Review Advance Publication
The Navigation Guide—Evidence-Based Medicine Meets Environmental Health: Systematic Review of Nonhuman Evidence for PFOA Effects on Fetal Growth
This EHP Advance Publication article has been peer-reviewed, revised, and accepted for publication. EHP Advance Publication articles are completely citable using the DOI number assigned to the article. This document will be replaced with the copyedited and formatted version as soon as it is available. Through the DOI number used in the citation, you will be able to access this document at each stage of the publication process.
Citation: Koustas E, Lam J, Sutton P, Johnson PI, Atchley DS, Sen S, Robinson KA, Axelrad DA, Woodruff TJ. The Navigation Guide—Evidence-Based Medicine Meets Environmental Health: Systematic Review of Nonhuman Evidence for PFOA Effects on Fetal Growth. Environ Health Perspect; http://dx.doi.org/10.1289/ehp.1307177.
Received: 4 June 2013
Accepted: 23 April 2014
Advance Publication: 25 June 2014
For materials with complex tables, EHP offers “Alt 508″ versions optimized for use with screen-reading software.
Background: In contrast to current methods of “expert-based narrative review”, the Navigation Guide is a systematic and transparent method for synthesizing environmental health research from multiple evidence streams. The Navigation Guide was developed to effectively and efficiently translate the available scientific evidence into timely prevention-oriented action.
Objectives: Apply the Navigation Guide systematic review method to answer the question: “Does fetal developmental exposure to perfluorooctanoic acid (PFOA) or its salts affect fetal growth in animals,” and rate the strength of the experimental animal evidence.
Methods: We conducted a comprehensive search of the literature, applied pre-specified criteria to the search results to identify relevant studies, extracted data from studies, obtained additional information from study authors, conducted meta-analyses, and rated the overall quality and the strength of the evidence.
Results: Twenty-one studies met the inclusion criteria. From the meta-analysis of eight mouse gavage datasets, we estimated that exposure of pregnant mice to increasing concentrations of PFOA was associated with a decrease in mean pup birth weight of -0.023g (95% CI: -0.029, -0.016) per 1-unit increase in dose (mg/kg BW/day). The evidence, consisting of 15 mammalian and 6 non-mammalian studies, was rated as ‘moderate’ and ‘low’ quality, respectively.
Conclusion: Based on this first application of the Navigation Guide methodology, we found ‘sufficient’ evidence that fetal developmental exposure to PFOA reduces fetal growth in animals.
CEHN July 2014 Article of the Month
“Outdoor Formaldehyde and NO2 Exposures and Markers of Genotoxicity in Children Living Near Chipboard Industries” (Environ Health Perspect; DOI:10.1289/ehp.1307259) has been selected by the Children’s Environmental Health Network (CEHN) as its July 2014 Article of the Month. These CEHN summaries discuss the potential policy implications of current children’s environmental health research.
Sign Up to Receive E-mail Alerts
Recent Advance Publications
- Prenatal Organochlorine and Methylmercury Exposure and Memory and Learning in School-Age Children in Communities Near the New Bedford Harbor Superfund Site, Massachusetts
- Ligand Binding and Activation of PPARγ by Firemaster® 550: Effects on Adipogenesis and Osteogenesis in Vitro
- Effects of Developmental Activation of the AhR on CD4+ T-Cell Responses to Influenza Virus Infection in Adult Mice
- Prenatal and Postnatal Serum PCB Concentrations and Cochlear Function in Children at 45 Months of Age
- Variability in Temperature-Related Mortality Projections under Climate Change
- Environmental Health Research Recommendations from the Inter-Environmental Health Sciences Core Center Working Group on Unconventional Natural Gas Drilling Operations
- Residential Greenness and Birth Outcomes: Evaluating the Influence of Spatially Correlated Built-Environment Factors
- Trending EHP news this week: Rethinking sterile: the hospital microbiome http://t.co/AU6rVNREbi
- Trending EHP research this week: Neurodevelopmental disorders and residential proximity to agricultural pesticides http://t.co/WimjcXekOm
- AdvPubl: Prenatal neurotoxicant exposure and childhood memory http://t.co/dVAZcudE1Q
- AdvPubl: Flame retardant effects on adipogenesis and osteogenesis in vitro http://t.co/9NAwruoPAx
- EHPNoonNews: If it's raining, NYC's raw sewage is probably pouring into waterways http://t.co/tJJxBEM8xF @newsweek