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.

中文翻译：

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建立系统评价环境和职业风险因素暴露流行率的框架

暴露流行率研究（如本文定义）记录暴露于环境和职业风险因素对人类健康的流行率。将系统评价方法应用于这些研究的综合将提高基于这些证据（例如，暴露流行率估计）生产的规范产品的严谨性和透明度。然而，尚未建立一个专门的框架，包括标准方法和工具，用于系统地审查暴露流行率研究。我们通过世界卫生组织和国际劳工组织为世卫组织/国际劳工组织对与工作相关的疾病和伤害负担的联合估计（WHO/国际劳工组织联合估计）。我们解释说，现有的环境和职业健康系统评价框架不能直接应用于产生暴露流行率估计，因为它们试图综合不同类型的证据（例如，干预或暴露对健康的影响）用于不同目的（例如，确定干预有效性或暴露毒性或致癌性）。暴露流行率研究特有的概念（例如，“预期的异质性”：暴露流行率因空间和/或时间的变化而产生的真实的、非虚假的变异性）也需要新的评估方法。对环境和职业暴露流行率进行系统评价的框架需要对现有方法（例如，标准方案）进行调整，并开发新的工具或方法（例如，用于评估偏倚风险和证据的确定性，包括探索预期的异质性）。作为世卫组织/国际劳工组织联合估计的系统审查系列的一部分，世界卫生组织与合作伙伴合作创建了一个初步框架，用于系统审查职业风险因素暴露的流行率研究。这包括开发方案模板、数据提取模板、偏倚风险评估工具以及评估这些研究中证据确定性的方法。科学界和政策界，尤其是曝光科学家和政策制定者，需要进一步关注和努力，