Annals of Occupational Hygiene Advance Access originally published online on September 10, 2007
Annals of Occupational Hygiene 2007 51(7):601-610; doi:10.1093/annhyg/mem037
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Published by Oxford University Press on behalf of the British Occupational Hygiene Society
Inter-Rater Agreement for a Retrospective Exposure Assessment of Asbestos, Chromium, Nickel and Welding Fumes in a Study of Lung Cancer and Ionizing Radiation
1 National Institute for Occupational Safety and Health, Division of Surveillance, Hazard Evaluations, and Field Studies, 4676 Columbia Parkway, Cincinnati, OH 45226, USA
2 Westat Inc., 1650 Research Boulevard, Rockville, MD 20850, USA
* Author to whom correspondence should be addressed. Tel: +513-841-4422; fax: +513-841-4470; e-mail: lseel{at}cdc.gov
A retrospective exposure assessment of asbestos, welding fumes, chromium and nickel (in welding fumes) was conducted at the Portsmouth Naval Shipyard for a nested case–control study of lung cancer risk from external ionizing radiation. These four contaminants were included because of their potential to confound or modify the effect of a lung cancer–radiation relationship. The exposure assessment included three experienced industrial hygienists from the shipyard who independently assessed exposures for 3519 shop/job/time period combinations. A consensus process was used to resolve estimates with large differences. Final exposure estimates were linked to employment histories of the 4388 study subjects to calculate their cumulative exposures. Inter-rater agreement analyses were performed on the original estimates to better understand the estimation process. Although concordance was good to excellent (78–99%) for intensity estimates and excellent (96–99%) for frequency estimates, overall simple kappa statistics indicated only slight agreement beyond chance (
< 0.2). Unbalanced distributions of exposure estimates partly contributed to the weak observed overall inter-rater agreement. Pairwise weighted kappa statistics revealed better agreement between two of the three panelists ( = 0.19–0.65). The final consensus estimates were similar to the estimates made by these same two panelists. Overall welding fume exposures were fairly stable across time at the shipyard while asbestos exposures were higher in the early years and fell in the mid-1970s. Mean cumulative exposure for all study subjects was 520 fiber-days cc–1 for asbestos and 1000 mg-days m–3 for welding fumes. Mean exposure was much lower for nickel (140 µg-days m–3) and chromium (45 µg-days m–3). Asbestos and welding fume exposure estimates were positively associated with lung cancer in the nested case–control study. The radiation–lung cancer relationship was attenuated by the inclusion of these two confounders. This exposure assessment provided exposure estimates that aided in understanding of the lung cancer–radiation relationship at the shipyard.
Keywords: expert judgment • inter-rater agreement • job-exposure matrix • retrospective exposure assessment
Received November 21, 2006; in final form July 10, 2007
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