ArticleOccupational and environmental medicine2019
Validity of retrospective occupational exposure estimates of lead and manganese in a case-control study.
Article in Occupational and environmental medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed, 3 citations in OpenAlex.
- Associations between a mixture of trace elements and bladder cancer occurrence: A study of possible reverse causation.Environmental epidemiology (Philadelphia, Pa.) · 2026Article
- Evaluation of the validity of a perfluorooctane sulfonic acid exposure reconstruction using a measured serum concentration among workers with a wide range of exposure.Annals of work exposures and health · 2025Article
- Using Decision Rules to Assess Occupational Exposure in Population-Based Studies.Current environmental health reports · 2019Review
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Authors and funding
18 authors at 5 institutions in 1 country.
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Abstract
objectivesThe validity of surrogate measures of retrospective occupational exposure in population-based epidemiological studies has rarely been evaluated. Using toenail samples as bioindicators of exposure, we assessed whether work tasks and expert assessments of occupational metal exposure obtained from personal interviews were associated with lead and manganese concentrations.
methodsWe selected 609 controls from a case-control study of bladder cancer in New England who had held a job for ≥1 year 8-24 months prior to toenail collection. We evaluated associations between toenail metal concentrations and five tasks extracted from occupational questionnaires (grinding, painting, soldering, welding, working near engines) using linear regression models. For 139 subjects, we also evaluated associations between the toenail concentrations and exposure estimates from three experts.
resultsWe observed a 1.9-fold increase (95% CI 1.4 to 2.5) in toenail lead concentrations with painting and 1.4-fold increase (95% CI 1.1 to 1.7) in manganese concentrations with working around engines and handling fuel. We observed significant trends with increasing frequency of both activities. For lead, significant trends were observed with the ratings from all three experts. Their average ratings showed the strongest association, with subjects rated as possibly or probably exposed to lead having concentrations that were 2.0 and 2.5 times higher, respectively, than in unexposed subjects (p
conclusionsOur findings support the ability of experts to identify broad contrasts in previous occupational exposure to lead. The stronger associations with task frequency and expert assessments support using refined exposure characterisation whenever possible.
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