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The CONSTANCES job exposure matrix based on self-reported exposure to physical risk factors: development and evaluation.

ABSTRACT: OBJECTIVES:Job exposure matrices (JEMs) can be constructed from expert-rated assessments, direct measurement and self-reports. This paper describes the construction of a general population JEM based on self-reported physical exposures, its ability to create homogeneous exposure groups (HEG) and the use of different exposure metrics to express job-level estimates. METHODS:The JEM was constructed from physical exposure data obtained from the Cohorte des consultants des Centres d'examens de santé (CONSTANCES). Using data from 35?526 eligible participants, the JEM consisted of 27 physical risk factors from 407 job codes. We determined whether the JEM created HEG by performing non-parametric multivariate analysis of variance (NPMANOVA). We compared three exposure metrics (mean, bias-corrected mean, median) by calculating within-job and between-job variances, and by residual plots between each metric and individual reported exposure. RESULTS:NPMANOVA showed significantly higher between-job than within-job variance among the 27 risk factors (F(253,21964)=61.33, p<0.0001, r2=41.1%). The bias-corrected mean produced more favourable HEG as we observed higher between-job variance and more explained variance than either means or medians. When compared with individual reported exposures, the bias-corrected mean led to near-zero mean differences and lower variance than other exposure metrics. CONCLUSIONS:CONSTANCES JEM using self-reported data yielded HEGs, and can thus classify individual participants based on job title. The bias-corrected mean metric may better reflect the shape of the underlying exposure distribution. This JEM opens new possibilities for using unbiased exposure estimates to study the effects of workplace physical exposures on a variety of health conditions within a large general population study.

SUBMITTER: Evanoff BA

PROVIDER: S-EPMC6520135 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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The CONSTANCES job exposure matrix based on self-reported exposure to physical risk factors: development and evaluation.

Evanoff Bradley A BA Yung Marcus M Buckner-Petty Skye S Andersen Johan Hviid JH Roquelaure Yves Y Descatha Alexis A Dale Ann Marie AM

Occupational and environmental medicine 20190131 6

<h4>Objectives</h4>Job exposure matrices (JEMs) can be constructed from expert-rated assessments, direct measurement and self-reports. This paper describes the construction of a general population JEM based on self-reported physical exposures, its ability to create homogeneous exposure groups (HEG) and the use of different exposure metrics to express job-level estimates.<h4>Methods</h4>The JEM was constructed from physical exposure data obtained from the Cohorte des consultants des Centres d'exa ...[more]

PMID: 30705110

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Project description:ObjectivesThe aim was to construct and validate a gender-specific job exposure matrix (JEM) for physical exposures to be used in epidemiological studies of low back pain (LBP).Materials and methodsWe utilized two large Finnish population surveys, one to construct the JEM and another to test matrix validity. The exposure axis of the matrix included exposures relevant to LBP (heavy physical work, heavy lifting, awkward trunk posture and whole body vibration) and exposures that increase the biomechanical load on the low back (arm elevation) or those that in combination with other known risk factors could be related to LBP (kneeling or squatting). Job titles with similar work tasks and exposures were grouped. Exposure information was based on face-to-face interviews. Validity of the matrix was explored by comparing the JEM (group-based) binary measures with individual-based measures. The predictive validity of the matrix against LBP was evaluated by comparing the associations of the group-based (JEM) exposures with those of individual-based exposures.ResultsThe matrix includes 348 job titles, representing 81% of all Finnish job titles in the early 2000s. The specificity of the constructed matrix was good, especially in women. The validity measured with kappa-statistic ranged from good to poor, being fair for most exposures. In men, all group-based (JEM) exposures were statistically significantly associated with one-month prevalence of LBP. In women, four out of six group-based exposures showed an association with LBP.ConclusionsThe gender-specific JEM for physical exposures showed relatively high specificity without compromising sensitivity. The matrix can therefore be considered as a valid instrument for exposure assessment in large-scale epidemiological studies, when more precise but more labour-intensive methods are not feasible. Although the matrix was based on Finnish data we foresee that it could be applicable, with some modifications, in other countries with a similar level of technology.

Project description:To examine the associations between job exposure to the public (e.g., customers, guests, users of a public service, patients) and alcohol, tobacco and cannabis use.From the French population-based CONSTANCES cohort, 16,566 men and 17,426 women currently working were included between 2012 and 2016. They reported their exposure to the public (daily versus no daily), and among the daily exposed participants (10,323 men and 13,318 women), the frequency of stressful exposure (often versus rarely). Dependent variables were: chronic alcohol consumption (<1(1), 1-27(1-13), 28-42(14-28), >42(28) drinks per week in men(women)), heavy episodic drinking (never, at most once a month, more than once a month), alcohol use risk with Alcohol Use Disorders Identification Test (mild, dangerous, problematic or dependence), tobacco use (non-smoker, former smoker, 1-9, 10-19, >19 cigarettes per day) and cannabis use (never, not in past year, less than once a month, once a month or more). Logistic regressions provided odds ratios of substance use, stratifying for gender and adjusting for sociodemographic confounders, depression, effort-reward imbalance and perceived health status.Exposed men had higher risks of alcohol (chronic alcohol consumption, heavy episodic drinking and alcohol use risk), tobacco and cannabis use. Exposed women had higher risks of tobacco and cannabis use. In men, stressful exposure was associated with increased risks of heavy episodic drinking, tobacco and cannabis use. In women, stressful exposure was associated with increased risks of chronic alcohol consumption, alcohol use risk, tobacco and cannabis use. All these findings remained significant in multivariable analyses, taking into account sociodemographic variables, depressive symptoms, perceived health status and effort-reward imbalance.Interventions to reduce emotional job demand should systematically integrate assessment and prevention measures of addictive behaviors. Vulnerable workers may be offered more specific interventions to reduce the impact of exposure to the public on their substance use.

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The CONSTANCES job exposure matrix based on self-reported exposure to physical risk factors: development and evaluation.

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The CONSTANCES job exposure matrix based on self-reported exposure to physical risk factors: development and evaluation.

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