Application of a method to evaluate the quality of work histories and document the exposure assessment process

Our plain-English summary of Application of a method to evaluate the quality of work histories and document the exposure assessment process, by C. Rice, E.F. Heineman (American Journal of Industrial Medicine, 2003).

The study

• Authors: C. Rice, E.F. Heineman
• Journal: American Journal of Industrial Medicine
• Published: 2003;44(1):94-106
• Cited by: 2 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: Review of work history records by industrial hygienists is an important component of many occupational epidemiologic studies. A number of factors may influence the hygienist, such as the quality of the data and his or her previous experience. As part of a case-control study of mesothelioma, a system was developed to capture data on several factors that can be considered in a review of work history information.

Methods: The overall quality of the work history record was described by noting the completeness and the consistency of the information; for any potential exposures, the reviewer experience on which the decision was based and the relative quality of the information were categorized. Because of the potential for mesothelioma cases and their next-of-kin to have undergone rigorous questioning about previous asbestos exposure an evaluation of the knowledge of the respondent was included. The frequency and intensity of exposure were also evaluated.

Results: Evaluation of 3,444 work records is described. The importance of data completeness in the overall evaluation of quality is shown; follow-up questions regarding specific work tasks provide information not elicited in the standard interview process. The use of the literature was an important resource to the reviewer. Asbestos was reported by the respondent as an exposure on 149 work records; of these, 111 (74%) were judged to represent an unusual level of knowledge for a next-of-kin respondent.

Conclusions: The approach presented allows capture of information about data quality and experience of the reviewer in an epidemiologic analysis. The ratings of frequency and intensity of exposure allow exploration of differences in exposure-response analyses using various exposure metrics.

Copyright 2003 Wiley-Liss, Inc.

In plain English

The authors developed and applied a system for recording how an industrial hygienist judged job histories collected for an earlier U.S. case-control study of mesothelioma. Next-of-kin of 208 mesothelioma cases diagnosed 1975–1980 and of deceased controls (428 men, 105 women) were interviewed by telephone in 1982–1984. An author, without knowing who was a case, reviewed 3,444 job records for 741 subjects. The reviewer rated each record's completeness, consistency and usefulness and the experience behind each decision, and estimated the probability, frequency and intensity of 19 exposures, including asbestos. Overall, 94% of records were judged sufficient to evaluate at least one exposure, and this share fell as fewer interview items were usefully answered. Of 5,023 possible exposures, 40% rested on the reviewer's direct experience, 48% on indirect experience and 12% on literature alone. Next-of-kin named asbestos on 149 records, and 111 (74%) of these were judged to show unusual knowledge. The authors concluded the approach documents data quality and reviewer experience for later analysis. They noted that ratings may vary among hygienists and that no workplace measurements were available.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Methods study: development and application of a rating system for industrial hygienist review of work histories, using records from a case-control study of mesothelioma
• Who was studied: 3,444 work records for 741 subjects. The subjects were 208 mesothelioma cases (183 men, 25 women; 183 pleural or pleural and peritoneal, 25 peritoneal only) diagnosed 1975–1980 and identified through the New York State or Los Angeles County Cancer Registries or 39 Veterans Administration hospitals, plus deceased controls (428 men, 105 women). Information came from next-of-kin telephone interviews completed 1982–1984.
• Exposure: 19 agents or industries possibly related to mesothelioma, including asbestos, man-made vitreous fibers, ionizing radiation, organic solvents, siliceous dusts, PAHs and metals. Asbestos intensity was rated on a four-level scale: very low (below the phase-contrast microscopy detection limit), low (below 2 f/cc), medium (2 to 7.9 f/cc) and high (8 or more f/cc).
• Main results:
  • 94% of work records were judged sufficient to evaluate at least one exposure.
  • The share of records rated sufficient fell as the number of usefully completed interview elements fell from five to zero (100, 99, 85, 35, 17 and 0%). All five elements were usefully completed in 69% of records.
  • Of 5,023 exposures rated possible, 40% were based on the reviewer's direct knowledge, 48% on indirect knowledge and 12% on literature references.
  • Follow-up questions added information beyond the basic work history for 800 of the 5,023 assessed exposures (16%) and were judged inconsistent with it for 209 (4%).
  • Next-of-kin reported asbestos exposure on 149 records; the reviewer judged 111 (74%) of these to show unusual knowledge of the subject's work. The reviewer was not aware of workers' compensation claims or legal action.
  • Asbestos was rated as a possible exposure for 912 job records. Of these, 493 (54%) were rated high probability (Table V).
  • Literature searching added about one person-month to roughly two person-months of record review, increasing project time by 50%.
• The authors' conclusion: The authors concluded that the approach allowed cataloguing of data quality, the data used, reviewer experience and respondent knowledge, and that differences in these were seen across exposures. They stated that further research is needed on other settings and on intra-rater and inter-rater variability.
• Limitations the authors state:
  • Ratings may vary among different hygienists reviewing the same records.
  • No actual exposure measurements were available for the subjects' workplaces, so asbestos rankings should be treated as relative values.
  • Only next-of-kin could provide work histories, and the respondent's relationship to the subject was not in the data set.
  • Follow-back contact with respondents was not possible.
  • The reviewer may have hesitated to assign low probability when exposure was uncertain.
  • The numerical codes assigned to the rating variables are arbitrary.

Topics

Medical terms in this study, explained in our Lexicon: Work History, Case-Control Study, Mesothelioma, Asbestos Exposure.

Related studies

• Occupational exposure to asbestos as evaluated from work histories and analysis of lung tissues from patients with mesothelioma — T. Tuomi, M.S. Huuskonen, et al. (1991)
• A PC-based quality control (QC) program for an industrial hygiene laboratory — D.K. Verma, K. Ferguson, et al. (2006)
• Retrospective Exposure Assessment Methods Used in Occupational Human Health Risk Assessment: A Systematic Review — F. Borghi, L.A. Mazzucchelli, et al. (2020)
• Pleural mesothelioma and exposure to asbestos: evaluation from work histories and analysis of asbestos bodies in bronchoalveolar lavage fluid or lung tissue in 131 patients — J.C. Pairon, E. Orlowski, et al. (1994)
• Estimation and inference for case-control studies with multiple non-gold standard exposure assessments: with an occupational health application — H. Chu, S.R. Cole, et al. (2009)
• Patterns of histopathological change determined by the point counting method and its application for the hazard assessment of respirable dust — A. Ogami, Y. Morimoto, et al. (2004)

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