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Original article
Comparison of expert and job-exposure matrix-based retrospective exposure assessment of occupational carcinogens in the Netherlands Cohort Study
  1. Nadine S M Offermans1,
  2. Roel Vermeulen2,3,
  3. Alex Burdorf4,
  4. Susan Peters2,
  5. R Alexandra Goldbohm5,
  6. Tom Koeman2,
  7. Martie van Tongeren6,
  8. T Kauppinen7,
  9. Ijmert Kant8,
  10. Hans Kromhout2,
  11. Piet A van den Brandt1
  1. 1Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
  2. 2Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
  3. 3Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
  4. 4Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
  5. 5Department of Prevention and Health, TNO Quality of Life, Leiden, The Netherlands
  6. 6Institute of Occupational Medicine, Edinburgh, UK
  7. 7Department of Occupational Health, Finnish Institute of Occupational Health, Helsinki, Finland
  8. 8CAPHRI School for Public Health and Primary Care, Department of Epidemiology, Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Center, Maastricht, The Netherlands
  1. Correspondence to Nadine S M Offermans, Department of Epidemiology, Maastricht University Medical Centre, P.O. Box 616, 6200 MD Maastricht, The Netherlands; nadine.offermans{at}


Objectives Reliable retrospective exposure assessment continues to be a challenge in most population-based studies. Several methodologies exist for estimating exposures retrospectively, of which case-by-case expert assessment and job-exposure matrices (JEMs) are commonly used. This study evaluated the reliability of exposure estimates for selected carcinogens obtained through three JEMs by comparing the estimates with case-by-case expert assessment within the Netherlands Cohort Study (NLCS).

Methods The NLCS includes 58 279 men aged 55–69 years at enrolment in 1986. For a subcohort of these men (n=1630), expert assessment is available for exposure to asbestos, polycyclic aromatic hydrocarbons (PAHs) and welding fumes. Reliability of the different JEMs (DOMJEM (asbestos, PAHs), FINJEM (asbestos, PAHs and welding fumes) and Asbestos JEM (asbestos) was determined by assessing the agreement between these JEMs and the expert assessment.

Results Expert assessment revealed the lowest prevalence of exposure for all three exposures (asbestos 9.3%; PAHs 5.3%; welding fumes 11.7%). The DOMJEM showed the highest level of agreement with the expert assessment for asbestos and PAHs (κs=0.29 and 0.42, respectively), closely followed by the FINJEM. For welding fumes, concordance between the expert assessment and FINJEM was high (κ=0.70). The Asbestos JEM showed poor agreement with the expert asbestos assessment (κ=0.10).

Conclusions This study shows case-by-case expert assessment to result in the lowest prevalence of occupational exposure in the NLCS. Furthermore, the DOMJEM and FINJEM proved to be rather similar in agreement when compared with the expert assessment. The Asbestos JEM appeared to be less appropriate for use in the NLCS.

  • Population-based study
  • occupational exposure
  • expert
  • job-exposure matrix
  • agreement
  • retrospective exposure assessment
  • cancer
  • hygiene/occupational hygiene
  • epidemiology
  • biological monitoring
  • longitudinal studies
  • genotoxicity
  • exposure assessment
  • dermal exposure
  • rubber
  • dioxins
  • diesel fumes
  • benzene
  • agriculture
  • leukaemia
  • haematology
  • contact dermatitis
  • back disorders
  • ergonomics
  • male reproduction
  • electromagnetic fields
  • wood dust
  • bronchitis
  • health and safety

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  • Funding This study was supported by a grant from ZonMw (grant 50-50-500-98-6153). The sponsor had no role in the study design; collection, analysis, and interpretation of data; writing process or decision where to submit the paper for publication.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval The NLCS has been approved by the institutional review boards of the Netherlands Organisation for Applied Scientific Research TNO (Zeist) and Maastricht University (Maastricht).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement This study contains unpublished data for the Spearman's correlation coefficients of the continuous cumulative exposure estimates. These data can be obtained from the corresponding author of this article.