ABSTRACT
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.
Subject(s)
Asbestos , Compensation and Redress , Mesothelioma/epidemiology , Occupational Diseases/epidemiology , Occupational Exposure/classification , Risk Assessment/methods , Asbestos/analysis , Case-Control Studies , Female , France/epidemiology , Humans , Male , Occupational Exposure/analysis , Occupations/statistics & numerical data , Probability , Reproducibility of Results , Surveys and QuestionnairesABSTRACT
An assessment survey of occupational exposure to beryllium (Be) was conducted in France between late 2004 and the end of 2006. Exposure estimates were based on the analytical results of samples collected from workplace air and from work surfaces in 95 facilities belonging to 37 sectors of activity. The results of this study indicated airborne Be concentrations in excess of the occupational exposure limit value of 2 microg m(-3) recommended in France. Metallurgy and electronic component manufacturing represented the activities and occupations where workers had the highest arithmetic mean exposures to Be. Surface contamination levels were also high and frequently exceeded thresholds recommended by different bodies. These results should prompt the development of prevention programmes that include Be substitution, process control and surface decontamination, in conjunction with suitable medical surveillance.
