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Occupational exposure assessment in case–control studies: opportunities for improvement
  1. K Teschke1,
  2. A F Olshan2,
  3. J L Daniels3,
  4. A J De Roos4,
  5. C G Parks2,
  6. M Schulz2,
  7. T L Vaughan5
  1. 1Department of Health Care and Epidemiology, University of British Columbia, Vancouver, BC, Canada
  2. 2Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA
  3. 3National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
  4. 4Occupational Eidemiology Branch, National Cancer Institute, Rockville, MD, USA
  5. 5Department of Epidemiology, University of Washington, and the Fred Hutchinson Cancer Research Center, Seattle, WA, USA
  1. Correspondence to:
 Dr K Teschke, Department of Health Care and Epidemiology, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada;


Community based case–control studies are an efficient means to study disease aetiologies, and may be the only practical means to investigate rare diseases. However, exposure assessment remains problematic. We review the literature on the validity and reliability of common case–control exposure assessment methods: occupational histories, job–exposure matrices (JEMs), self reported exposures, and expert assessments. Given the variable quality of current exposure assessment techniques, we suggest methods to improve assessments, including the incorporation of hygiene measurements: using data from administrative exposure databases; using results of studies identifying determinants of exposure to develop questionnaires; and where reasonable given latency and biological half life considerations, directly measuring exposures of study subjects.

  • case-control studies
  • occupational exposure
  • reproducibility of results

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