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Incident CTS in a large pooled cohort study: associations obtained by a Job Exposure Matrix versus associations obtained from observed exposures. | LitMetric

AI Article Synopsis

  • A job exposure matrix (JEM) is increasingly used to estimate work-related musculoskeletal disorder exposures, but its validity needs more research compared to traditional methods.
  • This study compared JEM-derived exposure estimates with actual physical exposure measures from a large group of workers (2393) to assess associations with carpal tunnel syndrome (CTS).
  • Both methods showed similar exposure-disease associations for CTS, suggesting that JEMs can be useful in certain studies, even though they have limitations.

Article Abstract

Background: There is growing use of a job exposure matrix (JEM) to provide exposure estimates in studies of work-related musculoskeletal disorders; few studies have examined the validity of such estimates, nor did compare associations obtained with a JEM with those obtained using other exposures.

Objective: This study estimated upper extremity exposures using a JEM derived from a publicly available data set (Occupational Network, O*NET), and compared exposure-disease associations for incident carpal tunnel syndrome (CTS) with those obtained using observed physical exposure measures in a large prospective study.

Methods: 2393 workers from several industries were followed for up to 2.8 years (5.5 person-years). Standard Occupational Classification (SOC) codes were assigned to the job at enrolment. SOC codes linked to physical exposures for forceful hand exertion and repetitive activities were extracted from O*NET. We used multivariable Cox proportional hazards regression models to describe exposure-disease associations for incident CTS for individually observed physical exposures and JEM exposures from O*NET.

Results: Both exposure methods found associations between incident CTS and exposures of force and repetition, with evidence of dose-response. Observed associations were similar across the two methods, with somewhat wider CIs for HRs calculated using the JEM method.

Conclusion: Exposures estimated using a JEM provided similar exposure-disease associations for CTS when compared with associations obtained using the 'gold standard' method of individual observation. While JEMs have a number of limitations, in some studies they can provide useful exposure estimates in the absence of individual-level observed exposures.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6035491PMC
http://dx.doi.org/10.1136/oemed-2017-104744DOI Listing

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