Use of a crop and job specific exposure matrix for retrospective assessment of long term exposure in studies of chronic neurotoxic effects of agrichemicals

Rationale-Job exposure matrices (JEMs) are widely used in occupational epidemiology, particularly when biological or environmental monitoring data are scanty. However, as with most exposure estimates, JEMs may be vulnerable to misclassification. Objectives-To estimate the long term exposure of farm workers based on a JEM developed for use in a study of the neurotoxic effects of organophosphates and to evaluate the repeatability and validity of the JEM. Methods-A JEM was constructed with secondary data from industry and expert opinion of the estimate of agrichemical exposure within every possible job activity in the JEM to weight job days for exposure to organophosphates. Cumulative lifetime and average intensity exposure of organophosphate exposure were calculated for 163 pesticide applicators and 84 controls. Repeat questionnaires were given to 29 participants three months later to test repeatability of measurements. The ability of JEM based exposure to predict a known marker of organophosphate exposure was used to validate the JEM. Results-Cumulative lifetime exposure as measured in kg organophosphate exposure, was significantly associated with erythrocyte cholinesterase concentrations (partial r(2)=5%; p < 0.01), controlled for a range of confounders. Repeatability in a subsample of 29 workers of the estimates of cumulative (Pearson's r=0.67; 95% confidence interval (95% CI) 0.41 to 0.83), and average lifetime intensity of exposure (Pearson's r=0.60 95% CI 0.31 to 0.79) was adequate. Conclusion-The JEM seems promising for farming settings, particularly in developing countries where data on chemical application and biological monitoring are unavailable.