Matrix Labor Exposure Matrix for Occupational Carcinogens Agents as a tool for exposure identification

Introduction
There is a great under-diagnosis of occupational cancer in our country. Part of the factors is the lack of knowledge of workers and physician in identifying possible carcinogens present at the work environment. Created a matrix to identify 60 carcinogens of IARC groups 1 and 2 (A), by economic activity, which could facilitate suspect such exposure and correlate it with the type of cancer, in order to guide the process of definition of origin the cancer.

Methods
A concordance study was conducted on 307 labor surveys detailed in people older than 30 years who had developed primary tumor between 2006 and 2009, of at least one of the 10 sites of interest. Comparing the rating by a group of experts and the use of the matrix designed. Used the index Kappa and compared the time invested in the ratings with each methodology.

Results
Kappa index indicated a high concordance between two methodologies. Human resources and the time spent on the analysis of each case were minor applying the matrix. Expert’s assessment identified agents and exposure characteristics better than matrix methodology. The matrix is based in economic activity and not used the job: usually upon-estimations the exposure while in other cases it does not identified.

Discussion
This matrix is an innovative tool in the process of rating of origin of a chronic disease as occupational cancer. It is based on literature review, records of CAREX of other countries and knowledge of Colombian industrial hygienists. We recommended to go adjust it periodically according to the exposures identified by economic activity or occupational cancer cases recognized. Its use is recommended also to suspect the presence of carcinogens by economic activity and thereby provide better advice to companies. There will be a guide to spread its use at the national level.