Validity assessment of self-reported smoking status in firefighters using the urine cotinine test

Han Cheol Heo; Young Seok Byun; Soo Ho Sohn; Seong Min Jo; Sung Kyu Park; Joon Sakong

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자료유형: 학술저널

저자정보: Han Cheol Heo (Yeungnam University Hospital) Young Seok Byun (Yeungnam University Hospital) Soo Ho Sohn (Yeungnam University Hospital) Seong Min Jo (Yeungnam University Hospital) Sung Kyu Park (Yeungnam University Hospital) Joon Sakong (Yeungnam University Hospital)

저널정보: 대한직업환경의학회 대한직업환경의학회지 대한직업환경의학회지 제32권 제1호

발행연도: 2020.1

수록면: 10 - 24 (15page)

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Background: In firefighters, smoking management is important because they are exposed to various harmful substances in their occupational environment. Accurate surveys of smoking status are essential to control tobacco use. The main disadvantage of self-report questionnaires, which are commonly used for investigating smoking status, is the possibility that the subjects" response are invalid. If the validity of firefighters" answers on smoking questionnaires is not adequate, different methods will be needed for investigating smoking status in firefighters.
Methods: This study was conducted on 445 male firefighters from 9 fire stations in Daegu (the city in South Korea) who visited a medical institution for medical checkup in 2016. The urine cotinine test strip (DCT-102; CLIAwaived Inc., cut-off value = 200 ng/mL) was used to classify the actual smoking status and to assess the validity of self-reported smoking status on questionnaires. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the smoking questionnaires were analyzed. Subjects testing positive in the urine cotinine test (assumed the actual current smokers) were selected. The frequency at which actual current smokers were misclassified as current non-smokers by the questionnaire was calculated. Subjects" characteristics were analyzed for possible association with any discrepancy between self-reported smoking status and urine cotinine test results.
Results: The smoking rates among firefighters surveyed using the smoking questionnaire and the urine cotinine test were 22.47% and 51.24%, respectively. Of the all subjects, 29.66% (n = 132) were misclassified. The sensitivity of the smoking questionnaire was 42.98%, the specificity was 99.08%, the PPV was 98.00%, and the NPV was 62.32%. In the 228 subjects classified as current actual smokers by the urine cotinine test, 57.02% (n = 130) were misclassified on the questionnaire. The misclassification rate increased with age. The degree of misclassification also increased when subjects had a history of disease.
Conclusions: In present study, the validity of the smoking questionnaire for firefighters was not suitable for investigating smoking status due to low sensitivity. To increase the validity of smoking status monitoring in firefighters, consideration of the various factors like survey environment, subjects" characteristics, and occupational factors is needed.

#Firefighter #Smoking questionnaire #Validity #Self-report #Urine cotinine

참고문헌 (60)

참고문헌 신청

World Health Organization (WHO) / Tobacco; data and statistics

World Health Organization (WHO) / Tobacco

Demetriou C / 2014 / Self-report questionnaires. In: The encyclopedia of clinical psychology / John Wiley & Sons, In :1~6

Caraballo RS / 2001 / Factors associated with discrepancies between self-reports on cigarette smoking and measured serum cotinine levels among persons aged 17 years or older: Third National Health and Nutrition Examination Survey, 1988–1994 / Am J Epidemiol 153(8):807~814

Wong SL / 2012 / Assessment of validity of self-reported smoking status / Health Rep 23(1):47~53

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