Implementing systematic review techniques in chemical risk assessment: Challenges, opportunities and recommendations.

Systematic review (SR) is a rigorous, protocol-driven approach designed to minimise error and bias when summarising the body of research evidence relevant to a specific scientific question. Taking as a comparator the use of SR in synthesising research in healthcare, we argue that SR methods could also pave the way for a "step change" in the transparency, objectivity and communication of chemical risk assessments (CRA) in Europe and elsewhere. We suggest that current controversies around the safety of certain chemicals are partly due to limitations in current CRA procedures which have contributed to ambiguity about the health risks posed by these substances.

Meta-analysis on occupational exposure to pesticides--neurobehavioral impact and dose-response relationships.

While the health impact of high exposures to pesticides is acknowledged, the impact of chronic exposures in the absence of acute poisonings is controversial. A systematic analysis of dose-response relationships is still missing. Its absence may provoke alternative explanations for altered performances.

Toward better research practice--shortcomings decreasing the significance of epidemiological studies in the toxicological field.

Neurobehavioral studies do not always gain the impact they should have, neither in the scientific nor in the regulatory field of neurotoxicology. Among others, shortcomings and inconsistencies across epidemiological studies may contribute to this situation. Examples were compiled to increase awareness of obstacles for conclusions.

The neurobehavioral impact of manganese: results and challenges obtained by a meta-analysis of individual participant data.

Results from a meta-analysis of aggregated data provoked a new analysis using individual data on the neuropsychological performance of occupationally exposed workers. Data from eight studies examining 579 exposed and 433 reference participants were included, 28 performance variables analyzed. The performance scores were adjusted for well-known individual-level covariates; the influence of possible, but unknown study-level covariates was attenuated by means of a z-normalization.

Occupational exposure to neurotoxic substances in Asian countries - challenges and approaches.

The fact that a conference on neurotoxicity was held in China triggered the idea to provide an insight into occupational diseases, their development and the approaches to investigate them in Asian countries. A historical review, a meta-analysis, and studies on humans and animals provide impressions on past and current problems. The Korean example showed that each newly introduced industry is accompanied by its own problems as regards occupational diseases.

Statistical means to enhance the comparability of data within a pooled analysis of individual data in neurobehavioral toxicology.

Meta-analyses of individual participant data (IPD) provide important contributions to toxicological risk assessments. However, comparability of individual data cannot be taken for granted when information from different studies has to be summarized. By means of statistical standardization approaches the comparability of data might be increased.

Performance alterations associated with occupational exposure to manganese--a meta-analysis.

The review aimed at quantifying the evidence of performance effects resulting from occupational exposure to manganese. Epidemiological studies published between 1987 and 2008 were analyzed. The approach was based on the meta-analytical method of effect size estimates and sought to contribute to the following issues: (1) identification of the affected functions; (2) identification of sensitive neuropsychological tests; (3) analyses of exposure-effect relationships.

The impact of solvent mixtures on neurobehavioral performance: conclusions from epidemiological data.

The review of epidemiological studies investigating the neurobehavioral effects of occupational exposure to solvent mixtures sought to contribute to the following issues: (1) Identification of affected cognitive and motor functions. (2) Identification of sensitive neuropsychological tests. (3) Analysis of exposure-effect relationships.

Occupational aluminum exposure: evidence in support of its neurobehavioral impact.

Aluminum is a metal with known neurotoxic properties which are linked to encephalopathy and neurodegenerative diseases. The objectives of the current meta-analysis study were: (1) to summarize neurobehavioral data obtained by epidemiological studies in occupational settings and (2) to analyze confounding within these data. The meta-analysis was based on estimates of effect sizes.

A meta-analytical approach to neurobehavioural effects of occupational toluene exposure.

Twenty-two studies investigating neurobehavioural effects of toluene were reviewed. Repeatedly applied neuropsychological performance tests and appropriately documented results allowed to include 10 of the studies into a meta-analysis based on effect sizes. Mean exposure level of the studies was 57ppm (range 20-117ppm) toluene.

Impairments of colour vision induced by organic solvents: a meta-analysis study.

The impairment of colour discrimination induced by occupational exposure to toluene, styrene and mixtures of organic solvents is reviewed and analysed using a meta-analytical approach. Thirty-nine studies were surveyed covering a wide range of exposure conditions. Those studies using the Lanthony Panel D-15 desaturated test (D-15d) were further considered.

Neurobehavioural test results and exposure to inorganic mercury: in search of dose-response relations.

The aim of the analysis was, in general, to find a way to summarise results of studies in search of exposure-response relationships and, in particular, to ask whether an exposure-response relationship can be ascertained for neurobehavioural studies on occupational mercury exposure. Eighteen studies dealing with human mercury exposure and examining 1,106 exposed and 1,105 control subjects were included in the analysis. Effect sizes were calculated for each of the single neuropsychological test results on cognitive and motor performance and were considered in relation to mean current concentrations of exposure.

A summary of two meta-analyses on neurobehavioural effects due to occupational lead exposure.

The conclusions from published results about neurotoxic effects of inorganic lead exposures <700 microg lead/l blood are contradictory at present. Effects measured by neurobehavioural methods are evaluated differently as far as recommendations for a Biological Exposure Index (BEI) of occupational lead exposure are concerned. Arguments against the German BEI of 400 microg/l were put forward in new publications, and discussion of the issues is the aim of this article.

A meta-analysis for neurobehavioural results due to occupational mercury exposure.

A meta-analysis for neurobehavioural test results of subjects occupationally exposed to mercury was carried out in order to find general tendencies and express possible deficits numerically. Out of 44 studies investigating neurobehavioural functions of occupationally exposed individuals, 12 studies provided the data required and were included in the analysis. In all, 14 neuropsychological tests with 20 different tasks were analysed.