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Original article
Comparison of exposure assessment methods in a lung cancer case-control study: performance of a lifelong task-based questionnaire for asbestos and PAHs
  1. Eve Bourgkard1,
  2. Pascal Wild1,2,
  3. Maria Gonzalez3,
  4. Joëlle Févotte4,
  5. Emmanuelle Penven2,
  6. Christophe Paris2,5
  1. 1Département Epidémiologie en Entreprise, Institut National de Recherche et de Sécurité (INRS), Vandœuvre-lès-Nancy, France
  2. 2INGRES, EA 7298, Université de Lorraine, Vandœuvre-lès-Nancy, France
  3. 3Hôpitaux Universitaires de Strasbourg, Centre de consultation de pathologie professionnelle, Strasbourg, France
  4. 4Unité mixte de recherche épidémiologique et de surveillance en transport, travail et environnement—Umrestte (UCB Lyon 1/Inrets), Université Claude Bernard Lyon 1 8, Lyon, France
  5. 5Centre Hospitalier Universitaire de Nancy, Centre de consultation de pathologie professionnelle, Vandœuvre-lès-Nancy, France
  1. Correspondence to Dr Eve Bourgkard, Département Epidémiologie en Entreprise, INRS, 1 rue du Morvan, CS60027, Vandœuvre-lès-Nancy 54519, France; eve.bourgkard{at}


Objective To describe the performance of a lifelong task-based questionnaire (TBQ) in estimating exposures compared with other approaches in the context of a case-control study.

Methods A sample of 93 subjects was randomly selected from a lung cancer case-control study corresponding to 497 jobs. For each job, exposure assessments for asbestos and polycyclic aromatic hydrocarbons (PAHs) were obtained by expertise (TBQ expertise) and by algorithm using the TBQ (TBQ algorithm) as well as by expert appraisals based on all available occupational data (REFERENCE expertise) considered to be the gold standard. Additionally, a Job Exposure Matrix (JEM)-based evaluation for asbestos was also obtained. On the 497 jobs, the various evaluations were contrasted using Cohen's κ coefficient of agreement. Additionally, on the total case-control population, the asbestos dose-response relationship based on the TBQ algorithm was compared with the JEM-based assessment.

Results Regarding asbestos, the TBQ-exposure estimates agreed well with the REFERENCE estimate (TBQ expertise: level-weighted κ (lwk)=0.68; TBQ algorithm: lwk=0.61) but less so with the JEM estimate (TBQ expertise: lwk=0.31; TBQ algorithm: lwk=0.26). Regarding PAHs, the agreements between REFERENCE expertise and TBQ were less good (TBQ expertise: lwk=0.43; TBQ algorithm: lwk=0.36). In the case-control study analysis, the dose-response relationship between lung cancer and cumulative asbestos based on the JEM is less steep than with the TBQ-algorithm exposure assessment and statistically non-significant.

Conclusions Asbestos-exposure estimates based on the TBQ were consistent with the REFERENCE expertise and yielded a steeper dose-response relationship than the JEM. For PAHs, results were less clear.

  • Lung cancer < Organ system, disease, disease type
  • Task-based exposure assessment < Methodology, speciality

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