碳达峰碳中和背景下推进空气污染和气候变化与人群健康研究

空气污染和气候变化是威胁全世界人类健康的重要环境健康问题,中国面临的挑战更加凸显。本期重点展示大气污染控制、大气污染健康风险和气温预警阈值方面的研究成果,为中国空气污染、气候变化与健康领域研究提供最新研究证据。同时提出碳达峰碳中和背景下推进空气污染和气候变化与人群健康研究建议。     

燃煤发电排放污染物对人群心肺健康影响的流行病学研究进展

为实现碳达峰与碳中和(双碳)目标, 我国低碳燃煤发电技术不断更新和发展, 在降低二氧化碳排放的同时实现了颗粒物、二氧化硫、氮氧化物等污染物排放的大幅度下降, 但同时伴随着某些污染物如三氧化硫、氨、挥发性有机物等排放的相对升高, 污染物排放的种类和比例改变。本文梳理汇总国内外燃煤发电的技术改进, 以及不同燃煤发电模式排放污染物种类与占比的情况;综述燃煤发电排放污染物对人群心肺健康影响的流行病学研究进展, 从不同煤电模式角度阐述其环境影响, 分析低碳煤电排放的人群暴露负荷变化和心肺健康收益, 旨在为实现降碳减排目标和保障人群健康提供参考。     

应重视大气污染和气候变化急性健康风险评估与适应研究

大气污染和气候变化已成为世界各国面临的重大环境和公共卫生问题,对人类健康构成重要威胁。如何评估其造成的健康风险,如何减缓风险、提高公众适应成为极为急迫的研究课题。本期“气候变化、空气污染与健康”栏目的论文围绕急性健康风险评估和适应,在研究设计、分析方法、指标的选择和构建等方面提供了重要且丰富的信息,体现了空气污染与气候变化健康风险研究的多中心、区域化及多污染物综合急性效应研究的前沿概念,但研究中所涉及的城市数量和类型仍然有限。今后应进一步扩大精细化的多中心、多区域研究,并在此基础上开展区域性预测预警和加强适应性研究。     

我国老年流行病学研究进展

老年流行病学是运用流行病学原理和方法,研究老年人群健康状态、疾病及其危险因素的分布和预防,并采取干预措施促进老年人群健康的学科。我国人口老龄化和高龄化进程逐渐加深,老年流行病学作为流行病学的重要分支和老年预防医学的骨干学科之一,为实现预防疾病、促进健康的目标发挥着重要作用。本文总结了近年来我国老年流行病学研究的进展,梳理我国老年人的健康分布规律和危险因素等,并对老年流行病学学科发展的趋势进行了展望。     

长寿老人流行病学研究的科学意义与展望

我国已快速进入老龄化社会, 人口老龄化及老年人群的健康问题日益突出, 长寿老人作为"健康老人模板", 对其开展健康相关的流行病学研究, 建设健康老龄社会有重要的指导意义。目前长寿老人流行病学研究前瞻性研究仍然较少, 尚需涵盖人口社会学、生活习惯、饮食结构、疾病谱、心理精神状态、医学影像指标、生物标志物、基因等诸多层面的长寿老人队列数据的长期随访收集以及生物样本库的建立完善。本期重点号展示了中国海南百岁老人队列研究基于7年随访数据, 围绕百岁老人全因死亡的风险因素展开的研究成果, 以期为长寿老人流行病学研究的深入和健康老龄化策略的制定提供科学依据。     

装修垃圾预处理中试研究

介绍了我国建筑装修垃圾处理现状及主要处理方式,明确了装修垃圾预处理技术的研究及应用将是实现建材再生资源化领域"双碳"目标的关键环节.重点介绍了以"破袋粗破+预筛分+高效分级风选+磁选+人工分拣+成品分级精细风选"工艺技术路线为指导开展的带料中试实验研究.该生产线稳定产能可维持在50 t/h以上,作为实验生产线的主产品再...     

回家吃饭,一起减"碳"

"碳中和"火了 今年的全国两会首次将"碳达峰"和"碳中和"写入政府工作报告中,这两个概念一下火了起来.其实在2020年9月,中国政府就曾在联合国大会上提出:"二氧化碳排放力争于2030年前达到峰值,努力争取2060年前实现碳中和."简单地说,就是指到2030年,我国的碳排放量达到最高值,之后通过植树造林、节能减排等环保手段抵消碳排放量,到2060年完全实现零排放.     

受控的空气污染物暴露与心律失常风险[摘要]

[背景]流行病学研究报道了空气污染暴露与心血管疾病发病率和死亡率增加之间的关联。空气污染物暴露可以影响心脏自主神经节律并降低心率变异性,可能增加心律失常的风险,特别是在敏感的患者群体中。[目的]研究在可控制的空气污染物暴露期间和之后,统计分析了健康志愿者和冠状动脉心脏疾病患者的心律失常发生率。[方法]分析数据来自13个随机双盲交叉研究,包括282名参加者（140名健康志愿者和142例稳定性冠状动脉心脏疾病患者）的连续心电图记录。记录研究人群每次暴露时发生心律失常的情况。[结果]在稀释的柴油车尾气、木材烟雾、臭氧、浓缩的环境颗粒物、工程碳纳米颗粒或空气污染高环境水平的暴露期间或者之后,无论在健康志愿者或冠状动脉心脏疾病患者中,任何形式心律失常的发生均没有增加。[结论]急性、可控制的空气污染物暴露不增加受试者发生心律失常的短期风险。研究中所采用的这些技术,对于确定涉及空气污染不利影响的重要病理生理途径依然至关重要,并且在为环境和公共卫生政策决策提供信息中也起着重要的作用。     

关注学科热点 加强诚信建设

2019年,在编委、专家、作者及读者的大力支持下,中华预防医学杂志刊登了空气污染、气候变化与健康,脑膜炎脑炎流行病学和病原学研究等12个重点号,成功举办了包括第十届传染病防控基础研究与应用技术论坛在内的多个精品学术会议。荣获"2018年中国百种杰出学术期刊""2019年国际影响力优秀学术期刊",入选"中国科技期刊卓越行动计划(梯队期刊)",综合排名继续在同类期刊中居首位。     

气候变化对老年人群健康的影响分析

为了提高人们对气候变化与老年人群健康关系的认识,采用文献综述的方法,系统地回顾国内外气候变化对老年人产生的健康效应。分析气候变化下极端温度、极端气候、空气污染和气候敏感性传染病对老年人群产生的直接和间接健康影响,并根据老年人死因排序,重点围绕极端温度对心脑血管系统疾病和空气污染对呼吸系统疾病的影响、致病机理及对不同地区老年人发病率和死亡率的影响程度进行探讨。为推动健康老龄化,促进老年人群应对气候变化提出以下建议:一是积极支持气候变化纳入老年健康服务体系建设;二是提高老年人对气候变化影响健康的认知;三是加大研究支持力度,尤其是交叉学科研究。     

How Can Urban Policies Improve Air Quality and Help Mitigate Global Climate Change: a Systematic Mapping Review

Tackling climate change at the global level is central to a growing field of scientific research on topics such as environmental health, disease burden, and its resulting economic impacts. At the local level, cities constitute an important hub of atmospheric pollution due to the large amount of pollutants that they emit. As the world population shifts to urban centers, cities will increasingly concentrate more exposed populations. Yet, there is still significant progress to be made in understanding the contribution of urban pollutants other than CO₂, such as vehicle emissions, to global climate change. It is therefore particularly important to study how local governments are managing urban air pollution. This paper presents an overview of local air pollution control policies and programs that aim to reduce air pollution levels in megacities. It also presents evidence measuring their efficacy. The paper argues that local air pollution policies are not only beneficial for cities but are also important for mitigating and adapting to global climate change. The results systematize several policy approaches used around the world and suggest the need for more in-depth cross-city studies with the potential to highlight best practices both locally and globally. Finally, it calls for the inclusion of a more human rights-based approach as a mean of guaranteeing of clean air for all and reducing factors that exacerbate climate change.     

Wastewater irrigation and environmental health: implications for water governance and public policy

Climate change is a large-scale and emerging environmental risk. It challenges environmental health and the sustainability of global development. Wastewater irrigation can make a sterling contribution to reducing water demand, recycling nutrients, improving soil health and cutting the amount of pollutants discharged into the waterways. However, the resource must be carefully managed to protect the environment and public health. Actions promoting wastewater reuse are every where, yet the frameworks for the protection of human health and the environment are lacking in most developing countries. Global change drivers including climate change, population growth, urbanization, income growth, improvements in living standard, industrialization, and energy intensive lifestyle will all heighten water management challenges. Slowing productivity growth, falling investment in irrigation, loss of biodiversity, risks to public health, environmental health issues such as soil salinity, land degradation, land cover change and water quality issues add an additional layer of complexity. Against this backdrop, the potential for wastewater irrigation and its benefits and risks are examined. These include crop productivity, aquaculture, soil health, groundwater quality, environmental health, public health, infrastructure constraints, social concerns and risks, property values, social equity, and poverty reduction. It is argued that, wastewater reuse and nutrient capture can contribute towards climate change adaptation and mitigation. Benefits such as avoided freshwater pumping and energy savings, fertilizer savings, phosphorous capture and prevention of mineral fertilizer extraction from mines can reduce carbon footprint and earn carbon credits. Wastewater reuse in agriculture reduces the water footprint of food production on the environment; it also entails activities such as higher crop yields and changes in cropping patterns, which also reduce carbon footprint. However, there is a need to better integrate water reuse into core water governance frameworks in order to effectively address the challenges and harness the potential of this vital resource for environmental health protection. The paper also presents a blueprint for future water governance and public policies for the protection of environmental health.     

Air pollution and population health: a global challenge

“Air pollution and population health” is one of the most important environmental and public health issues. Economic development, urbanization, energy consumption, transportation/motorization, and rapid population growth are major driving forces of air pollution in large cities, especially in megacities. Air pollution levels in developed countries have been decreasing dramatically in recent decades. However, in developing countries and in countries in transition, air pollution levels are still at relatively high levels, though the levels have been gradually decreasing or have remained stable during rapid economic development. In recent years, several hundred epidemiological studies have emerged showing adverse health effects associated with short-term and long-term exposure to air pollutants. Time-series studies conducted in Asian cities also showed similar health effects on mortality associated with exposure to particulate matter (PM), sulfur dioxide (SO₂), nitrogen dioxide (NO₂) and ozone (O₃) to those explored in Europe and North America. The World Health Organization (WHO) published the “WHO Air Quality Guidelines (AQGs), Global Update” in 2006. These updated AQGs provide much stricter guidelines for PM, NO₂, SO₂ and O₃. Considering that current air pollution levels are much higher than the WHO-recommended AQGs, interim targets for these four air pollutants are also recommended for member states, especially for developing countries in setting their country-specific air quality standards. In conclusion, ambient air pollution is a health hazard. It is more important in Asian developing countries within the context of pollution level and population density. Improving air quality has substantial, measurable and important public health benefits.     

青岛市大气污染对人体健康经济损失评估

目的 对青岛市区1981～2000年大气污染状况进行综合质量评价，并对青岛市大气污染健康影响状况进行回顾性分析。方法 采用大气质量综合指数，对青岛市区大气环境质量进行评价；采用修正人力资本法，对大气污染导致人体健康危害的经济损失进行定量评估。结果 青岛市区呼吸系统疾病高发，肺癌死亡率显高于对照区。结论 大气污染是造成健康危害的重要环境因素之一，NOx污染亦应引起重视。     

Recessions and Health: The Impact of Economic Trends on Air Pollution in California

Objectives. I explored the hypothesis that economic activity has a significant impact on exposure to air pollution and ultimately human health.Methods. I used county-level employment statistics in California (1980–2000), along with major regulatory periods and other controlling factors, to estimate local concentrations of the coefficient of haze, carbon monoxide, and nitrogen dioxide using a mixed regression model approach.Results. The model explained between 33% and 48% of the variability in air pollution levels as estimated by the overall R² values. The relationship between employment measures and air pollution was statistically significant, suggesting that air quality improves during economic downturns. Additionally, major air quality regulations played a significant role in reducing air pollution levels over the study period.Conclusions. This study provides important evidence of a role for the economy in understanding human exposure to environmental pollution. The evidence further suggests that the impact of environmental regulations are likely to be overstated when they occur during recessionary periods, and understated when they play out during periods of economic growth.Understanding the dynamics of human exposure to pollution is fundamental to the study of environmental epidemiology. Recent evidence suggests that economic activity may play an important exposure-modifying role in the relationship between air pollution and human health.1,2 Community-level air pollution is driven in large part by the economic engine within which these exposures are generated, ranging from nearby polluting factories to truck and vehicle traffic on roadways. When unemployment levels are low and the economic engine is working at full speed, economic output and air pollution–generating activities will likely increase, leading to higher ambient air pollution levels. The opposite scenario will play out during a recession, and regulatory policies aimed at improving air quality may act to speed up or slow down the underlying trend or pace set by the economy. For this reason, the effectiveness of regulatory policies is likely to be overstated when they occur during recessionary periods, and understated when they occur during periods of economic growth. By jointly considering the impact of both the economy and environmental regulations within a framework that models exposure to air pollution, it is possible to disentangle these important effects from one another. I identify the impact of economic activity and regulatory policy on the coefficient of haze (COH), carbon monoxide (CO), and nitrogen dioxide (NO₂) in a set of California counties in the years 1980 through 2000.     

The potential impacts of climate variability and change on air pollution-related health effects in the United States

Climate change may affect exposures to air pollutants by affecting weather, anthropogenic emissions, and biogenic emissions and by changing the distribution and types of airborne allergens. Local temperature, precipitation, clouds, atmospheric water vapor, wind speed, and wind direction influence atmospheric chemical processes, and interactions occur between local and global-scale environments. If the climate becomes warmer and more variable, air quality is likely to be affected. However, the specific types of change (i.e., local, regional, or global), the direction of change in a particular location (i.e., positive or negative), and the magnitude of change in air quality that may be attributable to climate change are a matter of speculation, based on extrapolating present understanding to future scenarios. There is already extensive evidence on the health effects of air pollution. Ground-level ozone can exacerbate chronic respiratory diseases and cause short-term reductions in lung function. Exposure to particulate matter can aggravate chronic respiratory and cardiovascular diseases, alter host defenses, damage lung tissue, lead to premature death, and possibly contribute to cancer. Health effects of exposures to carbon monoxide, sulfur dioxide, and nitrogen dioxide can include reduced work capacity, aggravation of existing cardiovascular diseases, effects on pulmonary function, respiratory illnesses, lung irritation, and alterations in the lung's defense systems. Adaptations to climate change should include ensuring responsiveness of air quality protection programs to changing pollution levels. Research needs include basic atmospheric science work on the association between weather and air pollutants; improving air pollution models and their linkage with climate change scenarios; and closing gaps in the understanding of exposure patterns and health effects.     

Climate change impacts on human health over Europe through its effect on air quality

This review examines the current literature on the effects of future emissions and climate change on particulate matter (PM) and O₃ air quality and on the consequent health impacts, with a focus on Europe. There is considerable literature on the effects of climate change on O₃ but fewer studies on the effects of climate change on PM concentrations. Under the latest Intergovernmental Panel on Climate Change (IPCC) 5th assessment report (AR5) Representative Concentration Pathways (RCPs), background O₃ entering Europe is expected to decrease under most scenarios due to higher water vapour concentrations in a warmer climate. However, under the extreme pathway RCP8.5 higher (more than double) methane (CH₄) abundances lead to increases in background O₃ that offset the O₃ decrease due to climate change especially for the 2100 period. Regionally, in polluted areas with high levels of nitrogen oxides (NO_x), elevated surface temperatures and humidities yield increases in surface O₃ – termed the O₃ climate penalty – especially in southern Europe. The O₃ response is larger for metrics that represent the higher end of the O₃ distribution, such as daily maximum O₃. Future changes in PM concentrations due to climate change are much less certain, although several recent studies also suggest a PM climate penalty due to high temperatures and humidity and reduced precipitation in northern mid-latitude land regions in 2100.A larger number of studies have examined both future climate and emissions changes under the RCP scenarios. Under these pathways the impact of emission changes on air quality out to the 2050s will be larger than that due to climate change, because of large reductions in emissions of O₃ and PM pollutant precursor emissions and the more limited climate change response itself. Climate change will also affect climate extreme events such as heatwaves. Air pollution episodes are associated with stagnation events and sometimes heat waves. Air quality during the 2003 heatwave over Europe has been examined in numerous studies and mechanisms for enhancing O₃ have been identified.There are few studies on health effects associated with climate change impacts alone on air quality, but these report higher O₃-related health burdens in polluted populated regions and greater PM_2.5 health burdens in these emission regions. Studies that examine the combined impacts of climate change and anthropogenic emissions change under the RCP scenarios report reductions in global and European premature O₃-respiratory related and PM mortalities arising from the large decreases in precursor emissions. Under RCP 8.5 the large increase in CH₄ leads to global and European excess O₃-respiratory related mortalities in 2100. For future health effects, besides uncertainty in future O₃ and particularly PM concentrations, there is also uncertainty in risk estimates such as effect modification by temperature on pollutant-response relationships and potential future adaptation that would alter exposure risk.