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By Dina Beverly

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25 26 IDENTIFYING THE PROBLEM For scenario 2 style reviews, a particularly useful type of grey literature can be reports from working parties of official bodies. These reports often list the topics the experts jointly believe to be important. Such lists make useful checklists to ensure all suggested outcomes have been identified. An example of this is the WHO briefing reflecting several Expert Committee meetings which listed all relevant effects (WHO, 2010). This list could be checked against the literature you have identified to ensure all topics are covered.

Often the extent of population exposure is not well known; the estimation does not take into account widespread low exposures to a recognized harmful agent; exposures to suspected EPIDEMIOLOGY OF ENVIRONMENTAL HAZARDS hazards are not documented in good human studies; the analysis does not take into account that most chronic diseases arise from a complicated collection of multiple exposures, not exposure to single agents. As a result, the PAF estimates often underestimate the true disease burden.

1), measurement of exposed residents near a landfill might benefit from integration of information from monitoring, modelling, and responses from individuals. Self-reported information might be affected by participants’ expected gain from a certain type of result, but integration of more objective methods would reassure about the validity of any later health assessment (Mohan, 2009). Effective study of exposures over long time periods requires measurements taken at multiple time points. Because repeated direct measurements can be prohibitively burdensome, it may be necessary to develop alternative strategies that rely on external indicators of exposure.

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