Addressing complex structures of measurement error arising in the exposure assessment in occupational epidemiology using a Bayesian hierarchical approach

Abstract

Exposure assessment in occupational epidemiology may involve multiple unknown quantities that are measured or reconstructed simultaneously for groups of workers and over several years. Additionally, exposures may be collected using different assessment strategies, depending on the period of exposure. As a consequence, researchers who are analyzing occupational cohort studies are commonly faced with challenging structures of exposure measurement error, involving complex dependence structures and multiple measurement error models, depending on the period of exposure. However, previous work has often made many simplifying assumptions concerning these errors. In this work, we propose a Bayesian hierarchical approach to account for a broad range of error structures arising in occupational epidemiology. The considered error structures may involve several unknown quantities that can be subject to mixtures of Berkson and classical measurement error. It is possible to account for different error structures, depending on the exposure period and the location of a worker. Moreover, errors can present complex dependence structures over time and between workers. We illustrate the proposed hierarchical approach on a subgroup of the German cohort of uranium miners to account for potential exposure uncertainties in the association between radon exposure and lung cancer mortality. The performance of the proposed approach and its sensitivity to model misspecification are evaluated in a simulation study. The results show that biases in estimates arising from very complex measurement errors can be corrected through the proposed Bayesian hierarchical approach.