Challenges and pitfalls in analyzing, reporting, and interpreting health effects related to occupational and environmental exposures

Occupational and environmental epidemiology play a vital role in efforts to reduce preventable forms of disease and premature mortality worldwide by evaluating disease risk in relation to exposure sources, routes, and levels in a variety of industrial and community settings. There are considerable challenges in measuring these exposures due to wide variations in intensity, frequency, and duration. Because exposure levels and conditions often vary by site, comparing results across studies is also difficult. In this paper, we address these challenges and provide suggestions pertaining to the design, analysis, and reporting of individual studies as well as systemic reviews and meta-analyses. Key recommendations include reporting specific exposure levels within a study population and including quantitative bias assessment to address the impact of exposure measurement error on results within and across studies. These recommendations can improve the reporting quality and utility of occupational and environmental epidemiology, thereby strengthening its role in risk assessment.