Bugge, M. D.

Peters, S.

Turner, M. C.

Vermeulen, R.

Vienneau, D.

English

edoc

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com© The Author(s) 2020. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.EditorialInternational Inventory of Occupational Exposure Information: OMEGA-NETSusan Peters1,2,*, , Michelle C. Turner3, Merete D. Bugge4,  Danielle Vienneau5,6 and Roel Vermeulen1,2,1Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; 2University Medical Centre Utrecht, Utrecht, The Netherlands; 3Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; 4National Institute of Occupational Health (STAMI), Oslo, Norway; 5Swiss Tropical and Public Health Institute, Basel, Switzerland; 6University of Basel, Basel, Switzerland*Author to whom correspondence should be addressed. Tel: +31-30-253-2347; e-mail: s.peters@uu.nlEmployment is a major determinant of health and healthy ageing. The working life comprises a large pro-portion of the total life span, including vulnerable life stages such as the reproductive period. Occupation can also invoke a broad range of exposures often higher than that encountered in the general environment. Assessment of occupational exposure is thus a crucial aspect of assessing total exposure over the life course. To support such ambitious goals, concerted effort is needed to catalogue occupational exposure informa-tion. OMEGA-NET (the Network on the Coordination and Harmonisation of European Occupational Cohorts, http://omeganetcohorts.eu/) is a 4-year EU COST Action that started in 2017 intending to do just this.Specifically, OMEGA-NET aims to enable optimiza-tion of the use of occupational, industrial, and general population cohorts across Europe to advance aetio-logical research and support public health. One obvious way to strengthen and elaborate ongoing research is to seek and leverage collaboration of cohorts with exten-sive occupational histories. The coordination and har-monization of occupational exposure assessment efforts, to facilitate an integrated research strategy for occupa-tional health in Europe and beyond, is also of utmost importance (Turner and Mehlum, 2018).Despite the numerous large cohort studies conducted world-wide, data on occupational risks as a whole are not being used to their full potential. We provisionally es-timated approximately 30 million individuals in Europe are represented in existing cohort studies with extensive occupational and employment information (Turner and Mehlum, 2018). Pooling such cohorts would offer op-timal exploitation of these resources, and unique oppor-tunities for advancing aetiological research. Making the best use of a wide range of cohorts, however, requires high-quality large-scale systematic and harmonized ex-posure assessment.Exposure assessment is a cornerstone in occupational epidemiology—one of the key methodological consider-ations—and not without its challenges. The goal in any study is to derive an accurate, precise, and biologically relevant exposure estimate for each worker under study (Nieuwenhuijsen, 2003). Without high-quality exposure assessment, the power of a study to detect an association between exposure and health outcome is diminished, which may bias results and lead to spurious interpret-ations. Study to study differences in exposure assessment quality are more apparent when drawing the evidence together. As has been shown in examples on benzene (Vlaanderen et al., 2008), asbestos (Lenters et al., 2011), and trichloroethylene (Purdue et al., 2011), heterogen-eity in findings across epidemiological studies are at least partly explained by variations in the quality of exposure assessment.Annals of Work Exposures and Health, 2020, 64, No. 5, 465–467doi: 10.1093/annweh/wxaa021Advance Access publication 10 March 2020EditorialDownloaded from https://academic.oup.com/annweh/article/64/5/465/5802560 by University of Basel user on 03 September 2020In addition to high-quality exposure assessment, it is essential to make the method objective, consistent, and transparent. These aspects are particularly important when pooling data to enable comparison of findings from different populations. Pooling of data is becoming increasingly important in detection of rare exposures, exposures with lower potency, and interactions with vul-nerability including genetics.The typical step before pooling of cohort data is har-monization. Harmonization of occupational histories is not straightforward though. Many different systems for coding of job titles are being used world-wide: there are national classification systems [such as the French PCS (professions et catégories socioprofessionnelles) or the Dutch SBC (standaard beroepenclassificatie)], and there is the International Standard Classification of Occupations (ISCO). These systems also have several version updates, which may be very different from each other. The same is true for industrial coding. In general, conversion between these different systems is not trivial. Ongoing efforts for developing cross-walks or automatic coding systems that allow free text to be transferred into standardized codes may provide solutions to har-monizing occupational and industrial coding. To have an easy entry point into finding these tools is one of the goals of OMEGA-NET.This information on job title and industry collected in occupational histories within cohorts in fact forms the foundation for exposure assessment. Using existing cohorts, basic analyses of harmonized job titles alone may already be informative when large numbers are available, potentially revealing patterns between occu-pations and health outcomes. An example is the use of the RNV3P database in France, identifying emerging dis-ease–exposure associations through a network approach (Faisandier et al., 2011). The efforts within OMEGA-NET to draw together information about existing co-horts and exposure assessment tools ultimately aim to facilitate similar initiatives.Job titles can also be translated into specific expos-ures via a job-exposure matrix (JEM). A JEM consists of a job axis and an exposure axis, sometimes expanded with time and/or regional dimensions. JEMs provide ex-posure assessment in a systematic and unbiased way, rep-resenting a highly efficient and reproducible methodology (Kromhout and Vermeulen, 2001). If observed patterns of associations between jobs and health outcomes cannot be explained by exposures covered in available JEMs, it is likely that unknown or non-suspected exposures are re-sponsible, laying the groundwork for new hypotheses.Numerous national and transnational JEMs have been developed. Examples in Europe are the Finnish FIN-JEM (Kauppinen et al., 1998), the French Constances-JEM (Evanoff et al., 2019), the Scandinavian NOCCA-JEM (Kauppinen et al., 2009), and the international SYN-JEM (Peters et al., 2016), to name a few. Transferability is of course a challenge, with JEMs based on different oc-cupational coding systems, and a wide variation in the exposure definitions and exposure indices (e.g. inten-sity, probability, and peaks of exposure). OMEGA-NET strives to compile a listing of available JEMs; pairing these with the cross-walks mentioned above can facilitate linkage to a broader range of cohorts.Since many methods and tools are used for occupa-tional exposure assessment, and method uncertainties are largely unknown, systematic comparisons of epidemio-logical results are complicated. Another consequence is that many cohort data remain unexploited with regard to work-related exposures and diseases. It is our hope that sharing information on occupational exposure assess-ment methods and tools may accelerate research.With this specific intention in mind, the OMEGA-NET consortium is compiling online inventories of ex-isting cohort studies (Kogevinas et al., submitted) and occupational exposure information. Recently, we have launched an online tool for these two inventories: http://omeganetcohorts.eu/resources/inventory/. The inventory for occupational exposure information specifically aims to collect metadata on all JEMs, exposure databases, occupational coding systems and the associated cross-walks available across Europe. This inventory will be the basis for a searchable web-based database, which will become publicly available.To make such a comprehensive inventory possible, the OMEGA-NET consortium seeks the participation from all researchers involved in these types of studies or data collection. Via the searchable web-based database, researchers around the globe will have a quick and clear overview of all available information that they could use for assessing occupational exposures in their cohorts.Our overall aim is to facilitate a concerted effort on harmonization of occupational exposure data to allow pooling and replication of findings, towards accelerating aetiological research.FundingOMEGA-NET is supported by COST (European Cooperation in Science and Technology), project CA16216: Network on the Coordination and Harmonisation of European Occupational Cohorts. MCT is funded by a Ramón y Cajal fellowship (RYC-2017-01892) from the Spanish Ministry of Science, Innovation and Universities and cofunded by the European Social Fund. ISGlobal is a member of the CERCA Programme, Generalitat de Catalunya.466 Annals of Work Exposures and Health, 2020, Vol. 64, No. 5Downloaded from https://academic.oup.com/annweh/article/64/5/465/5802560 by University of Basel user on 03 September 2020AcknowledgementsThe authors are grateful to the OMEGA-NET Working Group 2.1 members: Balázs Ádám, Gemma Castaño, Alex Burdorf, Deborah Glass, Marco Gnesi, Lode Godderis, Marcel Goldberg, Irina Guseva Canu, Sibel Kiran, Damien McElvenny, Nurka Pranjic, Vivi Schlünssen, and Henk van der Molen. All authors contributed substantially to the work and approved the final version of the manuscript. They also agree to take respon-sibility for the work.Conflict of interestNone declared.ReferencesEvanoff  BA, Yung  M, Buckner-Petty  S et  al. (2019) The CONSTANCES job exposure matrix based on self-reported exposure to physical risk factors: development and evalu-ation. Occup Environ Med; 76: 398–406.Faisandier L, Bonneterre V, De Gaudemaris R et al. (2011) Occupational exposome: a network-based approach for characterizing Occupational Health Problems. J Biomed Inform; 44: 545–52.Kauppinen T, Heikkilä P, Plato N et al. (2009) Construction of job-exposure matrices for the Nordic Occupational Cancer Study (NOCCA). Acta Oncol; 48: 791–800.Kauppinen T, Toikkanen J, Pukkala E. (1998) From cross-tabula-tions to multipurpose exposure information systems: a new job-exposure matrix. Am J Ind Med; 33: 409–17.Kromhout H, Vermeulen R. (2001) Application of job-exposure matrices in studies of the general population. Some clues to their performance. Eur Respir Rev; 11: 80–90.Lenters V, Vermeulen R, Dogger S et al. (2011) A meta-analysis of asbestos and lung cancer: is better quality exposure assess-ment associated with steeper slopes of the exposure-response relationships? Environ Health Perspect; 119: 1547–55.Nieuwenhuijsen M. (2003) Exposure assessment in occupa-tional and environmental epidemiology. Oxford, United Kingdom: Oxford University Press.Peters S, Vermeulen R, Portengen L et al. (2016) SYN-JEM: a quantitative job-exposure matrix for five lung carcinogens. Ann Occup Hyg; 60: 795–811.Purdue MP, Bakke B, Stewart P et al. (2011) A case-control study of occupational exposure to trichloroethylene and non-Hodgkin lymphoma. Environ Health Perspect; 119: 232–8.Turner MC, Mehlum IS. (2018) Greater coordination and har-monisation of European occupational cohorts is needed. Occup Environ Med; 75: 475–6.Vlaanderen J, Vermeulen R, Heederik D et al.; ECNIS Integrated Risk Assessment Group, European Union Network Of Excellence. (2008) Guidelines to evaluate human obser-vational studies for quantitative risk assessment. Environ Health Perspect; 116: 1700–5.Annals of Work Exposures and Health, 2020, Vol. 64, No. 5 467Downloaded from https://academic.oup.com/annweh/article/64/5/465/5802560 by University of Basel user on 03 September 2020

International inventory of occupational exposure information: OMEGA-NET

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International inventory of occupational exposure information: OMEGA-NET

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