Comparison of Task-Based Exposure Metrics for an Epidemiologic Study of Isocyanate Inhalation Exposures Among Autobody Shop Workers

Abstract

Because many occupational epidemiologic studies use exposure surrogates rather than quantitative exposure metrics, the UMass Lowell and Yale study of autobody shop workers provided an opportunity to evaluate the relative utility of surrogates and quantitative exposure metrics in an exposure response analysis of cross-week change in respiratory function. A task-based exposure assessment was used to develop several metrics of inhalation exposure to isocyanates. The metrics included the surrogates, job title, counts of spray painting events during the day, counts of spray and bystander exposure events, and a quantitative exposure metric that incorporated exposure determinant models based on task sampling and a personal workplace protection factor for respirator use, combined with a daily task checklist. The result of the quantitative exposure algorithm was an estimate of the daily time-weighted average respirator-corrected total NCO exposure (μ g/m³). In general, these four metrics were found to be variable in agreement using measures such as weighted kappa and Spearman correlation. A logistic model for 10% drop in FEV₁ from Monday morning to Thursday morning was used to evaluate the utility of each exposure metric. The quantitative exposure metric was the most favorable, producing the best model fit, as well as the greatest strength and magnitude of association. This finding supports the reports of others that reducing exposure misclassification can improve risk estimates that otherwise would be biased toward the null. Although detailed and quantitative exposure assessment can be more time consuming and costly, it can improve exposure-disease evaluations and is more useful for risk assessment purposes. The task-based exposure modeling method successfully produced estimates of daily time-weighted average exposures in the complex and changing autobody shop work environment. The ambient TWA exposures of all of the office workers and technicians and 57% of the painters were found to be below the current U.K. Health and Safety Executive occupational exposure limit (OEL) for total NCO of 20 μ g/m³. When respirator use was incorporated, all personal daily exposures were below the U.K. OEL.

Keywords:

• autobody shop
• exposure assessment
• isocyanate
• occupational epidemiology
• task-based

ACKNOWLEDGMENTS

The authors are grateful to all the shop proprietors and workers whose cooperation made the study possible. Thanks to Frank Walsh for his invaluable assistance in the field work. This study was supported by CDC/NIOSH grant R01-OH03457.

Notes

^A Job category: Office Work, Technician, Painter.

^B Nonparametric chi-square test on Wilcoxon scores by job category.

^C Weighted kappa using natural cutpoints from histograms to determine high, medium, and low categories of exposure metrics for comparison with job categories.

^D Weighted kappa using job categories compared with exposure categories determined by sorting 232 subjects 3-day average exposures lowest to highest. Lowest 28% measurements = low (64/232 office workers), next 51% (118/232 technicians) as medium, and top 21% (49/232 painters) as high.

^A AIC, Aiken Information Criterion.