Exposure Assessment for a Nested Case-Control Study of Lung Cancer among European Asphalt Workers

Michela Agostini, Gilles Ferro, Ann Olsson, Igor Burstyn, Frank De Vocht, Johnni Hansen, Christina Funch Lassen, Christoffer Johansen, Kristina Kjaerheim, Sverre Langard, Isabelle Stucker, Wolfgang Ahrens, Thomas Behrens, Marja-Liisa Lindbohm, Pirjo Heikkila, Dick Heederik, Lutzen Portengen, Judith Shaham, Paolo Boffetta, Hans Kromhout*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

7 Citations (Scopus)


Methods: Company questionnaires and structured questionnaires used in interviews and industry-specific job-exposure matrices (JEMs) were elaborated and applied. Three sources of information were eventually used for exposure assessment and assignment: (i) data obtained in cohort phase, (ii) data from living subjects, next-of-kin, and fellow-workers questionnaires, and (iii) JEMs for bitumen exposure by inhalation and via skin and co-exposures to known or suspected lung carcinogens within and outside cohort companies. Inhalation and dermal exposure estimates for bitumen were adjusted for time trends, time spent in a job, and other determinants of exposure (e.g. oil gravel paving). Clothing patterns, personal protective devices, and personal hygiene were taken into consideration while estimating dermal exposure.

Results: Occupational exposures could be assessed for 433 cases and 1253 controls for relevant time periods. Only 43% of work histories were spent inside original asphalt and construction companies. A total of 95.8% of job periods in cohort companies could be coded at a more detailed level. Imputation of work time and 'hygienic behaviour' multipliers was needed for <10% of work history years. Overall, downward trends in exposure were present and differences existed between countries and companies. As expected, correlations were strongest (r > 0.7) among bitumen-related agents, while correlations between coal tar, bitumen-related agents, and established lung carcinogens were weaker (r <0.4).

Conclusions: A systematic and detailed approach was developed to estimate inhalation and dermal exposure for a nested case-control study among asphalt workers.

Original languageEnglish
Pages (from-to)813-823
Number of pages11
JournalAnnals of Occupational Hygiene
Issue number7
Publication statusPublished - Oct 2010


  • asphalt industry
  • bitumen
  • case-control study
  • dermal exposure
  • epidemiology
  • exposure assessment
  • inhalation exposure
  • lung cancer
  • RISK

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