The performance of different criteria for self-reported occupational exposure in a study of exacerbation of asthma

Details

• Personal Author:
  Andersson E ; Dahlman-Hoglund A ; Henneberger, Paul K. ; Liang X ; Lillienberg L ; Toren KO
• Description:
  RATIONALE: In epidemiologic studies of respiratory diseases, self-reported occupational exposures are easy to collect by questionnaire. However, some research indicates that symptomatic participants are more likely to report exposures, thus biasing relative risk estimates away from the null. A job-exposure matrix (JEM) provides an external basis to assess exposure that is not influenced by study participants. In an investigation of working adults with asthma, we determined how closely different criteria for self-reported occupational exposure agreed with JEM-derived exposure, and how strongly these assessments were associated with severe exacerbation of asthma. METHODS: We conducted a telephone survey of 557 working adults with prevalent asthma who were enrolled in a health maintenance organization in the state of Massachusetts in the United States. For the 12 months before interview, we assessed occupational exposure based on an asthma-specific JEM, and a self-report indicated by a positive response to at least one or two of thirteen questions about working with asthma-related agents. Severe exacerbation for the same time period was defined as being hospitalized for asthma, or having received both unplanned care for an asthma attack and a short course of oral corticosteroids for asthma. RESULTS: Asthma-related occupational exposure was more common when based on self-reports of at least one asthma agent (68%) versus the JEM (46%), but self-reports of at least two agents (48%) were approximately as frequent as JEM-derived exposures. Overall agreement with JEM-assessed exposures was 70% and 74% for self-reports of >1 and >2 agents, respectively. Twenty-nine percent of participants fulfilled the criteria for severe exacerbation of asthma. Regression models of severe exacerbation that controlled for potential confounders revealed similar statistically significant prevalence ratios (PRs) for occupational exposure based on the JEM (PR=1.39, 95% confidence interval (CI) 1.08, 1.78) and >2 self-reported agents (PR=1.34, 95% CI 1.04, 1.73). A self-report of one or more agents had an elevated PR that was not statistically significant (PR=1.24, 95% CI 0.93, 1.65). CONCLUSION: In this study of working adults with asthma, stricter criteria for a self-report of occupational exposure provided somewhat better agreement with exposure assessed using a JEM and a stronger association with severe exacerbation of asthma. [Description provided by NIOSH]
• Subjects:
  Asthma Asthma, Occupational Hypersensitivity Lung Lung Diseases Occupational Health Respiratory System Respiratory Tract Diseases Safety Surveys And Questionnaires
• Keywords:
  Allergens Bronchial Asthma Chemical Agents Exposure Assessment Health Care Health Surveys Humans JEM Job Analysis Job Exposure Matrix Lung Disorders Medical Surveys Occupational Asthma Pulmonary System Disorders Regression Analysis Respiratory System Disorders Statistical Analysis Workers

  More +
• ISSN:
  1073-449X
• Document Type:
  Text
• Genre:
  Abstract or Summary
• Place as Subject:
  OSHA Region 3 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  RHD - Respiratory Health Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  191
• NIOSHTIC Number:
  nn:20048523
• Citation:
  Am J Respir Crit Care Med 2015 May; 191(Abstract Issue):A2593
• Contact Point Address:
  P. K. Henneberger, CDC National Institute for Occupational Safety and Health (NIOSH), Morgantown, WV
• Federal Fiscal Year:
  2015
• Peer Reviewed:
  False
• Source Full Name:
  American Journal of Respiratory and Critical Care Medicine
• Supplement:
  Abstract Issue
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:52e2d9da51b82f840c495157bed5585526e9b8d2d1ebbd019a4185dad88407a244e660a316e1f6d1c91a998865990488e98384cda968f29bd0008dee35587ada
• Download URL:
  https://stacks.cdc.gov/view/cdc/203263/cdc_203263_DS1.pdf
• File Type:
  [PDF - 17.31 KB ]