TY - JOUR T1 - Incident CTS in a large pooled cohort study: associations obtained by a Job Exposure Matrix versus associations obtained from observed exposures JF - Occupational and Environmental Medicine JO - Occup Environ Med DO - 10.1136/oemed-2017-104744 SP - oemed-2017-104744 AU - Ann Marie Dale AU - Christine C Ekenga AU - Skye Buckner-Petty AU - Linda Merlino AU - Matthew S Thiese AU - Stephen Bao AU - Alysha Rose Meyers AU - Carisa Harris-Adamson AU - Jay Kapellusch AU - Ellen A Eisen AU - Fred Gerr AU - Kurt T Hegmann AU - Barbara Silverstein AU - Arun Garg AU - David Rempel AU - Angelique Zeringue AU - Bradley A Evanoff Y1 - 2018/03/29 UR - http://oem.bmj.com/content/early/2018/03/29/oemed-2017-104744.abstract N2 - Background There is growing use of a job exposure matrix (JEM) to provide exposure estimates in studies of work-related musculoskeletal disorders; few studies have examined the validity of such estimates, nor did compare associations obtained with a JEM with those obtained using other exposures.Objective This study estimated upper extremity exposures using a JEM derived from a publicly available data set (Occupational Network, O*NET), and compared exposure-disease associations for incident carpal tunnel syndrome (CTS) with those obtained using observed physical exposure measures in a large prospective study.Methods 2393 workers from several industries were followed for up to 2.8 years (5.5 person-years). Standard Occupational Classification (SOC) codes were assigned to the job at enrolment. SOC codes linked to physical exposures for forceful hand exertion and repetitive activities were extracted from O*NET. We used multivariable Cox proportional hazards regression models to describe exposure-disease associations for incident CTS for individually observed physical exposures and JEM exposures from O*NET.Results Both exposure methods found associations between incident CTS and exposures of force and repetition, with evidence of dose–response. Observed associations were similar across the two methods, with somewhat wider CIs for HRs calculated using the JEM method.Conclusion Exposures estimated using a JEM provided similar exposure-disease associations for CTS when compared with associations obtained using the ‘gold standard’ method of individual observation. While JEMs have a number of limitations, in some studies they can provide useful exposure estimates in the absence of individual-level observed exposures. ER -