ABSTRACT
Systematic review (SR) is a rigorous methodology applied to synthesize and evaluate a body of scientific evidence to answer a research or policy question. Effective use of systematic-review methodology enables use of research evidence by decision makers. In addition, as reliance on systematic reviews increases, the required standards for quality of evidence enhances the policy relevance of research. Authoritative guidance has been developed for use of SR to evaluate evidence in the fields of medicine, social science, environmental epidemiology, toxicology, as well as ecology and evolutionary biology. In these fields, SR is typically used to evaluate a cause-effect relationship, such as the effect of an intervention, procedure, therapy, or exposure on an outcome. However, SR is emerging to be a useful methodology to transparently review and integrate evidence for a wider range of scientifically informed decisions and actions across disciplines. As SR is being used more broadly, there is growing consensus for developing resources, guidelines, ontologies, and technology to make SR more efficient and transparent, especially for handling large amounts of diverse data being generated across multiple scientific disciplines. In this article, we advocate for advancing SR methodology as a best practice in the field of exposure science to synthesize exposure evidence and enhance the value of exposure studies. We discuss available standards and tools that can be applied and extended by exposure scientists and highlight early examples of SRs being developed to address exposure research questions. Finally, we invite the exposure science community to engage in further development of standards and guidance to grow application of SR in this field and expand the opportunities for exposure science to inform environment and public health decision making.
Subject(s)
Environmental Health , Systematic Reviews as Topic , Decision Making , Ecology , Humans , Public HealthABSTRACT
Environmental lead (Pb) contamination is a persistent public health issue that prominently impacts communities across the United States. Multimedia Pb exposure assessments are utilized to provide a holistic evaluation of Pb exposure and inform the development of programs and regulations that are protective of human health. To conduct multimedia exposure assessments, robust, media-specific environmental Pb concentration data are necessary. To support this effort, systematic review and meta-analysis methods were used to conduct a comprehensive synthesis of research measuring Pb in multiple environmental media (soil, dust, water, food, and air) over a 20-year period within the United States. The breadth of the resulting database allowed for the evaluation of sample characteristics that can serve as indicators of environmental Pb contamination. Random effects models run on literature and national survey datasets generated overall mean estimates of Pb concentrations that can be used for multimedia Pb exposure modeling for general and high-exposure-risk populations. Results from our study highlighted several important trends: 1) The mean estimate of Pb in residential soils is three times higher for urbanized areas than non-urbanized areas; 2) The mean estimate of Pb in produce reported in the literature is approximately three orders of magnitude greater than commercially-sourced raw produce monitored in national surveys; 3) The mean estimate of Pb in soils from shooting ranges is two times greater than non-residential Pb contaminated Superfund sites reported in the literature; 4) Research reporting environmental Pb concentrations for school and daycare sites is very limited; 5) Inconsistent sample collection and reporting of results limited synthesis efforts; and 6) The U.S. EPA's Air Quality System was the most robust, publicly available national survey resource. Results from these analyses will inform future multimedia Pb exposure assessments and be useful in prioritizing future research and program development.
