Guidelines to evaluate human observational studies for quantitative risk assessment

Environ Health Perspect. 2008 Dec;116(12):1700-5. doi: 10.1289/ehp.11530. Epub 2008 Aug 12.


Background: Careful evaluation of the quality of human observational studies (HOS) is required to assess the suitability of HOS for quantitative risk assessment (QRA). In particular, the quality of quantitative exposure assessment is a crucial aspect of HOS to be considered for QRA.

Objective: We aimed to develop guidelines for the evaluation of HOS for QRA and to apply these guidelines to case-control and cohort studies on the relation between exposure to benzene and acute myeloid leukemia (AML).

Methods: We developed a three-tiered framework specific for the evaluation of HOS for QRA and used it to evaluate HOS on the relation between exposure to benzene and AML.

Results: The developed framework consists of 20 evaluation criteria. A specific focus of the framework was on the quality of exposure assessment applied in HOS. Seven HOS on the relation of benzene and AML were eligible for evaluation. Of these studies, five were suitable for QRA and were ranked based on the quality of the study design, conduct, and reporting on the study.

Conclusion: The developed guidelines facilitate a structured evaluation that is transparent in its application and harmonizes the evaluation of HOS for QRA. With the application of the guidelines, it was possible to identify studies suitable for QRA of benzene and AML and rank these studies based on their quality. Application of the guidelines in QRA will be a valuable addition to the assessment of the weight of evidence of HOS for QRA.

Keywords: benzene; epidemiology; evidence-based medicine; human observational studies; quantitative risk assessment.

MeSH terms

  • Benzene / toxicity
  • Carcinogens / toxicity
  • Case-Control Studies
  • Cohort Studies
  • Guidelines as Topic*
  • Humans
  • Leukemia, Myeloid, Acute / chemically induced
  • Risk Assessment / methods*


  • Carcinogens
  • Benzene