@article {Quinot130, author = {C Quinot and O Dumas and PK Henneberger and R Varraso and AS Wiley and FE Speizer and M Goldberg and JP Zock and CA Camargo, Jr and N Le Moual}, title = {Development of a job-task-exposure matrix to assess occupational exposure to disinfectants among US nurses}, volume = {74}, number = {2}, pages = {130--137}, year = {2017}, doi = {10.1136/oemed-2016-103606}, publisher = {BMJ Publishing Group Ltd}, abstract = {Objectives Occupational exposure to disinfectants is associated with work-related asthma, especially in healthcare workers. However, little is known about the specific products involved. To evaluate disinfectant exposures, we designed job-exposure (JEM) and job-task-exposure (JTEM) matrices, which are thought to be less prone to differential misclassification bias than self-reported exposure. We then compared the three assessment methods: self-reported exposure, JEM and JTEM.Methods Disinfectant use was assessed by an occupational questionnaire in 9073 US female registered nurses without asthma, aged 49{\textendash}68 years, drawn from the Nurses{\textquoteright} Health Study II. A JEM was created based on self-reported frequency of use (1{\textendash}3, 4{\textendash}7 days/week) of 7 disinfectants and sprays in 8 nursing jobs. We then created a JTEM combining jobs and disinfection tasks to further reduce misclassification. Exposure was evaluated in 3 classes (low, medium, high) using product-specific cut-offs (eg, \<30\%, 30{\textendash}49.9\%, >=50\%, respectively, for alcohol); the cut-offs were defined from the distribution of self-reported exposure per job/task.Results The most frequently reported disinfectants were alcohol (weekly use: 39\%), bleach (22\%) and sprays (20\%). More nurses were classified as highly exposed by JTEM (alcohol 41\%, sprays 41\%, bleach 34\%) than by JEM (21\%, 30\%, 26\%, respectively). Agreement between JEM and JTEM was fair-to-moderate (κ 0.3{\textendash}0.5) for most disinfectants. JEM and JTEM exposure estimates were heterogeneous in most nursing jobs, except in emergency room and education/administration.Conclusions The JTEM may provide more accurate estimates than the JEM, especially for nursing jobs with heterogeneous tasks. Use of the JTEM is likely to reduce exposure misclassification.}, issn = {1351-0711}, URL = {https://oem.bmj.com/content/74/2/130}, eprint = {https://oem.bmj.com/content/74/2/130.full.pdf}, journal = {Occupational and Environmental Medicine} }