城市大气污染健康危险度评价的方法第五讲大气污染对城市居民健康危害的定量评估(续五)

近100年来,各国学者就大气污染物对人体健康的影响进行了很多研究,对生活、生产环境中可能遇到的暴露量(暴露浓度和暴露时间)的评估也积累了许多经验。如何把两者结合起来,定量评估大气污染对人体健康的影响是本讲着重讲述的内容。流行病学研究将居民大气污染暴露与健康效应终点的变化相关联,是定量评估大气污染健康危害的基础。目前,国内外用于大气污染的环境流行病学研究方法主要包括个体水平上的队列研究(cohortstudy)和群体水平上的生态学研究(ecologicalstudy)。前者基于个体而不是群体的特点使它更易于控制各种混杂因素的影响;后者包…     

大气污染暴露对肝功能指标影响的流行病学研究进展

随着全球环境污染问题日趋严峻,大气污染对健康的影响已受到广泛关注。越来越多的证据表明,大气污染物可能通过直接或间接作用影响肝脏功能,改变肝功能指标水平。流行病学研究是评价大气污染健康效应的重要方法。目前国内外已逐渐开展大气污染暴露对肝功能指标影响的流行病学研究,但不同研究的结论不一致。本文从长期暴露和短期暴露两方面综述了大气污染对肝功能指标影响的流行病学研究进展,并指出现有研究存在的不足,为今后开展此类研究提供建议。     

大气颗粒物对人体皮肤健康影响的研究进展

近年来我国大气污染问题日益严重,国内外大量研究表明,大气污染与许多健康效应直接或间接相关。已有流行病学研究证实,大气颗粒物污染与皮肤疾病的发病率密切相关。该文从氧化应激与炎症反应、芳香烃受体(Ah R)的活化、皮肤表面微生物的影响,就现有大气颗粒物对皮肤健康影响的流行病学及毒理学研究进行综述。     

雾霾污染致人体健康效应的研究进展

近些年,伴随着城市化进程的加速,重工业集中的大中型城市所面临的大气污染问题越加严重,雾霾天气随之增多,由此引发的人体健康问题如急性刺激、心血管疾病等引起了社会的普遍关注。目前多数学者认为雾霾是有毒有害气体、颗粒物等污染物共同导致的以能见度降低为主要表现的空气污染现象。雾霾引起的人群健康效应已得到许多研究的证实。作者系统总结了雾霾这一污染型天气的理化特征,介绍了被广泛认可的雾霾定义,其物理组成及化学成分等,并从环境流行病学研究角度出发,对国内外雾霾对人体的健康效应的研究进行综述,较为系统地提出雾霾天气对人体的健康效应,最后提出目前监测现状、亟需解决的科学问题和研究方向。     

辽宁省大气污染与人体健康研究进展

辽宁省大气污染的重要特征为煤烟型污染,该文回顾了辽宁省大气污染对人体健康影响的研究,提出了辽宁省开展大气污染健康效应调查方法、典型区域大气污染物对人体健康损害的风险评估技术、特征污染物暴露反应关系模型及健康效应剂量-反应关系等研究设想,为开展以人体健康指标特征为基础的大气环境风险评价提供科学依据。     

电磁辐射健康效应流行病学研究进展

目前,电磁辐射对人体健康的损伤效应尚未有确切定论,相关流行病学研究结论尚存争议,其主要原因之一是所采用的流行病学研究方法存在缺陷.开展电磁辐射流行病学研究通常会受到混杂因素和各种偏倚的影响,使得研究调查并不能得到真实可信的结果.因此,该文从流行病学研究方法及存在的问题等方面,就近年来国内外主要的电磁辐射流行病学研究进展进行综述,为更好地进行电磁辐射对人体健康影响的研究提供依据.     

对我国大气质量标准未来修订的思考

1952年英国伦敦烟雾事件后,西方发达国家采取了大量综合措施,大气污染浓度下降,大气质量得到了显著改善.20世纪80年代起,由于环境和健康监测资料的完善和可及性,以及流行病学研究和统计方法的改进,在北美和西欧发达国家涌现了大量大气污染对居民健康影响的流行病学研究报告[1-3].研究证实目前发达国家较低大气污染水平对居民健康仍有损害.     

雅典大气污染对死亡率的短期影响

二次大战前后,美国、欧洲和日本曾发生多次大气污染事件,其时大气污染高峰浓度引起死亡率骤升。通过对这些事件的调查研究,人们获得大气污染对人体健康潜在影响的证据,并制订出被大家接受的大气标准。世界上多数城市的大气污染水平已有显著降低,但改善后的现有大气污染水平对人体健康有无影响这点还不清楚。为了研究低浓度大气污染对健     

珠江三角洲地区大气污染对人群健康影响的研究进展

近年来珠江三角洲地区整体空气质量虽有所改善,但污染依然严重,煤烟型污染与机动车污染形成的复合型污染日趋明显。珠江三角洲地区大气污染对人体健康的影响研究主要集中在广州、深圳,多采用时间序列和病例交叉方法探讨大气污染对人体健康的短期效应。大部分研究结果显示大气污染水平与人群死亡、住院等健康结局密切相关。现有的研究在研究对象、研究方法和健康结局指标选择上仍有许多不足,有待进一步完善。     

大气污染对青少年血压及肺功能的影响

大气污染对青少年血压及肺功能的影响金永堂１周晓铁２工业企业是造成大气污染的主要来源，尤其象有色金属冶炼厂等对环境污染严重且复杂。由此对人体健康造成的影响，一直受到人们的关注。我们采用环境流行病学的方法，选择确定大气的污染区与对照区，对两区内的青少年，...     

Quasi-experimental studies suggest that lowering air pollution levels benefits infants' and children's health

Many human studies have shown a correlation between air pollution and poor health in children. This paper focuses on studies that employ quasi-experimental designs to study the effects of air pollution on specific populations in an effort to isolate the causes and minimize the effect of confounding factors. Human studies of many and varied designs have found that exposure to some pollutants, even at levels below regulatory thresholds, adversely affects health. Our review of quasi-experimental studies adds additional support to these findings. Together, the research suggests that lowering the thresholds for acceptable air pollution levels may be a prudent and necessary step toward improving population health, especially among the most vulnerable members of society: infants and children. Policy makers should also consider providing specific information to families and pregnant women about when and where the risk of pollution exposure is highest, so that they can minimize their exposure or avoid it altogether.     

Health effects of particulate air pollution: time for reassessment?

Numerous studies have observed health effects of particulate air pollution. Compared to early studies that focused on severe air pollution episodes, recent studies are more relevant to understanding health effects of pollution at levels common to contemporary cities in the developed world. We review recent epidemiologic studies that evaluated health effects of particulate air pollution and conclude that respirable particulate air pollution is likely an important contributing factor to respiratory disease. Observed health effects include increased respiratory symptoms, decreased lung function, increased hospitalizations and other health care visits for respiratory and cardiovascular disease, increased respiratory morbidity as measured by absenteeism from work or school or other restrictions in activity, and increased cardiopulmonary disease mortality. These health effects are observed at levels common to many U.S. cities including levels below current U.S. National Ambient Air Quality Standards for particulate air pollution.     

Health effects of ambient air pollution – recent research development and contemporary methodological challenges

Exposure to high levels of air pollution can cause a variety of adverse health outcomes. Air quality in developed countries has been generally improved over the last three decades. However, many recent epidemiological studies have consistently shown positive associations between low-level exposure to air pollution and health outcomes. Thus, adverse health effects of air pollution, even at relatively low levels, remain a public concern. This paper aims to provide an overview of recent research development and contemporary methodological challenges in this field and to identify future research directions for air pollution epidemiological studies.     

Particulate matter pollution in African cities

Rapid urban population growth, air pollution emissions, and changing patterns of disease in African cities may increase the burden of air pollution-related morbidity and mortality in coming decades. Yet, air monitoring is limited across the continent and many countries lack air quality standards. This paper focuses on particulate matter (PM) pollution, one of the most relevant and widely used indicators of urban air quality. We provide an overview of published PM monitoring studies in Africa, outline major themes, point out data gaps, and discuss strategies for addressing particulate air pollution in rapidly growing African cities. Our review reveals that, although few studies have reported annual mean levels of coarse and fine particles, collective evidence from short- and long-term air monitoring studies across urban Africa demonstrates that pollution levels often exceed international guidelines. Furthermore, pollution levels may be rising as a result of increased motor vehicle traffic building on already high background concentrations of PM in many locations due to climatic and geographic conditions. Biomass burning and industrial activities, often located in cities, further exacerbate levels of PM. Despite the health risks this situation presents, air quality programs, particularly in sub-Saharan Africa, have been stalled or discontinued in recent years. Implementation of systematic PM data collection would enable air pollution-related health impact assessments, the development of strategies to reduce the air pollution health burden, and facilitate urban planning and transportation policy as it relates to air quality and health.     

Health, wealth, and air pollution: advancing theory and methods

The effects of both ambient air pollution and socioeconomic position (SEP) on health are well documented. A limited number of recent studies suggest that SEP may itself play a role in the epidemiology of disease and death associated with exposure to air pollution. Together with evidence that poor and working-class communities are often more exposed to air pollution, these studies have stimulated discussion among scientists, policy makers, and the public about the differential distribution of the health impacts from air pollution. Science and public policy would benefit from additional research that integrates the theory and practice from both air pollution and social epidemiologies to gain a better understanding of this issue. In this article we aim to promote such research by introducing readers to methodologic and conceptual approaches in the fields of air pollution and social epidemiology; by proposing theories and hypotheses about how air pollution and socioeconomic factors may interact to influence health, drawing on studies conducted worldwide; by discussing methodologic issues in the design and analysis of studies to determine whether health effects of exposure to ambient air pollution are modified by SEP; and by proposing specific steps that will advance knowledge in this field, fill information gaps, and apply research results to improve public health in collaboration with affected communities.     

北京市大气污染对居民健康影响的研究

1989年对北京市不同程度污染区的居民3 000名进行了采暖期、非采暖期的健康检查。收集了相应地区1980~1988年的大气监测数据,并与健康检查同步进行采暖期、非采暖期的大气质量监测,填写了7000份呼吸道疾病流行病学标准询问表。利用SIEMENS 7.750C计算机对获取的近百万数据进行了分析,证实北京市大气污染对居民健康已造成不良影响。     

Health risk assessment of traffic-related air pollution near busy roads

BackgroundAlthough ambient urban air pollution has well-established health effects, epidemiology faces many difficulties in estimating the risks due to exposure to traffic pollutants near busy roads. This review aims to summarize how exposure to traffic-related air pollution near busy roads is assessed in epidemiological studies and main findings regarding health effects.MethodAfter presenting the specificity of emissions due to traffic road, this review identifies the key methods and main results found in epidemiologic studies seeking to measure the influence of exposure to nearby traffic on health published over the past decade.ResultsThe characterization and measurement of population exposure to traffic pollution faces many difficulties. Thus, epidemiological studies have used two broad categories of surrogates to assess exposure: direct measures of traffic itself such as distance of the residence to the nearest road and traffic volume and modeled concentrations of pollutant surrogates. Studies that implemented these methods showed that people living near heavy traffic road or exposed to near-road air pollution tend to report more health outcomes.DiscussionTraffic-related air pollution near busy roads is the subject of increasing attention, and tends to be better characterized. However, its health impacts remain difficult to grasp, especially because of the vast diversity of approaches used in epidemiological studies. Greater consistency in the protocols would be desirable to provide better understanding of the health issue of traffic in urban areas and thus to better implement policies to protect those most at risk.     

Methods for assessing the extent of exposure and effects of air pollution.

BACKGROUND AND OBJECTIVES: In many places in Europe, the ambient air pollution exceeds the levels considered to be safe for health. The objective of the paper is to review and summarise the methods of assessment of its impact on health, and to indicate the contributions of various research disciplines, particularly environmental epidemiology. METHODS: The framework for assessment of impact is based on a four stage model: assessment of release of pollutant; assessment of exposure; assessment of the consequence; and risk estimation. RESULTS: Epidemiology is crucial in providing the data for the assessment of consequence. The criteria that determine the use of epidemiological studies for this task include lack of bias, correct control of confounding, and measured estimates of exposure. At present, those criteria are easier to satisfy for studies of short term effects on health than for the delayed consequences of exposure, or exposure accumulated over a prolonged period. Combinations of results from various populations through meta-analysis of existing studies or conducting multicentre studies is often necessary to increase the reliability of the consequence assessment stage. CONCLUSION: To assess the impact on health systematically helps to focus on actions to limit air pollutants with the greatest impacts on human health and on the most affected populations. This method allows identification of the most pertinent questions which have to be answered by studies on relations between pollution and health and on exposure of populations to air pollutants. Epidemiology has considerable potential to contribute to this research.     

空气污染物对胎儿生长发育影响的研究进展

胎儿生长发育迟缓与围产期、儿童时期及成年后的多种疾病相关,是重要的公共卫生问题。随着空气污染物长期暴露测量技术的进步,近年来陆续有流行病学研究观察了孕期空气污染物暴露水平对胎儿生长发育的影响。笔者通过查阅Medline、Web of Science数据库,对近年来空气污染物与胎儿生长发育关系的研究进展做综述。