Evidence of recall bias in volunteered vs. prompted responses about occupational exposures

Recall bias remains a concern in case-control studies, although few investigations have found evidence of differential recall. This study examined whether differences in occupational exposure reporting occur in volunteered vs. prompted questionnaire responses.

In a large, population-based, case-control study of a childhood cancer, neuroblastoma, we calculated odds ratios for broad occupational exposure groups on the assumption that in the absence of recall bias, risk estimates for such broad groupings should be close to the null value.

Prompted exposures and work activities showed little evidence of differential recall by parents of cases and controls (all OR < 1.2), but case parents were more likely to volunteer information about other exposures or activities (ORs: 1.35-1.71). Case mothers were also more likely than control mothers to report activities involving indirect exposure (OR = 1.41).

These findings suggest that prompted exposure questions are less likely to be subject to recall bias than open-ended questions.