O-109 Status of knowledge and gaps in associations between occupational exposures and their health effects: inform priority setting

Objective

Within the framework of the Exposome Project for Health and Occupational Research (EPHOR), we aimed to provide an overview of knowledge gaps in the associations between occupational exposures and their health effects across multiple health outcomes.

Methods

We conducted a narrative umbrella review of occupational risk factors that can be considered established (sufficient evidence) and suspected (with limited, insufficient or inconsistent evidence) for six main non-communicable disease (NCD) groups: non-malignant respiratory diseases; cancer; neurodegenerative diseases; cardiovascular and metabolic diseases; mental diseases; and musculoskeletal disorders. For each NCD-group, a working group was formed where the literature searches were coordinated and findings discussed. Regular meetings between working group leaders were held to align efforts. The narrative review was mainly based on systematic reviews and authoratitive reports supplemented with narrative reviews, reports and original studies as appropriate. The status of knowledge was summarized in tables and heatmaps. We further identified knowledge gaps, e.g., based on missing information on exposure-response relationships, gender differences, critical time windows, multiple exposures, as well as inadequate study quality.

Results

We identified over 200 occupational exposures with suspected or established associations to common NCDs. Various exposures were identified as possible risk factors for multiple outcomes, including diesel engine exhaust, silica, cadmium and shift work. Potential areas for future research have been identified considering an exposome research context. For suspected associations, conclusive evidence would be needed, while for established risk factors improvements in case definition, as well as quality of exposure assessment and study design could lead to better understanding of the association.

Conclusion

By providing an overview of knowledge gaps in the associations between occupational exposures and their health effects, our narrative review helps to set priorities in exposome-based occupational health research.