a population-based case-control study. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2014; 11:757-70. [PMID: 25256317 PMCID: PMC4359797 DOI: 10.1080/15459624.2014.918984] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We describe an approach for estimating the probability that study subjects were exposed to metalworking fluids (MWFs) in a population-based case-control study of bladder cancer. Study subject reports on the frequency of machining and use of specific MWFs (straight, soluble, and synthetic/semi-synthetic) were used to estimate exposure probability when available. Those reports also were used to develop estimates for job groups, which were then applied to jobs without MWF reports. Estimates using both cases and controls and controls only were developed. The prevalence of machining varied substantially across job groups (0.1->0.9%), with the greatest percentage of jobs that machined being reported by machinists and tool and die workers. Reports of straight and soluble MWF use were fairly consistent across job groups (generally 50-70%). Synthetic MWF use was lower (13-45%). There was little difference in reports by cases and controls vs. controls only. Approximately, 1% of the entire study population was assessed as definitely exposed to straight or soluble fluids in contrast to 0.2% definitely exposed to synthetic/semi-synthetics. A comparison between the reported use of the MWFs and U.S. production levels found high correlations (r generally >0.7). Overall, the method described here is likely to have provided a systematic and reliable ranking that better reflects the variability of exposure to three types of MWFs than approaches applied in the past. [Supplementary materials are available for this article. Go to the publisher's online edition of Journal of Occupational and Environmental Hygiene for the following free supplemental resources: a list of keywords in the occupational histories that were used to link study subjects to the metalworking fluids (MWFs) modules; recommendations from the literature on selection of MWFs based on type of machining operation, the metal being machined and decade; popular additives to MWFs; the number and proportion of controls who reported various MWF responses by job group; the number and proportion of controls assigned to the MWF types by job group and exposure category; and the distribution of cases and controls assigned various levels of probability by MWF type.].
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Affiliation(s)
- Dong-Uk Park
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, 9609 Medical Center Drive Room 6E608 MSC 9771 Bethesda, MD 20892 USA
- Department of Environmental Health, Korea National Open University, 169, Donsungdong, Jongroku, Seoul, Korea, 110-791
| | - Joanne S. Colt
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, 9609 Medical Center Drive Room 6E608 MSC 9771 Bethesda, MD 20892 USA
| | - Dalsu Baris
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, 9609 Medical Center Drive Room 6E608 MSC 9771 Bethesda, MD 20892 USA
| | | | | | - Karla R. Armenti
- New Hampshire Department of Health and Human Services, Division of Public Health Services, Bureau of Public Health Statistics and Informatics, Concord, New Hampshire, USA
| | | | - Debra T Silverman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, 9609 Medical Center Drive Room 6E608 MSC 9771 Bethesda, MD 20892 USA
| | - Patricia A Stewart
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, DHHS, 9609 Medical Center Drive Room 6E608 MSC 9771 Bethesda, MD 20892 USA
- Stewart Exposure Assessments, LLC, 6045 N 27th. St, Arlington, VA 22207
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