Abstract
Context: A detailed evaluation of the correlation and linearity of industrial hygiene retrospective exposure assessment (REA) for cumulative asbestos exposure with asbestos lung burden analysis (LBA) has not been previously performed, but both methods are utilized for case-control and cohort studies and other applications such as setting occupational exposure limits.Objective: (a) To correlate REA with asbestos LBA for a large number of cases from varied industries and exposure scenarios; (b) to evaluate the linearity, precision, and applicability of both industrial hygiene exposure reconstruction and LBA; and (c) to demonstrate validation methods for REA.Methods: A panel of four experienced industrial hygiene raters independently estimated the cumulative asbestos exposure for 363 cases with limited exposure details in which asbestos LBA had been independently determined. LBA for asbestos bodies was performed by a pathologist by both light microscopy and scanning electron microscopy (SEM) and free asbestos fibers by SEM. Precision, reliability, correlation and linearity were evaluated via intraclass correlation, regression analysis and analysis of covariance. Plaintiff’s answers to interrogatories, work history sheets, work summaries or plaintiff’s discovery depositions that were obtained in court cases involving asbestos were utilized by the pathologist to provide a summarized brief asbestos exposure and work history for each of the 363 cases.Results: Linear relationships between REA and LBA were found when adjustment was made for asbestos fiber-type exposure differences. Significant correlation between REA and LBA was found with amphibole asbestos lung burden and mixed fiber-types, but not with chrysotile. The intraclass correlation coefficients (ICC) for the precision of the industrial hygiene rater cumulative asbestos exposure estimates and the precision of repeated laboratory analysis were found to be in the excellent range. The ICC estimates were performed independent of specific asbestos fiber-type.Conclusions: Both REA and pathology assessment are reliable and complementary predictive methods to characterize asbestos exposures. Correlation analysis between the two methods effectively validates both REA methodology and LBA procedures within the determined precision, particularly for cumulative amphibole asbestos exposures since chrysotile fibers, for the most part, are not retained in the lung for an extended period of time.
Highlights
Determining and characterizing past exposures to chemicals and physical agents is a vexing but essential challenge in industrial hygiene, pathology, occupational medicine and epidemiologic research
Have we explored the correlation between the industrial hygiene raters and asbestos lung burden, but we evaluated the linearity between cumulative exposure assessment and the pathology assessment methods
Correlation between only amphibole asbestos and retrospective exposure assessment (REA) was found, but no such correlation was found for chrysotile exposures, we believe that chrysotile exposure estimation by experienced industrial hygienists can be performed as reliably as for amphibole asbestos
Summary
Determining and characterizing past exposures to chemicals and physical agents is a vexing but essential challenge in industrial hygiene, pathology, occupational medicine and epidemiologic research. Cumulative retrospective exposure assessment (REA) of asbestos has allowed dose– response characterization of cohorts and individuals with respect to asbestosis, lung and other cancers, as well as mesothelioma. The determination of reliability and linearity of either industrial hygiene exposure estimation or asbestos. The general purposes of this study are (a) to correlate asbestos REA with various forms of LBA for a large number of cases from varied industries, exposure scenarios, and fibertypes; (b) to evaluate the linearity, precision, reliability and applicability of both REA and LBA for these different scenarios with limited asbestos exposure parameter information; and (c) to demonstrate a validation procedure for REA methods
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