Scientific Concept of the National Cohort (status ... - Nationale Kohorte

Instruments:
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A.3 Study design
Information on medical radiation exposure and related organ doses will be collected with
a newly developed questionnaire. The questionnaire is being developed and validated in a
pilot study funded by the BfS in 2011/2012. The purpose of the pilot study is to assess the
feasibility to validly and reliably reconstruct medical exposures.
Occupational exposure/history
Adverse health effects of common occupational exposures include the occurrence of chronic
diseases such as cancer and cardiovascular, musculoskeletal, and neurodegenerative
diseases, and it is therefore important to monitor both occupational exposures and disease
occurrence in the general population and in particular in the aging workforce. Occupational
exposures comprise a wide range of work-related circumstances. Shift work has increased
in the Western industrialized world in the last few decades and night work and shift work
may be associated with circadian disruption, which in turn may be associated with chronic
disease 536-538 . Noise exposure is one of the major occupational hazards in many workplaces
and has several health effects, including hearing loss and psychological effects 539 . Exposure
to particulate matter (PM) is a health problem at many workplaces that is regulated for
the inhalable fraction of particles and fine particulate matter reaching the alveolar region of
the lung. The role of adverse psychosocial factors at work has been described above.
Instruments:
A detailed occupational history will be retrieved for each study participant from secondary
data sources, namely, the IAB Database of the Institute for Employment Research, Federal
Employment Agency. The procedure for linking data is currently being tested in a feasibility
study. Information on occupations held and industries in which the occupation was performed
will be classified according to the International Standard Classification of Occupations
(ISCO) and to the International Standard Industrial Classification (ISIC). During the
core interview, a few occupational screening questions for defined exposures of interest will
be included; this will allow subsequent Level 3 studies (with separate funding) in which supplemental
questionnaires will be applied via telephone interviews, mailed questionnaires, or
web-based questionnaires at a later time. The job and industry codes as well as the screening
questions will supply valuable exposure information in addition to exposure levels in
biological samples. Furthermore, work-related psychosocial stress will be assessed using
different validated questionnaires (see Sect. A.2.4.4, Psychosocial factors).
health care utilization and compliance
Not all aspects of illness and health, health care, and health care delivery can be assessed validly
by means of secondary data sources (health insurance data). In order to determine the efficiency
of health care delivery and usage, the perspective of the health care recipient is crucial.
It can be expected that claims data will not be available for all study participants. Therefore,
basic variables on health care utilization are assessed in the core protocol. Moreover,
consultation times are of increasing interest 540-542 since time which has to be spent seeking
health care may affect both morbidity and adherence to medical care.
Instruments:
The following items will be included in the core protocol subsequent to the assessment of
current medication use (IDOM, Sect. A.3.2.1, Medication).
A.3