Evaluation of an exposure assessment used in epidemiological studies of diesel exhaust and lung cancer in underground mines

Exposure assessment quality is a fundamental consideration in the design and evaluation of observational studies. High quality exposure assessment is particularly relevant for outcomes with long latency, such as cancer, where detailed information on past exposures are often missing and must therefore be estimated.For the IARC Monograph on welding, the exposure group provided an overview of assessment methods used in the key epidemiological studies. Strengths and weaknesses of each study were assessed, along with their potential effects on interpretation of risk estimates.For the association between lung cancer and welding fume exposure, 9 cohort and 10 case-control studies were reviewed. For ocular melanoma and ultraviolet radiation (UVR) from welding, 7 case-control studies were reviewed. Quality criteria were: full occupational histories, and standardized, blinded and quantitative exposure assessment. Additional criteria for lung cancer: specifically assessing welding fumes and using information on welding tasks. For ocular melanoma: assessing artificial and solar radiation separately, taking into account eye burns, eye protection and welding type.Exposure assessment of welding fumes by applying a ‘welding-exposure matrix’ (n=2) or welding-specific questionnaires (n=3) were considered highest quality, followed by case-by-case expert assessment (n=5) or general job-exposure matrices (JEMs, n=4). Job title alone was considered less informative (n=5). For exposure to UVR, JEMs were most informative (n=2), followed by self-reported eye burns and self-reported exposure from specific welding types (n=2), although caution is advised regarding recall bias. Assessing welding fume exposure or ever exposure to welding arcs as proxy for UVR was considered less informative. For both exposures, ever versus never welder, or assessments based on data collected from proxies, were considered least informative.The overall evaluation was that there is sufficient evidence in humans for the carcinogenicity of welding fumes and ultraviolet radiation from welding.

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Reducing risk of lung cancer from diesel exhaust in underground mines

American Journal of Industrial Medicine ◽

10.1002/(sici)1097-0274(199809)34:3<203::aid-ajim1>3.0.co;2-w ◽

1998 ◽

Vol 34 (3) ◽

pp. 203-206 ◽

Cited By ~ 3

Author(s):

James L. Weeks

Keyword(s):

Lung Cancer ◽

Diesel Exhaust ◽

Underground Mines

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Radon: Occupational or Domestic Carcinogen?

Radiation Protection Dosimetry ◽

10.1093/oxfordjournals.rpd.a082427 ◽

1994 ◽

Vol 56 (1-4) ◽

pp. 81-88 ◽

Cited By ~ 2

Author(s):

G. Monchaux ◽

R. Masse (INVITED)

Keyword(s):

Lung Cancer ◽

Indoor Radon ◽

Meta Analysis ◽

Epidemiological Studies ◽

Biological Data ◽

Excess Risk ◽

Underground Mines ◽

Case Control Studies ◽

Remedial Actions ◽

Radon Measurements

Abstract An association between an excess risk of lung cancer and exposure to radon and its daughters has been demonstrated in uranium miners and in other miners. In various countries, radon measurements in dwellings showed that indoor radon concentrations are in the same range as in underground mines. Geographical epidemiological studies do not show an excess risk of lung cancer in people living in radon rich areas and case-control studies of domestic exposures lead to conflicting results. A joint study allowing meta-analysis of the results from 19 epidemiological studies carried out throughout the world should provide reliable data by and after 1995. Experimental data and biological data from radon-induced human tumours might allow the identification of tumours induced by irradiation compared with tumours induced by other agents. Until now, the role of domestic exposure in the occurrence of lung cancer remains unclear and therefore the usefulness of remedial actions questionable.

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The First Attempt to Reevaluate Radon and Thoron Exposure in Gansu Province Study Using Radon-Thoron Discriminating Measurement Technique

Frontiers in Public Health ◽

10.3389/fpubh.2021.764201 ◽

2021 ◽

Vol 9 ◽

Author(s):

Hiromi Kudo ◽

Shinji Yoshinaga ◽

Xiaoliang Li ◽

Shujie Lei ◽

Shouzhi Zhang ◽

...

Keyword(s):

Lung Cancer ◽

Cancer Risk ◽

Exposure Assessment ◽

Measurement Technique ◽

Lung Cancer Risk ◽

Indoor Radon ◽

Epidemiological Studies ◽

Increased Risk ◽

Residential Radon ◽

Radon Concentrations

Although the epidemiological studies provide evidence for an increased risk of lung cancer risk associated with residential radon, an issue of radon-thoron discrimination remains to be solved. In this study, an updated evaluation of lung cancer risk among the residents in Gansu, China was performed where one of the major epidemiological studies on indoor radon demonstrated an increased risk of lung cancer. We analyzed data from a hospital-based case-control study that included 30 lung cancer cases and 39 controls with special attention to internal exposure assessment based on the discriminative measurement technique of radon isotopes. Results from the analyses showed non-significant increased lung cancer risks; odds ratios (ORs) adjusted for age, smoking, and total income were 0.35 (95% CI: 0.07–1.74) and 0.27 (95% CI: 0.04–1.74) for groups living in residences with indoor radon concentrations of 50–100 Bq m−3 and over 100 Bq m−3, respectively, compared with those with < 50 Bq m−3 indoor radon concentrations. Although the small sample size hampers the usefulness of present analyses, our study suggests that reevaluation of lung cancer risk associated with residential radon in the epidemiological studies will be required on the basis of precise exposure assessment.

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Diesel aerosols and gases in underground mines: guide to exposure assessment and control.

10.26616/nioshpub2012101 ◽

2011 ◽

Keyword(s):

Exposure Assessment ◽

Underground Mines ◽

And Control

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Inter-Rater Agreement for a Retrospective Exposure Assessment of Asbestos, Chromium, Nickel and Welding Fumes in a Study of Lung Cancer and Ionizing Radiation

The Annals of Occupational Hygiene ◽

10.1093/annhyg/mem037 ◽

2007 ◽

Cited By ~ 10

Keyword(s):

Lung Cancer ◽

Ionizing Radiation ◽

Exposure Assessment ◽

Welding Fumes ◽

Rater Agreement

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A Systematic Review and Appraisal of Epidemiological Studies on Household Fuel Use and Its Health Effects Using Demographic and Health Surveys

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041411 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1411

Author(s):

Daniel B. Odo ◽

Ian A. Yang ◽

Luke D. Knibbs

Keyword(s):

Health Outcomes ◽

Exposure Assessment ◽

Health Effects ◽

Low Birthweight ◽

Respiratory Infections ◽

Epidemiological Studies ◽

The Body ◽

Demographic And Health Surveys ◽

Fuel Use ◽

Cooking Fuel

The domestic combustion of polluting fuels is associated with an estimated 3 million premature deaths each year and contributes to climate change. In many low- and middle-income countries (LMICs), valid and representative estimates of people exposed to household air pollution (HAP) are scarce. The Demographic and Health Survey (DHS) is an important and consistent source of data on household fuel use for cooking and has facilitated studies of health effects. However, the body of research based on DHS data has not been systematically identified, nor its strengths and limitations critically assessed as a whole. We aimed to systematically review epidemiological studies using DHS data that considered cooking fuel type as the main exposure, including the assessment of the extent and key drivers of bias. Following PRISMA guidelines, we searched PubMed, Web of Science, Scopus and the DHS publication portal. We assessed the quality and risk of bias (RoB) of studies using a novel tool. Of 2748 records remaining after removing duplicates, 63 were read in full. A total of 45 out of 63 studies were included in our review, spanning 11 different health outcomes and representing 50 unique analyses. In total, 41 of 45 (91%) studies analysed health outcomes in children <5 years of age, including respiratory infections (n = 17), death (all-cause) (n = 14), low birthweight (n = 5), stunting and anaemia (n = 5). Inconsistencies were observed between studies in how cooking fuels were classified into relatively high- and low-polluting. Overall, 36/50 (80%) studies reported statistically significant adverse associations between polluting fuels and health outcomes. In total, 18/50 (36%) of the analyses were scored as having moderate RoB, while 16/50 (32%) analyses were scored as having serious or critical RoB. Although HAP exposure assessment is not the main focus of the DHS, it is the main, often only, source of information in many LMICs. An appreciable proportion of studies using it to analyse the association between cooking fuel use and health have potential for high RoB, mostly related to confounder control, exposure assessment and misclassification, and outcome ascertainment. Based on our findings, we provide some suggestions for ways in which revising the information collected by the DHS could make it even more amenable to studies of household fuel use and health, and reduce the RoB, without being onerous to collect and analyse.

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