Document v65nBp9J3eG62oL8vN83zMeG6

I. Some thoughts on EA updating 1. Coding system: Consistent job title identified Each 3-digit occupational and industry code Combined use of 1982 consensus and the updated Industry Classification Code (by Hu Shida, et aI, SHA CDCP?) Check the coding system used by Shanghai Cancer Institute, Gao Yutang, et aI, 2. Exposure status 3. Ranged exposure intensity: 0-1 ppm; 1-10 ppm; 10-50 ppm; >50 ppm or mg/m3 by multiplying with 3.2 based on IPHS database Frequency: times-hr/day x 5 (days) x 50 (wks) Duration: focused between historical period either 1980-2005 or 1985-2005 4. Route of exposure Inhalation Dermal contact 5. Task: job titles and activities in details: Clearly define industry, occupation, job title and task; for example, a truck driver could probably be categorized as: Industry: transportation Occupation: driver Job title: lead driver or assistant driver Tasks: mechanical maintenance, fueling, driving, etc 6. Information sources required IPHS database Literature published including: 1) case reports characterized by higher exposure: peak, maximum; 2) industrial hygiene surveys available in relatively systematic data of sampling, by passive badge, tube, or pumped in low/medium flow rate in l/min; monitored in area and/or personal samplings; expressed as MAC, TWA, mathematic mean, etc 7. Supplemental information Further subject investigation: to decide who should be further tracked-backlfollowed-up, need a collated file for the existing subjects identified as Bn exposure and potential Bn exposure, approximately 100-130 at the moment Further factory investigation: to support surrogate factories selecting it requires: 1) analysis of existing data from Qs obtained; 2) updated criteria for the selection, in terms of scale of factory, ownership, products, age of factory, working conditions, job title/task of workers, materials content % Bn, etc; and 3) further evidence from IPHS database 8. Possibility of access 9. Consideration of workers' mobility during different historical period 10. Decision tree SH ELL-MCCLU RG-OS7S27 11. Initiate a pilot study for 10-20 subjects concerned II. Work history 1. Can we assign range for each segment of the work history? Example: 0-lppm; 1-10 ppm; 10-50 ppm; >50 ppm 2. Work period and title A. Shoes factory 1985-87 B. Shoes factory 1992-94 C. Painting-indoor 1995-2000 For work A: shoes Factory No.3, 1985-87, may include: a) To ask worker: about tasks-define specific tasks on what, when, how often, how long, how big, etc, that are unlikely to actually have access to factory records b) To check [PHS database: Is there IPHS data at the correct time, geographically similar (Time mismatch, similar areas in Shanghai?) c) To update surrogate criteria: 1) What is a "surrogate factory"; 2) Similarities in scale, size of working population, ownership of factory, products, age of factory, working conditions, job title/task, materials content % Bn, etc; 3. Do we need a pilot study now for some (say, 10) of the 98 definitive Bn exposure cases, and 10 uncertain cases to make sure: Where are we? Can we meet existing Protocol? What revisions are necessary; what to simplify/accelerate? Do we have adequate staff? How long will it take to work-up the cases? What are the difficulties? What are the barriers? 4. Factors affecting job mobility: Chronology (example) Date of birth (DOB) Age in 1980 Age at Diagnosis 1930 50 75 1940 40 65 1950 30 55 1960 20 45 1970 10 35 1980 0 25 "Supposed Scenario": Development domain Time period Socioeconomic characteristics Agri culture- indus try Pre-1965 Great leap to pre-cultural revolution Agri culture- indus try 1966-1976 Cultural revolution SH ELL-MCCLU RG-057528 Rapid industrialization Industry-service-agriculture Service-industry-agriculture 1978-1990 1990-2005 1980-1985 1985-1990 1990-2000 2000-2005 Deng's economy reform and openness policy Rapid development in Shanghai Employment stability Economy restructuring Rapid migration/transition Accelerated transition to services So, what is the likely employment history, for people who were born in 1930? Year Age Supposed employment status 1950-1960 20 Agriculture, state-owned enterprises, professionaVservice or student 1960-1970 30-40 Agriculture, state-owned enterprises (cultural revolution) 1970-1975 40-45 Cultural revolution, agriculture, state-owned enterprises 1980-1985 50-55 Start of economy reform 1990-1995 60-65 Rapid transition; urbanization, job movement (job-insecurity) 1995-2000 65-70 Retirement, rapid transition, labor movement/migration 2000-2005 70-75 Fully retired, accelerated transition, labor movement/migration III. IPHS database 1. Does the factory reported by the worker exist in the IPHS database? Yes or No If yes, what are the dates? Do these dates match the workers history? Yes or No If no, what is the mismatch? Early dates on late data ? What level of "mismatch" is acceptable? Pre 1990-92 versus 1992? 2. Same questions for literature database 3. How do we use surrogates? Can we use a surrogate pre-1990-92 for a post-1992 factory? 4. What are the "mismatching" requirements Size of factory Date of factory construction: Pre-1990-92 How do we know processes and job asks are similar? 5. What is the appropriate expression of the exposure? Is it appropriate to time-weight a I-hour high exposure intensity to a 8-hour TWA? 6. For example, IPHS: 10 ppm (32 mg/m3)-1 hr extrapolate to a cumulative exposure level of TWA ppm-yr. (Summarized, 26-27 March, 2005, Shanghai) SH ELL-MCCLU RG-057529