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  • Research Article
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Reliability of a semi-quantitative method for dermal exposure assessment (DREAM)

Abstract

Valid and reliable semi-quantitative dermal exposure assessment methods for epidemiological research and for occupational hygiene practice, applicable for different chemical agents, are practically nonexistent. The aim of this study was to assess the reliability of a recently developed semi-quantitative dermal exposure assessment method (DREAM) by (i) studying inter-observer agreement, (ii) assessing the effect of individual observers on dermal exposure estimates for different tasks, and (iii) comparing inter-observer agreement for ranking of body parts according to their exposure level. Four studies were performed in which a total of 29 observers (mainly occupational hygienists) were asked to fill in DREAM while performing side-by-side observations for different tasks, comprising dermal exposures to liquids, solids, and vapors. Intra-class correlation coefficients ranged from 0.68 to 0.87 for total dermal exposure estimates, indicating good to excellent inter-observer agreement. The effects of individual observers on task estimates were estimated using a linear mixed effect model with logged DREAM estimates as explanatory variable; “task”, “company/department”, and the interaction of “task” and “company/department” as fixed effects; and “observer” as a random effect. Geometric mean (GM) dermal exposure estimates for different tasks were estimated by taking the exponent of the predicted betas for the tasks. By taking the exponent of the predicted observer's intercept (expωi), a multiplier (MO) was estimated for each observer. The effects of individual observers on task estimates were relatively small, as the maximum predicted mean observers’ multiplier was only a factor 2, while predicted GMs of dermal exposure estimates for tasks ranged from 0 to 1226, and none of the predicted individual observers’ multipliers differed significantly from 1 (t-test α=0.05). Inter-observer agreement for ranking of dermal exposure of nine body parts was moderate to good, as median values of Spearman correlation coefficients for pairs of observers ranged from 0.29 to 0.93. DREAM provides reproducible results for a broad range of tasks with dermal exposures to liquids, solids, as well as vapors. DREAM appears to offer a useful advance for estimations of dermal exposure both for epidemiological research and for occupational hygiene practice.

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Notes

  1. In study 1 (grape farming) and study 3 (chemical industry), some tasks were observed repeatedly in different companies; in study 2 (truck factory, rubber factory, and pharmacy), some tasks were observed repeatedly in different departments.

Abbreviations

ANP:

antineoplastic drugs

CNC:

computer numeric control

DREAM:

dermal exposure assessment method

ICC:

intra-class correlation coefficient

MP:

metal parts

O:

observer

References

  • Benke G., Sim M., Forbes A., and Salzberg M. Retrospective assessment of occupational exposure to chemicals in community-based studies: validity and repeatability of occupational hygiene panel ratings. Int J Epidemiol 1997: 26 (3): 635–642.

    Article  CAS  Google Scholar 

  • Brouwer D.H., Semple S., Marquart J., and Cherrie J.W. A dermal model for spray painters. Part I: subjective exposure modelling of spray paint deposition. Ann Occup Hyg 2001: 45(1): 15–23.

    Article  CAS  Google Scholar 

  • Cherrie J.W., and Schneider T. Validation of a new method for structured subjective assessment of past concentrations. Ann Occup Hyg 1999: 43(4): 235–245.

    Article  CAS  Google Scholar 

  • Cherrie J.W., Schneider T., Spankie S., and Quinn M. A new method for structured, subjective assessments of past concentrations. Occup Hyg 1996: 3: 75–83.

    CAS  Google Scholar 

  • Cherrie J.W., Tickner J., Friar J., Rae R., Warren N., and Pryde D.E. Evaluation and further development of the EASE model 2.0. Research report 136, prepared by the Institute of Occupational Medicine for the Health and Safety Executive, ISBN 0 7176 2714 4, 2003.

  • de Cock J., Kromhout H., Heederik D., and Burema J. Experts' subjective assessment of pesticide exposure in fruit growing. Scand J Work Environ Health 1996: 22(6): 425–432.

    Article  CAS  Google Scholar 

  • Fleiss J.L. Measuring agreement between two judges on the presence or absence of a trait. Biometrics 1975: 31(3): 651–659.

    Article  CAS  Google Scholar 

  • Hawkins N.C., and Evans J.S. Subjective estimation of toluene exposures: a calibration study of occupational hygienists. Appl Ind Hyg J 1989: 4: 61–68.

    Article  CAS  Google Scholar 

  • Hertzman C., Teschke K., Dimich-Ward H., and Ostry A. Validity and reliability of a method for retrospective evaluation of chlorophenate exposure in the lumber industry. Am J Ind Med 1988: 14(6): 703–713.

    Article  CAS  Google Scholar 

  • Kromhout H. Commentary. Occup Environ Med 2002: 59: 594.

    Article  Google Scholar 

  • Kromhout H., Oostendorp Y., Heederik D., and Boleij J.S. Agreement between qualitative exposure estimates and quantitative exposure measurements. Am J Ind Med 1987: 12(5): 551–562.

    Article  CAS  Google Scholar 

  • Landis J.R., and Koch G.G. The measurement of observer agreement for categorical data. Biometrics 1977: 33(1): 159–174.

    Article  CAS  Google Scholar 

  • Post W., Kromhout H., Heederik D., Noy D., and Smit Duijzentkunst R. Semiquantitative estimates of exposure to methylene chloride and styrene: the influence of quantitative exposure data. Appl Occup Environ Hyg 1991: 6(3): 197–204.

    Article  CAS  Google Scholar 

  • Schneider T., Vermeulen R., Brouwer D.H., Cherrie J.W., Kromhout H., and Fogh C.L. Conceptual model for assessment of dermal exposure. Occup Environ Med 1999: 56: 765–773.

    Article  CAS  Google Scholar 

  • Semple S.E., Proud L.A., Tannahill S.N., Tindall M.E., and Cherrie J.W. A training exercise in subjectively estimating inhalation exposures. Scand J Work Environ Health 2001: 27(6): 395–401.

    Article  CAS  Google Scholar 

  • Siemiatycki J., Fritschi L., Nadon L., and Gerin M. Reliability of an expert rating procedure for retrospective assessment of occupational exposures in community-based case-control studies. Am J Ind Med 1997: 31(3): 280–286.

    Article  CAS  Google Scholar 

  • Teschke K., Hertzman C., Dimich-Ward H., Ostry A., Blair J., and Hershler R. A comparison of exposure estimates by worker raters and occupational hygienists. Scand J Work Environ Health 1989: 15(6): 424–429.

    Article  CAS  Google Scholar 

  • Teschke K., Olshan A.F., Daniels J.L., De Roos A.J., Parks C.G., and Schulz, et al. Occupational exposure assessment in case–control studies: opportunities for improvement. Occup Environ Med 2002: 59(9): 575–593.

    Article  CAS  Google Scholar 

  • Van-Wendel-de-Joode B., Brouwer D.H., Vermeulen R., Van Hemmen J.J., Heederik D., and Kromhout H. DREAM: a method for semi-quantitative dermal exposure assessment. Ann Occup Hyg 2003: 47(1): 71–87.

    PubMed  Google Scholar 

  • Vermeulen R., Stewart P., and Kromhout H. Dermal exposure assessment in occupational epidemiologic research. Scand J Work Environ Health 2002: 28(6): 371–385.

    Article  Google Scholar 

  • Walker K.D., Catalano P., Hammit J.K., and Evans J.S. Use of expert judgement in exposure assessment: Part 2. Calibration of expert judgements about personal exposures to benzene. J Expo Anal Environ Epidemiol 2003: 13: 1–16.

    Article  CAS  Google Scholar 

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Acknowledgements

We thank Simone Hilhorst, Martijn Kerkman, Mark Lurvink, Motlagomang Maruping, and occupational hygienists of the eastern part of the Netherlands for observing exposure situations and applying DREAM. We are grateful to Jim Deddens and Brian Miller for their statistical advice. This study was financed by the Dutch Ministry of Social Affairs and Employment and partly facilitated by the South Africa Netherlands Research Program on Alternatives in Development 00/17(SANPAD). The cooperation of employers and employees who participated in the study is gratefully acknowledged.

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Correspondence to Hans Kromhout.

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de Joode, B., Hemmen, J., Meijster, T. et al. Reliability of a semi-quantitative method for dermal exposure assessment (DREAM). J Expo Sci Environ Epidemiol 15, 111–120 (2005). https://doi.org/10.1038/sj.jea.7500369

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