Towards a framework for systematic reviews of the prevalence of exposure to environmental and occupational risk factors
Abstract Exposure prevalence studies (as here defined) record the prevalence of exposure to environmental and occupational risk factors to human health. Applying systematic review methods to the synthesis of these studies would improve the rigour and transparency of normative products produced based...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | Environmental Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12940-022-00878-4 |
| _version_ | 1811323683107504128 |
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| author | Frank Pega Natalie C. Momen Lisa Bero Paul Whaley |
| author_facet | Frank Pega Natalie C. Momen Lisa Bero Paul Whaley |
| author_sort | Frank Pega |
| collection | DOAJ |
| description | Abstract Exposure prevalence studies (as here defined) record the prevalence of exposure to environmental and occupational risk factors to human health. Applying systematic review methods to the synthesis of these studies would improve the rigour and transparency of normative products produced based on this evidence (e.g., exposure prevalence estimates). However, a dedicated framework, including standard methods and tools, for systematically reviewing exposure prevalence studies has yet to be created. We describe the need for this framework and progress made towards it through a series of such systematic reviews that the World Health Organization and the International Labour Organization conducted for their WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury (WHO/ILO Joint Estimates). We explain that existing systematic review frameworks for environmental and occupational health cannot be directly applied for the generation of exposure prevalence estimates because they seek to synthesise different types of evidence (e.g., intervention or exposure effects on health) for different purposes (e.g., identify intervention effectiveness or exposure toxicity or carcinogenicity). Concepts unique to exposure prevalence studies (e.g., “expected heterogeneity”: the real, non-spurious variability in exposure prevalence due to exposure changes over space and/or time) also require new assessment methods. A framework for systematic reviews of prevalence of environmental and occupational exposures requires adaptation of existing methods (e.g., a standard protocol) and development of new tools or approaches (e.g., for assessing risk of bias and certainty of a body of evidence, including exploration of expected heterogeneity). As part of the series of systematic reviews for the WHO/ILO Joint Estimates, the World Health Organization collaborating with partners has created a preliminary framework for systematic reviews of prevalence studies of exposures to occupational risk factors. This included development of protocol templates, data extraction templates, a risk of bias assessment tool, and an approach for assessing certainty of evidence in these studies. Further attention and efforts are warranted from scientific and policy communities, especially exposure scientists and policy makers, to establish a standard framework for comprehensive and transparent systematic reviews of studies estimating prevalence of exposure to environmental and occupational risk factors, to improve estimates, risk assessments and guidelines. |
| first_indexed | 2024-04-13T13:59:31Z |
| format | Article |
| id | doaj.art-3187e54f4f854492a616a9ad86d23d81 |
| institution | Directory Open Access Journal |
| issn | 1476-069X |
| language | English |
| last_indexed | 2024-04-13T13:59:31Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Environmental Health |
| spelling | doaj.art-3187e54f4f854492a616a9ad86d23d812022-12-22T02:44:05ZengBMCEnvironmental Health1476-069X2022-07-012111710.1186/s12940-022-00878-4Towards a framework for systematic reviews of the prevalence of exposure to environmental and occupational risk factorsFrank Pega0Natalie C. Momen1Lisa Bero2Paul Whaley3Department of Environment, Climate Change and Health, World Health OrganizationDepartment of Environment, Climate Change and Health, World Health OrganizationGeneral Internal Medicine/Public Health/Center for Bioethics and Humanities, University of Colorado—Anschutz Medical CampusLancaster Environment Center, Lancaster UniversityAbstract Exposure prevalence studies (as here defined) record the prevalence of exposure to environmental and occupational risk factors to human health. Applying systematic review methods to the synthesis of these studies would improve the rigour and transparency of normative products produced based on this evidence (e.g., exposure prevalence estimates). However, a dedicated framework, including standard methods and tools, for systematically reviewing exposure prevalence studies has yet to be created. We describe the need for this framework and progress made towards it through a series of such systematic reviews that the World Health Organization and the International Labour Organization conducted for their WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury (WHO/ILO Joint Estimates). We explain that existing systematic review frameworks for environmental and occupational health cannot be directly applied for the generation of exposure prevalence estimates because they seek to synthesise different types of evidence (e.g., intervention or exposure effects on health) for different purposes (e.g., identify intervention effectiveness or exposure toxicity or carcinogenicity). Concepts unique to exposure prevalence studies (e.g., “expected heterogeneity”: the real, non-spurious variability in exposure prevalence due to exposure changes over space and/or time) also require new assessment methods. A framework for systematic reviews of prevalence of environmental and occupational exposures requires adaptation of existing methods (e.g., a standard protocol) and development of new tools or approaches (e.g., for assessing risk of bias and certainty of a body of evidence, including exploration of expected heterogeneity). As part of the series of systematic reviews for the WHO/ILO Joint Estimates, the World Health Organization collaborating with partners has created a preliminary framework for systematic reviews of prevalence studies of exposures to occupational risk factors. This included development of protocol templates, data extraction templates, a risk of bias assessment tool, and an approach for assessing certainty of evidence in these studies. Further attention and efforts are warranted from scientific and policy communities, especially exposure scientists and policy makers, to establish a standard framework for comprehensive and transparent systematic reviews of studies estimating prevalence of exposure to environmental and occupational risk factors, to improve estimates, risk assessments and guidelines.https://doi.org/10.1186/s12940-022-00878-4Systematic reviewsSystematic review methodsPrevalenceExposuresEnvironmental healthOccupational health |
| spellingShingle | Frank Pega Natalie C. Momen Lisa Bero Paul Whaley Towards a framework for systematic reviews of the prevalence of exposure to environmental and occupational risk factors Environmental Health Systematic reviews Systematic review methods Prevalence Exposures Environmental health Occupational health |
| title | Towards a framework for systematic reviews of the prevalence of exposure to environmental and occupational risk factors |
| title_full | Towards a framework for systematic reviews of the prevalence of exposure to environmental and occupational risk factors |
| title_fullStr | Towards a framework for systematic reviews of the prevalence of exposure to environmental and occupational risk factors |
| title_full_unstemmed | Towards a framework for systematic reviews of the prevalence of exposure to environmental and occupational risk factors |
| title_short | Towards a framework for systematic reviews of the prevalence of exposure to environmental and occupational risk factors |
| title_sort | towards a framework for systematic reviews of the prevalence of exposure to environmental and occupational risk factors |
| topic | Systematic reviews Systematic review methods Prevalence Exposures Environmental health Occupational health |
| url | https://doi.org/10.1186/s12940-022-00878-4 |
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