In 2014, early in the GRADE Working Group's initiative of expanding evidence assessment and guideline develop to address specific topic areas, the working group created the Environmental and Occupational Health Project Group. The project group began by developing a research agenda to advance the rigor and transparency of systematic reviews and guideline development in this field by adapting GRADE to support decision-making in environmental health. In a commentary for Environment International, we first introduced GRADE, examined steps of the guideline development process currently used for decision-making, and outlined suggestions for a research agenda to address decision-making in the environmental and occupational health field (Morgan et al., 2016).