Annals of Occupational Hygiene Advance Access published online on September 20, 2004
Annals of Occupational Hygiene, doi:10.1093/annhyg/meh052
Copyright © 2004 by the British Occupational Hygiene Society.
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1 Department of Preventive Medicine and Public Health, Faculty of Medicine, National Autonomous University of Nicaragua, León, Nicaragua; Department of Public Health Sciences, Division of Occupational Health, Karolinska Institutet, Stockholm, Sweden
* To whom correspondence should be addressed. E-mail: aragon{at}unanleon.edu.ni.
Background and objectives: We modified Fenske's semi-quantitative ‘visual scoring system’ of fluorescent tracer deposited on the skin of pesticide applicators and evaluated its reproducibility in the Nicaraguan setting. Methods: The body surface of 33 farmers, divided into 31 segments, was videotaped in the field after spraying with a pesticide solution containing a fluorescent tracer. A portable UV lamp was used for illumination in a foldaway dark room. The videos of five farmers were randomly selected. The scoring was based on a matrix with extension of fluorescent patterns (scale 0-5) on the ordinate and intensity (scale 0-5) on the abscissa, with the product of these two ranks as the final score for each body segment (0-25). Five medical students rated and evaluated the quality of 155 video images having undergone 4 h of training. Cronbach alpha coefficients and two-way random effects intraclass correlation coefficients (ICC) with absolute agreement were computed to assess inter-rater reliability. Results: Consistency was high (Cronbach alpha = 0.96), but the scores differed substantially between raters. The overall ICC was satisfactory [0.75; 95% confidence interval (CI) = 0.62-0.83], but it was lower for intensity (0.54; 95% CI = 0.40-0.66) and higher for extension (0.80; 95% CI = 0.71-0.86). ICCs were lowest for images with low scores and evaluated as low quality, and highest for images with high scores and high quality. Conclusions: Inter-rater reliability coefficients indicate repeatability of the scoring system. However, field conditions for recording fluorescence should be improved to achieve higher quality images, and training should emphasize a better mechanism for the reading of body areas with low contamination.
Accepted April 16, 2004
Article
Reliability of a Visual Scoring System with Fluorescent Tracers to Assess Dermal Pesticide Exposure
2 Department of Preventive Medicine and Public Health, Faculty of Medicine, National Autonomous University of Nicaragua, León, Nicaragua
3 Department of Medicine, Occupational and Environmental Dermatology, Karolinska Institutet and Stockholm County Council, Sweden
4 Department of Public Health Sciences, Division of Occupational Health, Karolinska Institutet, Stockholm, Sweden
5 Department of Public Health Sciences, Division of Occupational Health, Karolinska Institutet, Stockholm, Sweden; Central American Institute for Studies on Toxic Substances, Universidad Nacional, Heredia, Costa Rica
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