Environmental Tobacco Smoke Measuring Exposures and Assessing Health Effects (1986) / Chapter Skim
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6 Assessing Exposures to Enviromental Tobacco Smoke Using Questionnaires
6 Assessing Exposures to Enviromental Tobacco Smoke Using Questionnaires
Pages 101-119
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From page 101... ...
A variety of methods is used to estimate individual exposures associated with human health effects in industrial and nonindustrial settings. These exposure indicators may be direct such as the use of personal-monitoring data or biochemical measures oh tanned by testing body fluids for the compound or its metabolites or indirect such as the use of data from interview responses of firmly members regarding activities of the subject and modeling based on environmental monitoring of the ambient or industrial setting.
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From page 102... ...
There are several major issues in epidemiologic studies of health effects of exposure to ETS that rely on indirect measures of exposure as derived from questionnaire data. First, the assessment of ETS exposures associated with acute health effects requires a different approach than that for chronic health effects.
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From page 103... ...
103 ct U2 ct 1 v, ._ v, ._ c~ ._ o z ce ._ s" c~ ~: ._ a~ s~ u, o x ~3 ct ._ ;> ._ o c~ s" o ct c, ._ s: ~ _ ~o ct _ ~ ~ ct \0 t~ ~ C~ C)
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From page 106... ...
Developing such a measure is complex even for relatively acute health outcomes, such as acute cardiovascular, respiratory, or neurotoxic symptoms, for which it may be sufficient to estimate recent exposures. Developing a comprehensive measure to ETS exposures is far more complex for diseases with long induction times, such as cancer and chronic obstructive pulmonary disease.
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From page 107... ...
In studies of chronic health effects in adults, such as cancer, exposure of nonsmokers to ETS has been largely determined by smoking status of the spouse. Most studies of lung cancer among nonsmoking women have relied solely or principally on information regarding smoking status of the spouse to assess ETS exposures, with little attempt to corroborate self-reports of exposure to ETS.
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From page 108... ...
argue that since no objective criteria for lifetime exposure to ETS exits, a direct validation of an instrument to assess lifelong ETS exposure cannot be obtained. They propose that the instrument be validated on a recent tone frame, such as 24-hour data.
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From page 109... ...
In studies of ETS exposures, information about the smoking habits of the subject, family, and household members is obtained by interviews with the study subject when available, or by mterview with a family member when the study subject is deceased or unavailable. That is, surrogate respondents may be used to collect information regarding personal exposures of the study subject.
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From page 110... ...
also reported perfect agreement for smoking status information obtained by interview with a close relative (parent, wife, or child) for 14 lung cancer cases when information was compared with that obtained previously by the plant physician.
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From page 111... ...
When amount smoked (current amount at baseline versus usual amount at foDow-up) Is compared for smokers only, the agreement rates are substantially affected by type of respondent; 55~o agreement for subject responses versus 35% agreement for proxy responses.
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From page 112... ...
by Type of Respondent at Follow-up Smoking Status Reported at Follow-up Baseline SmokingEver Never Total Status(NHANES I)
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From page 114... ...
These findings, although from a Innited number of studies, have direct implications for the studies of ETS exposures where ETS exposure information is derived from surrogate reports. It should be noted that in the special instance where the spouse surrogate is reporting on his personal smoking history, the information regarding ETS exposure of the nonsmoking study subject may be more accurate with regard to home exposures than the report by the study subject.
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From page 115... ...
Other methods currently available for comparison with questionnaire and interview responses include biochemical measures, environmental modeling, review of existing records, and reports of additional respondents. OTHER VARIABLES Confounding factors that should be considered in the design, collection, and use of questionnaire data are other risk factors associated with the disease that may or may not be correlated with exposures to ETS.
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From page 116... ...
A history of exposure to all other known or suspected confounding factors should be obtained in a comparable manner for cases and comparison subjects by interview and corroborated whenever possible by comparison with existing records or selfreports obtained before development of the disease. The exposure data collected should strive to be as detailed as possible with respect to intensity, duration, and calendar time for all exposures, including ETS exposures.
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From page 117... ...
2. Future investigations should be concerned with detailed characterization of ETS that would provide a more precise estunation of individual exposures and include additional considerations of physical characteristics of the environment, activity patterns of the study subject, and ages at which exposures occurred.
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From page 118... ...
Skipper. Salivary cotinine levels and passive tobacco smoke exposure in the home.
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From page 119... ...
Blot. In~rmatlon Callable Cow surrogate respondents in c~se-control lute~lew studies.
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