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Chartres N, Sass JB, Gee D, Bălan SA, Birnbaum L, Cogliano VJ, Cooper C, Fedinick KP, Harrison RM, Kolossa-Gehring M, Mandrioli D, Mitchell MA, Norris SL, Portier CJ, Straif K, Vermeire T. Conducting evaluations of evidence that are transparent, timely and can lead to health-protective actions. Environ Health 2022; 21:123. [PMID: 36471342 PMCID: PMC9720912 DOI: 10.1186/s12940-022-00926-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 10/20/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND In February 2021, over one hundred scientists and policy experts participated in a web-based Workshop to discuss the ways that divergent evaluations of evidence and scientific uncertainties are used to delay timely protection of human health and the environment from exposures to hazardous agents. The Workshop arose from a previous workshop organized by the European Environment Agency (EEA) in 2008 and which also drew on case studies from the EEA reports on 'Late Lessons from Early Warnings' (2001, 2013). These reports documented dozens of hazardous agents including many chemicals, for which risk reduction measures were delayed for decades after scientists and others had issued early and later warnings about the harm likely to be caused by those agents. RESULTS Workshop participants used recent case studies including Perfluorooctanoic acid (PFOA), Extremely Low Frequency - Electrical Magnetic Fields (ELF-EMF fields), glyphosate, and Bisphenol A (BPA) to explore myriad reasons for divergent outcomes of evaluations, which has led to delayed and inadequate protection of the public's health. Strategies to overcome these barriers must, therefore, at a minimum include approaches that 1) Make better use of existing data and information, 2) Ensure timeliness, 3) Increase transparency, consistency and minimize bias in evidence evaluations, and 4) Minimize the influence of financial conflicts of interest. CONCLUSION The recommendations should enhance the production of "actionable evidence," that is, reliable evaluations of the scientific evidence to support timely actions to protect health and environments from exposures to hazardous agents. The recommendations are applicable to policy and regulatory settings at the local, state, federal and international levels.
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Affiliation(s)
- Nicholas Chartres
- Program On Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, 490 Illinois Street, Floor 10, San Francisco, CA, 94143, USA.
| | - Jennifer B Sass
- Natural Resources Defense Council, Washington, DC, USA
- George Washington University, Washington, DC, USA
| | | | - Simona A Bălan
- California Department of Toxic Substances Control, Berkeley, CA, USA
- University of California at Berkeley, Berkeley, CA, USA
| | - Linda Birnbaum
- Nicholas School of the Environment, Duke University, Durham, NC, USA
| | | | - Courtney Cooper
- Program On Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California at San Francisco, 490 Illinois Street, Floor 10, San Francisco, CA, 94143, USA
| | | | - Roy M Harrison
- School of Geography, Earth & Environmental Sciences, University of Birmingham, Birmingham, UK
- Department of Environmental Sciences/Centre of Excellence in Environmental Studies, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Marike Kolossa-Gehring
- Department of Environmental Hygiene, Section Toxicology, Health Related Environmental Monitoring, German Federal Environmental Agency, Dessau-Roßlau, Germany
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Mark A Mitchell
- George Mason University, Fairfax, VA, USA
- Connecticut Coalition for Environmental Justice, Hartford, CT, USA
| | - Susan L Norris
- Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Christopher J Portier
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Toxicogenomics, Maastricht University, Maastricht, Netherlands
- CJP Consulting, Seattle, WA, USA
| | - Kurt Straif
- ISGlobal, Barcelona, Spain
- Boston College, Newton, MA, USA
| | - Theo Vermeire
- Retired, National Institute for Public Health and the Environment (RIVM), Utrecht, The Netherlands
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El Tabbal J. Monosodium glutamate in a type 2 diabetes context: A large scoping review. Regul Toxicol Pharmacol 2022; 133:105223. [PMID: 35817208 DOI: 10.1016/j.yrtph.2022.105223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/16/2022] [Accepted: 07/06/2022] [Indexed: 11/30/2022]
Abstract
This scoping review aimed to map and elaborate the heterogenous and inconclusive body of evidence relating monosodium glutamate (MSG) and type 2 diabetes (T2DM). For this reason, multiple health outcomes related to T2DM were included and a systematic search was conducted. Experimental and observational trials between 1995 and January 2021 were collected. The tests were highly heterogenous in their samples, doses, route of exposures, durations, diets and conclusions. There was a pattern of negative effects of MSG at oral doses ≥2,000 mg/kg of body weight, and by gavage or injection at any given dose. Evidence was lacking in many areas and most of the evidence relied on short term tests. Further research should focus on standardizing and justifying methodologies, conducting long term studies and toxicokinetic tests, and avoiding bias. Focusing on the gaps highlighted and investigating mechanisms of action of MSG is crucial. Evidence-based toxicology is encouraged.
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Affiliation(s)
- Jana El Tabbal
- Department of Health Sciences, University of Leicester, University Road, Leicester, LE1 7RH, United Kingdom.
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Pega F, Momen NC, Gagliardi D, Bero LA, Boccuni F, Chartres N, Descatha A, Dzhambov AM, Godderis L, Loney T, Mandrioli D, Modenese A, van der Molen HF, Morgan RL, Neupane S, Pachito D, Paulo MS, Prakash KC, Scheepers PTJ, Teixeira L, Tenkate T, Woodruff TJ, Norris SL. Assessing the quality of evidence in studies estimating prevalence of exposure to occupational risk factors: The QoE-SPEO approach applied in the systematic reviews from the WHO/ILO Joint Estimates of the Work-related burden of disease and Injury. ENVIRONMENT INTERNATIONAL 2022; 161:107136. [PMID: 35182944 PMCID: PMC8885428 DOI: 10.1016/j.envint.2022.107136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 01/05/2022] [Accepted: 02/04/2022] [Indexed: 05/04/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) have produced the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury (WHO/ILO Joint Estimates). For these, systematic reviews of studies estimating the prevalence of exposure to selected occupational risk factors have been conducted to provide input data for estimations of the number of exposed workers. A critical part of systematic review methodology is to assess the quality of evidence across studies. In this article, we present the approach applied in these WHO/ILO systematic reviews for performing such assessments on studies of prevalence of exposure. It is called the Quality of Evidence in Studies estimating Prevalence of Exposure to Occupational risk factors (QoE-SPEO) approach. We describe QoE-SPEO's development to date, demonstrate its feasibility reporting results from pilot testing and case studies, note its strengths and limitations, and suggest how QoE-SPEO should be tested and developed further. METHODS Following a comprehensive literature review, and using expert opinion, selected existing quality of evidence assessment approaches used in environmental and occupational health were reviewed and analysed for their relevance to prevalence studies. Relevant steps and components from the existing approaches were adopted or adapted for QoE-SPEO. New steps and components were developed. We elicited feedback from other systematic review methodologists and exposure scientists and reached consensus on the QoE-SPEO approach. Ten individual experts pilot-tested QoE-SPEO. To assess inter-rater agreement, we counted ratings of expected (actual and non-spurious) heterogeneity and quality of evidence and calculated a raw measure of agreement (Pi) between individual raters and rater teams for the downgrade domains. Pi ranged between 0.00 (no two pilot testers selected the same rating) and 1.00 (all pilot testers selected the same rating). Case studies were conducted of experiences of QoE-SPEO's use in two WHO/ILO systematic reviews. RESULTS We found no existing quality of evidence assessment approach for occupational exposure prevalence studies. We identified three relevant, existing approaches for environmental and occupational health studies of the effect of exposures. Assessments using QoE-SPEO comprise three steps: (1) judge the level of expected heterogeneity (defined as non-spurious variability that can be expected in exposure prevalence, within or between individual persons, because exposure may change over space and/or time), (2) assess downgrade domains, and (3) reach a final rating on the quality of evidence. Assessments are conducted using the same five downgrade domains as the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach: (a) risk of bias, (b) indirectness, (c) inconsistency, (d) imprecision, and (e) publication bias. For downgrade domains (c) and (d), the assessment varies depending on the level of expected heterogeneity. There are no upgrade domains. The QoE-SPEO's ratings are "very low", "low", "moderate", and "high". To arrive at a final decision on the overall quality of evidence, the assessor starts at "high" quality of evidence and for each domain downgrades by one or two levels for serious concerns or very serious concerns, respectively. In pilot tests, there was reasonable agreement in ratings for expected heterogeneity; 70% of raters selected the same rating. Inter-rater agreement ranged considerably between downgrade domains, both for individual rater pairs (range Pi: 0.36-1.00) and rater teams (0.20-1.00). Sparse data prevented rigorous assessment of inter-rater agreement in quality of evidence ratings. CONCLUSIONS We present QoE-SPEO as an approach for assessing quality of evidence in prevalence studies of exposure to occupational risk factors. It has been developed to its current version (as presented here), has undergone pilot testing, and was applied in the systematic reviews for the WHO/ILO Joint Estimates. While the approach requires further testing and development, it makes steps towards filling an identified gap, and progress made so far can be used to inform future work in this area.
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Affiliation(s)
- Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Natalie C Momen
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland
| | - Diana Gagliardi
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy
| | - Lisa A Bero
- Charles Perkins Centre, The University of Sydney, Sydney, Australia; General Internal Medicine/Public Health/Center for Bioethics and Humanities, University of Colorado-Anschutz Medical Campus, Denver, CO, United States
| | - Fabio Boccuni
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy
| | - Nicholas Chartres
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, United States
| | - Alexis Descatha
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), Occupational Health Unit, University Hospital of West Suburb of Paris, Poincaré Site, Garches, France /Versailles St-Quentin Univ - Paris Saclay Univ (UVSQ), UMS 011, UMR-S 1168, France; Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S1085, CAPTV CDC, Angers, France
| | - Angel M Dzhambov
- Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Institute for Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
| | - Lode Godderis
- Centre for Environment and Health, KU Leuven, Leuven, Belgium; KIR Department (Knowledge, Information & Research), IDEWE, External Service for Prevention and Protection at Work, Leuven, Belgium
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Henk F van der Molen
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence and Impact, McMaster University, Ontario, Canada
| | - Subas Neupane
- Faculty of Social Science (Health Sciences), University of Tampere, Tampere, Finland
| | - Daniela Pachito
- Evidence-based Health, Universidade Federal de São Paulo, Sao Paulo, Brazil; Cochrane Brazil, Sao Paulo, Brazil
| | - Marilia S Paulo
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
| | - K C Prakash
- Faculty of Social Science (Health Sciences), University of Tampere, Tampere, Finland
| | - Paul T J Scheepers
- Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands
| | - Liliane Teixeira
- Workers' Health and Human Ecology Research Center, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Thomas Tenkate
- School of Occupational and Public Health, Ryerson University, Toronto, Ontario, Canada
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, United States
| | - Susan L Norris
- Oregon Health & Science University, Portland, OR, United States; Department of Quality Assurance, Norms and Standards, World Health Organization, Geneva, Switzerland
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4
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Momen NC, Streicher KN, da Silva DTC, Descatha A, Frings-Dresen MHW, Gagliardi D, Godderis L, Loney T, Mandrioli D, Modenese A, Morgan RL, Pachito D, Scheepers PTJ, Sgargi D, Paulo MS, Schlünssen V, Sembajwe G, Sørensen K, Teixeira LR, Tenkate T, Pega F. Assessor burden, inter-rater agreement and user experience of the RoB-SPEO tool for assessing risk of bias in studies estimating prevalence of exposure to occupational risk factors: An analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. ENVIRONMENT INTERNATIONAL 2022; 158:107005. [PMID: 34991265 PMCID: PMC8685606 DOI: 10.1016/j.envint.2021.107005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 11/19/2021] [Accepted: 11/23/2021] [Indexed: 05/08/2023]
Abstract
BACKGROUND As part of the development of the World Health Organization (WHO)/International Labour Organization (ILO) Joint Estimates of the Work-related Burden of Disease and Injury, WHO and ILO carried out several systematic reviews to determine the prevalence of exposure to selected occupational risk factors. Risk of bias assessment for individual studies is a critical step of a systematic review. No tool existed for assessing the risk of bias in prevalence studies of exposure to occupational risk factors, so WHO and ILO developed and pilot tested the RoB-SPEO tool for this purpose. Here, we investigate the assessor burden, inter-rater agreement, and user experience of this new instrument, based on the abovementioned WHO/ILO systematic reviews. METHODS Twenty-seven individual experts applied RoB-SPEO to assess risk of bias. Four systematic reviews provided a total of 283 individual assessments, carried out for 137 studies. For each study, two or more assessors independently assessed risk of bias across the eight RoB-SPEO domains selecting one of RoB-SPEO's six ratings (i.e., "low", "probably low", "probably high", "high", "unclear" or "cannot be determined"). Assessors were asked to report time taken (i.e. indicator of assessor burden) to complete each assessment and describe their user experience. To gauge assessor burden, we calculated the median and inter-quartile range of times taken per individual risk of bias assessment. To assess inter-rater reliability, we calculated a raw measure of inter-rater agreement (Pi) for each RoB-SPEO domain, between Pi = 0.00, indicating no agreement and Pi = 1.00, indicating perfect agreement. As subgroup analyses, Pi was also disaggregated by systematic review, assessor experience with RoB-SPEO (≤10 assessments versus > 10 assessments), and assessment time (tertiles: ≤25 min versus 26-66 min versus ≥ 67 min). To describe user experience, we synthesised the assessors' comments and recommendations. RESULTS Assessors reported a median of 40 min to complete one assessment (interquartile range 21-120 min). For all domains, raw inter-rater agreement ranged from 0.54 to 0.82. Agreement varied by systematic review and assessor experience with RoB-SPEO between domains, and increased with increasing assessment time. A small number of users recommended further development of instructions for selected RoB-SPEO domains, especially bias in selection of participants into the study (domain 1) and bias due to differences in numerator and denominator (domain 7). DISCUSSION Overall, our results indicated good agreement across the eight domains of the RoB-SPEO tool. The median assessment time was comparable to that of other risk of bias tools, indicating comparable assessor burden. However, there was considerable variation in time taken to complete assessments. Additional time spent on assessments may improve inter-rater agreement. Further development of the RoB-SPEO tool could focus on refining instructions for selected RoB-SPEO domains and additional testing to assess agreement for different topic areas and with a wider range of assessors from different research backgrounds.
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Affiliation(s)
- Natalie C Momen
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Kai N Streicher
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
| | - Denise T C da Silva
- Workers' Health and Human Ecology Research Center, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Alexis Descatha
- UNIV Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, Angers, France; AP-HP (Paris Hospital), Occupational Health Unit, Poincaré University Hospital, Garches, France; Versailles St-Quentin Univ-Paris Saclay Univ (UVSQ), UMS 011, UMR-S 1168, France; Inserm, U1168 UMS 011, Villejuif, France.
| | - Monique H W Frings-Dresen
- Amsterdam UMC, University of Amsterdam, Department Public and Occupational Health/Coronel Institute of Occupational Health, Amsterdam Research Institute, Amsterdam, the Netherlands.
| | - Diana Gagliardi
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy.
| | - Lode Godderis
- Centre for Environment and Health, KU Leuven, Leuven, Belgium; KIR Department (Knowledge, Information & Research), IDEWE, External Service for Prevention and Protection at Work, Leuven, Belgium.
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy.
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
| | - Daniela Pachito
- Núcleo de Avaliação de Tecnologias em Saúde, Hospital Sírio-Libanês, Bela Vista, São Paulo, SP, Brazil; Fundação Getúlio Vargas, Bela Vista, São Paulo, SP, Brazil.
| | - Paul T J Scheepers
- Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands.
| | - Daria Sgargi
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Marília Silva Paulo
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
| | - Vivi Schlünssen
- Aarhus University, Aarhus, Denmark; National Research Center for the Working Environment, Copenhagen, Denmark.
| | - Grace Sembajwe
- Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health and Health Policy, CUNY Institute for Implementation Science in Population Health, New York, NY, United States.
| | - Kathrine Sørensen
- National Research Center for the Working Environment, Copenhagen, Denmark.
| | - Liliane R Teixeira
- Workers' Health and Human Ecology Research Center, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
| | - Thomas Tenkate
- School of Occupational and Public Health, Ryerson University, Toronto, ON, Canada.
| | - Frank Pega
- Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland.
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5
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Sprinkle RH, Payne-Sturges DC. Mixture toxicity, cumulative risk, and environmental justice in United States federal policy, 1980-2016 : Why, with much known, was little done? Environ Health 2021; 20:104. [PMID: 34535123 PMCID: PMC8449500 DOI: 10.1186/s12940-021-00764-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 06/24/2021] [Indexed: 05/12/2023]
Abstract
Toxic chemicals - "toxicants" - have been studied and regulated as single entities, and, carcinogens aside, almost all toxicants, single or mixed and however altered, have been thought harmless in very low doses or very weak concentrations. Yet much work in recent decades has shown that toxicants can injure wildlife, laboratory animals, and humans following exposures previously expected to be harmless. Additional work has shown that toxicants can act not only individually and cumulatively but also collectively and even synergistically and that they affect disadvantaged communities inordinately - and therefore, as argued by reformers, unjustly. As late as December 2016, the last full month before the inauguration of a president promising to rescind major environmental regulations, the United States federal environmental-health establishment, as led by the Environmental Protection Agency (EPA), had not developed coherent strategies to mitigate such risks, to alert the public to their plausibility, or to advise leadership in government and industry about their implications. To understand why, we examined archival materials, reviewed online databases, read internal industry communications, and interviewed experts. We confirmed that external constraints, statutory and judicial, had been in place prior to EPA's earliest interest in mixture toxicity, but we found no overt effort, certainly no successful effort, to loosen those constraints. We also found internal constraints: concerns that fully committing to the study of complex mixtures involving numerous toxicants would lead to methodological drift within the toxicological community and that trying to act on insights from such study could lead only to regulatory futility. Interaction of these constraints, external and internal, shielded the EPA by circumscribing its responsibilities and by impeding movement toward paradigmatic adjustment, but it also perpetuated scientifically dubious policies, such as those limiting the evaluation of commercial chemical formulations, including pesticide formulations, to only those ingredients said by their manufacturers to be active. In this context, regulators' disregard of synergism contrasted irreconcilably with biocide manufacturers' understanding that synergism enhanced lethality and patentability. In the end, an effective national response to mixture toxicity, cumulative risk, and environmental injustice did not emerge. In parallel, though, the National Institute of Environmental Health Sciences, which was less constrained, pursued with scientific investigation what the EPA had not pursued with regulatory action.
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Affiliation(s)
| | - Devon C Payne-Sturges
- Maryland Institute for Applied Environmental Health, School of Public Health, University of Maryland, College Park, MD, 20742, USA
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Benbrook C, Perry MJ, Belpoggi F, Landrigan PJ, Perro M, Mandrioli D, Antoniou MN, Winchester P, Mesnage R. Commentary: Novel strategies and new tools to curtail the health effects of pesticides. Environ Health 2021; 20:87. [PMID: 34340709 PMCID: PMC8330079 DOI: 10.1186/s12940-021-00773-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 07/18/2021] [Indexed: 05/02/2023]
Abstract
BACKGROUND Flaws in the science supporting pesticide risk assessment and regulation stand in the way of progress in mitigating the human health impacts of pesticides. Critical problems include the scope of regulatory testing protocols, the near-total focus on pure active ingredients rather than formulated products, lack of publicly accessible information on co-formulants, excessive reliance on industry-supported studies coupled with reticence to incorporate published results in the risk assessment process, and failure to take advantage of new scientific opportunities and advances, e.g. biomonitoring and "omics" technologies. RECOMMENDED ACTIONS Problems in pesticide risk assessment are identified and linked to study design, data, and methodological shortcomings. Steps and strategies are presented that have potential to deepen scientific knowledge of pesticide toxicity, exposures, and risks. We propose four solutions: (1) End near-sole reliance in regulatory decision-making on industry-supported studies by supporting and relying more heavily on independent science, especially for core toxicology studies. The cost of conducting core toxicology studies at labs not affiliated with or funded directly by pesticide registrants should be covered via fees paid by manufacturers to public agencies. (2) Regulators should place more weight on mechanistic data and low-dose studies within the range of contemporary exposures. (3) Regulators, public health agencies, and funders should increase the share of exposure-assessment resources that produce direct measures of concentrations in bodily fluids and tissues. Human biomonitoring is vital in order to quickly identify rising exposures among vulnerable populations including applicators, pregnant women, and children. (4) Scientific tools across disciplines can accelerate progress in risk assessments if integrated more effectively. New genetic and metabolomic markers of adverse health impacts and heritable epigenetic impacts are emerging and should be included more routinely in risk assessment to effectively prevent disease. CONCLUSIONS Preventing adverse public health outcomes triggered or made worse by exposure to pesticides will require changes in policy and risk assessment procedures, more science free of industry influence, and innovative strategies that blend traditional methods with new tools and mechanistic insights.
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Affiliation(s)
- Charles Benbrook
- Heartland Health Research Alliance, 10526 SE Vashon Vista Drive, Port Orchard, WA 98367 USA
| | - Melissa J. Perry
- Department of Environmental and Occupational Health, George Washington University, Washington, DC USA
| | | | - Philip J. Landrigan
- Schiller Institute for Integrated Science and Society, Boston College, Newton, MA 02467 USA
| | | | | | - Michael N. Antoniou
- Gene Expression and Therapy Group, Department of Medical and Molecular Genetics, King’s College London, Faculty of Life Sciences and Medicine, Guy’s Hospital, London, UK
| | - Paul Winchester
- School of Medicine, Department of Pediatrics, Indiana University, Indianapolis, IN USA
| | - Robin Mesnage
- Gene Expression and Therapy Group, Department of Medical and Molecular Genetics, King’s College London, Faculty of Life Sciences and Medicine, Guy’s Hospital, London, UK
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7
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Sutton P, Chartres N, Rayasam SDG, Daniels N, Lam J, Maghrbi E, Woodruff TJ. Reviews in environmental health: How systematic are they? ENVIRONMENT INTERNATIONAL 2021; 152:106473. [PMID: 33798823 PMCID: PMC8118386 DOI: 10.1016/j.envint.2021.106473] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 02/09/2021] [Accepted: 02/16/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Synthesizing environmental health science is crucial to taking action to protect public health. Procedures for evidence evaluation and integration are transitioning from "expert-based narrative" to "systematic" review methods. However, little is known about the methodology being utilized for either type of review. OBJECTIVES To appraise the methodological strengths and weaknesses of a sample of "expert-based narrative" and "systematic" reviews in environmental health. METHODS We conducted a comprehensive search of multiple databases and identified relevant reviews using pre-specified eligibility criteria. We applied a modified version of the Literature Review Appraisal Toolkit (LRAT) to three environmental health topics that assessed the utility, validity and transparency of reviews. RESULTS We identified 29 reviews published between 2003 and 2019, of which 13 (45%) were self-identified as systematic reviews. Across every LRAT domain, systematic reviews received a higher percentage of "satisfactory" ratings compared to non-systematic reviews. In eight of these domains, there was a statistically significant difference observed between the two types of reviews and "satisfactory" ratings. Non-systematic reviews performed poorly with the majority receiving an "unsatisfactory" or "unclear" rating in 11 of the 12 domains. Systematic reviews performed poorly in six of the 12 domains; 10 (77%) did not state the reviews objectives or develop a protocol; eight (62%) did not state the roles and contribution of the authors, or evaluate the internal validity of the included evidence consistently using a valid method; and only seven (54%) stated a pre-defined definition of the evidence bar on which their conclusions were based, or had an author disclosure of interest statement. DISCUSSION Systematic reviews produced more useful, valid, and transparent conclusions compared to non-systematic reviews, but poorly conducted systematic reviews were prevalent. Ongoing development and implementation of empirically based systematic review methods are required in environmental health to ensure transparent and timely decision making to protect the public's health.
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Affiliation(s)
- Patrice Sutton
- UCSF Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology & Reproductive Sciences, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States.
| | - Nicholas Chartres
- UCSF Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology & Reproductive Sciences, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States.
| | - Swati D G Rayasam
- UCSF Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology & Reproductive Sciences, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States.
| | - Natalyn Daniels
- UCSF Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology & Reproductive Sciences, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States
| | - Juleen Lam
- Department of Health Sciences, California State University East Bay, SF 533, 25800 Carlos Bee Blvd, Hayward, CA 94542, United States.
| | - Eman Maghrbi
- Department of Health Sciences, California State University East Bay, SF 533, 25800 Carlos Bee Blvd, Hayward, CA 94542, United States.
| | - Tracey J Woodruff
- UCSF Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology & Reproductive Sciences, Box 0132, 490 Illinois Street, Floor 10, San Francisco, CA 94143, United States.
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Schenk L, Johanson G. Management of bias and conflict of interest among occupational exposure limit expert groups. Regul Toxicol Pharmacol 2021; 123:104929. [PMID: 33872741 DOI: 10.1016/j.yrtph.2021.104929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/13/2021] [Accepted: 04/08/2021] [Indexed: 10/21/2022]
Abstract
Our aim was to evaluate policies and procedures for management of conflict of interest (CoI) and other sources of bias, implemented in Occupational Exposure Limit (OEL) expert groups. First, we compiled procedural criteria applicable to OEL-setting, based on literature on CoI and systematic reviews. Second, we identified 58 global OEL-sources and sought the underlying expert groups and operating procedures. We identified eleven active groups, of which five have documented CoI policies. In all five, CoI management is based on declarations of interests (DoIs) and removal of experts from decisions in which they have an interest. Notable differences include publication of DoIs (three of five groups), limitation of DoI to current interests (two groups), quantitative limits for financial interests (none specified to ≥€10,000 per interest), control procedures for undisclosed CoI (one group), and procedures in case of discovery of undisclosed CoI (three groups). Methods to evaluate study quality are described by three groups, while reproducible and comprehensive strategies to identify and select data receive less attention. We conclude that procedures to manage CoI and bias are not broadly implemented, or at least not openly and transparently communicated. This lack of visible procedures is remarkable, considering OEL's impact on health and economy.
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Affiliation(s)
- Linda Schenk
- Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden; Department of Philosophy and History, KTH- Royal Institute of Technology, Teknikringen 76, 100 44, Stockholm, Sweden.
| | - Gunnar Johanson
- Integrative Toxicology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden.
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Canavez ADPM, de Oliveira Prado Corrêa G, Isaac VLB, Schuck DC, Lorencini M. Integrated approaches to testing and assessment as a tool for the hazard assessment and risk characterization of cosmetic preservatives. J Appl Toxicol 2021; 41:1687-1699. [PMID: 33624850 DOI: 10.1002/jat.4156] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/04/2021] [Accepted: 02/09/2021] [Indexed: 01/21/2023]
Abstract
The safety assessment of cosmetic products is based on the safety of the ingredients, which requires information on chemical structures, toxicological profiles, and exposure data. Approximately 6% of the population is sensitized to cosmetic ingredients, especially preservatives and fragrances. In this context, the aim of this study was to perform a hazard assessment and risk characterization of benzalkonium chloride (BAC), benzyl alcohol (BA), caprylyl glycol (CG), ethylhexylglycerin (EG), chlorphenesin (CP), dehydroacetic acid (DHA), sodium dehydroacetate (SDH), iodopropynyl butylcarbamate (IPBC), methylchloroisothiazolinone and methylisothiazolinone (MCI/MIT), methylisothiazolinone (MIT), phenoxyethanol (PE), potassium sorbate (PS), and sodium benzoate (SB). Considering the integrated approaches to testing and assessment (IATA) and weight of evidence (WoE) as a decision tree, based on published safety reports. The hazard assessment was composed of a toxicological matrix correlating the toxicity level, defined as low (L), moderate (M), or high (H) and local or systemic exposure, considering the endpoints of skin sensitization, skin irritation, eye irritation, phototoxicity, acute oral toxicity, carcinogenicity, mutagenicity/genotoxicity, and endocrine activity. In a risk assessment approach, most preservatives had a margin of safety (MoS) above 100, except for DHA, SDH, and EG, considering the worst-case scenario (100% dermal absorption). However, isolated data do not set up a safety assessment. It is necessary to carry out a rational risk characterization considering hazard and exposure assessment to estimate the level of risk of an adverse health outcome, based on the concentration in a product, frequency of use, type of product, route of exposure, body surface location, and target population.
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Affiliation(s)
| | | | | | | | - Marcio Lorencini
- Department of Safety Assessment, Grupo Boticário, São José dos Pinhais, PR, Brazil
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10
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Griffin MD, Pereira SR, DeBari MK, Abbott RD. Mechanisms of action, chemical characteristics, and model systems of obesogens. BMC Biomed Eng 2020; 2:6. [PMID: 32903358 PMCID: PMC7422567 DOI: 10.1186/s42490-020-00040-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 04/07/2020] [Indexed: 02/06/2023] Open
Abstract
There is increasing evidence for the role of environmental endocrine disrupting contaminants, coined obesogens, in exacerbating the rising obesity epidemic. Obesogens can be found in everyday items ranging from pesticides to food packaging. Although research shows that obesogens can have effects on adipocyte size, phenotype, metabolic activity, and hormone levels, much remains unknown about these chemicals. This review will discuss what is currently known about the mechanisms of obesogens, including expression of the PPARs, hormone interference, and inflammation. Strategies for identifying obesogenic chemicals and their mechanisms through chemical characteristics and model systems will also be discussed. Ultimately, research should focus on improving models to discern precise mechanisms of obesogenic action and to test therapeutics targeting these mechanisms.
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Affiliation(s)
- Mallory D Griffin
- Carnegie Mellon University, 5000 Forbes Avenue, Scott Hall, Pittsburgh, PA 15213 USA
| | - Sean R Pereira
- Carnegie Mellon University, 5000 Forbes Avenue, Scott Hall, Pittsburgh, PA 15213 USA
| | - Megan K DeBari
- Carnegie Mellon University, 5000 Forbes Avenue, Scott Hall, Pittsburgh, PA 15213 USA
| | - Rosalyn D Abbott
- Carnegie Mellon University, 5000 Forbes Avenue, Scott Hall, Pittsburgh, PA 15213 USA
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11
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Pega F, Norris SL, Backes C, Bero LA, Descatha A, Gagliardi D, Godderis L, Loney T, Modenese A, Morgan RL, Pachito D, Paulo MBS, Scheepers PTJ, Schlünssen V, Sgargi D, Silbergeld EK, Sørensen K, Sutton P, Tenkate T, Torreão Corrêa da Silva D, Ujita Y, van Deventer E, Woodruff TJ, Mandrioli D. RoB-SPEO: A tool for assessing risk of bias in studies estimating the prevalence of exposure to occupational risk factors from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. ENVIRONMENT INTERNATIONAL 2020; 135:105039. [PMID: 31864023 PMCID: PMC7479507 DOI: 10.1016/j.envint.2019.105039] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 07/10/2019] [Accepted: 07/19/2019] [Indexed: 05/20/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates). For this, systematic reviews of studies estimating the prevalence of exposure to selected occupational risk factors will be conducted to provide input data for estimations of the number of exposed workers. A critical part of systematic review methods is to assess risk of bias (RoB) of individual studies. In this article, we present and describe the development of such a tool, called the Risk of Bias in Studies estimating Prevalence of Exposure to Occupational risk factors (RoB-SPEO) tool; report results from RoB-SPEO's pilot testing; note RoB-SPEO's limitations; and suggest how the tool might be tested and developed further. METHODS Selected existing RoB tools used in environmental and occupational health systematic reviews were reviewed and analysed. From existing tools, we identified domains for the new tool and, if necessary, added new domains. For each domain, we then identified and integrated components from the existing tools (i.e. instructions, domains, guiding questions, considerations, ratings and rating criteria), and, if necessary, we developed new components. Finally, we elicited feedback from other systematic review methodologists and exposure scientists and agreed upon RoB-SPEO. Nine experts pilot tested RoB-SPEO, and we calculated a raw measure of inter-rater agreement (Pi) for each of its domain, rating Pi < 0.4 as poor, 0.4 ≤ Pi ≥ 0.8 as substantial and Pi > 0.80 as almost perfect agreement. RESULTS Our review found no standard tool for assessing RoB in prevalence studies of exposure to occupational risk factors. We identified six existing tools for environmental and occupational health systematic reviews and found that their components for assessing RoB differ considerably. With the new RoB-SPEO tool, assessors judge RoB for each of eight domains: (1) bias in selection of participants into the study; (2) bias due to a lack of blinding of study personnel; (3) bias due to exposure misclassification; (4) bias due to incomplete exposure data; (5) bias due to conflict of interest; (6) bias due to selective reporting of exposures; (7) bias due to difference in numerator and denominator; and (8) other bias. The RoB-SPEO's ratings are low, probably low, probably high, high or no information. Pilot testing of the RoB-SPEO tool found substantial inter-rater agreement for six domains (range of Pi for these domains: 0.51-0.80), but poor agreement for two domains (i.e. Pi of 0.31 and 0.33 for biases due to incomplete exposure data and in selection of participants into the study, respectively). Limitations of RoB-SPEO include that it has not yet been fully performance-tested. CONCLUSIONS We developed the RoB-SPEO tool for assessing RoB in prevalence studies of exposure to occupational risk factors. The tool will be applied and its performance tested in the ongoing systematic reviews for the WHO/ILO Joint Estimates.
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Affiliation(s)
- Frank Pega
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Susan L Norris
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland
| | - Claudine Backes
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland
| | - Lisa A Bero
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Alexis Descatha
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), Occupational Health Unit, University Hospital of West Suburb of Paris, Poincaré Site, Garches, France; Versailles St-Quentin Univ - Paris Saclay Univ (UVSQ), UMS 011, UMR-S 1168, France; Inserm, U1168 (VIMA: Aging and chronic diseases. Epidemiological and public health approaches), UMS 011 (Population-based Epidemiologic Cohorts Unit), Villejuif, France
| | - Diana Gagliardi
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy
| | - Lode Godderis
- Centre for Environment and Health, KU Leuven, Leuven, Belgium; KIR Department (Knowledge, Information & Research), IDEWE, External Service for Prevention and Protection at Work, Leuven, Belgium
| | - Tom Loney
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Rebecca L Morgan
- Department of Health Research Methods, Evidence and Impact, McMaster University, Ontario, Canada
| | - Daniela Pachito
- Evidence-based Health, Universidade Federal de São Paulo, Sao Paulo, Brazil; Cochrane Brazil, Sao Paulo, Brazil
| | - Marilia B S Paulo
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Paul T J Scheepers
- Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands
| | - Vivi Schlünssen
- Department of Public Health, Aarhus University, Aarhus, Denmark; National Research Center for the Working Environment, Copenhagen, Denmark
| | - Daria Sgargi
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
| | - Ellen K Silbergeld
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Kathrine Sørensen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Patrice Sutton
- Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, United States of America
| | - Thomas Tenkate
- School of Occupational and Public Health, Ryerson University, Toronto, Ontario, Canada
| | - Denise Torreão Corrêa da Silva
- Workers' Health and Human Ecology Research Center, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland
| | - Emilie van Deventer
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, United States of America
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy
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12
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He H, Malloy TF, Schoenung JM. Multicriteria Decision Analysis Characterization of Chemical Hazard Assessment Data Sources. INTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT 2019; 15:895-908. [PMID: 31283083 DOI: 10.1002/ieam.4182] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 06/27/2019] [Indexed: 06/09/2023]
Abstract
Chemical hazard assessment (CHA), which aims to investigate the inherent hazard potential of chemicals, has been developed with the purpose of promoting safer consumer products. Despite the increasing use of CHA in recent years, finding adequate and reliable toxicity data required for CHA is still challenging due to issues regarding data completeness and data quality. Also, collecting data from primary toxicity reports or literature can be time consuming, which promotes the use of secondary data sources instead. In this study, we evaluate and characterize numerous secondary data sources on the basis of 5 performance attributes: reliability, adequacy, transparency, volume, and ease of use. We use GreenScreen for Safer Chemicals v1.4 as the CHA framework, which defines the endpoints of interest used in this analysis. We focused upon 34 data sources that reflect 3 types of secondary data: chemical-oriented data sources, hazard-trait-oriented data sources, and predictive data sources. To integrate and analyze the evaluation results, we applied 2 multicriteria decision analysis (MCDA) methodologies: multiattribute utility theory (MAUT) and stochastic multiobjective acceptability analysis (SMAA). Overall, the findings in this research program allow us to explore the relative importance of performance criteria and the data source quality for effectively conducting CHA. Integr Environ Assess Manag 2019;00:1-14. © 2019 SETAC.
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Affiliation(s)
- Haoyang He
- Department of Materials Science and Engineering, University of California, Irvine, California, USA
| | - Timothy F Malloy
- School of Law, University of California, Los Angeles, California, USA
| | - Julie M Schoenung
- Department of Materials Science and Engineering, University of California, Irvine, California, USA
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13
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Rugulies R, Ando E, Ayuso-Mateos JL, Bonafede M, Cabello M, Di Tecco C, Dragano N, Durand-Moreau Q, Eguchi H, Gao J, Garde AH, Iavicoli S, Ivanov ID, Leppink N, Madsen IEH, Pega F, Prüss-Üstün AM, Rondinone BM, Sørensen K, Tsuno K, Ujita Y, Zadow A. WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of exposure to long working hours and of the effect of exposure to long working hours on depression. ENVIRONMENT INTERNATIONAL 2019; 125:515-528. [PMID: 30737040 DOI: 10.1016/j.envint.2018.11.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 11/01/2018] [Accepted: 11/05/2018] [Indexed: 05/12/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years from depression attributable to exposure to long working hours, to inform the development of the WHO/ILO joint methodology. OBJECTIVES We aim to systematically review studies on occupational exposure to long working hours (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of long working hours on depression (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework, conducting both systematic reviews in tandem and in a harmonized way. DATA SOURCES Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Medline, EMBASE, Web of Science, CISDOC and PsycINFO. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand search reference list of previous systematic reviews and included study records; and consult additional experts. STUDY ELIGIBILITY AND CRITERIA We will include working-age (≥15 years) participants in the formal and informal economy in any WHO and/or ILO Member State, but exclude child workers (<15 years) and unpaid domestic workers. For Systematic Review 1, we will include quantitative prevalence studies of relevant levels of occupational exposure to long working hours (i.e. 35-40, 41-48, 49-54 and ≥55 h/week) stratified by country, sex, age and industrial sector or occupation, in the years 2005-2018. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the relative effect of relevant level(s) of long working hours on the incidence of or mortality due to depression, compared with the theoretical minimum risk exposure level (i.e. 35-40 h/week). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO REGISTRATION NUMBER CRD42018085729.
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Affiliation(s)
- Reiner Rugulies
- National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
| | | | - Jose Luis Ayuso-Mateos
- Department of Psychiatry, Universidad Autonoma de Madrid, Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain.
| | - Michela Bonafede
- Department of Environmental and Occupational Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, Rome, Italy.
| | - Maria Cabello
- Department of Psychiatry, Universidad Autonoma de Madrid, Madrid, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
| | - Cristina Di Tecco
- Department of Environmental and Occupational Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, Rome, Italy.
| | - Nico Dragano
- Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
| | - Quentin Durand-Moreau
- Occupational Diseases Center, University Hospital of Brest, Brest, France; LABERS EA 3149, University of Brest, Brest, France.
| | - Hisashi Eguchi
- Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
| | - Junling Gao
- School of Public Health, Fudan University, Shanghai, China.
| | - Anne H Garde
- National Research Centre for the Working Environment, Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Sergio Iavicoli
- Department of Environmental and Occupational Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, Rome, Italy.
| | - Ivan D Ivanov
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Nancy Leppink
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Ida E H Madsen
- National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - Frank Pega
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Annette M Prüss-Üstün
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Bruna M Rondinone
- Department of Environmental and Occupational Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone, Rome, Italy.
| | - Kathrine Sørensen
- National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - Kanami Tsuno
- Wakayama Medical University, Wakayama-shi, Wakayama, Japan.
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Amy Zadow
- University of South Australia, Adelaide, Australia.
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14
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Hulshof CTJ, Colosio C, Daams JG, Ivanov ID, Prakash KC, Kuijer PPFM, Leppink N, Mandic-Rajcevic S, Masci F, van der Molen HF, Neupane S, Nygård CH, Oakman J, Pega F, Proper K, Prüss-Üstün AM, Ujita Y, Frings-Dresen MHW. WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of exposure to occupational ergonomic risk factors and of the effect of exposure to occupational ergonomic risk factors on osteoarthritis of hip or knee and selected other musculoskeletal diseases. ENVIRONMENT INTERNATIONAL 2019; 125:554-566. [PMID: 30583853 PMCID: PMC7794864 DOI: 10.1016/j.envint.2018.09.053] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 09/27/2018] [Accepted: 09/28/2018] [Indexed: 05/20/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of disability-adjusted life years from osteoarthritis of hip or knee, and selected other musculoskeletal diseases respectively, attributable to exposure to occupational ergonomic risk factors to inform the development of the WHO/ILO joint methodology. OBJECTIVES We aim to systematically review studies on exposure to occupational ergonomic risk factors (Systematic Review 1) and systematically review and meta-analyze estimates of the effect of exposure to occupational ergonomic risk factors on osteoarthritis of the hip or knee, and selected other musculoskeletal diseases respectively (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework, conducting both systematic reviews in tandem and in a harmonized way. DATA SOURCES Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Medline, EMBASE, Web of Science and CISDOC. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference lists of previous systematic reviews and included study records; and consult additional experts. STUDY ELIGIBILITY AND CRITERIA We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. The included occupational ergonomic risk factors will be any exposure to one or more of: force exertion; demanding posture; repetitiveness; hand-arm vibration; lifting; kneeling and/or squatting; and climbing. Included outcomes will be (i) osteoarthritis and (ii) other musculoskeletal diseases (i.e., one or more of: rotator cuff syndrome; bicipital tendinitis; calcific tendinitis; shoulder impingement; bursitis shoulder; epicondylitis medialis; epicondylitis lateralis; bursitis elbow; bursitis hip; chondromalacia patellae; meniscus disorders; and/or bursitis knee). For Systematic Review 1, we will include quantitative prevalence studies of any exposure to occupational ergonomic risk factors stratified by country, gender, age and industrial sector or occupation. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control-studies and other non-randomized intervention studies with an estimate of the relative effect of any exposure with occupational ergonomic risk factors on the prevalence or incidence of osteoarthritis and/or selected musculoskeletal diseases, compared with the theoretical minimum risk exposure level (i.e., no exposure). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration number: CRD42018102631.
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Affiliation(s)
- Carel T J Hulshof
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
| | - Claudio Colosio
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Joost G Daams
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
| | - Ivan D Ivanov
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - K C Prakash
- Faculty of Social Science (Health Sciences), University of Tampere, Tampere, Finland.
| | - Paul P F M Kuijer
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
| | - Nancy Leppink
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Stefan Mandic-Rajcevic
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Frederica Masci
- Department of Health Sciences, University of Milan, Milan, Italy; International Centre for Rural Heath, University Hospital San Paolo, Milan, Italy.
| | - Henk F van der Molen
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
| | - Subas Neupane
- Faculty of Social Science (Health Sciences), University of Tampere, Tampere, Finland.
| | - Clas-Håkan Nygård
- Faculty of Social Science (Health Sciences), University of Tampere, Tampere, Finland.
| | | | - Frank Pega
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Karin Proper
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, Amsterdam, Netherlands.
| | - Annette M Prüss-Üstün
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Monique H W Frings-Dresen
- Coronel Institute of Occupational Health, Amsterdam UMC, location AMC, Amsterdam Public Health Research Institute, Amsterdam, Netherlands.
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Teixeira LR, Azevedo TM, Bortkiewicz A, Corrêa da Silva DT, de Abreu W, de Almeida MS, de Araujo MAN, Gadzicka E, Ivanov ID, Leppink N, Macedo MRV, de S Maciel EMG, Pawlaczyk-Łuszczyńska M, Pega F, Prüss-Üstün AM, Siedlecka J, Stevens GA, Ujita Y, Braga JU. WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of exposure to occupational noise and of the effect of exposure to occupational noise on cardiovascular disease. ENVIRONMENT INTERNATIONAL 2019; 125:567-578. [PMID: 30683322 DOI: 10.1016/j.envint.2018.09.040] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 09/17/2018] [Accepted: 09/23/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years from cardiovascular disease attributable to exposure to occupational noise, to inform the development of the WHO/ILO joint methodology. OBJECTIVES We aim to systematically review studies on exposure to occupational noise (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of occupational noise on cardiovascular diseases (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework, conducting both systematic reviews in tandem and in a harmonized way. DATA SOURCES Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Medline, EMBASE, Web of Science and CISDOC. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand search reference list of previous systematic reviews and included study records; and consult additional experts. STUDY ELIGIBILITY AND CRITERIA We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. The eligible risk factor will be occupational noise. Eligible outcomes will be hypertensive heart disease, ischaemic heart disease, stroke, cardiomyopathy, myocarditis, endocarditis and other circulatory diseases. For Systematic Review 1, we will include quantitative prevalence studies of exposure to occupational noise (i.e., low: <85 dB(A) and high: ≥85 dB(A)) stratified by country, sex, age and industrial sector or occupation. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the relative effect of high exposure to occupational noise on the prevalence of, incidence of or mortality due to cardiovascular disease, compared with the theoretical minimum risk exposure level (i.e., low exposure). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration number: CRD42018092272.
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Affiliation(s)
- Liliane R Teixeira
- Workers' Health and Human Ecology Research Center, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
| | - Tatiana M Azevedo
- Workers' State Secretariat of Health, Rio de Janeiro, State Reference Center in Workers' Health, Rio de Janeiro, RJ, Brazil.
| | - Alicja Bortkiewicz
- Department of Work Physiology and Ergonomics, Nofer Institute of Occupational Medicine, Lodz, Poland.
| | - Denise T Corrêa da Silva
- Workers' Health and Human Ecology Research Center, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
| | - Wagner de Abreu
- Workers' Health and Human Ecology Research Center, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
| | - Márcia S de Almeida
- Workers' Health and Human Ecology Research Center, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
| | - Marco A N de Araujo
- Workers' Health and Human Ecology Research Center, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
| | - Elzbieta Gadzicka
- Department of Work Physiology and Ergonomics, Nofer Institute of Occupational Medicine, Lodz, Poland.
| | - Ivan D Ivanov
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Nancy Leppink
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Marta R V Macedo
- Workers' Health Coordination, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
| | - Elvira M G de S Maciel
- Department of Epidemiology and Quantitative Methods in Health, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
| | | | - Frank Pega
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Annette M Prüss-Üstün
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Jadwiga Siedlecka
- Department of Work Physiology and Ergonomics, Nofer Institute of Occupational Medicine, Lodz, Poland.
| | - Gretchen A Stevens
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland.
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - José Ueleres Braga
- Department of Epidemiology and Quantitative Methods in Health, National School of Public Health Sergio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
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16
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Pelch KE, Bolden AL, Kwiatkowski CF. Environmental Chemicals and Autism: A Scoping Review of the Human and Animal Research. ENVIRONMENTAL HEALTH PERSPECTIVES 2019; 127:46001. [PMID: 30942615 PMCID: PMC6785231 DOI: 10.1289/ehp4386] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 02/18/2019] [Accepted: 02/28/2019] [Indexed: 05/23/2023]
Abstract
BACKGROUND Estimates of autism prevalence have increased dramatically over the past two decades. Evidence suggests environmental factors may contribute to the etiology of the disorder. OBJECTIVES This scoping review aimed to identify and categorize primary research and reviews on the association between prenatal and early postnatal exposure to environmental chemicals and the development of autism in epidemiological studies and rodent models of autism. METHODS PubMed was searched through 8 February 2018. Included studies assessed exposure to environmental chemicals prior to 2 months of age in humans or 14 d in rodents. Rodent studies were considered relevant if they included at least one measurement of reciprocal social communicative behavior or repetitive and stereotyped behavior. Study details are presented in interactive displays using Tableau Public. RESULTS The search returned 21,603 unique studies, of which 54 epidemiological studies, 46 experimental rodent studies, and 50 reviews were deemed relevant, covering 152 chemical exposures. The most frequently studied exposures in humans were particulate matter ([Formula: see text]), mercury ([Formula: see text]), nonspecific air pollution ([Formula: see text]), and lead ([Formula: see text]). In rodent studies, the most frequently studied exposures were chlorpyrifos ([Formula: see text]), mercury ([Formula: see text]), and lead ([Formula: see text]). DISCUSSION Although research is growing rapidly, wide variability exists in study design and conduct, exposures investigated, and outcomes assessed. Conclusions focus on recommendations to guide development of best practices in epidemiology and toxicology, including greater harmonization across these fields of research to more quickly and efficiently identify chemicals of concern. In particular, we recommend chlorpyrifos, lead, and polychlorinated biphenyls (PCBs) be systematically reviewed in order to assess their relationship with the development of autism. There is a pressing need to move forward quickly and efficiently to understand environmental influences on autism in order to answer current regulatory questions and inform treatment and prevention efforts. https://doi.org/10.1289/EHP4386.
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Affiliation(s)
| | | | - Carol F. Kwiatkowski
- The Endocrine Disruption Exchange, Eckert, Colorado, USA
- Department of Biological Sciences, North Carolina State University, Raleigh, North Carolina, USA
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17
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Tenkate T, Adam B, Al-Rifai RH, Chou BR, Gobba F, Ivanov ID, Leppink N, Loney T, Pega F, Peters CE, Prüss-Üstün AM, Silva Paulo M, Ujita Y, Wittlich M, Modenese A. WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of occupational exposure to solar ultraviolet radiation and of the effect of occupational exposure to solar ultraviolet radiation on cataract. ENVIRONMENT INTERNATIONAL 2019; 125:542-553. [PMID: 30737039 DOI: 10.1016/j.envint.2018.10.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 09/29/2018] [Accepted: 10/01/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. Here, we present the protocol for two systematic reviews of parameters for estimating the number of disability-adjusted life years of cataracts from occupational exposure to solar ultraviolet radiation, to inform the development of the WHO/ILO joint methodology. OBJECTIVES We aim to systematically review studies on occupational exposure to solar ultraviolet radiation (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of occupational exposure to solar ultraviolet radiation on the development of cataract (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework and conducting both systematic reviews in tandem and in a harmonized way. DATA SOURCES Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Ovid Medline, PubMed, EMBASE, and Web of Sciences. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand search reference list of previous systematic reviews and included study records; and consult additional experts. STUDY ELIGIBILITY AND CRITERIA We will include working-age (≥15 years) workers in WHO and/or ILO Member States, but exclude children (<15 years) and unpaid domestic workers. For Systematic Review 1, we will include quantitative studies on the prevalence of relevant levels of occupational exposure to solar ultraviolet radiation and of the total working time spent outdoors from 1960 to 2018, stratified by sex, age, country and industrial sector or occupation. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the effect of any occupational exposure to solar ultraviolet radiation (i.e. ≥30 Jm-2/day of occupational solar UV exposure at the surface of the eye) on the prevalence or incidence of cataract, compared with the theoretical minimum risk exposure level (i.e. <30 Jm-2/day of occupational solar UV exposure at the surface of the eye). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration: CRD42018098897.
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Affiliation(s)
- Thomas Tenkate
- School of Occupational and Public Health, Ryerson University, Toronto, ON, Canada.
| | - Balazs Adam
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; Division of Occupational Health, Department of Preventive Medicine, Faculty of Public Health, University of Debrecen, Debrecen, Hungary.
| | - Rami H Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
| | - B Ralph Chou
- School of Optometry and Vison Science, University of Waterloo, Waterloo, ON, Canada.
| | - Fabriziomaria Gobba
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
| | - Ivan D Ivanov
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Nancy Leppink
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Tom Loney
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
| | - Frank Pega
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Cheryl E Peters
- Alberta Health Services, University of Calgary, Calgary, AB, Canada; CAREX Canada, Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada.
| | - Annette M Prüss-Üstün
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Marilia Silva Paulo
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates; Global Health and Tropical Medicine, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisbon, Portugal.
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Marc Wittlich
- Institute for Occupational Safety and Health, German Social Accident Insurance (IFA), Sankt Augustin, Germany.
| | - Alberto Modenese
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
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18
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Chartres N, Bero LA, Norris SL. A review of methods used for hazard identification and risk assessment of environmental hazards. ENVIRONMENT INTERNATIONAL 2019; 123:231-239. [PMID: 30537638 DOI: 10.1016/j.envint.2018.11.060] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 11/22/2018] [Accepted: 11/22/2018] [Indexed: 05/14/2023]
Abstract
BACKGROUND Approximately one quarter of all deaths globally are attributed to living or working in an unhealthy environment, with household and ambient air pollution, along with exposures to ultraviolet radiation and chemicals amongst the leading causes. At present there are no international standards for assessing the risks of these environmental hazards. The use of heterogeneous methods to identify health risks from environmental hazards may reduce the level of confidence the public has in the conclusions that are made. OBJECTIVES To describe and compare the processes and methods used by national and international organisations that conduct hazard identification and/or risk assessment (HI/RA) of environmental hazards and to identify knowledge gaps to inform the development of future methods. METHODS We searched the websites of 19 organisations (ten national, five international and four World Health Organization (WHO) units) and extracted data from all relevant, publicly available resources which described the processes and methods used in HI/RA of environmental hazards. We contacted each organisation for any additional information. RESULTS Five organisations were excluded from further analysis: three made recommendations but did not conduct HI/RA; one used heterogenous methods across their reviews for HI; and one WHO unit did not have any published guidelines. Of the 14 organisations analysed, five (36%) describe the process for establishing the questions to be answered in the assessments. Only one (7%) organisation uses systematic review methods, although five (36%) state that they use such methods. Ten (71%) assess the scientific quality of the included studies, however only three (21%) use explicit criteria. Only three (21%) organisations assess the quality of the body of evidence using explicit criteria. Four (29%) organisations describe the process for making the final HI conclusions and three (38%) the final RA conclusions. Eight (57%) have a conflict of interest policy and seven (50%) organisations describe a process for managing them. The US Office of Health Assessment and Translation and the World Health Organisation meet the most criteria for describing their processes and methods. CONCLUSIONS The processes and methods used by organisations conducting HI/RA of environmental hazards are inconsistent. There is a need for empirically based tools and methods to be adopted for the evaluation and synthesis of evidence, and the formulation of conclusions across all organisations that conduct HI or RA. These tools and methods will lead to increased transparency, comparability and validity of the assessments.
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Affiliation(s)
- Nicholas Chartres
- The University of Sydney, D17, The Hub, 6th floor, Charles Perkins Centre, NSW 2006, Australia.
| | - Lisa A Bero
- The University of Sydney, D17, The Hub, 6th floor, Charles Perkins Centre, NSW 2006, Australia.
| | - Susan L Norris
- Department of Innovation, Evidence and Research, World Health Organization, Av. Appia 20 CH-1211, Geneva 27, Switzerland.
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19
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Godderis L, Boonen E, Cabrera Martimbianco AL, Delvaux E, Ivanov ID, Lambrechts MC, Latorraca COC, Leppink N, Pega F, Prüss-Ustün AM, Riera R, Ujita Y, Pachito DV. WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of exposure to long working hours and of the effect of exposure to long working hours on alcohol consumption and alcohol use disorders. ENVIRONMENT INTERNATIONAL 2018; 120:22-33. [PMID: 30055358 DOI: 10.1016/j.envint.2018.07.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 07/06/2018] [Accepted: 07/16/2018] [Indexed: 05/24/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years from alcohol consumption and alcohol use disorder attributable to exposure to long working hours, to inform the development of the WHO/ILO joint methodology. OBJECTIVES We aim to systematically review studies on exposure to long working hours (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of exposure to long working hours on alcohol consumption and alcohol use disorder (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework. DATA SOURCES Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including MEDLINE, Embase, Web of Science, CISDOC and PsychINFO. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference list of previous systematic reviews and included study records; and consult additional experts. STUDY ELIGIBILITY AND CRITERIA We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State but exclude children (<15 years) and unpaid domestic workers. For Systematic Review 1, we will include quantitative prevalence studies of relevant levels of exposure to long working hours (i.e., 35-40, 41-48, 49-54 and ≥55 h/week) stratified by country, sex, age and industrial sector or occupation. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the relative effect of a relevant level of exposure to long working hours on total amount of alcohol consumed and on the incidence of, prevalence of or mortality from alcohol use disorders, compared with the theoretical minimum risk exposure level (i.e., worked 35-40 h/week). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors will independently screen titles and abstracts at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration number: CRD42018084077.
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Affiliation(s)
- Lode Godderis
- Centre for Environment and Health, KU Leuven, Kapucijnenvoer 35/5, box 7001, 3000 Leuven, Belgium; KIR Department (Knowledge, Information & research), IDEWE, External Service for Prevention and Protection at Work, Interleuvenlaan 58, 3001 Leuven, Belgium.
| | - Emma Boonen
- KIR Department (Knowledge, Information & research), IDEWE, External Service for Prevention and Protection at Work, Interleuvenlaan 58, 3001 Leuven, Belgium.
| | - Ana L Cabrera Martimbianco
- Evidence-based Health, Universidade Federal de São Paulo and Cochrane Brazil, 564 Borges Lagoa, Sao Paulo, Brazil
| | - Ellen Delvaux
- KIR Department (Knowledge, Information & research), IDEWE, External Service for Prevention and Protection at Work, Interleuvenlaan 58, 3001 Leuven, Belgium.
| | - Ivan D Ivanov
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.
| | - Marie-Claire Lambrechts
- Centre for Environment and Health of KU Leuven, Kapucijnenvoer 35/5, box 7001, 3000 Leuven, Belgium; VAD, Flemish Expertise centre for Alcohol and other Drugs, Vanderlindenstraat 15, Brussels, Belgium.
| | - Carolina O C Latorraca
- Evidence-based Health, Universidade Federal de São Paulo and Cochrane Brazil, 564 Borges Lagoa, Sao Paulo, Brazil
| | - Nancy Leppink
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Route des Morillons 4, 1211 Geneva, Switzerland.
| | - Frank Pega
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.
| | - Annette M Prüss-Ustün
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.
| | - Rachel Riera
- Evidence-based Health, Universidade Federal de São Paulo and Cochrane Brazil, 564 Borges Lagoa, Sao Paulo, Brazil
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Route des Morillons 4, 1211 Geneva, Switzerland.
| | - Daniela V Pachito
- Evidence-based Health, Universidade Federal de São Paulo and Cochrane Brazil, 564 Borges Lagoa, Sao Paulo, Brazil.
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20
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Descatha A, Sembajwe G, Baer M, Boccuni F, Di Tecco C, Duret C, Evanoff BA, Gagliardi D, Ivanov ID, Leppink N, Marinaccio A, Magnusson Hanson LL, Ozguler A, Pega F, Pell J, Pico F, Prüss-Üstün A, Ronchetti M, Roquelaure Y, Sabbath E, Stevens GA, Tsutsumi A, Ujita Y, Iavicoli S. WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of exposure to long working hours and of the effect of exposure to long working hours on stroke. ENVIRONMENT INTERNATIONAL 2018; 119:366-378. [PMID: 30005185 DOI: 10.1016/j.envint.2018.06.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 06/12/2018] [Accepted: 06/13/2018] [Indexed: 05/12/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years from stroke attributable to exposure to long working hours, to inform the development of the WHO/ILO joint methodology. OBJECTIVES We aim to systematically review studies on occupational exposure to long working hours (called Systematic Review 1 in the protocol) and systematically review and meta-analyse estimates of the effect of long working hours on stroke (called Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework, conducting both systematic reviews in tandem and in a harmonized way. DATA SOURCES Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Medline, EMBASE, Web of Science, CISDOC and PsychINFO. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference list of previous systematic reviews and included study records; and consult additional experts. STUDY ELIGIBILITY AND CRITERIA We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. For Systematic Review 1, we will include quantitative prevalence studies of relevant levels of occupational exposure to long working hours (i.e. 35-40, 41-48, 49-54 and ≥55 h/week) stratified by country, sex, age and industrial sector or occupation, in the years 2005-2018. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the relative effect of a relevant level of long working hours on the incidence of or mortality due to stroke, compared with the theoretical minimum risk exposure level (i.e. 35-40 h/week). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration number: CRD42017060124.
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Affiliation(s)
- Alexis Descatha
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), Occupational Health Unit, University Hospital of West Suburb of Paris, Poincaré Site, Garches, France; Versailles St-Quentin Univ - Paris Saclay Univ (UVSQ), UMS 011, UMR-S 1168, France; Inserm, U1168 (VIMA: Aging and chronic diseases. Epidemiological and public health approaches,), UMS 011 (Population-based Epidemiologic Cohorts Unit), Villejuif, France.
| | - Grace Sembajwe
- Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health and Health Policy, CUNY Institute for Implementation Science in Population Health, New York, NY, United States of America.
| | - Michael Baer
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), SAMU92, Poincaré University Hospital, Garches, France.
| | - Fabio Boccuni
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy.
| | - Cristina Di Tecco
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), SAMU92, Poincaré University Hospital, Garches, France.
| | - Clément Duret
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), Occupational Health Unit, Poincaré University Hospital, Garches, France; Versailles St-Quentin Univ - Paris Saclay Univ (UVSQ), France; Inserm, U1168 UMS 011, Villejuif, France
| | - Bradley A Evanoff
- Washington University School of Medicine, St. Louis, MO, United States of America.
| | - Diana Gagliardi
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy.
| | - Ivan D Ivanov
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Nancy Leppink
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Alessandro Marinaccio
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy.
| | | | - Anna Ozguler
- AP-HP (Paris Hospital "Assistance Publique Hôpitaux de Paris"), SAMU92, Poincaré University Hospital, Garches, France; Inserm UMS 011 (Population-based Epidemiologic Cohorts Unit), Villejuif, France.
| | - Frank Pega
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - John Pell
- Hunter College Libraries, Social Work and Public Health Library, New York, NY, United States of America.
| | - Fernando Pico
- Neurology and Stroke Unit, Versailles Hospital, Le Chesnay, France.
| | - Annette Prüss-Üstün
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Matteo Ronchetti
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy.
| | - Yves Roquelaure
- Irset - Inserm UMR 1085 - Equipe Ester, UFR Santé, Département de Médecine, Angers Cedex, France.
| | - Erika Sabbath
- Boston College School of Social Work, Chestnut Hill, MA, United States of America.
| | - Gretchen A Stevens
- Department of Information, Evidence and Research, World Health Organization, Geneva, Switzerland.
| | - Akizumi Tsutsumi
- Kitasato University School of Medicine, Minami, Sagamihara, Japan.
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | - Sergio Iavicoli
- Inail, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Rome, Italy.
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Mandrioli D, Schlünssen V, Ádám B, Cohen RA, Colosio C, Chen W, Fischer A, Godderis L, Göen T, Ivanov ID, Leppink N, Mandic-Rajcevic S, Masci F, Nemery B, Pega F, Prüss-Üstün A, Sgargi D, Ujita Y, van der Mierden S, Zungu M, Scheepers PTJ. WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of occupational exposure to dusts and/or fibres and of the effect of occupational exposure to dusts and/or fibres on pneumoconiosis. ENVIRONMENT INTERNATIONAL 2018; 119:174-185. [PMID: 29958118 DOI: 10.1016/j.envint.2018.06.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 05/20/2018] [Accepted: 06/06/2018] [Indexed: 05/18/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years attributable to pneumoconiosis from occupational exposure to dusts and/or fibres, to inform the development of the WHO/ILO joint methodology. OBJECTIVES We aim to systematically review studies on occupational exposure to dusts and/or fibres (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of occupational exposure to dusts and/or fibres on pneumoconiosis (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework. DATA SOURCES Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, including Medline, EMBASE, Web of Science and CISDOC. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference list of previous systematic reviews and included study records; and consult additional experts. STUDY ELIGIBILITY AND CRITERIA We will include working-age (≥15 years) study participants in the formal and informal economy in any WHO and/or ILO Member State but exclude children (<15 years) and unpaid domestic workers. Eligible risk factors will be dusts and/or fibres from: (i) asbestos; (ii) silica; and/or (iii) coal (defined as pure coal dust and/or dust from coal mining). Included outcomes will be (i) asbestosis; (ii) silicosis; (iii) coal worker pneumoconiosis; and (iv) unspecified pneumoconiosis. For Systematic Review 1, we will include quantitative prevalence studies of occupational exposure to dusts and/or fibres (i.e. no versus any exposure) stratified by country, sex, age and industrial sector or occupation. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of any occupational exposure to dusts and/or fibres on the prevalence of, incidence of or mortality due to pneumoconiosis, compared with the theoretical minimum risk exposure level of no exposure. STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO REGISTRATION NUMBER CRD42018084131.
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Affiliation(s)
- Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bologna, Italy.
| | - Vivi Schlünssen
- Aarhus University, Aarhus, Denmark; National Research Center for the Working Environment, Copenhagen, Denmark.
| | | | - Robert A Cohen
- Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
| | - Claudio Colosio
- Department of Health Sciences, University of Milano, Milano, Italy; International Centre for Rural Health, San Paolo Hospital, Milano, Italy.
| | - Weihong Chen
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | | | | | - Thomas Göen
- University of Erlangen-Nuremberg, Erlangen, Germany.
| | - Ivan D Ivanov
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Nancy Leppink
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | | | - Federica Masci
- Department of Health Sciences, University of Milano, Milano, Italy.
| | | | - Frank Pega
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | - Annette Prüss-Üstün
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, Geneva, Switzerland.
| | | | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland.
| | | | - Muzimkhulu Zungu
- National Institute for Occupational Health, South Africa, Johannesburg, Gauteng Province, South Africa.
| | - Paul T J Scheepers
- Radboud Institute for Health Sciences, Radboudumc, Nijmegen, the Netherlands.
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22
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Li J, Brisson C, Clays E, Ferrario MM, Ivanov ID, Landsbergis P, Leppink N, Pega F, Pikhart H, Prüss-Üstün A, Rugulies R, Schnall PL, Stevens G, Tsutsumi A, Ujita Y, Siegrist J. WHO/ILO work-related burden of disease and injury: Protocol for systematic reviews of exposure to long working hours and of the effect of exposure to long working hours on ischaemic heart disease. ENVIRONMENT INTERNATIONAL 2018; 119:558-569. [PMID: 30125833 DOI: 10.1016/j.envint.2018.06.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 06/18/2018] [Accepted: 06/18/2018] [Indexed: 05/12/2023]
Abstract
BACKGROUND The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years of ischaemic heart disease from exposure to long working hours, to inform the development of the WHO/ILO joint methodology. OBJECTIVES We aim to systematically review studies on occupational exposure to long working hours (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of long working hours on ischaemic heart disease (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework. The selection of both, the exposure and the health outcome is justified by substantial scientific evidence on adverse effects of long working hours on ischaemic heart disease risk. DATA SOURCES Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, Medline, EMBASE, Web of Science, CISDOC and PsychINFO. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference list of previous systematic reviews and included study records; and consult additional experts. STUDY ELIGIBILITY AND CRITERIA We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. For Systematic Review 1, we will include quantitative prevalence studies of relevant levels of exposure to long working hours (i.e. 35-40, 41-48, 49-54 and ≥55 h/week) stratified by country, sex, age and industrial sector or occupation. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the relative effect of relevant level(s) of long working hours on the prevalence of, incidence of or mortality from ischaemic heart disease, compared with the theoretical minimum risk exposure level (i.e. 35-40 h/week). STUDY APPRAISAL AND SYNTHESIS METHODS At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration number: CRD42017084243.
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Affiliation(s)
- Jian Li
- Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstraße 1, Düsseldorf 40225, Germany.
| | - Chantal Brisson
- Centre de Recherche du CHU de Québec, Université Laval, 1050 Chemin Ste-Foy, Quebec City, G1S 4L8, Quebec, Canada.
| | - Els Clays
- Department of Public Health, Ghent University, Campus University Hospital, 4K3, De Pintelaan 185, B-9000 Ghent, Belgium.
| | - Marco M Ferrario
- Research Centre EPIMED, University of Insubria, Via O Rossi 9, 21100 Varese, Italy.
| | - Ivan D Ivanov
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.
| | - Paul Landsbergis
- State University of New York-Downstate School of Public Health, 450 Clarkson Ave., Brooklyn, NY 11238, United States of America.
| | - Nancy Leppink
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Route des Morillons 4, 1211 Geneva, Switzerland.
| | - Frank Pega
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.
| | - Hynek Pikhart
- Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom.
| | - Annette Prüss-Üstün
- Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.
| | - Reiner Rugulies
- National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, DK-1353 Copenhagen, Denmark.
| | - Peter L Schnall
- Center for Occupational and Environmental Health, University of California-Irvine, 100 Theory Way, Irvine, CA, United States of America.
| | - Gretchen Stevens
- Department of Information, Evidence and Research, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.
| | - Akizumi Tsutsumi
- Department of Public Health, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami, Sagamihara 252-0374, Japan.
| | - Yuka Ujita
- Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Route des Morillons 4, 1211 Geneva, Switzerland.
| | - Johannes Siegrist
- Life Science Centre, University of Düsseldorf, Merowingerplatz 1a, Düsseldorf 40225, Germany.
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23
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Perinatal exposures to phthalates and phthalate mixtures result in sex-specific effects on body weight, organ weights and intracisternal A-particle (IAP) DNA methylation in weanling mice. J Dev Orig Health Dis 2018; 10:176-187. [PMID: 29991372 DOI: 10.1017/s2040174418000430] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Developmental exposure to phthalates has been implicated as a risk for obesity; however, epidemiological studies have yielded conflicting results and mechanisms are poorly understood. An additional layer of complexity in epidemiological studies is that humans are exposed to mixtures of many different phthalates. Here, we utilize an established mouse model of perinatal exposure to investigate the effects of three phthalates, diethylhexyl phthalate (DEHP), diisononyl phthalate (DINP) and dibutyl phthalate (DBP), on body weight and organ weights in weanling mice. In addition to individual phthalate exposures, we employed two mixture exposures: DEHP+DINP and DEHP+DINP+DBP. Phthalates were administered through phytoestrogen-free chow at the following exposure levels: 25 mg DEHP/kg chow, 25 mg DBP/kg chow and 75 mg DINP/kg chow. The viable yellow agouti (A vy ) mouse strain, along with measurement of tail DNA methylation, was used as a biosensor to examine effects of phthalates and phthalate mixtures on the DNA methylome. We found that female and male mice perinatally exposed to DINP alone had increased body weights at postnatal day 21 (PND21), and that exposure to mixtures did not exaggerate these effects. Females exposed to DINP and DEHP+DINP had increased relative liver weights at PND21, and females exposed to a mixture of DEHP+DINP+DBP had increased relative gonadal fat weight. Phthalate-exposed A vy /a offspring exhibited altered coat color distributions and altered DNA methylation at intracisternal A-particles (IAPs), repetitive elements in the mouse genome. These findings provide evidence that developmental exposures to phthalates influence body weight and organ weight changes in early life, and are associated with altered DNA methylation at IAPs.
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Martin P, Bladier C, Meek B, Bruyere O, Feinblatt E, Touvier M, Watier L, Makowski D. Weight of Evidence for Hazard Identification: A Critical Review of the Literature. ENVIRONMENTAL HEALTH PERSPECTIVES 2018; 126:076001. [PMID: 30024384 PMCID: PMC6108859 DOI: 10.1289/ehp3067] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 05/22/2018] [Accepted: 05/25/2018] [Indexed: 05/30/2023]
Abstract
BACKGROUND Transparency when documenting and assessing weight of evidence (WOE) has been an area of increasing focus for national and international health agencies. OBJECTIVE The objective of this work was to conduct a critical review of WOE analysis methods as a basis for developing a practical framework for considering and assessing WOE in hazard identification in areas of application at the French Agency for Food, Environmental and Occupational Health and Safety (ANSES). METHODS Based on a review of the literature and directed requests to 63 international and national agencies, 116 relevant articles and guidance documents were selected. The WOE approaches were assessed based on three aspects: the extent of their prescriptive nature, their purpose-specific relevance, and their ease of implementation. RESULTS Twenty-four approaches meeting the specified criteria were identified from selected reviewed documents. Most approaches satisfied one or two of the assessed considerations, but not all three. The approaches were grouped within a practical framework comprising the following four stages: (1) planning the assessment, including scoping, formulating the question, and developing the assessment method; (2) establishing lines of evidence (LOEs), including identifying and selecting studies, assessing their quality, and integrating with studies of similar type; (3) integrating the LOEs to evaluate WOE; and (4) presenting conclusions. DISCUSSION Based on the review, considerations for selecting methods for a wide range of applications are proposed. Priority areas for further development are identified. https://doi.org/10.1289/EHP3067.
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Affiliation(s)
- Pierre Martin
- French Agricultural Research Centre for International Development (CIRAD), Agroecology and sustainable intensification of annual crops (UPR AIDA), Montpellier, France
- AIDA, CIRAD, Montpellier University, Montpellier, France
| | - Claire Bladier
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Maisons-Alfort, France
| | - Bette Meek
- McLaughlin Center for Risk Science, University of Ottawa, Ottawa, Canada
| | - Olivier Bruyere
- WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Aging, Department of Public Health, Epidemiology, and Health Economics, University of Liège, Liège, Belgium
| | - Eve Feinblatt
- French Agency for Food, Environmental and Occupational Health and Safety (ANSES), Maisons-Alfort, France
| | - Mathilde Touvier
- Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and Statistics, Sorbonne Paris Cité (CRESS), Institute for Health and Medical Research (INSERM, U1153), French National Institute of Research for Agriculture (INRA, U1125), National Conservatory of Arts and Crafts (CNAM), Paris University, Bobigny, France
| | - Laurence Watier
- Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), INSERM, UVSQ, Pasteur Institute, University of Paris-Saclay, Paris, France
| | - David Makowski
- UMR Agronomy, INRA, AgroParisTech, University of Paris-Saclay, Thiverval-Grignon, France
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Smirnova L, Kleinstreuer N, Corvi R, Levchenko A, Fitzpatrick SC, Hartung T. 3S - Systematic, systemic, and systems biology and toxicology. ALTEX 2018; 35:139-162. [PMID: 29677694 PMCID: PMC6696989 DOI: 10.14573/altex.1804051] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 04/06/2018] [Indexed: 12/11/2022]
Abstract
A biological system is more than the sum of its parts - it accomplishes many functions via synergy. Deconstructing the system down to the molecular mechanism level necessitates the complement of reconstructing functions on all levels, i.e., in our conceptualization of biology and its perturbations, our experimental models and computer modelling. Toxicology contains the somewhat arbitrary subclass "systemic toxicities"; however, there is no relevant toxic insult or general disease that is not systemic. At least inflammation and repair are involved that require coordinated signaling mechanisms across the organism. However, the more body components involved, the greater the challenge to reca-pitulate such toxicities using non-animal models. Here, the shortcomings of current systemic testing and the development of alternative approaches are summarized. We argue that we need a systematic approach to integrating existing knowledge as exemplified by systematic reviews and other evidence-based approaches. Such knowledge can guide us in modelling these systems using bioengineering and virtual computer models, i.e., via systems biology or systems toxicology approaches. Experimental multi-organ-on-chip and microphysiological systems (MPS) provide a more physiological view of the organism, facilitating more comprehensive coverage of systemic toxicities, i.e., the perturbation on organism level, without using substitute organisms (animals). The next challenge is to establish disease models, i.e., micropathophysiological systems (MPPS), to expand their utility to encompass biomedicine. Combining computational and experimental systems approaches and the chal-lenges of validating them are discussed. The suggested 3S approach promises to leverage 21st century technology and systematic thinking to achieve a paradigm change in studying systemic effects.
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Affiliation(s)
- Lena Smirnova
- Johns Hopkins University, Bloomberg School of Public Health, Center for Alternatives to Animal Testing (CAAT), Baltimore, MD, USA
| | | | - Raffaella Corvi
- European Commission, Joint Research Centre (JRC), EU Reference Laboratory for Alternatives to Animal Testing (EURL ECVAM), Ispra, (VA), Italy
| | - Andre Levchenko
- Yale Systems Biology Institute and Biomedical Engineering Department, Yale University, New Haven, CT, USA
| | - Suzanne C Fitzpatrick
- Food and Drug Administration (FDA), Center for Food Safety and Applied Nutrition, College Park, MD, USA
| | - Thomas Hartung
- Johns Hopkins University, Bloomberg School of Public Health, Center for Alternatives to Animal Testing (CAAT), Baltimore, MD, USA.
- CAAT-Europe, University of Konstanz, Konstanz, Germany
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26
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Malloy T, Zaunbrecher V, Beryt E, Judson R, Tice R, Allard P, Blake A, Cote I, Godwin H, Heine L, Kerzic P, Kostal J, Marchant G, McPartland J, Moran K, Nel A, Ogunseitan O, Rossi M, Thayer K, Tickner J, Whittaker M, Zarker K. Advancing alternatives analysis: The role of predictive toxicology in selecting safer chemical products and processes. INTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT 2017; 13:915-925. [PMID: 28247928 DOI: 10.1002/ieam.1923] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 09/26/2016] [Accepted: 02/07/2017] [Indexed: 05/20/2023]
Abstract
Alternatives analysis (AA) is a method used in regulation and product design to identify, assess, and evaluate the safety and viability of potential substitutes for hazardous chemicals. It requires toxicological data for the existing chemical and potential alternatives. Predictive toxicology uses in silico and in vitro approaches, computational models, and other tools to expedite toxicological data generation in a more cost-effective manner than traditional approaches. The present article briefly reviews the challenges associated with using predictive toxicology in regulatory AA, then presents 4 recommendations for its advancement. It recommends using case studies to advance the integration of predictive toxicology into AA, adopting a stepwise process to employing predictive toxicology in AA beginning with prioritization of chemicals of concern, leveraging existing resources to advance the integration of predictive toxicology into the practice of AA, and supporting transdisciplinary efforts. The further incorporation of predictive toxicology into AA would advance the ability of companies and regulators to select alternatives to harmful ingredients, and potentially increase the use of predictive toxicology in regulation more broadly. Integr Environ Assess Manag 2017;13:915-925. © 2017 SETAC.
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Affiliation(s)
- Timothy Malloy
- School of Law, University of California Los Angeles (UCLA), Los Angeles, California, USA
- Fielding School of Public Health, UCLA, Los Angeles, California, USA
- UC Center for the Environmental Implications of Nanotechnology, UCLA, Los Angeles, California, USA
| | - Virginia Zaunbrecher
- School of Law, University of California Los Angeles (UCLA), Los Angeles, California, USA
- Fielding School of Public Health, UCLA, Los Angeles, California, USA
| | - Elizabeth Beryt
- UC Center for the Environmental Implications of Nanotechnology, UCLA, Los Angeles, California, USA
| | - Richard Judson
- National Center for Computational Toxicology, Research Triangle Park, North Carolina, USA
| | - Raymond Tice
- National Toxicology Program, Durham, North Carolina, USA
| | - Patrick Allard
- Fielding School of Public Health, UCLA, Los Angeles, California, USA
- Institute for Society & Genetics, UCLA, Los Angeles, California, USA
| | - Ann Blake
- Environmental and Public Health Consulting, Alameda, California, USA
| | - Ila Cote
- US Environmental Protection Agency, Washington, DC
| | - Hilary Godwin
- Fielding School of Public Health, UCLA, Los Angeles, California, USA
- UC Center for the Environmental Implications of Nanotechnology, UCLA, Los Angeles, California, USA
| | | | - Patrick Kerzic
- California Department of Toxic Substances Control, Chatsworth, California, USA
| | - Jakub Kostal
- Computational Biology Institute at the George Washington University, Ashburn, Virginia, USA
| | - Gary Marchant
- Sandra Day O'Connor School of Law, Arizona State University, Tempe, Arizona, USA
| | | | - Kelly Moran
- TDC Environmental, San Mateo, California, USA
| | - Andre Nel
- UC Center for the Environmental Implications of Nanotechnology, UCLA, Los Angeles, California, USA
| | - Oladele Ogunseitan
- School of Public Health, University of California Irvine (UCI), Irvine, California, USA
| | - Mark Rossi
- Clean Production Action, Somerville, Massachusetts, USA
| | | | - Joel Tickner
- University of Massachusetts, Lowell, Massachusetts, USA
| | | | - Ken Zarker
- Washington State Department of Ecology, Olympia,, Washington,, USA
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Manservisi F, Marquillas CB, Buscaroli A, Huff J, Lauriola M, Mandrioli D, Manservigi M, Panzacchi S, Silbergeld EK, Belpoggi F. An Integrated Experimental Design for the Assessment of Multiple Toxicological End Points in Rat Bioassays. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:289-295. [PMID: 27448388 PMCID: PMC5332192 DOI: 10.1289/ehp419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 04/27/2016] [Accepted: 06/20/2016] [Indexed: 05/03/2023]
Abstract
BACKGROUND For nearly five decades long-term studies in rodents have been the accepted benchmark for assessing chronic long-term toxic effects, particularly carcinogenicity, of chemicals. The European Food Safety Authority (EFSA) and the World Health Organization (WHO) have pointed out that the current set of internationally utilized test methods capture only some of the potential adverse effects associated with exposures to these agents over the lifetime. OBJECTIVES In this paper, we propose the adaption of the carcinogenicity bioassay to integrate additional protocols for comprehensive long-term toxicity assessment that includes developmental exposures and long-term outcomes, capable of generating information on a broad spectrum of different end points. DISCUSSION An integrated study design based on a stepwise process is described that includes the priority end points of the Economic Co-operation and Development and the National Toxicology Program guidelines on carcinogenicity and chronic toxicity and developmental and reproductive toxicity. Integrating a comprehensive set of relevant toxicological end points in a single protocol represents an opportunity to optimize animal use in accordance with the 3Rs (replacement, reduction and refinement). This strategy has the potential to provide sufficient data on multiple windows of susceptibility of specific interest for risk assessments and public health decision-making by including prenatal, lactational, neonatal exposures and evaluating outcomes over the lifespan. CONCLUSION This integrated study design is efficient in that the same generational cohort of rats used for evaluating long-term outcomes can be monitored in satellite parallel experiments to measure biomarkers and other parameters related to system-specific responses including metabolic alterations and endocrine disturbances. Citation: Manservisi F, Babot Marquillas C, Buscaroli A, Huff J, Lauriola M, Mandrioli D, Manservigi M, Panzacchi S, Silbergeld EK, Belpoggi F. 2017. An integrated experimental design for the assessment of multiple toxicological end points in rat bioassays. Environ Health Perspect 125:289-295; http://dx.doi.org/10.1289/EHP419.
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Affiliation(s)
- Fabiana Manservisi
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bentivoglio, Bologna, Italy
| | - Clara Babot Marquillas
- Leonardo da Vinci Programme at the Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bentivoglio, Bologna, Italy
| | - Annalisa Buscaroli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bentivoglio, Bologna, Italy
| | - James Huff
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA
| | - Michelina Lauriola
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bentivoglio, Bologna, Italy
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bentivoglio, Bologna, Italy
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Marco Manservigi
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bentivoglio, Bologna, Italy
| | - Simona Panzacchi
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bentivoglio, Bologna, Italy
| | - Ellen K. Silbergeld
- Leonardo da Vinci Programme at the Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bentivoglio, Bologna, Italy
| | - Fiorella Belpoggi
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Bentivoglio, Bologna, Italy
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28
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Sass J, Heine L, Hwang N. Use of a modified GreenScreen tool to conduct a screening-level comparative hazard assessment of conventional silver and two forms of nanosilver. Environ Health 2016; 15:105. [PMID: 27825359 PMCID: PMC5101654 DOI: 10.1186/s12940-016-0188-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 10/26/2016] [Indexed: 05/02/2023]
Abstract
BACKGROUND Increased concern for potential health and environmental impacts of chemicals, including nanomaterials, in consumer products is driving demand for greater transparency regarding potential risks. Chemical hazard assessment is a powerful tool to inform product design, development and procurement and has been integrated into alternative assessment frameworks. The extent to which assessment methods originally designed for conventionally-sized materials can be used for nanomaterials, which have size-dependent physical and chemical properties, have not been well established. We contracted with a certified GreenScreen profiler to conduct three GreenScreen hazard assessments, for conventional silver and two forms of nanosilver. The contractor summarized publicly available literature, and used defined GreenScreen hazard criteria and expert judgment to assign and report hazard classification levels, along with indications of confidence in those assignments. Where data were not available, a data gap (DG) was assigned. Using the individual endpoint scores, an aggregated benchmark score (BM) was applied. RESULTS Conventional silver and low-soluble nanosilver were assigned the highest possible hazard score and a silica-silver nanocomposite called AGS-20 could not be scored due to data gaps. AGS-20 is approved for use as antimicrobials by the US Environmental Protection Agency. CONCLUSIONS An existing method for chemical hazard assessment and communication can be used - with minor adaptations- to compare hazards across conventional and nano forms of a substance. The differences in data gaps and in hazard profiles support the argument that each silver form should be considered unique and subjected to hazard assessment to inform regulatory decisions and decisions about product design and development. A critical limitation of hazard assessments for nanomaterials is the lack of nano-specific hazard data - where data are available, we demonstrate that existing hazard assessment systems can work. The work is relevant for risk assessors and regulators. We recommend that regulatory agencies and others require more robust data sets on each novel nanomaterial before granting market approval.
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Affiliation(s)
- Jennifer Sass
- Natural Resources Defense Council and George Washington University Milken Institute School of Public Health, 1152 15th St NW, Suite 300, Washington DC, 20005 USA
| | - Lauren Heine
- Northwest Green Chemistry and Lauren Heine Group LLC, Spokane, WA USA
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Morgan RL, Thayer KA, Bero L, Bruce N, Falck-Ytter Y, Ghersi D, Guyatt G, Hooijmans C, Langendam M, Mandrioli D, Mustafa RA, Rehfuess EA, Rooney AA, Shea B, Silbergeld EK, Sutton P, Wolfe MS, Woodruff TJ, Verbeek JH, Holloway AC, Santesso N, Schünemann HJ. GRADE: Assessing the quality of evidence in environmental and occupational health. ENVIRONMENT INTERNATIONAL 2016; 92-93:611-6. [PMID: 26827182 PMCID: PMC4902742 DOI: 10.1016/j.envint.2016.01.004] [Citation(s) in RCA: 177] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 11/24/2015] [Accepted: 01/10/2016] [Indexed: 05/19/2023]
Abstract
There is high demand in environmental health for adoption of a structured process that evaluates and integrates evidence while making decisions and recommendations transparent. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework holds promise to address this demand. For over a decade, GRADE has been applied successfully to areas of clinical medicine, public health, and health policy, but experience with GRADE in environmental and occupational health is just beginning. Environmental and occupational health questions focus on understanding whether an exposure is a potential health hazard or risk, assessing the exposure to understand the extent and magnitude of risk, and exploring interventions to mitigate exposure or risk. Although GRADE offers many advantages, including its flexibility and methodological rigor, there are features of the different sources of evidence used in environmental and occupational health that will require further consideration to assess the need for method refinement. An issue that requires particular attention is the evaluation and integration of evidence from human, animal, in vitro, and in silico (computer modeling) studies when determining whether an environmental factor represents a potential health hazard or risk. Assessment of the hazard of exposures can produce analyses for use in the GRADE evidence-to-decision (EtD) framework to inform risk-management decisions about removing harmful exposures or mitigating risks. The EtD framework allows for grading the strength of the recommendations based on judgments of the certainty in the evidence (also known as quality of the evidence), as well as other factors that inform recommendations such as social values and preferences, resource implications, and benefits. GRADE represents an untapped opportunity for environmental and occupational health to make evidence-based recommendations in a systematic and transparent manner. The objectives of this article are to provide an overview of GRADE, discuss GRADE's applicability to environmental health, and identify priority areas for method assessment and development.
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Affiliation(s)
- Rebecca L Morgan
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Health Sciences Centre, Room 2C14, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada.
| | - Kristina A Thayer
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, P.O. Box 12233, Mail Drop K2-02, Research Triangle Park, NC 27709, USA.
| | - Lisa Bero
- Charles Perkins Centre, The University of Sydney, D17, The Hub, 6th floor, New South Wales, 2006, Australia.
| | - Nigel Bruce
- Department of Public Health and Policy, University of Liverpool, L69 3GB, United Kingdom.
| | - Yngve Falck-Ytter
- Division of Gastroenterology, Case Western Reserve University and Louis Stokes VA Medical Center, 10701 East Blvd., Cleveland, OH 44106, USA.
| | - Davina Ghersi
- Sydney Medical School, University of Sydney, New South Wales 2006, Australia; National Health and Medical Research Council, 16 Marcus Clarke Street, Canberra City, ACT 2601, Australia.
| | - Gordon Guyatt
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Health Sciences Centre, Room 2C14, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada.
| | - Carlijn Hooijmans
- Departments of SYRCLE and Anesthesiology, Radboud University Medical Centre, Geert Grooteplein-Noord 29, Route 231, 6525 GA Nijmegen, The Netherlands.
| | - Miranda Langendam
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Academic Medical Center, University of Amsterdam, Room J1B-211, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
| | - Daniele Mandrioli
- Cesare Maltoni Cancer Research Center, Ramazzini Institute, Via Saliceto 3, Bentivoglio, Bologna, P.O. Box 40133, Italy.
| | - Reem A Mustafa
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Health Sciences Centre, Room 2C14, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada; Departments of Medicine/Nephrology and Biomedical & Health Informatics, University of Missouri-Kansas City, School of Medicine, M4-303, 2411 Holmes St., Kansas City, Missouri 64108-2792, USA.
| | - Eva A Rehfuess
- Institute for Medical Informatics, Biometry and Epidemiology, University of Munich, Marchioninistr. 15, 81377 Munich, Germany.
| | - Andrew A Rooney
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, P.O. Box 12233, Mail Drop K2-02, Research Triangle Park, NC 27709, USA.
| | - Beverley Shea
- Bruyere Research Institute and Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
| | - Ellen K Silbergeld
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, E6644, Baltimore, MD 21205, USA.
| | - Patrice Sutton
- Program on Reproductive Health and the Environment, University of California-San Francisco, 550 16th Street, San Francisco, CA 94143, USA.
| | - Mary S Wolfe
- Division of the National Toxicology Program, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, P.O. Box 12233, Mail Drop K2-02, Research Triangle Park, NC 27709, USA.
| | - Tracey J Woodruff
- Program on Reproductive Health and the Environment, University of California-San Francisco, 550 16th Street, San Francisco, CA 94143, USA.
| | - Jos H Verbeek
- Finnish Institute of Occupational Health, Cochrane Work, PO Box 310, 70101 Kuopio, Finland.
| | - Alison C Holloway
- Department of Obstetrics and Gynecology, McMaster University, Health Sciences Centre, Room 3N52A, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada.
| | - Nancy Santesso
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Health Sciences Centre, Room 2C14, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada.
| | - Holger J Schünemann
- Department of Clinical Epidemiology & Biostatistics, McMaster University, Health Sciences Centre, Room 2C14, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada; Department of Medicine, McMaster University, Health Sciences Centre, Room 2C14, 1280 Main Street West, Hamilton, ON L8S 4K1, Canada.
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Preconception Care: A New Standard of Care within Maternal Health Services. BIOMED RESEARCH INTERNATIONAL 2016; 2016:6150976. [PMID: 27314031 PMCID: PMC4903143 DOI: 10.1155/2016/6150976] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2015] [Accepted: 04/18/2016] [Indexed: 12/13/2022]
Abstract
Emerging research suggests that much pediatric affliction has origins in the vulnerable phase of fetal development. Prenatal factors including deficiency of various nutrients and exposure to assorted toxicants are major etiological determinants of myriad obstetrical complications, pediatric chronic diseases, and perhaps some genetic mutations. With recent recognition that modifiable environmental determinants, rather than genetic predestination, are the etiological source of most chronic illness, modification of environmental factors prior to conception offers the possibility of precluding various mental and physical health conditions. Environmental and lifestyle modification through informed patient choice is possible but evidence confirms that, with little to no training in clinical nutrition, toxicology, or environmental exposures, most clinicians are ill-equipped to counsel patients about this important area. With the totality of available scientific evidence that now exists on the potential to modify disease-causing gestational determinants, failure to take necessary precautionary action may render members of the medical community collectively and individually culpable for preventable illness in children. We advocate for environmental health education of maternity health professionals and the widespread adoption and implementation of preconception care. This will necessitate the translation of emerging knowledge from recent research literature, to health professionals, to reproductive-aged women, and to society at large.
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Attanasio R. The rise of evidence-based ecotoxicology. INTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT 2016; 12:215. [PMID: 27017839 DOI: 10.1002/ieam.1759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 01/25/2016] [Indexed: 06/05/2023]
Affiliation(s)
- Roberta Attanasio
- Integrated Environmental Assessment and Management, Georgia State University, Atlanta, Georgia, USA
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