Gender Differences in Susceptibility to Environmental Factors: A Priority Assessment (1998)

In 1996, the Office for Research on Women's Health, National Institutes of Health (NIH), requested that the Institute of Medicine (IOM) conduct a workshop study to review the current research programs of the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and the Environmental Protection Agency (EPA) that are devoted to women's health. The purpose of this activity was to identify the state of knowledge regarding gender differences in susceptibility to environmental factors and make recommendations about promising areas of inquiry that may profit from interagency coordination.

In order to do this, the committee reviewed a variety of research reports, publications, and journal articles, as well as relevant project summaries of funded research of the NIH, CDC, and EPA. Based on this literature review and analysis of existing research, the committee conducted a workshop that focused on three questions:

1. What areas within the existing portfolio are likely to yield information appropriate to this topic? What are the gaps in knowledge that warrant future research?

2. Are there research strategies and priorities for addressing the gaps in knowledge?

3. What other strategies, including interagency coordination, might improve the prospect of developing knowledge that will identify gender differences in susceptibility to environmental factors?

The committee concluded that for the purpose of promoting interagency strategies, a yearly workshop should be held. A second conclusion was that additional factors, such as ergonomic, behavioral, and cultural need to be in-

cluded in the definitions of ''gender," "environment," and "susceptibility." The committee made recommendations in three general areas:

1. Research on exposures to include a broader definition of terms; more occupational data elements; multiple-exposure data; research across lifespans and during critical periods; development of animal models; and identification of cultural and historical factors.

2. Basic research to include studies on environmental contributions and biological causes for gender differences; gender differences in disease outcomes; metabolic and hormonal differences; genetic markers of susceptibility; and translational research.

3. Research policy to include presenting annual workshops; fostering institutional changes; increasing the number of sponsoring agencies; funding long-term prospective studies; encouraging public and private cofunding; improving access to and content of national databases; and devising strategies for research resource protection and utilization.