Between Rigor and Relevance: Rethinking risk of bias in occupational epidemiology

To create real impact, we must act on the best scientific evidence available—a principle that few would dispute. Yet, the question remains: what constitutes the best evidence, and how do we identify it?

In recent years, tools to assess risk of bias have been introduced to bring greater rigor and transparency to evidence synthesis. These instruments can help standardize quality evaluations, but they are not without challenges. Concerns have been raised about potential over-penalization, misapplication, and the unintended exclusion of valuable evidence—particularly from regions where resources are limited and research must adapt to real-world constraints.

At the same time, our field cannot ignore the broader “replication crisis” in science. The rapid growth of research outputs has brought exciting new evidence, but also a flood of studies that vary widely in quality. Ensuring that our collective work reaches the standard of rigor needed to inform practice and policy is more urgent than ever.

This session invites us to step back and reflect on what we need to do as a community of occupational epidemiologists. How can we strengthen replication and reproducibility? How do we respond to the increasing volume of (lower-quality) studies? And how can we apply standardized tools in a way that remains fair, context-sensitive, and globally inclusive?

By confronting these questions openly, we move closer to building a foundation of evidence that is both scientifically rigorous and relevant to the diverse realities of occupational health worldwide.

Discussion leader: Roel Vermeulen

Panellists: Karen Walker-Bone; Mary Schubauer-Berigan; Rianka Rijnhout; Javier Mancilla-Galindo; and Berna van Wendel de Joode

Panellists

Professor Karen Walker-Bone trained as a Rheumatologist. Her PhD about neck /upper limb disorders in working-aged adults sparked a lifetime passion for health and work research. She was former Director of the UK MRC Versus Arthritis Centre for Musculoskeletal Health and Work and migrated to Australia to become Professor of Occupational Rheumatology and Director of the Monash Centre for Occupational and Environmental Health (MonCOEH) in the School of Public Health and Preventive Medicine (SPHPM) at Monash University. The Centre mission is to improve the likelihood that working in any job, employment or capacity anywhere in the world will be safer, healthier and more inclusive.

Mary Schubauer-Berigan is head of the Evidence Synthesis and Classification Branch of the International Agency for Research on Cancer (IARC), where she leads the IARC Monographs programme, an essential programme for cancer prevention worldwide. Her scientific and technical staff organize systematic evaluations of epidemiologic, experimental, and mechanistic evidence to identify the preventable causes of human cancer. Mary recently co-edited an IARC Scientific Publication on bias assessment in case-control and cohort studies for cancer hazard identification.

Before joining IARC, Mary worked for two decades as an epidemiologist at the National Institute for Occupational Safety and Health, where she led multidisciplinary teams conducting epidemiology studies of the health effects of occupational exposures to beryllium, carbon nanotubes, nuclear work, radon, cosmic radiation, and circadian disruption. She also developed and applied statistical models used in compensating claimants for the Energy Employees Occupational Illness Compensation Program for radiogenic cancers.  

Rianka Rijnhout is Professor of Institutions, Private Law and Conflict Resolution at Utrecht University, School of Law. Her research focuses on compensation or (tort law) claims settlement, with an emphasis on personal injury cases and collective harm cases. She is especially interested in how rules work out in legal practice and in what way the law can limit conflicts between parties. She regularly publishes on these themes and supervises dissertation projects in this field. She is particularly interested in occupational disease cases, because in legal practice claim settlement through tort law (or compensation in general) can be particularly complex and conflictual due to scientific uncertainty and/or uncertainty in the assessment in individual cases. Rijnhout is also a deputy judge at the District Court of Overijssel (NL) and chair of the Permanent Committee on Standardization of the Personal Injury Council, a foundation in which various parties in the personal injury sector try to agree on guidelines (extrajudicially), so that the personal injury victim is less burdened in a settlement process.

Javier Mancilla-Galindo is a PhD candidate at the Institute for Risk Assessment Sciences (IRAS), Utrecht University. He trained as a medical doctor in Mexico, where he gained experience in designing and conducting research in a resource-constrained healthcare system. As an environmental and occupational epidemiologist, he has combined causal inference and evidence synthesis in studies of the indoor dust microbiome and for the financial compensation of workers affected by lung cancer due to occupational exposure to asbestos in the Netherlands. Javier represents the interests of early-career and Global South researchers in the Scientific and Medical Advisory Board of openRxiv.

Dr. Berendina (Berna) van Wendel de Joode is the principal investigator of the Infants’ Environmental Health birth cohort https://www.isa.una.ac.cr/index.php/en/. She is professor in Exposure Assessment Sciences and Environmental Epidemiology at the Central American Institute for Studies on Toxic Substances (IRET), Universidad Nacional (UNA), Costa Rica, https://www.iret.una.ac.cr/index.php/es/. Her research focuses on understanding how environmental contaminants affect children’s and women’s health, and what mitigation strategies can be implemented to reduce its impact, using ecosystem approaches. She coordinates a interuniversity master’s program in Occupational Health (UNA – Instituto Tecnológico de Costa Rica). She is member of the National Science Academy in Costa Rica, member of the Editorial Board of ‘Environmental Epidemiology’, has been councilor of the International Society for Environmental Epidemiology, and has co-headed  a large Canada-Latin America Community of Practice in Ecosystem Approaches to Human Health (COPEH-LAC), amongst others.