An innovative approach to identify past exposure to asbestos integrating questionnaire information and administrative data. Issue 2 (February 2021)

• Record Type: Journal Article
• Authors: Fontana, Luca; Massari, Stefania; Maisonneuve, Patrick; Persechino, Benedetta; Marinaccio, Alessandro; Rampinelli, Cristiano; Spaggiari, Lorenzo; Veronesi, Giulia; Iavicoli, Sergio
• Is Part Of: Health policy. Volume 125:Issue 2(2021)
• Page Start: 246
• Page End: 253
• Publication Date: 2021-02
• Subjects: Asbestos -- Work history -- Occupational carcinogens -- Screening programs -- Follow-up programs; Medical education -- Periodicals; Medical policy -- Periodicals; Delivery of Health Care -- Periodicals; Education, Medical -- Periodicals; Health Education -- Periodicals; Health Planning -- Periodicals; Public Policy -- Periodicals; Enseignement médical -- Périodiques; Politique sanitaire -- Périodiques; Medical education; Medical policy; Periodicals; Electronic journals; Electronic journals; 362.1
• DOI: 10.1016/j.healthpol.2020.11.013
• Languages: English
• ISSNs: 0168-8510

Abstract

Highlights: Linkage of self-administered questionnaires with social security files allows for the acquisition of a reliable work history. These data are useful for implementing screening programs for the early diagnosis of occupational cancer. The suggested strategy is simple, cost-effective and easily adaptable to other occupational carcinogens. Abstract: Reconstruction of work history of subjects exposed to occupational carcinogens might be extremely challenging and provide unreliable results. This study, carried out in Italy from February to November 2014, aimed to explore the validity of an innovative approach to reconstruct the occupational history of workers who have previously been exposed to asbestos combining the administration of structured questionnaire with the use of administrative data. Subjects recruited in this study were enrolled in the cohorts of COSMOS 1 and 2 studies. Participants indicating an exposure to asbestos were contacted and a structured questionnaire was administered to them to verify the validity of the self-reported asbestos exposure. Subsequently, work histories of respondents were investigated using administrative information. The record linkage with social security archives allowed the reassembling of the complete work history of 487 participants. In detail, administrative files allow the retrieval of 98 % of workers declaring not to be exposed, versus 77 % using the questionnaire. Furthermore, the percentage of retrieved cases is not relevant for high risk sectors but it is almost double for industries with probable presence of asbestos. The combined and integrated use of structured questionnaire with administrative data proved effective in accurately identifying subjects who actually had an asbestos exposure. This innovative strategy, being cost-effective and easily adaptable to other carcinogens, could be particularly useful in selecting subjects to recruit in specific screening and control programs for the early diagnosis of occupational cancers.