Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, United States.
Program on Reproductive Health and the Environment, Department of OB/GYN & RS, University of California, San Francisco, United States.
Environ Int. 2016 Jul-Aug;92-93:647-56. doi: 10.1016/j.envint.2016.02.016. Epub 2016 Feb 28.
Systematic review and meta-analysis (SRMA) are increasingly employed in environmental health (EH) epidemiology and, provided methods and reporting are sound, contribute to translating science evidence to policy. Ambient air pollution (AAP) is both among the leading environmental causes of mortality and morbidity worldwide, and of growing policy relevance due to health co-benefits associated with greenhouse gas emissions reductions.
We reviewed the published AAP SRMA literature (2009 to mid-2015), and evaluated the consistency of methods, reporting and evidence evaluation using a 22-point questionnaire developed from available best-practice consensus guidelines and emerging recommendations for EH. Our goal was to contribute to enhancing the utility of AAP SRMAs to EH policy.
We identified 43 studies that used both SR and MA techniques to examine associations between the AAPs PM2.5, PM10, NO2, SO2, CO and O3, and various health outcomes. On average AAP SRMAs partially or thoroughly addressed 16 of 22 questions (range 10-21), and thoroughly addressed 13 of 22 (range 5-19). We found evidence of an improving trend over the period. However, we observed some weaknesses, particularly infrequent formal reviews of underlying study quality and risk-of-bias that correlated with lower frequency of thorough evaluation for key study quality parameters. Several other areas for enhanced reporting are highlighted.
The AAP SRMA literature, in particular more recent studies, indicate broad concordance with current and emerging best practice guidance. Development of an EH-specific SRMA consensus statement including a risk-of-bias evaluation tool, would be a contribution to enhanced reliability and robustness as well as policy utility.
系统评价和荟萃分析（SRMA）越来越多地应用于环境卫生（EH）流行病学领域，只要方法和报告合理，就有助于将科学证据转化为政策。环境空气污染（AAP）是全球导致死亡和发病的主要环境原因之一，由于与温室气体减排相关的健康共同效益，其政策相关性也日益增加。
我们对已发表的 AAP SRMA 文献（2009 年至 2015 年年中）进行了综述，并使用从现有最佳实践共识指南和新兴 EH 建议中开发的 22 点问卷，评估了方法、报告和证据评估的一致性。我们的目标是为提高 AAP SRMA 在 EH 政策中的实用性做出贡献。
我们确定了 43 项研究，这些研究都使用了 SR 和 MA 技术来研究 AAPs（PM2.5、PM10、NO2、SO2、CO 和 O3）与各种健康结果之间的关系。平均而言，AAP SRMA 部分或全面回答了 22 个问题中的 16 个（范围 10-21），并全面回答了 22 个问题中的 13 个（范围 5-19）。我们发现这一趋势在这一时期有所改善。然而，我们也观察到了一些不足之处，特别是对基础研究质量和风险偏倚的正式审查不频繁，这与对关键研究质量参数进行全面评估的频率较低有关。还突出了其他一些需要改进报告的领域。
AAP SRMA 文献，尤其是最近的研究，表明与当前和新兴的最佳实践指南有广泛的一致性。制定包括风险偏倚评估工具在内的 EH 特定的 SRMA 共识声明将有助于提高可靠性和稳健性以及政策实用性。
