Evidence map›Paper›PMID 27156197›Full record

SynthesisEnvironment international

Application of the Navigation Guide systematic review methodology to the evidence for developmental and reproductive toxicity of triclosan.

Paula I Johnson, Erica Koustas, Hanna M Vesterinen, Patrice Sutton, Dylan S Atchley, Allegra N Kim, Marlissa Campbell, James M Donald, Saunak Sen, Lisa Bero and 2 more

Open access · hybridAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Environment international. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 17 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
67citing papers in PubMed, 17 pooled it
13.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

67 citing papers in PubMed, 17 syntheses or guidelines pooled it, 141 citations in OpenAlex.

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  3. Associations of Urban Built Environment with Cardiovascular Risks and Mortality: a Systematic Review.Journal of urban health : bulletin of the New York Academy of Medicine · 2023
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  16. Industry sponsorship and research outcome.The Cochrane database of systematic reviews · 2017
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7 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 1 country.

Paula I JohnsonUniversity of California San Francisco, Program on Reproductive Health and the Environment, Oakland, CA, USA. Electronic address: Paula.Johnson@cdph.ca.gov.
Erica KoustasORISE Post-doctoral Fellowship, U.S. Environmental Protection Agency, Office of Policy, National Center for Environmental Economics, Washington, D.C., USA.
Hanna M VesterinenUniversity of California San Francisco, Program on Reproductive Health and the Environment, Oakland, CA, USA.
Patrice SuttonUniversity of California San Francisco, Program on Reproductive Health and the Environment, Oakland, CA, USA.
Dylan S AtchleyUniversity of California San Francisco, Program on Reproductive Health and the Environment, Oakland, CA, USA.
Allegra N KimOffice of Environmental Health Hazard Assessment, California Environmental Protection Agency, CA, USA.
Marlissa CampbellOffice of Environmental Health Hazard Assessment, California Environmental Protection Agency, CA, USA.
James M DonaldOffice of Environmental Health Hazard Assessment, California Environmental Protection Agency, CA, USA.
Saunak SenUniversity of California San Francisco, Department of Epidemiology and Biostatistics, San Francisco, CA, USA.
Lisa BeroUniversity of California San Francisco, Department of Clinical Pharmacy, San Francisco, CA, USA.
Lauren ZeiseOffice of Environmental Health Hazard Assessment, California Environmental Protection Agency, CA, USA.
Tracey J WoodruffUniversity of California San Francisco, Program on Reproductive Health and the Environment, Oakland, CA, USA.
University of California, San Francisco · USCalifornia Environmental Protection Agency · USEnvironmental Protection Agency · US

Funding

The UCSF Pregnancy Exposures to Environmental Chemicals (PEEC) Children's CenterP01ES022841 · NIEHS · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI WOODRUFF, TRACEY J. · 2013 to 2018
$3.9M
NIEHS NIH HHS P01 ES022841
6 · The paper itself

Abstract

backgroundThere are reports of developmental and reproductive health effects associated with the widely used biocide triclosan.

objectiveApply the Navigation Guide systematic review methodology to answer the question: Does exposure to triclosan have adverse effects on human development or reproduction?

methodsWe applied the first 3 steps of the Navigation Guide methodology: 1) Specify a study question, 2) Select the evidence, and 3) Rate quality and strength of the evidence. We developed a protocol, conducted a comprehensive search of the literature, and identified relevant studies using pre-specified criteria. We assessed the number and type of all relevant studies. We evaluated each included study for risk of bias and rated the quality and strength of the evidence for the selected outcomes. We conducted a meta-analysis on a subset of suitable data.

resultsWe found 4282 potentially relevant records, and 81 records met our inclusion criteria. Of the more than 100 endpoints identified by our search, we focused our evaluation on hormone concentration outcomes, which had the largest human and non-human mammalian data set. Three human studies and 8 studies conducted in rats reported thyroxine levels as outcomes. The rat data were amenable to meta-analysis. Because only one of the human thyroxine studies quantified exposure, we did not conduct a meta-analysis of the human data. Through meta-analysis of the data for rats, we estimated for prenatal exposure a 0.09% (95% CI: -0.20, 0.02) reduction in thyroxine concentration per mg triclosan/kg-bw in fetal and young rats compared to control. For postnatal exposure we estimated a 0.31% (95% CI: -0.38, -0.23) reduction in thyroxine per mg triclosan/kg-bw, also compared to control. Overall, we found low to moderate risk of bias across the human studies and moderate to high risk of bias across the non-human studies, and assigned a "moderate/low" quality rating to the body of evidence for human thyroid hormone alterations and a "moderate" quality rating to the body of evidence for non-human thyroid hormone alterations.

conclusionBased on this application of the Navigation Guide systematic review methodology, we concluded that there was "sufficient" non-human evidence and "inadequate" human evidence of an association between triclosan exposure and thyroxine concentrations, and consequently, triclosan is "possibly toxic" to reproductive and developmental health. Thyroid hormone disruption is an upstream indicator of developmental toxicity. Additional endpoints may be identified as being of equal or greater concern as other data are developed or evaluated.

Indexed as

AnimalsAnti-Infective Agents, LocalEnvironmental PollutantsFetal DevelopmentHumansRatsThyroxineTriclosanAnti-Infective Agents, LocalEnvironmental PollutantsThyroxineTriclosanAntibacterialPersonal carePolicyRisk assessmentSoapThyroid

Identifiers

PMID27156197
PMCPMC4951161
OpenAlexW2345569386

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.