A job-exposure matrix for use in population based studies in England and Wales

The job-exposure matrix described has been developed for use in population based studies of occupational morbidity and mortality in England and Wales. The job axis of the matrix is based on the Registrar General's 1966 classification of occupations and 1968 classification of industries, and comprises 669 job categories. The exposure axis is made up of 49 chemical, physical, and biological agents, most of which are known or suspected causes of occupational disease. In the body of the matrix associations between jobs and exposures are graded to four levels. The matrix has been applied to data from a case-control study of lung cancer in which occupational histories were elicited by means of a postal questionnaire. Estimates of exposure to five known or suspected carcinogens (asbestos, chromates, cutting oils, formaldehyde, and inhaled polycyclic aromatic hydrocarbons were compared with those obtained by detailed review of individual occupational histories. When the matrix was used exposures were attributed to jobs more frequently than on the basis of individual histories. Lung cancer was significantly more common among subjects classed by the matrix as having potential exposure to chromates, but neither method of assigning exposures produced statistically significant associations with asbestos or polycyclic aromatic hydrocarbons. Possible explanations for the failure to show a clear effect of these known carcinogens are discussed. The greater accuracy of exposures inferred directly from individual histories was reflected in steeper dose response curves for asbestos, chromates, and polycyclic aromatic hydrocarbons. The improvement over results obtained with the matrix, however, was not great. For occupational data of the type examined in this study, direct exposure estimates offer little advantage over those provided at lower cost by a matrix.