1 Departments of Environmental and Occupational Health Sciences, Medicine & Epidemiology, University of Washington , Seattle, Washington, USA.
2 Department of Community and Environmental Health, Boise State University , Boise, Idaho, USA.
Environ Health Perspect. 2019 Apr;127(4):45001. doi: 10.1289/EHP4067.
Environmental health scientists may find it challenging to fit the structure of the questions addressed in their discipline into the prevailing paradigm for translational research.
We aim to frame the translational science paradigm to address the stages of scientific discovery, knowledge acquisition, policy development, and evaluation in a manner relevant to the environmental health sciences. Our intention is to characterize differences between environmental health sciences and clinical medicine, and to orient this effort towards public health goals.
Translational research is usually understood to have evolved from the bench-to-bedside framework by which basic science transitions to clinical treatment. Although many health-related fields have incorporated the terminology and context of translational science, environmental health research has not always found a clear fit into this paradigm. We describe a translational research framework applicable to environmental health sciences that retains the basic structure that underlies the original bench-to-bedside paradigm. We propose that scientific discovery (T1) in environmental health research frequently occurs through epidemiological or clinical observations. This discovery often involves understanding the potential for human health effects of exposure to a given environmental chemical or chemicals. The practical applications of this discovery evolve through an understanding of exposure-response relationships (T2) and identification of potential interventions to reduce exposure and improve health (T3). These stages of translation require an interdisciplinary partnership between exposure sciences, exposure biology, toxicology, epidemiology, biostatistics, risk assessment, and clinical sciences. Implementation science then plays a crucial role in the development of environmental and public health practice and policy interventions (T4). Outcome evaluation (T5) often takes the form of accountability research, as environmental health scientists work to quantify the costs and benefits of these interventions.
We propose an easily visualized framework for translation of environmental health science knowledge-from discovery to public health practice-that reflects the crucial interactions between multiple disciplines in our field. https://doi.org/10.1289/EHP4067.
环境健康科学家可能会发现,将他们学科中所研究问题的结构纳入到当前流行的转化研究范式中颇具挑战性。
我们旨在构建转化科学范式,以解决与环境健康科学相关的科学发现、知识获取、政策制定和评估等各个阶段的问题。我们的目的是描述环境健康科学与临床医学之间的差异,并将这一努力定位为公共卫生目标。
转化研究通常被理解为由基础科学向临床治疗转变的“从实验室到病床”的框架演变而来。尽管许多与健康相关的领域已经采用了转化科学的术语和背景,但环境健康研究并不总是能清晰地融入这一范式。我们描述了一个适用于环境健康科学的转化研究框架,保留了原始“从实验室到病床”范式的基本结构。我们提出,环境健康研究中的科学发现(T1)通常通过流行病学或临床观察来实现。这种发现通常涉及到理解暴露于特定环境化学物质或化学物质对人类健康的潜在影响。对这一发现的实际应用则通过对暴露-反应关系(T2)的理解以及确定潜在干预措施来减少暴露和改善健康(T3)而不断发展。这些转化阶段需要暴露科学、暴露生物学、毒理学、流行病学、生物统计学、风险评估和临床科学等多学科的合作。然后,实施科学在制定环境和公共卫生实践和政策干预措施(T4)方面发挥着至关重要的作用。结果评估(T5)通常采取问责制研究的形式,因为环境健康科学家致力于量化这些干预措施的成本和效益。
我们提出了一个易于可视化的环境健康科学知识转化框架,从发现到公共卫生实践,反映了我们领域中多个学科之间的关键相互作用。https://doi.org/10.1289/EHP4067.