Exposure-response functions protocol

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The text on this page is taken from an equivalent page of the IEHIAS-project.

As part of the EU-funded INTARESE project, which contributed to the development of this Toolbox, a protocol was devised giving guidance on how to derive exposure-response functions for use in health impact assessments. This protocol is recommended as a starting point for anyone planning to develop ERFs or to use functions developed by other researchers.

The protocol sets out two main approaches for deriving exposure-response functions (ERFs):

  • a systematic review of existing studies, aimed at deriving a best-estimate of the 'average' function, allowing for differences in study design and methodology;
  • an expert panel, aimed at achieving a consensus on the approximate level (and.or range) for the function, in the light of the available knowledge;
Key steps in the two approaches summarised
Step Systematic review Expert panel
1 Formulate review question Formulate aims of panel
2 Define inclusion/exclusion criteria Develop questions of interest
3 Specify 'location' of studies to be considered (and search methods) Identify and select experts
4 Select studies for review Develop calibration questions
5 Assess quality of studies Develop elicitation protocol
6 Extract data Training session
7 Analyse results Expert elicitation session
8 Interpret findings Analyse expert data
9  Robustness and discrepancy analysis

The protocol outlines the issues and criteria that need to be considered at each stage and summarises the methods that can be used. Methods for identifying and controlling the uncertainties inherent in the different approaches top ERF development are also presented. In addition, it outlines how data from animal and other toxicological studies can be used as a basis for deriving ERFs, and summarises some of the issues that arise.

A set of exposure-response functions developed on the basis of these guidelines is also available (see link below)

The attached document was compiled as part of the EU-funded INTARESE project, which contributed ot the development of this Toolbox. It sets out a general methodology for estimating exposure-response functions (ERFS), in the context of intergrated environmental health impact assessment. It defines principles for selecting exposure-response relationships for quantification, reviews methods for deriving exposure-response functions (including techniques of systematic review and expert elicitation), outlines methods for characterising uncertainties in ERFs, and discusses approaches for combining epidemiologically- and toxicolologically-based information where needed.

See also