Abstract
In 2011, World Health Organization (WHO) scientists reported that a significant percentage of global deaths and disability-adjusted life years (DALYs) in 2004 could be attributed to chemicals. The 2011 review focused only on certain chemicals, however, and concluded that the global burden of disease was underestimated because of serious data gaps. While various chemical assessment documents have identified research needs for individual chemicals, a systematic review of such documents to identify research themes that could be applied to the multitude of chemicals for which there is little information has not been done. Even for chemicals for which there are considerable data, the information is not sufficient to make an estimate of the chemical’s contribution to the burden of disease. The WHO Environmental Health Criteria (EHC) documents and Concise International Chemical Assessment Documents (CICADs) identify research needs or data gaps in our knowledge of chemicals. We identified several common themes in these documents and in documents prepared by WHO on 10 chemicals of major public health concern. These themes include biomarkers, longitudinal epidemiological studies, mechanisms of disease, reproductive and developmental effects and exposure assessment. Specific examples of data gaps culled from more than 300 WHO documents provide researchers with specific topics for further research.
Highlights
Prüss-Ustün et al estimated that in 2004, 4.9 million deaths (8.3% of deaths worldwide) and 86 million disability-adjusted life years (5.7% of DALYs worldwide) could be attributed to selected chemicals [1]
The purpose of the current review is to identify common research themes
The World Health Organization (WHO) documents included in this review are Environmental Health Criteria (EHC) documents [4], Concise International Chemical Assessment Documents (CICADs) [5], and WHO documents on
Summary
Prüss-Ustün et al estimated that in 2004, 4.9 million deaths (8.3% of deaths worldwide) and 86 million disability-adjusted life years (5.7% of DALYs worldwide) could be attributed to selected chemicals [1]. The authors conclude, that even these estimates significantly underestimate the real burden of disease due to chemicals [1]. Two reasons cited by Prüss-Ustün et al for the underestimation are (1) the lack of exposure–response relationships for many chemicals and (2) the lack of exposure data [1]. Even for chemicals with health consequences supported by strong evidence of causality, there are significant knowledge gaps. Prüss-Ustün et al analysis because of limited data include mercury, dioxins, organic chlorinated solvents, polychlorinated biphenyls (PCBs), and chronic pesticide exposures [2].
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