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首页> 外文期刊>Occupational and environmental medicine >Comparison of occupational exposure assessment methods in a case-control study of lead, genetic susceptibility and risk of adult brain tumours.
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Comparison of occupational exposure assessment methods in a case-control study of lead, genetic susceptibility and risk of adult brain tumours.

机译：在铅，遗传易感性和成人脑瘤风险的病例对照研究中比较职业接触评估方法。

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OBJECTIVES: There is great interest in evaluating gene-environment interactions with chemical exposures, but exposure assessment poses a unique challenge in case-control studies. Expert assessment of detailed work history data is usually considered the best approach, but it is a laborious and time-consuming process. We set out to determine if a less intensive method of exposure assessment (a job exposure matrix (JEM)) would produce similar results to a previous analysis that found evidence of effect modification of the association between expert-assessed lead exposure and risk of brain tumours by a single nucleotide polymorphism in the ALAD gene (rs1800435). METHODS: We used data from a study of 355 patients with glioma, 151 patients with meningioma and 505 controls. Logistic regression models were used to examine associations between brain tumour risk and lead exposure and effect modification by genotype. We evaluated Cohen's kappa, sensitivity and specificity for the JEM compared to the expert-assessed exposure metrics. RESULTS: Although effect estimates were imprecise and driven by a small number of cases, we found evidence of effect modification between lead exposure and ALAD genotype when using expert- but not JEM-derived lead exposure estimates. kappa Values indicated only modest agreement (<0.5) for the exposure metrics, with the JEM indicating high specificity ( approximately 0.9) but poor sensitivity ( approximately 0.5). Disagreement between the two methods was generally due to having additional information in the detailed work history. CONCLUSION: These results provide preliminary evidence suggesting that high quality exposure data are likely to improve the ability to detect genetic effect modification.
机译：目的：人们非常希望评估化学暴露与基因-环境的相互作用，但是暴露评估对病例对照研究提出了独特的挑战。通常，对详细的工作历史数据进行专家评估通常被认为是最好的方法，但这是一个费力且耗时的过程。我们着手确定一种强度较低的接触评估方法（工作接触矩阵（JEM））是否会产生与先前分析相似的结果，该分析发现了证据证明对专家评估的铅暴露与脑瘤风险之间的关联有有效的影响通过在ALAD基因中的单核苷酸多态性（rs1800435）。方法：我们使用了对355例神经胶质瘤，151例脑膜瘤和505例对照的研究数据。使用Logistic回归模型检查脑肿瘤风险与铅暴露以及基因型对效应的影响之间的关联。与专家评估的暴露指标相比，我们评估了Cohen对JEM的kappa，敏感性和特异性。结果：尽管效果估计值不精确，并受少数病例的影响，但我们发现使用专家（而非JEM派生的）铅含量估计值时，铅含量和ALAD基因型之间的效应发生了改变。 kappa值仅显示出适度的一致性（<0.5），而JEM表示特异性高（约0.9），但敏感性差（约0.5）。两种方法之间的分歧通常是由于详细的工作历史中包含其他信息。结论：这些结果提供了初步证据，表明高质量的暴露数据可能会提高检测遗传效应修饰的能力。

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