Choice of rating method for assessing occupational asbestos exposure: Study for compensation purposes in France

• Published in: American journal of industrial medicine 2012-05, Vol.55 (5), p.440-449
• Main Authors: Gramond, Celine, Rolland, Patrick, Lacourt, Aude, Ducamp, Stephane, Chamming's, Soizick, Creau, Yvon, Hery, Michel, Laureillard, Jacques, Mohammed-Brahim, Brahim, Orlowski, Ewa, Paris, Christophe, Pairon, Jean-Claude, Goldberg, Marcel, Brochard, Patrick
• Format: Article
• Language: English
• Subjects: asbestos; Asbestos - analysis; Biological and medical sciences; Case-Control Studies; Compensation and Redress; experts; Female; France - epidemiology; Humans; kappa coefficient; Male; Medical sciences; Mesothelioma - epidemiology; Miscellaneous; Occupational Diseases - epidemiology; occupational exposure; Occupational Exposure - analysis; Occupational Exposure - classification; Occupational medicine; Occupations - statistics & numerical data; Probability; Public health. Hygiene-occupational medicine; rating method; Reproducibility of Results; Risk Assessment - methods; Surveys and Questionnaires
• ISSN: 0271-3586; 1097-0274
• DOI: 10.1002/ajim.22008

Background In the course of setting up the National Mesothelioma Surveillance Program (PNSM), established in France in 1998, the question arose as to the most suitable method of assessing occupational exposure. The aim of this study was to define the most suitable rating method for assessing occupational asbestos exposure in order to assess medico‐social care. Method The study included 100 subjects—50 cases of mesothelioma and 50 controls—randomly selected and representing 457 jobs held. Job asbestos exposure was assessed by a six‐expert panel using two methods: “by job” rating, where all the jobs in were assessed regardless of the subjects; and “by subject” rating, where all the jobs of a subject were assessed at the same time. Consensus was obtained and subjects' exposure was calculated for each rating. Then, two internal experts assessed job asbestos exposure with the “by subject” rating. Kappa coefficients were used to measure agreement between the ratings. Results Agreement between “by job” and “by subject” ratings was very good for subject probability of exposure (kappa = 0.84) and cumulative exposure index (kappa = 0.80). Agreement between the six‐expert panel and the two internal experts was good for subject exposure (kappa for probability = 0.71; kappa for cumulative exposure index= 0.68). Conclusion This study shows that the two rating systems have good or very good agreement. These results validate the routine use in the PNSM of the “by subject” rating, with the advantage of being convenient and quick to provide feedback on occupational asbestos exposure to mesothelioma cases for compensation. Am. J. Ind. Med. 55:440–449, 2012. © 2012 Wiley Periodicals, Inc.