Top

BMC Public Health

Published in:

Open Access 01-12-2022 | Bronchial Asthma | Research

Comparison of agreement in asthmagen exposure assessments between rule-based automatic algorithms and a job exposure matrix in healthcare workers in Australia and Bhutan

Authors: Rajni Rai, Lin Fritschi, Deborah C Glass, Nidup Dorji, Sonia El-Zaemey

Published in: BMC Public Health | Issue 1/2022

Abstract

Background:

Assessment of occupational exposures is an integral component of population-based studies investigating the epidemiology of occupational diseases. However, all the available methods for exposure assessment have been developed, tested and used in high-income countries. Except for a few studies examining pesticide exposures, there is limited research on whether these methods are appropriate for assessing exposure in LMICs. The aim of this study is to compare a task-specific algorithm-based method (OccIDEAS) to a job-specific matrix method (OAsJEM) in the assessment of asthmagen exposures among healthcare workers in a high-income country and a low- and middle- income country (LMIC) to determine an appropriate assessment method for use in LMICs for future research.

Methods:

Data were obtained from a national cross-sectional survey of occupational asthmagens exposure in Australia and a cross-sectional survey of occupational chemical exposure among Bhutanese healthcare workers. Exposure was assessed using OccIDEAS and the OAsJEM. Prevalence of exposure to asthmagens and inter-rater agreement were calculated.

Results:

In Australia, the prevalence was higher for a majority of agents when assessed by OccIDEAS than by the OAsJEM (13 versus 3). OccIDEAS identified exposures to a greater number of agents (16 versus 7). The agreement as indicated by κ (Cohen’s Kappa coefficient) for six of the seven agents assessed was poor to fair (0.02 to 0.37). In Bhutan, the prevalence of exposure assessed by OccIDEAS was higher for four of the seven agents and κ was poor for all the four agents assessed (-0.06 to 0.13). The OAsJEM overestimated exposures to high-level disinfectants by assigning exposures to all participants from 10 (Bhutan) and 12 (Australia) ISCO-88 codes; whereas OccIDEAS assigned exposures to varying proportions of participants from these ISCO-codes.

Conclusion:

There was poor to fair agreement in the assessment of asthmagen exposure in healthcare workers between the two methods. The OAsJEM overestimated the prevalence of certain exposures. As compared to the OAsJEM, OccIDEAS appeared to be more appropriate for evaluating cross-country exposures to asthmagens in healthcare workers due to its inherent quality of assessing task-based determinants and its versatility in being adaptable for use in different countries with different exposure circumstances.

Teschke K, Olshan A, Daniels J, De Roos A, Parks C, Schulz M, et al. Occupational exposure assessment in case–control studies: opportunities for improvement. Occup Environ Med. 2002;59(9):575–94.CrossRefPubMedPubMedCentral

Fritschi L, Siemiatycki J, Richardson L. Self-assessed versus expert-assessed occupational exposures. Am J Epidemiol. 1996;144(5):521–27.CrossRefPubMed

Ge CB, Friesen MC, Kromhout H, Peters S, Rothman N, Lan Q, et al. Use and reliability of exposure assessment methods in occupational case–control studies in the general population: Past, present, and future. Ann Work Expo Health. 2018;62(9):1047–63.CrossRefPubMedPubMedCentral

Wheeler DC, Burstyn I, Vermeulen R, Yu K, Shortreed SM, Pronk A, et al. Inside the black box: starting to uncover the underlying decision rules used in a one-by-one expert assessment of occupational exposure in case-control studies. Occup Environ Med. 2013;70(3):203–10.CrossRefPubMed

Sauvé J-F, Friesen MC. Using Decision Rules to Assess Occupational Exposure in Population-Based Studies. Curr Environ Health Rep. 2019;6(3):148–59.CrossRefPubMedPubMedCentral

Rai R, El-Zaemey S, Dorji N, Fritschi L. Reliability and validity of an adapted questionnaire assessing occupational exposures to hazardous chemicals among health care workers in Bhutan. Int J Occup Environ Med. 2020;11:128–39.CrossRefPubMedPubMedCentral

Rai R, El-Zaemey S, Dorji N, Rai BD, Fritschi L. Exposure to occupational hazards among health care workers in low- and middle-Income countries: a scoping review. International Journal of Environmental Research and Public Health. 2021;18(5):2603. Available from: https://www.mdpi.com/1660-4601/18/5/2603.

Nuwayhid IA. Occupational health research in developing countries: a partner for social justice. Am J Public Health. 2004;94(11):1916–21.CrossRefPubMedPubMedCentral

Naidoo S. Challenges for exposure science in developing countries. Ann Work Expo Health. 2019;63(6):614–8.CrossRefPubMed

10.

Negatu B, Vermeulen R, Mekonnen Y, Kromhout H. A method for semi-quantitative assessment of exposure to pesticides of applicators and re-entry workers: an application in three farming systems in Ethiopia. Ann Occup Hyg. 2016;60(6):669–83.CrossRefPubMed

11.

Fuhrimann S, Staudacher P, Lindh C, De Joode BVW, Mora AM, Winkler MS, et al. Variability and predictors of weekly pesticide exposure in applicators from organic, sustainable and conventional smallholder farms in Costa Rica. Occup Environ Med. 2020;77(1):40–7.CrossRefPubMed

12.

Fritschi L. OccIDEAS–occupational exposure assessment in community-based studies. Occup Med. 2019;69:156–7.CrossRef

13.

Carey RN, Driscoll TR, Peters S, Glass DC, Reid A, Benke G, et al. Estimated prevalence of exposure to occupational carcinogens in Australia (2011–2012). Occup Environ Med. 2014;71(1):55–62.CrossRefPubMed

14.

Fritschi L, Crewe J, Darcey E, Reid A, Glass DC, Benke GP, et al. The estimated prevalence of exposure to asthmagens in the Australian workforce, 2014. BMC Pulm Med. 2016;16(1):48.CrossRefPubMedPubMedCentral

15.

Lewkowski K, Heyworth JS, Li IW, Williams W, McCausland K, Gray C, et al. Exposure to noise and ototoxic chemicals in the Australian workforce. Occup Environ Med. 2019;76(5):341–8.CrossRefPubMed

16.

Glass DC, Heyworth J, Thomson AK, Peters S, Saunders C, Fritschi L. Occupational exposure to solvents and risk of breast cancer. Am J Ind Med. 2015;58(9):915–22.CrossRefPubMed

17.

Buitenhuis W, Fritschi L, Thomson A, Glass D, Heyworth J, Peters S. Occupational exposure to ionizing radiation and risk of breast cancer in Western Australia. J Occup Environ Med. 2013;55(12):1431–5.CrossRefPubMed

18.

Rai R, Glass DC, Heyworth JS, Saunders C, Fritschi L. Occupational exposures to engine exhausts and other PAHs and breast cancer risk: A population-based case‐control study. Am J Ind Med. 2016;59(6):437–44.CrossRefPubMed

19.

El-Zaemey S, Heyworth J, Fritschi L. Noticing pesticide spray drift from agricultural pesticide application areas and breast cancer: a case‐control study. Aust NZ J Publ Heal. 2013;37(6):547–55.CrossRef

20.

MacFarlane E, Benke G, Sim MR, Fritschi L. OccIDEAS: an innovative tool to assess past asbestos exposure in the Australian Mesothelioma Registry. Saf Health Work. 2012;3(1):71–6.CrossRefPubMedPubMedCentral

21.

Crewe J, Carey R, Glass D, Peters S, Abramson MJ, Benke G, et al. A comprehensive list of asthmagens to inform health interventions in the Australian workplace. Aust N Z J Public Health. 2016;40(2):170–3.CrossRefPubMed

22.

Le Moual N, Zock J-P, Dumas O, Lytras T, Andersson E, Lillienberg L, et al. Update of an occupational asthma-specific job exposure matrix to assess exposure to 30 specific agents. Occup Environ Med. 2018;75(7):507–14.CrossRefPubMed

23.

Kennedy SM, Le Moual N, Choudat D, Kauffmann F. Development of an asthma specific job exposure matrix and its application in the epidemiological study of genetics and environment in asthma (EGEA). Occup Environ Med. 2000;57(9):635–41.CrossRefPubMedPubMedCentral

24.

Lillienberg L, Andersson E, Janson C, Dahlman-Höglund A, Forsberg B, Holm M, et al. Occupational exposure and new-onset asthma in a population-based study in Northern Europe (RHINE). Ann Occup Hyg. 2013;57(4):482–92.PubMed

25.

Pape K, Svanes C, Sejbæk CS, Malinovschi A, Benediktsdottir B, Forsberg B, et al. Parental occupational exposure pre-and post-conception and development of asthma in offspring. Int J Epidemiol. 2020;49(6):1856–69.CrossRefPubMedCentral

26.

Dumas O, Le Moual N, Lowe AJ, Lodge CJ, Zock J-P, Kromhout H, et al. Influence of childhood asthma and allergies on occupational exposure in early adulthood: a prospective cohort study. Int J Environ Res Public Health. 2019;16(12):2163.CrossRefPubMedCentral

27.

Skaaby S, Flachs EM, Lange P, Schlünssen V, Marott JL, Brauer C, et al. Occupational exposures and exacerbations of asthma and COPD- a general population study. PLoS ONE. 2020;15(12):e0243826.CrossRefPubMedPubMedCentral

28.

Rai R, El-Zaemey S, Dorji N, Fritschi L. Occupational exposures to hazardous chemicals and agents among healthcare workers in Bhutan. Am J Ind Med. 2020;63(12):1109–15.CrossRefPubMed

29.

McHugh ML. Interrater reliability: the kappa statistic. Biochemia Med. 2012;22(3):276–82.CrossRef

30.

Bourgkard E, Wild P, Gonzalez M, Févotte J, Penven E, Paris C. Comparison of exposure assessment methods in a lung cancer case-control study: performance of a lifelong task-based questionnaire for asbestos and PAHs. Occup Environ Med. 2013;70(12):884–91.CrossRefPubMed

31.

Lillienberg L, Dahlman-Höglund A, Schiöler L, Torén K, Andersson E. Exposures and asthma outcomes using two different job exposure matrices in a general population study in northern Europe. Ann Occup Hyg. 2014;58(4):469–81.CrossRefPubMed

32.

Henneberger PK, Kurth LM, Doney B, Liang X, Andersson E. Development of an asthma-specific job exposure matrix for use in the United States. Ann Work Expo Health. 2020;64(1):82–95.PubMed

33.

Kauppinen TP, Mutanen PO, Seitsamo JT. Magnitude of misclassification bias when using a job-exposure matrix. Scand J Work Environ Health. 1992;18:105–12.CrossRefPubMed

34.

Peters S, Vermeulen R, Cassidy A, Mannetje At, van Tongeren M, Boffetta P, et al. Comparison of exposure assessment methods for occupational carcinogens in a multi-centre lung cancer case–control study. Occup Environ Med. 2011;68(2):148–53.CrossRefPubMed

35.

Florath I, Glass DC, Rhazi MS, Parent M-E, Fritschi L. Inter-rater agreement between exposure assessment using automatic algorithms and using experts. Ann Work Expo Health. 2019;63(1):45–53.CrossRefPubMed

36.

Peters S, Glass DC, Milne E, Fritschi L. Rule-based exposure assessment versus case-by-case expert assessment using the same information in a community-based study. Occup Environ Med. 2014;71(3):215–9.CrossRefPubMed

37.

Pronk A, Stewart PA, Coble JB, Katki HA, Wheeler DC, Colt JS, et al. Comparison of two expert-based assessments of diesel exhaust exposure in a case–control study: programmable decision rules versus expert review of individual jobs. Occup Environ Med. 2012;69(10):752–8.CrossRefPubMed

38.

Benke G, Sim M, Fritschi L, Aldred G, Forbes A, Kauppinen T. Comparison of occupational exposure using three different methods: hygiene panel, job exposure matrix (JEM), and self reports. Appl Occup Environ Hyg. 2001;16(1):84–91.CrossRefPubMed

39.

Offermans NS, Vermeulen R, Burdorf A, Peters S, Goldbohm RA, Koeman T, et al. Comparison of expert and job-exposure matrix-based retrospective exposure assessment of occupational carcinogens in the Netherlands Cohort Study. Occup Environ Med. 2012;69(10):745–51.CrossRefPubMed

Title: Comparison of agreement in asthmagen exposure assessments between rule-based automatic algorithms and a job exposure matrix in healthcare workers in Australia and Bhutan
Authors: Rajni Rai
Lin Fritschi
Deborah C Glass
Nidup Dorji
Sonia El-Zaemey
Publication date: 01-12-2022
Publisher: BioMed Central
Keyword: Bronchial Asthma
Published in: BMC Public Health / Issue 1/2022
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-022-14514-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparison of agreement in asthmagen exposure assessments between rule-based automatic algorithms and a job exposure matrix in healthcare workers in Australia and Bhutan

Abstract

Background:

Methods:

Results:

Conclusion:

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background:

Methods:

Results:

Conclusion:

Please log in to get access to this content

Other articles of this Issue 1/2022

Text-messaging to promote smoking cessation among individuals with opioid use disorder: quantitative and qualitative evaluation

Correction: Effect of the Lights4Violence intervention on the sexism of adolescents in European countries

Weight changes and the incidence of depressive symptom in the middle-aged and older adults: findings from the Chinese nationwide cohort study

Poor implementation of tobacco control measures and lack of education influences the intention to quit tobacco: a structural equation modelling approach

The impact of two state-level approaches to restricting the sale of flavored tobacco products

Motivational determinants of physical activity in disadvantaged populations with (pre)diabetes: a cross-cultural comparison