International Journal of Epidemiology, Vol 22, S29-S35, Copyright © 1993 by International Epidemiological Association
AC Fletcher, G Engholm and A Englund
A total of 719 lung cancers were identified in a follow-up of 135,000
Swedish construction workers interviewed during 1971-1974 by occupational
health nurses as part of a routine health check-up. These were analysed in
a matched case-control study nested within this cohort, to compare
different methods of characterizing exposure to asbestos. Self-reported
exposure was contrasted with a job exposure matrix (JEM) of five levels of
exposure intensity, applied to the job at the time of health check-up.
Smoking adjusted odds ratios were computed and the JEM performed better
than self-reported exposure, in being able to discriminate high risk
subgroups. The same pattern was evident in a parallel analysis of 41
mesotheliomas. However both measures appeared subject to misclassification,
and the question put seemed to pick up the use of asbestos cement products
more effectively than asbestos insulation products. It is concluded that a
simple JEM can be more reliable than a simple question, but that both
should be much more detailed, to take account of different types of
asbestos exposure and their variation over time.
ARTICLES
The risk of lung cancer from asbestos among Swedish construction workers: self-reported exposure and a job exposure matrix compared
Department of Public Health Policy, London School of Hygiene and Tropical Medicine, UK.
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