汽车废气对人体健康的危害

本文综述了汽车废气污染的人群健康效应及在人群流行病学研究方面国内外近年的研究进展。目前研究显示，汽车废气中的有害气体气体和颗粒物可对人体呼吸系统产生显著的有害影响，导致呼吸系统免疫力下降，慢性气管炎，哮喘等发病率升高，肺功能下降等；对于汽车废气诱发人类肿瘤的研究，亦有较多职业流行病学的阳性结果报告，但因影响因素复杂，尚需进一步研究方可定 论。     

阿图什市日均气温与呼吸系统疾病日住院人次的时间序列研究

目的 分析阿图什市日均气温对呼吸系统疾病日住院人次的影响。方法 收集2016—2019年阿图什市呼吸系统疾病患者住院病例资料及同期气象和大气污染物数据，采用分布滞后非线性模型（distribution lag non-linear model,DLNM）分析日均气温对呼吸系统疾病日住院人次的影响及滞后效应。结果 日均气温与呼吸系统疾病日住院人次呈"J"型关系，住院风险最低温度为23℃。总人群在极低温、一般低温时滞后0～14 d下对呼吸系统疾病日住院人次累积效应的RR值及95%CI分别为2.32(1.55～3.47)和2.09(1.46～3.00)，两者均在当天时住院风险达到最大，且随着滞后日增加住院风险呈先下降后增加再下降趋势，滞后天数均为2 d。在亚组分析中，极低温、一般低温对女性和<16岁人群呼吸系统疾病住院风险的影响较大。极高温、一般高温对总人群及不同亚组中均未表现出明显的健康风险及滞后效应。结论 低温会造成呼吸系统疾病住院风险增加，早期呈明显急性影响，且存在滞后效应，女性和<16岁人群是敏感人群。     

无铅汽油推广二年来公交司售人员健康状况调查

了解１９９７年上海市全面推广无铅汽油后汽车尾气对职业接触人群的健康危害，是否无铅汽油的使用能有效地降低职业接触人群的血铅水平及影响人群的免疫功能。「方法」随机抽取７９４名职业接触人群及５３２名非职业接触人群，进行健康问卷调查和体格检查。对收集的数据进行了卡方分析、Ｌｏｇｉｓｔｉｃ回归及多因素方差分析。结果问卷调查显示汽车尾气职业接触人群的呼吸道症状的出现率高于非职业接触组，同时部分职业接触人群的健     

空气污染与阿尔茨海默病的相关性研究

空气污染对于人体的危害是多方面的,主要表现为对呼吸系统、生理机能及认知功能的影响,如记忆功能减弱、动作协调性下降等。目前国内外对空气污染导致心血管疾病或呼吸系统疾病的研究较为成熟。而空气污染对于人脑功能的影响及是否导致阿尔茨海默病(AD)形成是近年来的研究热点,但目前尚处于初步研究阶段。该文结合近年来臭氧、甲醛、PM_(2.5)及甲醛与PM_(2.5)协同效应对AD发生与发展的影响及可能机制进行综述。     

肺结核病人的生活质量的调查研究

肺结核是由结核杆菌引起的慢性传染病,常有低热、乏力等全身症状和咳嗽、咯血等呼吸系统表现.由于病情延迟,病人感到全身乏力,躯体功能下降,加之化疗中出现的副反应和持续治疗引起的经济上的压力,使病人深感痛苦;常有明显的心理变化影响其生活质量.本文通过对肺结核病人和正常人群生活质量的对照研究,了解肺结核患者的生活质量状况,为肺结核患者提高生活质量和给予心理干预提供依据.     

环境卫生与监测

地铁站车务人员上呼吸系统疾病的环境因素调查；交通协警多环芳烃暴露与健康风险的初步研究；泉州市机动车尾气污染对儿童神经行为功能影响初探;沙尘暴对呼吸系统疾病的影响；不同胆固醇水平人群吸烟与冠心病死亡的关系；多中心前瞻性队列研究发现主动和被动吸烟均增加年轻人糖耐量异常的危险．     

移动式尾气抽排装置对汽修工人职业危害的预防效果

汽车尾气对汽修工人呼吸系统、循环系统及中枢神经系统等有毒性作用.移动式尾气抽排装置可显著降低车间空气中一氧化碳、臭氧、氮氧化物等浓度,工人自觉症状发生率明显降低.此装置在预防汽车尾气对汽修工人健康危害方面效果明显.     

无铅汽油汽车尾气的职业接触人群健康状况研究

自１９９７年上海市全面推广使用无铅汽油,至今已１年多。为了解使用无铅汽油后汽车尾气对职业接触人群健康状况的影响及人体血铅浓度的变化,我们对职业接触人群及非职业接触人群进行现场调查,主要包括流行病学健康问卷调查,部分人群的血铅水平、免疫水平和呼出气ＣＯ浓度的检测,在消除混杂因素的影响后综合评价接触人群的健康状况,对汽油无铅化的效果作综合评定。一、材料与方法１．对象（１）职业接触人群：上海公交二汽公司公交车驾驶员和售票员、上海强生出租汽车公司司机、二汽公司汽车维修工等工作中接触汽车尾气,无粉尘及其他…     

垃圾焚烧暴露与居民呼吸系统的健康效应相关性研究

目的了解垃圾焚烧厂周围居民呼吸系统健康状况,探讨垃圾焚烧暴露对周围人群呼吸系统的健康影响。方法于2012年10—11月对垃圾焚烧厂附近0~5 km区域(暴露区)和5~10 km区域(非暴露区)的1 043名研究对象进行基本信息和呼吸系统健康状况的问卷调查,分析两区域内居民呼吸系统健康状况差异,并采用logistic回归分析垃圾焚烧暴露与呼吸系统症状间的关系。结果暴露区人群的呼吸系统症状总体发生率(72.73%)高于非暴露区(65.55%),差异有统计学意义(P0.05)。多因素logistic回归分析显示,暴露区人群咽部异物感的发生率是非暴露区的1.422倍(OR=1.422,95%CI:1.096~1.846),差异有统计学意义(P0.05),而对咳嗽、咯痰、鼻部不适、喘息及胸闷等其他呼吸系统症状的影响无统计学意义(P0.05)。结论垃圾焚烧暴露与人群咽部异物感可能存在一定关联。     

挥发性有机物致呼吸系统损害的流行病学研究综述

挥发性有机物(volatile organic compounds,VOCs)是一类有机化合物,也是职业场所和室内外空气中常见的污染物。呼吸道是VOCs进入人体的主要途径,VOCs可在呼吸系统吸收和蓄积,并直接引起呼吸系统损害。既往研究提示,VOCs暴露与肺功能下降、哮喘、慢性阻塞性肺疾病和肺癌等多种呼吸系统病损有关,但危害程度并不一致。本文综述了近年VOCs暴露所致呼吸系统损害的人群流行病学研究,为今后进一步研究VOCs的健康损害提供思路。     

Respiratory health associated with exposure to automobile exhaust. III. Results of a cross-sectional study in 1987, and repeated pulmonary function tests from 1987 to 1990

We conducted an epidemiological study to investigate the association between exposure to automobile exhaust and respiratory health. We selected 3 zones from two geographically different areas in Tokyo on the basis of expected exposure levels: (1) within 20 m from the side of major roads with heavy traffic, (2) between 20 and 150 m from the side of the same road, and (3) a residential district of suburban Tokyo. The subjects of the study were female adults aged 30-59 y. A cross-sectional study of respiratory symptoms and repeated pulmonary function testing were also performed in each zone. The results suggested that exposure to automobile exhaust may be associated with respiratory symptoms. Nevertheless, repeated pulmonary function testing did not reveal any consistent differences. Investigators should conduct additional follow-up studies to investigate the decline of pulmonary functions with age.     

The health effects of automobile exhaust. VI. Relationship of respiratory symptoms and pulmonary function in tunnel and turnpike workers

To examine the effect of automobile exhaust on respiratory symptoms and pulmonary function, the authors studied 175 tunnel and turnpike workers employed by the Massachusetts Turnpike Authority on two occasions 3 yr apart beginning in 1972. A standard respiratory symptom and illness questionnaire was administered, spirometry was performed, and proximal hair lead and blood lead content were measured as biologic indices of automobile exhaust exposure. One hundred nine (63%) workers were current cigarette smokers, 41 (23%) were exsmokers, and 24 (14%) had never smoked. Smoking was strongly related to respiratory symptoms of cough (P less than .001) and phlegm production (P less than .001), but not to wheezing (P = .41), breathlessness (P = .14), bronchial asthma (P = .13), or frequent chest colds (P = .14). When workers were stratified by smoking status, no effect could be seen between high automobile exhaust exposure as measured by a variety of parameters and all of the above respiratory symptoms and illnesses. The level of pulmonary function [forced expiratory volume in 1 sec (FEV1.0) and forced vital capacity (FVC)] was not related to past or current exhaust exposure in a cross-sectional analysis when we controlled for age, height, and cigarette consumption. In a prospective analysis of 84 of these workers, the observed changes in FEV1.0 and FVC over 3 yr were unrelated to exhaust exposure after controlling for age, height, cigarette consumption, and initial level of pulmonary function.     

Exposure to nitrogen oxides and other air pollutants from automobiles.

We have conducted an epidemiological study to investigate the association between exposure to automobile exhaust and respiratory health. Three zones were selected in Tokyo according to expected exposure levels. Zone A is within 20 meters from the roadside of major roads with heavy traffic. Zone B is 20-150 meters away from the roadside of the same road. Zone C is the residential district in a suburb of Tokyo. Zone A, which was nearest to the roads, had the highest mean levels of personal exposure to nitrogen dioxide for housewives, followed by Zone B and Zone C. Ambient levels of nitrogen oxides, and mass concentrations, polycyclic aromatic hydrocarbons and mutagenicity of suspended particulate matter were higher at the roadside within Zone A. A cross-sectional study of respiratory symptoms and repeated examinations of pulmonary function were also performed in each zone. These results suggest that exposure to automobile exhaust may be associated with respiratory symptoms. Nevertheless, pulmonary function didn't show consistent differences over all examinations. We should have further analyses about a decline of pulmonary function with age.     

Air pollution by gasoline exhaust fumes: effect on platelet function and blood viscosity

Air pollution induced by automobile exhaust fumes seems to be involved in increased cardiovascular and respiratory morbidity. The effects of inhalation of such pollutant gases on platelet function and blood viscosity have not been sufficiently investigated, even if these parameters seem to be in strict correlation with cardiovascular function. Twelve healthy non-smoking volunteers were exposed for 30 minutes in a closed room to air polluted by automobile fumes. Platelet aggregation, blood viscosity, HbCO levels and P50 STD were determined before and after exposure. Cardiovascular parameters (blood pressure, heart rate and ECG) were also measured. At the end of the test, HbCO levels were significantly increased, but P50 STD was significantly reduced; an impairment of both platelet function and blood viscosity was observed. No significant changes in cardiovascular parameters were recorded. The decreases in platelet aggregation and blood viscosity were not directly correlated with either the increase in carbon monoxide levels or with the reduced P50 STD levels. It can be reasonably concluded that gasoline exhaust fumes could have been responsible for the observed alterations.     

汽车尾气诱导小鼠体内氧化损伤与遗传毒性的研究

目的 探讨汽车尾气导致小鼠体内氧化损伤与遗传毒性的关系。方法 将受试小鼠随机分为4组，即对照组与汽车尾气、：10，1：20，1：30稀释度染毒组，采用动式染毒装置，使小鼠暴露不同稀释度汽车尾气，每天暴露2h，连续暴露5d，测定受试组小鼠体内血、肝、肺、睾丸中活性氧族（ROS）、丙二醛（MDA）含量以及超氧化物歧化酶（SOD）活性与微核率的变化。结果 染毒组小鼠血、肝、肺、睾丸ROS与肺、睾丸DA含量和骨髓细胞微核率明显升高，与对照组比较，其差异均有显著性意义（P＜0.01），其中小鼠骨髓细胞微核率呈现一定剂量－效应关系。血、肝、肺ROS含量与微核率呈明显相关关系。结论 汽车尾气可导致机体氧化与抗氧化系统平衡紊乱；并能引起细胞染色体损伤。汽车尾气导致机体组织的氧化损伤可能在细胞遗传毒性作用中起重要作用。     

使用无铅汽油后城乡儿童铅暴露的比较

[目的]了解汽油无铅化后,儿童体内血铅水平和智商的变化及汽车尾气对其呼吸道症状发生率的影响。[方法]选择市区Y小151名小学生为接触组,浦东Z小学160名小学生为对照组,进行健康问卷调查及体格检查,取无名指末梢血测定血铅浓度,采用瑞文测试法制定智商,以EPI Info和SAS软件进行统计分析。[结果]接触组与对照组的体内血铅水平差异有显著性。血铅浓度（x)与儿童智商（y)水平有良好的负相关（y=120.11-0.129x)。接触组咽部疼痛和不适、异物感、咳嗽等症状的发生率较对照组有明显的升高,OR值分别为1．71,2．64及2．92。多元线性回归表明接触汽车尾气和家庭居住位置是儿童血铅水平及呼吸道症状发生率主要影响因素。[结论]进一步控制汽车尾气的排放,合理规划住宅位置是控制儿童铅中毒及疾病发生的重要措施。     

Exposure to Automobile Exhaust

The prevalence of chronic, nonspecific respiratory disease was assessed using a modified version of the Medical Research Council’s (MRC) respiratory disease questionnaire in a population of 268 policemen exposed to a spectrum of levels of automobile exhaust as traffic officers, patrol car officers, and indoor clerical officers. There were 99 men (36.9%) who fulfilled the usual criteria used with the MRC questionnaire for the diagnosis of disease. Data are presented to show that the men represent comparable groups and that smoking, and to a lesser extent traffic exposure, are associated factors in the development of disease.

A summary of the environmental data is presented to indicate the kinds of exposure these men experience. Annual medical assessment and seasonal environmental assessments are planned to permit prospective evaluation of the effects of chronic exposure to automobile exhaust.     

Epidemiological studies of air pollution and health effects in areas near roadways with heavy traffic in Tokyo]

Recent concern regarding health effects of air pollution in Japan has concentrated mainly on traffic-induced air pollution and its health effects in large cities. In Japan, where many people in large cities have been living near major roadways, the increase of automobile exhaust due to heavy traffic congestion will predictably cause a greater impact on people living near major roadways. We surveyed the characterization of residential suspended particulate matter (SPM) and nitrogen dioxide (NO2) concentrations along the major roadways in Tokyo, along with a health survey on the respiratory conditions of residents living in the same area, to examine the relationships between indoor pollutant levels, prevalence of respiratory symptoms and distance from roadways. The environmental monitoring was conducted in five phases. Using a newly developed SPM sampler and NO2 filter badge, continuous 4 day (96 hours) measurements were conducted in two hundred residential homes for four weeks. NO2 was measured in the living room, kitchen and outside of each home, while SPM was monitored in the living room. Health information was collected in October 1987 using ATS-DLD self-administered questionnaires. Of the 1,093 homes investigated, responses from 805 homes were received. The following results were obtained. SPM and NO2 concentrations showed large variations. Indoor pollution levels mostly depended on indoor sources, i.e. cigarette smoking and unventilated space heaters, and the effects of those indoor sources were influenced by the building structure with respect to air tightness. An association between increase in pollutant levels and the distance from the roadway was observed. However its effect is small compared to indoor source effects. The prevalence rate of respiratory symptoms was higher in those areas nearest roadways with heavy traffic both in children and adults. These results suggest the presence of a relationship between automobile exhaust and health effects.     

Chrysotile asbestos exposure associated with removal of automobile exhaust systems (ca. 1945-1975) by mechanics: results of a simulation study

For decades, asbestos-containing gaskets were used in virtually every system that involved the transport of fluids or gases. Prior to the mid-1970s, some automobile exhaust systems contained asbestos gaskets either at flanges along the exhaust pipes or at the exhaust manifolds of the engine. A limited number of automobile mufflers were lined with asbestos paper. This paper describes a simulation study that characterized personal and bystander exposures to asbestos during the removal of automobile exhaust systems (ca. 1945-1975) containing asbestos gaskets. A total of 16 pre-1974 vehicles with old or original exhaust systems were studied. Of the 16 vehicles, 12 contained asbestos gaskets in the exhaust system and two vehicles had asbestos lining inside the muffler. A total of 82 samples (23 personal, 38 bystander, and 21 indoor background) were analyzed by Phase Contrast Microscopy (PCM) and 88 samples (25 personal, 41 bystander, and 22 indoor background) by Transmission Electron Microscopy (TEM). Only seven of 25 worker samples analyzed by TEM detected asbestos fibers and 18 were below the analytical sensitivity limit (mean 0.013 f/cc, range 0.001-0.074 f/cc). Applying the ratio of asbestos fibers:total fibers (including non-asbestos) as determined by TEM to the PCM results showed an average (1 h) adjusted PCM worker exposure of 0.018 f/cc (0.002-0.04 f/cc). The average (1 h) adjusted PCM airborne concentration for bystanders was 0.008 f/cc (range 0.0008-0.015 f/cc). Assuming a mechanic can replace four automobile single exhaust systems in 1 workday, the estimated 8-h time-weighted average (TWA) for a mechanic performing this work was 0.01 f/cc. Under a scenario where a mechanic might repeatedly conduct exhaust work, these results suggest that exposures to asbestos from work with automobile exhaust systems during the 1950s through the 1970s containing asbestos gaskets were substantially below 0.1 f/cc, the current PEL for chrysotile asbestos, and quite often were not detectable.     

Experimental Evaluation of the Effect of Filtration of Diesel Exhaust by Biologic Exposure Indicators

The airway resistance, compliance of the respiratory system, transfer factor, and alveolar volume of 33 healthy rabbits were studied before and after exposure to diluted diesel exhaust generated in an experimental motor. Three diesel fuels and two particle traps were tested. Subsequent to the post-exposure lung function measurements, the animals were sacrificed and the lungs were processed for morphologic examination. The concentrations of particles, nitrogen dioxide, and formaldehyde were measured. The inflammatory airway changes were most pronounced in animals exposed to exhaust from standard fuel. Small changes were identified in animals exposed to exhaust filtered through the catalytic trap as well or exposed to unfiltered exhaust from fuels intended for densely built-up areas. Increase in compliance of the respiratory system was associated with the concentration of soot particles and formaldehyde. Compliance decreased significantly in animals exposed to exhaust from standard fuel filtered through the particle traps and increased almost significantly in animals exposed to unfiltered exhaust from the same fuel.