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Berkson error adjustment and other exposure surrogates in occupational case-control studies, with application to the Canadian INTEROCC study.

ABSTRACT: Many epidemiological studies assessing the relationship between exposure and disease are carried out without data on individual exposures. When this barrier is encountered in occupational studies, the subject exposures are often evaluated with a job-exposure matrix (JEM), which consists of mean exposure for occupational categories measured on a comparable group of workers. One of the objectives of the seven-country case-control study of occupational exposure and brain cancer risk, INTEROCC, was to investigate the relationship of occupational exposure to electromagnetic fields (EMF) in different frequency ranges and brain cancer risk. In this paper, we use the Canadian data from INTEROCC to estimate the odds of developing brain tumours due to occupational exposure to EMF. The first step was to find the best EMF exposure surrogate among the arithmetic mean, the geometric mean, and the mean of log-normal exposure distribution for each occupation in the JEM, in comparison to Berkson error adjustments via numerical approximation of the likelihood function. Contrary to previous studies of Berkson errors in JEMs, we found that the geometric mean was the best exposure surrogate. This analysis provided no evidence that cumulative lifetime exposure to extremely low frequency magnetic fields increases brain cancer risk, a finding consistent with other recent epidemiological studies.

SUBMITTER: Oraby T

PROVIDER: S-EPMC8592374 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Berkson error adjustment and other exposure surrogates in occupational case-control studies, with application to the Canadian INTEROCC study.

Oraby Tamer T Sivaganesan Siva S Bowman Joseph D JD Kincl Laurel L Richardson Lesley L McBride Mary M Siemiatycki Jack J Cardis Elisabeth E Krewski Daniel D

Journal of exposure science & environmental epidemiology 20170329 3

Many epidemiological studies assessing the relationship between exposure and disease are carried out without data on individual exposures. When this barrier is encountered in occupational studies, the subject exposures are often evaluated with a job-exposure matrix (JEM), which consists of mean exposure for occupational categories measured on a comparable group of workers. One of the objectives of the seven-country case-control study of occupational exposure and brain cancer risk, INTEROCC, was ...[more]

PMID: 28352117

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Project description:BackgroundINTEROCC is a seven-country cohort study of occupational exposures and brain cancer risk, including occupational exposure to electromagnetic fields (EMF). In the absence of data on individual exposures, a Job Exposure Matrix (JEM) may be used to construct likely exposure scenarios in occupational settings. This tool was constructed using statistical summaries of exposure to EMF for various occupational categories for a comparable group of workers.MethodsIn this study, we use the Canadian data from INTEROCC to determine the best EMF exposure surrogate/estimate from three appropriately chosen surrogates from the JEM, along with a fourth surrogate based on Berkson error adjustments obtained via numerical approximation of the likelihood function. In this article, we examine the case in which exposures are gamma-distributed for each occupation in the JEM, as an alternative to the log-normal exposure distribution considered in a previous study conducted by our research team. We also study using those surrogates and the Berkson error adjustment in Poisson regression and conditional logistic regression.ResultsSimulations show that the introduced methods of Berkson error adjustment for non-stratified analyses provide accurate estimates of the risk of developing tumors in case of gamma exposure model. Alternatively, and under some technical assumptions, the arithmetic mean is the best surrogate when a gamma-distribution is used as an exposure model. Simulations also show that none of the present methods could provide an accurate estimate of the risk in case of stratified analyses.ConclusionWhile our previous study found the geometric mean to be the best exposure surrogate, the present study suggests that the best surrogate is dependent on the exposure model; the arithmetic means in case of gamma-exposure model and the geometric means in case of log-normal exposure model. However, we could present a better method of Berkson error adjustment for each of the two exposure models. Our results provide useful guidance on the application of JEMs for occupational exposure assessments, with adjustment for Berkson error.

Project description:IntroductionTo date, occupational exposure assessment of electromagnetic fields (EMF) has relied on occupation-based measurements and exposure estimates. However, misclassification due to between-worker variability remains an unsolved challenge. A source-based approach, supported by detailed subject data on determinants of exposure, may allow for a more individualized exposure assessment. Detailed information on the use of occupational sources of exposure to EMF was collected as part of the INTERPHONE-INTEROCC study. To support a source-based exposure assessment effort within this study, this work aimed to construct a measurement database for the occupational sources of EMF exposure identified, assembling available measurements from the scientific literature.MethodsFirst, a comprehensive literature search was performed for published and unpublished documents containing exposure measurements for the EMF sources identified, a priori as well as from answers of study subjects. Then, the measurements identified were assessed for quality and relevance to the study objectives. Finally, the measurements selected and complementary information were compiled into an Occupational Exposure Measurement Database (OEMD).ResultsCurrently, the OEMD contains 1624 sets of measurements (>3000 entries) for 285 sources of EMF exposure, organized by frequency band (0 Hz to 300 GHz) and dosimetry type. Ninety-five documents were selected from the literature (almost 35% of them are unpublished technical reports), containing measurements which were considered informative and valid for our purpose. Measurement data and complementary information collected from these documents came from 16 different countries and cover the time period between 1974 and 2013.ConclusionWe have constructed a database with measurements and complementary information for the most common sources of exposure to EMF in the workplace, based on the responses to the INTERPHONE-INTEROCC study questionnaire. This database covers the entire EMF frequency range and represents the most comprehensive resource of information on occupational EMF exposure. It is available at www.crealradiation.com/index.php/en/databases.

Dataset Information

Berkson error adjustment and other exposure surrogates in occupational case-control studies, with application to the Canadian INTEROCC study.

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Berkson error adjustment and other exposure surrogates in occupational case-control studies, with application to the Canadian INTEROCC study.

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