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Cited by 23Occupational Health and PerformanceGlobal Cancer Incidence and ScreeningMedical Coding and Health Information

Availability and accuracy of occupation in cancer registry data among Florida firefighters

Open access
McClure, Laura A., Koru-Sengul, Tulay, Hernandez, Monique N., Mackinnon, Jill A., Schaefer Solle, Natasha, Caban-Martinez, Alberto J., Lee, David J., Kobetz, Erin·2019·PLOS ONE
DOI 10.1371/journal.pone.0215867PMC PMC6490882
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Abstract

OBJECTIVES: Occupational exposures significantly contribute to the risk of adverse cancer outcomes, and firefighters face many carcinogenic exposures. Occupational research using cancer registry data, however, is limited by missing and inaccurate occupation-related fields. The objective of this study is to determine the frequency and predictors of missing and inaccurate occupation data for a cohort of career firefighters in a state cancer registry. METHODS: We conducted a linkage between data from the Florida Cancer Data System (1981-2014) and the Florida State Fire Marshal's Office (1972-2012). The percentage and the odds of having a firefighting-related occupation code in the cancer record were calculated, adjusting for other occupation and cancer-related factors. RESULTS: Among 3,928 career firefighters, nearly half (47%) were missing a registry-dervived occupation code and only 17% had a firefighting-related code. Males were more likely to have a firefighting-related code (OR = 2.31;95%CI: 1.41-3.76), as were those with more recent diagnoses (OR1992-2002 = 2.98;95%CI: 1.57-5.67; OR2003-2014 = 11.40;95%CI: 6.17-21.03), and those of younger ages (OR45-64y = 1.26;95%CI: 1.03-1.54; OR20-44y = 2.26;95%CI: 1.73-2.95). CONCLUSIONS: Accurate occupation data is key for identifying increased risk of advserse cancer outcomes. Cancer registry occupation fields, however, are overwhelmingly missing for firefighters and are missing disproportionally by sociodemographic and diagnosis characteristics. This study highlights the lack of accurate occupation data available for hypothesis-driven cancer research. Cancer registry linkage with external occupational data sources represents an essential resource for conducting studies among at-risk populations such as firefighters.

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Crossref · 10.1371/journal.pone.0215867

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  • Four studies found that occupational data were not missing at random and that male patients were more likely to have occupational information in their record.

    “Four studies found that data were not missing at random and that male patients were more likely to have occupational information in their record.60,62–64”

    From The quality of social determinants data in the electronic health record: a systematic review (2021) · cites this paper as [60]

    The Discussion (page not specified) says occupation fields are missing disproportionately by case characteristics, including gender. The Results (page not specified) find that male Florida firefighters were more likely to have a firefighting-related occupation code, but do not establish that male patients generally were more likely to have any occupational information in their records. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

  • The NIOSH Industry and Occupation Computerized Coding System, a free web-based system, was evaluated and recommended by several studies for increasing the quality of occupation data prior to analysis.

    “For researchers seeking to increase the quality of occupation data prior to analysis, the National Institute of Occupational Safety and Health (NIOSH) has created a free, web-based system called NIOSH Industry and Occupation Computerized Coding System78 that was evaluated and recommended by several studies.10,60,62,76”

    From The quality of social determinants data in the electronic health record: a systematic review (2021) · cites this paper as [60]

    The Discussion (page unavailable) describes NIOCCS as a web-based tool and reports that an eight-state study found it useful for improving occupation fields. It also calls such tools valuable, but this paper did not itself evaluate NIOCCS, and it cautions that the tool cannot remedy missing occupation information. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Six of the 7 studies (86%) that looked at the quality of occupational data primarily examined completeness, all noting that occupational information is frequently missing from the health record.

    “Six of the 7 studies (86%) that looked at the quality of occupational data primarily examined completeness, all noting that occupational information is frequently missing from the health record.10,60–64”

    From The quality of social determinants data in the electronic health record: a systematic review (2021) · cites this paper as [60]

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5 of the 17 references couldn’t be matched to a known paper.

Research works printed but not linked: 4

  1. [1]World Health Organization International Agency for Research on Cancer. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Volume 98: Painting, Firefighting, and Shiftwork Lyon, France2010 [Available from: https://monographs.iarc.fr/ENG/Monographs/vol98/mono98.pdf PMC4781497 21381544
  2. [9]Weiss NS, Cooper SP, Socias C, Weiss RA, Chen VW. Coding of Central Cancer Registry Industry and Occupation Information: The Texas and Louisiana Experiences. J Registry Manag. 2015; 42(3): 103– 10. 27028094
  3. [15]McClure LA, Miller EA, Tannenbaum SL, Hernandez MN, MacKinnon JA, He Y, et al Linking the National Health Interview Survey with the Florida Cancer Data System: A Pilot Study. J Registry Manag. 2016; 43(1): 16– 22. 27195994 PMC5682620
  4. [16]Miller E, Miller D, Hudson D, He Y, Day H, Zevallos K, et al Linkage of 1986–2009 National Health Interview Survey with 1981–2010 Florida Cancer Data System. National Center for Health Statistics. Vital Health Stat. 2014; 2(167). 25406513

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Authors
McClure, L. A., Koru-Sengul, T., Hernandez, M. N., Mackinnon, J. A., Schaefer Solle, N., Caban-Martinez, A. J., Lee, D. J., & Kobetz, E.
Affiliations
University of Miami (US)
Corresponding author
Lee, David J.
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2019-04-30
Volume
14
Issue
4
Pages
e0215867
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0215867
PMC
PMC6490882
OpenAlex
W2943498305
Cited by
23
References
17
Citations by year
2026: 3 · 2025: 2 · 2024: 7 · 2023: 2 · 2022: 4 · 2021: 2 · 2020: 3
FWCI
4.80
Type
journal article
Language
en
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
  • Florida Department of Health
  • National Institutes of Health (UL1TR002736)
  • National Center for Advancing Translational Sciences
  • State of Florida
Topics
  • Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Performance
  • Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
  • Health Sciences › Health Professions › Health Information Management › Medical Coding and Health Information
Keywords
firefighters, cancer registry data quality, occupational exposure, cancer registry linkage, occupational cancer
MeSH terms
Adult, Aged, Female, Florida, Humans, Male, Middle Aged, Neoplasms, Registries, Multivariate Analysis, Logistic Models, Occupational Exposure, Young Adult, Firefighters

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