A meta-analytic approach for characterizing the within-worker and between-worker sources of variation in occupational...

While many studies have quantified the sources of variation in exposure to workplace contaminants for individual groups of workers, patterns of exposure variability have not been investigated since a comprehensive evaluation was carried out over 10 years ago. Therefore, a systematic review of the literature was conducted to identify studies that applied the one-way random-effects model to describe exposure profiles of groups of workers classified on the basis of the kind of work performed and where it was performed. Quantitative estimates of the sources of variation in exposure along with information related to the workplace, contaminant and sampling strategy were compiled. For subsets of the data, based upon the classification scheme used to group workers, weighted empirical cumulative distribution functions were constructed and compared using the non-parametric Kolomogorov-Smirnov two-sample test. Further stratifications evaluated differences by industry, agent and characteristics of the sampling strategy. The review identified nearly 60 studies that examined the within-worker and between-worker sources of variation in exposure to workplace contaminants. In pooling results across studies, the between-worker variability increased as workers were aggregated across jobs and locations. The within-worker variability for an occupational group of workers was generally larger than the between-worker variability, although the differences in the variation in exposures across work shifts relative to the variation among workers' mean exposure levels diminished as groups were combined across jobs and locations. On average, gaseous exposures were more homogeneous than exposures to aerosols or dermal agents as were exposures in the chemical industry compared with the non-chemical industry. The design of sampling strategies also plays an important role with greater variability among groups of workers who were sampled randomly rather than systematically; in addition, differences were detected on the basis of the study period and sample size. In evaluating key features of the design and methods of the studies identified in the review, several methodological issues emerged given the heterogeneity in terms of how censored data were handled, which estimation method was applied and whether underlying assumptions of the models were met. Notwithstanding the utility of quantifying sources of variation in exposure, several challenges lie ahead with regard to ensuring quality in the collection, analysis and reporting of exposure monitoring data that would enhance efforts to accurately assess exposure.