title: Policy relevant results from an expert elicitation on the health risks of phthalates.
abstract: BACKGROUND
  The EU 6th Framework Program (FP)-funded Health and Environment Network (HENVINET) aimed to support informed policy making by facilitating the availability of relevant knowledge on different environmental health issues. An approach was developed by which scientific agreement, disagreement, and knowledge gaps could be efficiently identified, and expert advice prepared in a way that is usable for policy makers. There were two aims of the project: 1) to apply the tool to a relevant issue; the potential health impacts of the widely used plasticizers, phthalates, and 2) to evaluate the method and the tool by asking both scientific experts and the target audience, namely policy makers and stakeholders, for their opinions.
  
  
  METHODS
  The tool consisted of an expert consultation in several steps on the issue of phthalates in environmental health. A diagram depicting the cause-effect chain, from the production and use of phthalates to potential health impacts, was prepared based on existing reviews. This was used as a basis for an online questionnaire, through which experts in the field were consulted. The results of this first round of consultation laid the foundation for a new questionnaire answered by an expert panel that, subsequently, also discussed approaches and results in a workshop. One major task of the expert panel was to pinpoint priorities from the cause-effect chain according to their impact on the extent of potential health risks and their relevance for reducing uncertainty. The results were condensed into a policy brief that was sent to policy makers and stakeholders for their evaluation.
  
  
  RESULTS
  The experts agreed about the substantial knowledge gaps within the field of phthalates. The top three priorities for further research and policy action were: 1) intrauterine exposure, 2) reproductive toxicology, and 3) exposure from medical devices. Although not all relevant information from the cause-effect chain is known for phthalates, most experts thought that there are enough indications to justify a precautionary approach and to restrict their general use. Although some of the experts expressed some scepticism about such a tool, most felt that important issues were highlighted.
  
  
  CONCLUSIONS
  The approach used was an efficient way at summarising priority knowledge gaps as a starting point for health risk assessment of compounds, based on their relevance for the risk assessment outcome. We conclude that this approach is useful for supporting policy makers with state-of-the-art scientific knowledge weighed by experts. The method can assist future evidence-based policy making.
authors: Department of Basic Sciences and Aquatic Medicine, Norwegian School of Veterinary Science, PO Box 8146, 0033 Oslo, Norway. karin.zimmer@nvh.no
authors: Karin Elisabeth
authors: KE
authors: Zimmer
authors: Arno Christian
authors: AC
authors: Gutleb
authors: Solveig
authors: S
authors: Ravnum
authors: Martin
authors: M
authors: Krayer von Krauss
authors: Albertinka J
authors: AJ
authors: Murk
authors: Erik
authors: E
authors: Ropstad
authors: Janneche Utne
authors: JU
authors: Skaare
authors: Gunnar Sundstøl
authors: GS
authors: Eriksen
authors: Jan Ludvig
authors: JL
authors: Lyche
authors: Janna G
authors: JG
authors: Koppe
authors: Brooke L
authors: BL
authors: Magnanti
authors: Aileen
authors: A
authors: Yang
authors: Alena
authors: A
authors: Bartonova
authors: Hans
authors: H
authors: Keune
mesh_terms: D000818:Animals; D004781:Environmental Exposure; D004782:Environmental Health / Q000379:methods*; D058735:Environmental Policy; D004785:Environmental Pollutants / Q000493:pharmacokinetics / Q000633:toxicity*; D006801:Humans; D010795:Phthalic Acids / Q000493:pharmacokinetics / Q000633:toxicity*; D011050:Policy Making; D018570:Risk Assessment; D011795:Surveys and Questionnaires
chemical_list: D004785:Environmental Pollutants; D010795:Phthalic Acids