8290442 EPHOR: forecasting health intervention effects under increasingly complex working life exposome scenarios

<h3></h3> Background/Objectives: Given workplace exposures contribute to many non-communicable diseases (NCDs), ensuring a healthy work environment is a strategic goal for policy makers and employers. Understanding the heath impact of workplace exposure interventions, whilst under complex working life exposome, is important. Through simulations, we forecast the performance of exposure interventions whilst varying the exposome characteristics. <h3>Methods</h3> A dynamic longitudinal population cohort representing real-world Lung Cancer (LC) risk in construction workers was simulated. Life-time employee exposure profiles were generated for exposures silica, diesel fumes, and smoking understood to be associated with LC. The exposome characteristics were manipulated, modifying correlation structures, decaying risk, latency, and dose-response risk definitions. We applied intervention effects to working exposures such that 1. average exposure reduced 30% 2. max exposure limited to 75%. Annual population level LC incidence rates were forecasted and compared before and after interventions were applied. <h3>Results</h3> Five million construction workers were simulated to enter the workforce at a uniform rate between the 1970 and 2070. Annual incidence rates (prior to the addition of exposures) initially matched current general population incidence rates (i.e. 7% lifetime risk, 180 new cases per 100,000 person years in 2010s). By 2060, annual incidence rates decrease by ~20% and ~22% for 30% average reduction in silica only, and silica &amp; diesel, respectively. Whereas for 75% max exposure limit it was ~35%, and ~38%. <h3>Conclusion</h3> Intervention effects from single exposure outcome models are likely limited when determining the true effect of a health intervention effect dependent on the combination of exposome characteristics.