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首页> 外文期刊>American Journal of Epidemiology >Occupational exposures and asthma in health-care workers: comparison of self-reports with a workplace-specific job exposure matrix.
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Occupational exposures and asthma in health-care workers: comparison of self-reports with a workplace-specific job exposure matrix.

机译：卫生保健工作者的职业暴露和哮喘：自我报告与工作场所特定的工作暴露矩阵的比较。

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The authors compared self-reported occupational exposures with a workplace-specific job exposure matrix (JEM) in a 2004 survey of Texas health-care professionals (n = 3,650), by asthma status. Sensitivity, specificity, chance-corrected (kappa) and chance-independent (phi) agreement, and associations of self-reported exposures with asthma were compared with those for the JEM. Among asthmatics, the median sensitivity of self-reported exposures was 74% (range, 53-90); specificity was 64% (range, 27-74). For nonasthmatics, median sensitivity was 67% (range, 40-88) and specificity was 70% (range, 33-82). Sensitivity was higher among asthmatics for exposures involving perceptible odors. Specificity was higher among nonasthmatics for instrument cleaning and exposure to adhesives/solvents. Asthmatics showed better agreement with the JEM for patient-care-related cleaning (phi = 0.51 vs. 0.40); there was little difference for other exposures. In all cases, confidence intervals overlapped. Prevalence ratios were higher with self-reported exposures than with the JEM; differences were greatest for cleaning products, adhesives/solvents, and gases/vapors. However, confidence intervals overlapped with those obtained using the JEM. In asthma studies, differential reporting bias by health status should be taken into consideration. Findings favor using externally developed methods of exposure classification, although information gleaned from examining distributions of exposure self-reports, particularly among nondiseased persons, can provide useful information for improving the reliability of exposure ascertainment.
机译：作者在2004年对德克萨斯州医疗保健专业人员（n = 3,650）进行的哮喘状况调查中，将自我报告的职业暴露与工作场所特定的职业暴露矩阵（JEM）进行了比较。将敏感性，特异性，机会校正的（kappa）和机会独立的（phi）协议以及自我报告的暴露与哮喘的关联与JEM的关联进行了比较。在哮喘患者中，自我报告的暴露的中位敏感性为74％（范围53-90）。特异性为64％（范围27-74）。对于非哮喘患者，中位敏感性为67％（范围40-88），特异性为70％（范围33-82）。哮喘患者对涉及可闻气味的接触的敏感性较高。在非哮喘患者中，仪器清洁和暴露于粘合剂/溶剂的特异性更高。哮喘患者与JEM在患者护理相关清洁方面表现出更好的一致性（phi = 0.51 vs. 0.40）;其他曝光几乎没有差异。在所有情况下，置信区间都重叠。自我报告暴露的患病率高于JEM;清洁产品，粘合剂/溶剂和气体/蒸汽的差异最大。但是，置信区间与使用JEM获得的置信区间重叠。在哮喘研究中，应考虑因健康状况而异的报告偏倚。尽管通过检查暴露自我报告的分布（尤其是未患病者之间的分布）收集的信息可以为改善暴露确定的可靠性提供有用的信息，但发现倾向于使用外部开发的暴露分类方法。

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