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Using mechanistic information to support evidence integration and synthesis: a case study with inhaled formaldehyde and leukemia.

Authors: Gentry, Robinan, Chad M. Thompson, Allison Franzen, Joshua Salley, Richard Albertini, Kun Lu, and Tracy Greene.

This framework, the available evidence relevant to evaluating the postulated mode of actions (MOAs) for leukemia following formaldehyde inhalation exposure is organized in the World Health Organization (WHO)/International Programme on Chemical Safety (IPCS) MOA Framework. The integration of all the available evidence highlighted the limited amount of data that support any of the postulated MOAs and demonstrated a significant amount of research supporting the null hypothesis that there is no causal association between formaldehyde inhalation exposure and leukemia. These analyses result in a lack of confidence in any of the postulated MOAs, increasing confidence in the conclusion that there is a lack of biological plausibility for a causal association between formaldehyde inhalation exposure and leukemia.