Patrice Sutton

University of California, San Francisco | UCSF · Center for Reproductive Sciences

Background Every major federal regulation in the United States requires an economic analysis estimating its benefits and costs. Benefit-cost analyses related to regulations on formaldehyde exposure have not included asthma in part due to lack of clarity in the strength of the evidence. Objectives 1) To conduct a systematic review of evidence regar...

Background Synthesizing environmental health science is crucial to taking action to protect public health. Procedures for evidence evaluation and integration are transitioning from “expert-based narrative” to “systematic” review methods. However, little is known about the methodology being utilized for either type of review. Objectives To appraise...

Background: The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates). For this, systematic reviews of studies estimating the prevalence of exposure to selected occupational risk factors will be conducted to provide i...

Background Systematic reviews, which assess the risk of bias in included studies, are increasingly used to develop environmental hazard assessments and public health guidelines. These research areas typically rely on evidence from human observational studies of exposures, yet there are currently no universally accepted standards for assessing risk...

Changes needed for complete benefits assessment

Background: In the United States, one in six children are affected by neurodevelopmental disorders, and polybrominated diphenyl ethers (PBDEs) in flame-retardant chemicals are measured ubiquitously in children. Objective: We conducted a systematic a systematic review regarding developmental exposure to PBDEs and intelligence or Attention Deficit...

Background: Exposure to ambient air pollution is widespread and may be detrimental to human brain development and a potential risk factor for Autism Spectrum Disorder (ASD). We conducted a systematic review of the human evidence on the relationship between ASD and exposure to all airborne pollutants, including particulate matter air pollutants and...

Background: There are reports of developmental and reproductive health effects associated with the widely used biocide triclosan. Objective: Apply the Navigation Guide systematic review methodology to answer the question: Does exposure to triclosan have adverse effects on human development or reproduction? Methods: We applied the first 3 steps...

in press

There is high demand in environmental health for adoption of a structured process that evaluates and integrates evidence while making decisions and recommendations transparent. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework holds promise to address this demand. For over a decade, GRADE has been applied succe...

Exposure to toxic environmental chemicals during pregnancy and breastfeeding is ubiquitous and is a threat to healthy human reproduction. There are tens of thousands of chemicals in global commerce, and even small exposures to toxic chemicals during pregnancy can trigger adverse health consequences. Exposure to toxic environmental chemicals and rel...

Synthesizing what is known about the environmental contributors of health is instrumental to taking action to prevent harm but methods of research synthesis commonly used in environmental health lag behind comprehensive, rigorous and transparent systematic review methods developed in the clinical sciences over the past 20 years. To address this gap...

Abstract Objective: Glomerular filtration rate (GFR) may influence concentrations of biomarkers of exposure and their etiologic significance in observational studies of associations between environmental contaminants and fetal growth. It is unknown whether the size of a developing fetus affects maternal GFR such that a small fetus leads to reduced...

The environment is an underutilized pathway to breast cancer prevention. Current research approaches and funding streams related to breast cancer and the environment are unequal to the task at hand. We undertook the California Breast Cancer Prevention Initiatives, a four-year comprehensive effort to set a research agenda related to breast cancer, t...

Objective Describe the attitudes, beliefs, and practices of U.S. obstetricians on the topic of prenatal environmental exposures. Study Design A national online survey of American Congress of Obstetricians and Gynecologists (ACOG) fellows and 3 focus groups of obstetricians. Results We received 2,514 eligible survey responses, for a response rate...

Background: The Navigation Guide methodology was developed to meet the need for a robust method of systematic and transparent research synthesis in environmental health science. We conducted a case study systematic review to support proof of concept of the method. Objective: We applied the Navigation Guide systematic review methodology to determine...

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-o...

Background: Synthesizing what is known about the environmental drivers of health is instrumental to taking prevention-oriented action. Methods of research synthesis commonly used in environmental health lag behind systematic review methods developed in the clinical sciences over the past 20 years. Objectives: We sought to develop a proof of conc...

Background: The Navigation Guide is a novel systematic review method to synthesize scientific evidence and reach strength of evidence conclusions for environmental health decision making. Objective: Our aim was to integrate scientific findings from human and nonhuman studies to determine the overall strength of evidence for the question "Does de...

Scientific discovery linking the environment to beneficial and adverse health children's health outcomes is rapidly expanding, leading scientists and health professionals to call for timely action to prevent harm and secure benefits. A robust method to synthesize what is known about the environmental drivers of health is a foundational step to maki...

Virtually every pregnant woman in the United States has measurable levels of multiple chemicals in her body that can harm human reproduction and development. Chemical exposures during the prenatal period can have effects across the life span of individuals, ranging from short term effects such as birth defects to long term effects such as adult can...

As recognized in APHA's 2009 policy statement, the public health consequences of war are massive and leave few if any areas of public health practice untouched making war one of the greatest obstacles to realizing APHA's vision of a healthy global society. This presentation will describe the health consequences of war on women's health, including i...

Every pregnant woman in the United States is exposed to many and varied environmental chemicals. Rapidly accumulating scientific evidence documents that widespread exposure to environmental chemicals at levels that are encountered in daily life can impact reproductive and developmental health adversely. Preconception and prenatal exposure to enviro...

Problem statement: Mounting scientific evidence documents that the environment is an important driver of human reproductive health. The U.S. Environmental Protection Agency (USEPA) is the key federal agency with regulatory authority to act on the science to prevent harm. However, for a variety of reasons, public policy makers have only limited enga...

How and where we live, eat, work, play, and socialize profoundly influence our physical and mental health. Beginning in the womb and continuing throughout life, environmental factors are strong determinants of health decades later. Reproductive, children's, midlife and elder health are inherently interconnected. In addition, both positive and negat...

In November 1985, 116 individuals gathered at the close of the 113th annual meeting of APHA in Washington, DC, to form the Peace Caucus. This inaugural meeting of the Peace Caucus followed the closing plenary, Prevention of Nuclear War as a Public Health Responsibility. The following year, over 500 APHA members and conference attendees protested at...

What food is produced, and how, can have a critical impact on human nutrition and the environment, which in turn are key drivers of healthy human reproduction and development. The US food production system yields a large volume of food that is relatively low in cost for consumers but is often high in calories and low in nutritional value. In this a...

Physicians and other clinicians could help educate patients about hazardous environmental exposures, especially to substances that could affect their reproductive health. But the relevant scientific evidence is voluminous, of variable quality, and largely unfamiliar to health professionals caring for people of childbearing age. To bridge this gap b...

APHA has long recognized the public health benefits of nuclear weapons disarmament and the consequent need to support the abolition of nuclear weapons. The 2010 Nuclear Security Summit in Washington DC, and the Non-Proliferation Treaty (NPT) Review Conference at the UN underscored the continued dangers of nuclear weapons proliferation, and the rela...

There is heightened recognition that the environment is an important driver of human reproductive health. This article provides an overview of the nature and extent of the science in the field of reproductive environmental health and its implications for OB/GYN clinical practice. Women of childbearing age incur ubiquitous contact to numerous toxic...

BACKGROUND: Should reproductive health providers, policy makers and the public act to prevent exposure to a chemical that causes male frogs to resemble females, makes mice unable to bear a healthy litter, and results in humans having a slightly elevated level of risk of spontaneous abortion? Weaving the scientific data into a coherent signal is a c...

The use of volatile organic compounds (VOCs) in lithographic printing cleanup is an environmental and occupational hazard. Regulations to reduce ambient ozone levels limited VOC emissions from lithographic cleanup operations and spurred the development of low-VOC alternatives. The purpose of this project was to promote the substitution of hazardous...

Background Primary prevention of occupational asthma requires timely identification and regulation of asthma-causing agents.Methods We examined 39 substances identified as causing allergic occupational asthma in the US to determine the basis for their identification and their regulatory status. We compared them with occupational asthmagens identifi...

Exposure to toxic cleanup solvents used in lithographic printing can harm the health of workers who use these chemicals and pollute the environment. Safer alternatives to these solvents have been developed in response to improved environmental regulations in Southern California. We conducted a project to protect lithographic printers from chronic h...

With the collapse of the Soviet Union in 1991, the US re-affirmed the centrality of nuclear weapons as an integral component of a credible U.S. offensive posture, and soon began advancing nuclear weapons research at Department of Energy weapons facilities through computer simulation, enhanced laser technologies, subcritical testing, and other progr...

Exposure to glutaraldehyde is a recognized cause of work-related asthma. An investigation was undertaken to describe exposure to glutaraldehyde among workers making bioprosthetic heart valves and to make recommendations for prevention. At the two largest heart valve manufacturing facilities in California, the work process was observed; employer rep...

Background Aircraft “disinsection” is the application of pesticides inside an aircraft to kill insects that may be on board. Over a 1-year period, California's tracking system received 17 reports of illness involving flight attendants exposed to pesticides following disinsection.Methods Interviews, work process observations, and a records review we...

The US Centers for Disease Control and Prevention (CDC) recommends the prompt and sustained placement of potentially infectious tuberculosis patients in to negative-pressure isolation rooms, to help prevent other patients and workers, who remain outside of the room, from exposure to potential aerosols of Mycobacterium tuberculosis. The purpose of t...

To evaluate implementation of healthcare worker exposure control measures for tuberculosis (TB)-patient isolation, as specified by Centers for Disease Control and Prevention (CDC) guidelines and the hospital's TB-control policy. Prospective multihospital study comparing CDC guidelines and hospital policy for TB-patient isolation to once-weekly obse...

To evaluate adherence to components of the Centers for Disease Control and Prevention (CDC) guidelines for preventing the transmission of Mycobacterium tuberculosis in healthcare facilities. Multihospital study using direct observation and a standardized questionnaire. Three urban hospitals (two county hospitals and one private community hospital)...