[Screening of occupational exposure to asbestos and silica by job-exposure matrix among patients with lung cancer and mesothelioma]

Rev Mal Respir. 2019 Dec;36(10):1088-1095. doi: 10.1016/j.rmr.2019.08.006. Epub 2019 Nov 11.
[Article in French]

Abstract

Introduction: In the context of underreporting of occupational diseases, the aim was to study the validity of silica and asbestos job-exposure matrices in screening occupational exposure in the field of thoracic oncology.

Methods: Fifty patients hospitalized with primitive lung cancer or mesothelioma in a university hospital center in the Hauts-de-Seine department of France were included between November 2016 and September 2017. For each patient 1/the job history was collected, from which data was entered single-blindly into the job-exposure matrices by a resident in occupational medicine, 2/a questionnaire (Q-SPLF) was completed similarly, and 3/the patients also had a consultation with a chief resident in occupational medicine, considered the gold standard. The main outcome was the diagnostic performance of the matrices. The Q-SPLF diagnostic performance was also studied.

Results: The asbestos and silica matrices had sensitivities of 100%, specificities of respectively 76.1% and 87.8%, the positive likelihood ratios were at 4.19 [2.5-6] and 8.17 [3.8-10], and the negative likelihood ratios were at 0. The Q-SPLF diagnostic performance was comparable to that of the matrices.

Conclusions: The matrices and the questionnaire have a great diagnostic performance which seems interesting for a use as a screening tool for occupational exposures. These results have yet to be confirmed by large-scale studies.

Keywords: Amiante; Asbestos; Cancer pulmonaire; Exposition professionnelle; Job-exposure matrix; Lung cancer; Matrice emplois-expositions; Occupational exposure; Silica; Silice.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Asbestos / toxicity
  • Asbestosis / complications
  • Asbestosis / diagnosis*
  • Asbestosis / epidemiology
  • Carcinoma, Bronchogenic / diagnosis
  • Carcinoma, Bronchogenic / epidemiology*
  • Carcinoma, Bronchogenic / etiology
  • Female
  • France / epidemiology
  • Humans
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / epidemiology*
  • Lung Neoplasms / etiology
  • Male
  • Mass Screening / methods*
  • Mesothelioma / diagnosis
  • Mesothelioma / epidemiology*
  • Mesothelioma / etiology
  • Middle Aged
  • Occupational Diseases / diagnosis
  • Occupational Exposure / analysis
  • Silicon Dioxide / toxicity
  • Silicosis / complications
  • Silicosis / diagnosis*
  • Silicosis / epidemiology
  • Surveys and Questionnaires
  • Work / statistics & numerical data

Substances

  • Asbestos
  • Silicon Dioxide