Reliability of reported occupational history information for US coal miners, 1969-1977

Reliability and Validity of a Nationwide Survey (the Korean Radiation Workers Study)

Background

This study aimed to evaluate the reliability and validity of the self-administered questionnaire for Korean radiation workers.

Methods

From May 24, 2016, to June 30, 2017, 20,608 participants completed the questionnaire, providing information on sociodemographics, lifestyle, work history and practices, medical radiation exposure, and medical history, which was linked to the National Dose Registry and the National Cancer Registry. The validity of the questionnaire was evaluated using the responses of 20,608 workers, and reliability was evaluated using the responses of 3043 workers who responded to the survey twice.

Results

Responses concerning demographic characteristics and lifestyle showed reliability with a moderate-to-high agreement (kappa: 0.43–0.99), whereas responses concerning occupation and medical radiation exposure had a wide range of agreement (kappa: 0.05–0.95), possibly owing to temporal variability during employment. Regarding validity, responses to the question about the first year of employment had an excellent agreement with the national registry (intraclass correlation coefficient = 0.9); however, responses on cancer history had a wide range of agreement (kappa: 0.22–0.85).

Conclusion

Although the reliability and validity of the questionnaire were not distinguished by demographic characteristics, they tended to be low among participants whose occupational radiation exposure was minimal. Overall, the information collected can be reliable for epidemiological studies; however, caution must be exercised when using information such as medical exposure and work practices, which are prone to temporal variability.

Reliability and Validity of an Adapted Questionnaire Assessing Occupational Exposures to Hazardous Chemicals among Health Care Workers in Bhutan

BACKGROUND

Collection of reliable and valid occupational history data is of utmost importance to assess work-related exposures and their health effects. Few standardized questionnaires are available for the collection of occupational history data in low-and-middle income countries.

OBJECTIVE

To adapt and test a validated questionnaire developed in the United States by the National Institute of Safety and Health, in order to assess occupational chemical exposures among health care workers in Bhutan.

METHODS

The questionnaire was first adapted to suit the Bhutanese context with the advice of an expert review committee. 30 health care workers then completed the questionnaire at baseline and 10-14 days later. Test-retest reliability was assessed by calculating Cohen's κ and percentage agreement.

RESULTS

The questionnaire had high test-retest reliability. Cohen's κ ranged from 0.61 to 1.00, and percentage agreement ranged from 86.7% to 100%. Further adaptations included omitting questions on chemicals not available in Bhutan.

CONCLUSION

The adapted questionnaire is appropriate for assessing occupational chemical exposures among health care workers in Bhutan.

Reliability of self-reported questionnaire on occupational radiation practices among diagnostic radiologic technologists

BACKGROUND

We aimed to assess the reliability of a self-reported questionnaire on occupational radiation practices among radiologic technologists.

METHODS

We enrolled 941 participants who had repeatedly completed the questionnaire from the 2012-2013 radiologic technologists' health study in South Korea. We used percentage agreement, kappa statistics, and intraclass correlation coefficient (ICC) to assess the reliability of responses on work practices.

RESULTS

Overall agreement for ever-never diagnostic radiation procedures was high (87.5-97.5%), and κ values indicated substantial agreement (0.66-0.86) in all procedures except cephalometric and intraoral radiography. For the information of year of work start and working duration, high agreement was obtained (ICC: 0.99 and 0.98, respectively). However, use of a worn dosimeter and of personal protective equipment showed only moderate to substantial agreement.

CONCLUSIONS

Self-reported information on working practices regarding radiation exposure in radiologic technologists was reliable enough for epidemiologic studies. Am. J. Ind. Med. 60:377-385, 2017. © 2017 Wiley Periodicals, Inc.

Occupational Factors and Smoking Cessation among Unionized Building Trades Workers

The purpose of this study was to estimate the contribution of occupational factors to smoking cessation among building trades workers. Longitudinal data came from the MassBUILT smoking cessation intervention study for unionized building trades workers. Multivariable logistic regression analyses were applied to identify the significant predictors of smoking cessation, which was defined as abstinence from smoking during the previous 7 days at the 1-month monitoring and prolonged abstinence for at least 6 months at the 6-month monitoring. Greater concern about exposure to occupational hazards was significantly associated with increased likelihood of smoking cessation at 1 month (odds ratio = 1.06; 95% confidence interval = 1.01–1.11). Additionally, smokers who had a more positive view of their unions had at least marginally increased likelihood of smoking cessation at 1 month. Furthermore, older age, higher levels of educational attainment and household income, and fewer cigarettes smoked per day were important covariates that predicted smoking cessation. Concerns about exposures to work hazards should be incorporated into comprehensive intervention approaches for building trades workers. Additionally, the findings emphasize that blue-collar workers with lower income and education levels and heavy smokers should be considered target groups for implementing cessation interventions.

Cigarette smoking in building trades workers: the impact of work environment

BACKGROUND

Blue-collar workers smoke at higher rates than white-collar workers and the general population. Occupational factors may contribute to smoking behavior in this group. However, little is known about the role of occupational factors in explaining cigarette-smoking patterns.

METHODS

This study used cross-sectional data from the MassBUILT smoking cessation intervention study. Multivariable logistic regression analysis was conducted to investigate the association of occupational factors with current cigarette smoking among 1,817 building trades workers.

RESULTS

Current cigarette smoking was significantly associated with the following occupational factors: union commitment (OR = 1.06; 95% CI: 1.00-1.12); exposure to dust (OR = 1.50; 95% CI: 1.15-1.95), exposure to chemicals (OR = 1.41; 95% CI: 1.11-1.79); and concern about exposure to occupational hazards (OR = 0.93; 95% CI: 0.91-0.95).

CONCLUSION

The findings highlight the need to explicate the pathways by which occupational factors may contribute to current smoking behavior among building trades workers. Smoking cessation programs for this population should consider work-related occupational factors along with individual approaches.

Ascertainment of occupational histories in the working population: the occupational history calendar approach

BACKGROUND

self-reported occupational histories are an important means for collecting historical data in epidemiological studies. An occupational history calendar (OHC) has been developed for use alongside a national occupational hazard surveillance tool. This study presents the systematic development of the OHC and compares work histories collected via this calendar to those collected via a traditional questionnaire.

METHODS

the paper describes the systematic development of an OHC for use in the general working population. A comparison of data quality and recall was undertaken in 51 participants where both tools were administered.

RESULTS

the OHC enhanced job recall compared with the traditional questionnaire. Good agreement in the data captured by both tools was observed, with the exception of hazard exposures.

CONCLUSIONS

a calendar approach is suitable for collecting occupational histories from the general working population. Despite enhancing job recall the OHC approach has some shortcomings outweighing this advantage in large-scale population surveillance.

Later-Life Career Disruption and Self-Rated Health: An Analysis of General Social Survey Data

The transition from employment to retirement is changing dramatically in Canada and other industrialized societies, with a decreasing proportion of working life being spent in stable career progression. This study used a sample of 2,592 subjects, aged 45 to 64, from the 1994 General Social Survey of Canada (GSS): Cycle 9, to describe situations of later-life career disruption (LLCD) in older workers in Canada and to investigate the association between LLCD and self-rated health. Results showed that a large proportion of older Canadian workers had experienced such LLCD as job interruption and job loss. Experience of job loss and job interruption over the prior 5-year period was found to be significantly associated with poor self-rated health, after controlling for age, education, body mass index, and activity limitation. However, after excluding respondents whose LLCD was known to be due to poor health, job interruption and job loss were separately found not to be significantly associated with poor health. The complexity of the findings and the direction of causation between LLCD and self-rated health, as well as some methodology issues, are discussed. Areas of future research are indicated.

The association of workplace hazards and smoking in a U.S. multiethnic working-class population

OBJECTIVE

We investigated the extent to which smoking status was associated with exposure to occupational (e.g., dust, chemicals, noise, and ergonomic strain) and social (e.g., abuse, sexual harassment, and racial discrimination) workplace hazards in a sample of U.S. multiethnic working-class adults.

METHODS

United for Health is a cross-sectional study designed to investigate the combined burden of occupational and social workplace hazards in relation to race/ethnicity, gender, and wage and to evaluate related health effects in a working-class population. Using validated measures, we collected data from 1,282 multiethnic working-class participants using audio computer-assisted interviews. We used multiple imputation methods to impute data for those missing data. Crude and adjusted logistic odds ratios (ORs) were modeled to estimate ORs and 95% confidence intervals (CIs).

RESULTS

The prevalence of smoking was highest among non-Hispanic white workers (38.3%) and lowest for foreign-born workers (13.1%). We found an association between racial discrimination and smoking (OR = 1.12, 95% CI 1.01, 1.25). The relationship between smoking and sexual harassment, although not significant, was different for black women compared with men (OR = 1.79, 95% CI 0.99, 3.22). We did not find any associations by workplace abuse or by any of the occupational hazards.

CONCLUSION

These results indicate that racial discrimination might be related to smoking in working-class populations and should be considered in tobacco-control efforts that target this high-risk population.

Validity and reliability of an occupational exposure questionnaire for parkinsonism in welders

This study assessed the validity and test-retest reliability of a medical and occupational history questionnaire for workers performing welding in the shipyard industry. This self-report questionnaire was developed for an epidemiologic study of the risk of parkinsonism in welders. Validity participants recruited from three similar shipyards were asked to give consent for access to personnel files and complete the questionnaire. Responses on the questionnaire were compared with information extracted from personnel records. Reliability participants were recruited from the same shipyards and were asked to complete the questionnaire at two different times approximately 4 weeks apart. Percent agreement, kappa, intraclass correlation coefficient (ICC), and sensitivity and specificity were used as measures of validity and/or reliability. Personnel files were obtained for 101 of 143 participants (70%) in the validity study, and 56 of the 95 (58.9%) participants in the reliability study completed the retest of the questionnaire. Validity scores for items extracted from personnel files were high. Percent agreement for employment dates and job titles ranged from 83-100%, while ICC for start and stop dates ranged from 0.93-0.99. Sensitivity and specificity for current job title ranged from 0.5-1.0. Reliability scores for demographic, medical and health behavior items were mainly moderate or high, but ranged from 0.19 to 1.0. Most recent job/title items such as title, types of welding performed, and material used showed substantial to perfect agreement. Certain determinants of exposure such as days and hours per week exposed to welding fumes demonstrated mainly moderate agreement (kappa= 0.42-0.47, percent agreement 63-77%); however, mean days and hours reported did not differ between test and retest. The results of this study suggest that participants' self-report for job title and dates employed are valid compared with employer records. While kappa scores were low for some medical conditions and for caffeine consumption, high kappa scores for job title, dates worked, types of welding, and materials welded suggest participants generated reproducible answers important for occupational exposure assessment.

Current and lifetime exposure to working conditions. Do they explain educational differences in subjective health?

Previous research has shown that the association between education and health is partly mediated by working conditions. So far, most studies fail to take into account working careers and instead focus on working conditions at one point in time. This study examines the extent to which current and lifetime exposure to working conditions differ between educational groups, and whether taking into account lifetime exposure rather than current exposure improves our understanding of educational differences in health. A representative sample of the Dutch population (n = 1561) with retrospective information about working careers shows that lower educated men are significantly more exposed to adverse working conditions than higher educated men. These differences increase over the life course. Among women there are relatively small educational differences in exposure. Lifetime exposure to adverse working conditions explains a significant part (a third) of the health differences between the highest and lowest educated men. Moreover, measurements of lifetime exposure to working conditions offer a better explanation for educational differences in health than measurements of current exposure. Among women, only relative lifetime exposure to working conditions can explain a small part of the educational differences in health, while current and absolute lifetime exposure do not explain these differences.

Effects of occupational solvent exposure on reproductive hormone concentrations and fecundability in men

BACKGROUND

Little is known about the effects of organic solvents on male reproductive health. To assess fertility and reproductive endocrine function in solvent-exposed men, we investigated time-to-pregnancy using a retrospective cohort design and cross-sectionally measured reproductive hormone concentrations in painters and millwrights compared to a reference group of carpenters.

METHODS

Detailed occupational, exposure, medical, and time-to-pregnancy histories were obtained by telephone interview. Plasma luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone concentrations were determined by immunoassay. Exposure indices, which summarized working life exposure to total solvents, chlorinated solvents, aromatic solvents, and thinners, degreasers, varnishes, and adhesives as a category were calculated from exposure histories.

RESULTS

FSH concentrations increased significantly with increasing exposure indices for all solvents and for chlorinated solvents. There were no significant associations of solvent exposure indices with LH or testosterone levels. LH, FSH, and testosterone concentrations also did not differ by job title. Using Cox regression, time-to-pregnancy was non-significantly longer in the painters and millwrights than the carpenters. There was no significant association between time-to-pregnancy and any of the solvent exposure indices; however, it should be noted that some of the pregnancies occurred more than 20 years previously, potentially reducing the reliability of the retrospectively collected pregnancy and exposure data.

CONCLUSIONS

The significant associations between FSH levels and solvent exposure indices suggest the potential for adverse effects of solvent exposures on reproductive function in men.

Update on respiratory disease from coal mine and silica dust

Coal mine and silica dust cause significant respiratory disease in spite of modern dust control regulations. Susceptible individuals in exposed populations may develop fibrosing lung disease, obstructive airways disease, including chronic bronchitis and emphysema, or lung cancer. A careful occupational history that elicits exposure to respiratory hazards is the cornerstone of an accurate diagnosis. Treatment involves removal from exposure, supportive care, pulmonary rehabilitation, and when disabling disease is present, assistance obtaining compensation.

Reproducibility of survey results from a study of occupation-related respiratory health in the aluminum industry

Confidence in dose-response relationships arising from occupational studies is dependent upon the reliability and validity of relevant exposure and morbidity estimates. Often self-reported occupational histories are a surrogate for direct exposure measures, and self-report of symptoms serves a similar purpose in place of more objective measures of morbidity. Unfortunately, there are few methods for validating either of these sources of information. This study attempts to evaluate the reproducibility of a survey instrument, and resulting cumulative exposure estimates, utilized in a study of work-related respiratory morbidity in the aluminum industry. The survey instrument comprised measures of pulmonary function, atopic status, smoking, occupational history, and respiratory symptoms. A Task Exposure Matrix was used to estimate exposure categories and cumulative exposure scores. Two groups of employees were administered the survey instrument on two separate occasions. Group A (n = 74) completed their two surveys more than ten weeks apart and Group B (n = 43) completed their surveys less than two weeks apart. Reproducibility was assessed using Cohen's Kappa for categorically measured outcome measures and intraclass correlation coefficients for continuously measured outcomes. Agreement across most variables, for both groups, was generally high. Repeatability of self-reported respiratory symptoms ranged from 70 to 98 percent (Group A) and 88 to 100 percent (Group B). Cumulative exposure scores were highly reproducible, despite some discrepancies in the self-reported occupational histories across interviews, with most of the calculated intraclass r scores exceeding 0.8. These results give strength to studies reporting dose-response relationships derived from similarly collected data. Reproducibility of the survey data was enhanced by use of standardized questionnaire material, consistent interview structure, and calibrated equipment for objective observation. In particular the authors recommend use of a company job dictionary to optimize reproducibility of self-reported occupational information.

Occupational exposure assessment in case-control studies: opportunities for improvement

Community based case-control studies are an efficient means to study disease aetiologies, and may be the only practical means to investigate rare diseases. However, exposure assessment remains problematic. We review the literature on the validity and reliability of common case-control exposure assessment methods: occupational histories, job-exposure matrices (JEMs), self reported exposures, and expert assessments. Given the variable quality of current exposure assessment techniques, we suggest methods to improve assessments, including the incorporation of hygiene measurements: using data from administrative exposure databases; using results of studies identifying determinants of exposure to develop questionnaires; and where reasonable given latency and biological half life considerations, directly measuring exposures of study subjects.

Development of an asthma specific job exposure matrix and its application in the epidemiological study of genetics and environment in asthma (EGEA)

OBJECTIVES

To develop a method suitable for estimating exposure risks in population studies of asthma from job titles and international codes, by combining a new job exposure matrix (JEM) with the expert judgement approach. The method was applied in the French epidemiological study of the genetics and environment in asthma (EGEA).

METHODS

The JEM contains 22 exposure groups including 18 high risk groups based on known risk factors for occupational asthma, divided into high molecular weight agents, low molecular weight agents, and mixed environments. After applying the JEM to job codes, exposure estimates for each subject were re-evaluated by examining job title texts. Three high risk exposure estimates for asthma were compared: firstly, applying the JEM to original codes (from different coders in each study centre); secondly, applying the JEM to revised codes (from one experienced coder); and thirdly, after reviewing JEM exposure estimates in the light of job title texts.

RESULTS

The study comprised 173 cases with asthma and 285 controls (age 18-65). Odds ratios (ORs) for asthma for high risk jobs were 1.0 (95% confidence interval (95% CI) 0.6 to 1.7), applying the JEM to original codes; 1.4 (95% CI 0.8 to 2.3), applying the JEM to revised codes; and 1.7 (95% CI 1.1 to 2.7), applying the JEM and subsequently re-evaluating exposure estimates from job title texts. Asthma ORs were 1.4 (95% CI 0.6 to 2.9) for high molecular weight agents, 2.3 (95% CI 1.2 to 4.4) for low molecular weight agents, and 2.1 (95% CI 0.9 to 5.2) for mixed environments.

CONCLUSIONS

This asthma JEM, when enhanced by expert re-evaluation of exposure estimates from job title texts, may be a useful tool in general population studies of asthma. In this study, a 1.7-fold increase in prevalence odds of high risk exposures was found among asthmatic workers compared with controls, with risk magnitude varying for different classes of exposure.

Exposure-response relations for self reported asthma and rhinitis in bakers

OBJECTIVES

To explore relations between two estimates of exposure to inhalable flour dust, and the incidence rates (IRs) of asthma and rhinitis in bakers.

METHODS

This was a retrospective cohort study among 2923 bakers. A posted questionnaire registered the disease and work history. For every year, each baker was assigned an estimate of the exposure concentration to inhalable flour dust derived from reported job-tasks and dust measurements. Exposure at onset of disease was expressed as current dust exposure concentration, and as cumulative dose of exposure to dust. A multiple Poisson regression analysis assessed the impacts of the exposure estimates on the IRs of asthma and rhinitis.

RESULTS

IRs of asthma and rhinitis increased by dust concentration at onset of disease. The IR of asthma for the bakers with highest exposure (dough makers) was 7. 3/1000 person-years in men and 6.5 in women and for rhinitis 43.4 and 38.5, respectively. There was a significant association between the dust concentration at onset of disease and the risk for asthma or rhinitis, but not of the cumulative exposure.

CONCLUSION

The risk of asthma seemed to be increased at inhalable dust concentrations >/=3 mg/m(3) (dough making or bread forming), whereas the risk of rhinitis was increased at all concentrations >/=1 mg/m(3), indicating an increased risk in all bakery job-tasks. The risks seemed to be less dependent on the cumulative exposure dust than the inhalable dust concentrations.

Consistency of occupational exposure history from pattern and model makers

This study investigates the consistency of occupational histories reported by the same men in 1985 and again in 1988. Detroit-area pattern and model makers participating in a colorectal cancer screening program that was offered at 3-year intervals completed a career length occupational exposure questionnaire at each screening. Analysis of the data from the 243 men who participated in both screening programs provided the opportunity to examine the consistency with which these workers reported the extent of their exposure to 13 substances commonly found in their work environment. Workers were asked to provide a work history, and for each different pattern or model maker job they had held, to estimate the percentage of time they were exposed to the 13 substances. The data indicated that over the 3-year study period, pattern and model makers were highly consistent in reporting whether or not they were exposed to the 13 substances. In addition, their first estimates of the percentage of time they were exposed to each substance were within 10% of their second estimates more than 70% of the time. This concordance was somewhat diminished after excluding those who reported no exposure. These findings suggest that skilled tradesman can provide occupational exposure information that is likely to be useful for physicians in considering an occupational cause for a presenting health concern.

Occupational physical activity and breast cancer risk in the upper Cape Cod cancer incidence study

BACKGROUND

In several epidemiological studies, breast cancer risk has been reduced among women who reported high levels of occupational or leisure-time physical activity. We used data from a population-based case control study to evaluate the effect of occupational physical activity on breast cancer risk.

METHODS

Two hundred-thirty three incident cases of breast cancer and 670 controls or their next of kin were interviewed for information on breast cancer risk factors and a complete job history. Physical activity level of jobs were classified using a Department of Labor rating scheme. We calculated adjusted odds ratios for light and medium/heavy activity jobs compared to sedentary jobs.

RESULTS

Odds ratios for women who held medium/heavy jobs for less than 10 years and more than ten years were, respectively, 0.7 (95% CI = 0.4,1.3) and 1.7 (95% CI = 0.9,3.3).

CONCLUSIONS

In these data there was no evidence that holding a job of medium/heavy activity reduced breast cancer risk. The study was limited by misclassification inherent in the occupational exposure scheme and by the lack of information on leisure time physical activity. The modest risk increase for subjects holding a medium/heavy job for at least 10 years probably represents either confounding or random variation.