Objectives To develop an asthma-specific job-exposure matrix (JEM) optimised for the United States (US).
Methods We started with the asthma-specific N-JEM that was developed for use in northern Europe, and adapted it to reflect workplace conditions in the US and function with the 2010 Standard Occupational Classification (SOC-2010) codes, which are used widely in the US. The N-JEM functions with the 1988 International Standard Classification of Occupations (ISCO-88). Exposures assessed by the N-JEM for ISCO-88 codes were transferred to comparable SOC-2010 codes by using two cross-walks (ISCO-88 to ISCO-08 to SOC-2010). Three experts (two industrial hygienists, one epidemiologist) used the criterion of a high probability of relevant exposure for at least half the workers to delete or confirm exposure status assigned to SOC-2010 occupations, and to identify additional occupations as exposed. The experts worked independently, submitted initial decisions to the study coordinator, and discussed their decisions with the other experts before submitting final decisions. Exposure status in the JEM was based on a majority opinion of the three experts. The resulting alpha version of the new US Asthma-specific JEM (USA-JEM) was applied to current occupations in a cohort of working adults with asthma, exposures were compared to those assessed by the N-JEM, and disagreements were reviewed to consider further modifications to the USA-JEM.
Results We made numerous changes to N-JEM exposures assigned to SOC-2010 occupations by cross-walking from the ISCO-88 codes. Comparing exposure assessments from the two JEMs in the same cohort yielded changes for only 15 SOC-2010 detailed occupations. A total of 399 (47.5%) of the 840 SOC-2010 detailed occupations were assessed by the USA-JEM as having probable exposure to at least one of 19 types of work-related asthma agents.
Conclusions The new USA-JEM could be a useful research tool, but further evaluation of its performance is needed.
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