Cited by 349Per- and polyfluoroalkyl substances researchToxic Organic Pollutants ImpactEffects and risks of endocrine disrupting chemicals

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The Navigation Guide—Evidence-Based Medicine Meets Environmental Health: Systematic Review of Nonhuman Evidence for PFOA Effects on Fetal Growth

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Koustas, Erica, Lam, Juleen, Sutton, Patrice, Johnson, Paula I., Atchley, Dylan S., Sen, Saunak, Robinson, Karen A., Axelrad, Daniel A., Woodruff, Tracey J.·2014·Environmental Health Perspectives

DOI 10.1289/ehp.1307177PMC PMC4181920

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Abstract

Abstract Background: In contrast to current methods of expert-based narrative review, the Navigation Guide is a systematic and transparent method for synthesizing environmental health research from multiple evidence streams. The Navigation Guide was developed to effectively and efficiently translate the available scientific evidence into timely prevention-oriented action. Objectives: We applied the Navigation Guide systematic review method to answer the question “Does fetal developmental exposure to perfluorooctanoic acid (PFOA) or its salts affect fetal growth in animals ?” and to rate the strength of the experimental animal evidence. Methods: We conducted a comprehensive search of the literature, applied prespecified criteria to the search results to identify relevant studies, extracted data from studies, obtained additional information from study authors, conducted meta-analyses, and rated the overall quality and strength of the evidence. Results: Twenty-one studies met the inclusion criteria. From the meta-analysis of eight mouse gavage data sets, we estimated that exposure of pregnant mice to increasing concentrations of PFOA was associated with a change in mean pup birth weight of –0.023 g (95% CI: –0.029, –0.016) per 1-unit increase in dose (milligrams per kilogram body weight per day). The evidence, consisting of 15 mammalian and 6 nonmammalian studies, was rated as “moderate” and “low” quality, respectively. Conclusion: Based on this first application of the Navigation Guide methodology, we found sufficient evidence that fetal developmental exposure to PFOA reduces fetal growth in animals. Citation: Koustas E, Lam J, Sutton P, Johnson PI, Atchley DS, Sen S, Robinson KA, Axelrad DA, Woodruff TJ. 2014. The Navigation Guide—evidence-based medicine meets environmental health: systematic review of nonhuman evidence for PFOA effects on fetal growth. Environ Health Perspect 122:1015–1027; http://dx.doi.org/10.1289/ehp.1307177

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Authors: Koustas, E., Lam, J., Sutton, P., Johnson, P. I., Atchley, D. S., Sen, S., Robinson, K. A., Axelrad, D. A., & Woodruff, T. J.
Affiliations: Environmental Protection Agency (US)
University of California, San Francisco (US)
Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
Johns Hopkins University (US)
Corresponding author: Koustas, Erica
ORCID: Lam, Juleen
Johnson, Paula I.
Robinson, Karen A.
Axelrad, Daniel A.
Woodruff, Tracey J.
Venue: Environmental Health Perspectives
Publisher: American Chemical Society (ACS)
Published: 2014-06-25
Volume: 122
Issue: 10
Pages: 1015-1027
ISSN: 0091-6765 (ISSN-L)
1552-9924
DOI: 10.1289/ehp.1307177
PMC: PMC4181920
OpenAlex: W1969835924
Cited by: 349
References: 121
Citations by year: 2026: 5 · 2025: 14 · 2024: 14 · 2023: 30 · 2022: 25 · 2021: 41 · 2020: 60 · 2019: 31 · 2018: 30 · 2017: 42 · 2016: 24 · 2015: 22 · 2014: 10
FWCI: 3.08
Type: journal article
Language: en
Open access: gold
doi.org
Licence: public-domain
creativecommons.org/licenses/by/4.0/ (vor, 1283 d)
Locations: Environmental Health Perspectives (publishedVersion, public-domain)
PubMed Central (publishedVersion, public-domain)
PubMed (publishedVersion)
eScholarship (California Digital Library) (submittedVersion)
Funders: National Institute of Environmental Health Sciences (ES018135, P01ES022841, ES022841, P20ES018135)
Topics: Physical Sciences › Environmental Science › Environmental Chemistry › Per- and polyfluoroalkyl substances research
Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Toxic Organic Pollutants Impact
Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Effects and risks of endocrine disrupting chemicals
Keywords: perfluorooctanoic acid, fetal growth, prenatal exposure, animal studies, birth weight, evidence synthesis, perfluorinated compounds, developmental toxicity
MeSH terms: Animals, Birth Weight, Caprylates, Environmental Health, Environmental Pollutants, Female, Fluorocarbons, Pregnancy, Evidence-Based Medicine, Fetal Development, Mice

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The Navigation Guide—Evidence-Based Medicine Meets Environmental Health: Systematic Review of Nonhuman Evidence for PFOA Effects on Fetal Growth

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