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Reference group consists of Camp Lejeune civilian employees in the lowest tertile level of maximum cumulative exposure.
We also categorized cumulative exposures into tertiles and dichotomous (above or below the median) variables based on the cohort's distribution of maximum cumulative exposure.
They've found that pregnant women in their cohort show abnormally high urinary levels of organophosphate pesticide metabolites, with about 15% of them likely exceeding the maximum cumulative exposure levels advised by the EPA.
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To avoid unreasonably high estimates of the average exposure in the highest exposure group, we truncated the exposure distribution at the maximum reported cumulative exposure level.
*An individual's maximum amount of cumulative exposure (μg/L –months ) at the end of follow-up.
Typical daily environmental exposure to benzene can range up to 0.2 ppm, which, over a 70-year life span, accumulates to a maximum of 14 ppm-years of cumulative exposure (Johnson et al. 2007).
The linear spline model had the form (linear RR version) of RR = 1 + β1 × cumexp + β2z × maximum (0, cumexp – knot), where the value corresponding to maximum (0, cumexp – knot) is either the cumulative exposure value less the exposure level used to define the knot, or 0 if the cumulative exposure is less than the value of the knot.
Maximum Cumulative Ratio: The toxicity from the combined exposures to multiple chemicals divided the maximum toxicity from any one chemical.
In order to assess the health impacts of exposure to HRVs compared to no exposure, an ordinal variable was created representing the cumulative exposure to HRVs (minimum = 0, maximum truncated at 5 HRVs).
Splines for leukemias and cumulative exposures to PCE and VC indicated a steady rise in HRs to a maximum of about 2.2 to 2.3 at the 85th percentile of cumulative exposure and thereafter declining to HRs of about 1.6 (Additional file 4: Figures S1a-b).
There was no relationship with continuous metrics for the Canadian and UK studies but increases in the Australian study for cumulative exposure (OR: 1.06, 95% CI: 1.00, 1.12), maximum benzene exposure intensity (OR: 1.45, 95% CI: 0.79, 2.69) and average benzene exposure intensity (OR: 2.27, 95% CI: 0.64, 8.02).
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