环境卫生与监测

022660大气污染健康危险度评价的方法研究/陈秉衡…//环境与健康杂志.一2001,18(2).一67～69 综合定量评价大气污染的健康危害。以国际上通用的危险度评价方法为基础,结合大气污染物每增高1单位所产生的健康损失对大气污染物浓度变化所致的健康影响进行定量评估。结果,提出了大气污染物健康危险度评价流程图,以及估计由大气污染造成的超死亡数或超病例数的计算公式。采用本方法可对我国大气污染的健康危害做出时空分布的比较分析,也可对大气污染改善措施的优先选用和效果作出健康效益的评定,并可在此基础上进一步进行经济损失一效益分析。图…     

上海市闸北区大气PM10对居民健康影响的定量评价

[目的]综合定量评价上海市闸北区大气可吸入颗粒物（PM10）污染的健康危害.[方法]以国际上近年来通用的危险度评价方法为基础,结合大气污染物每增加1单位所产生的健康损失,对大气污染物浓度变化对健康的影响进行定量评估.[结果]2001年上海市闸北区大气可吸入颗粒物污染造成超额总死亡数为775人,急、慢性支气管炎和（儿童及成人）哮喘可避免患病数分别为27 151、7113人,呼吸系统及心血管系统可避免住院数分别为151和40人,内科和儿科可避免门诊数分别为9 378及697人.[结论]上海市闸北区大气可吸入颗粒物污染对居民造成了健康损失,需继续采用综合防治措施以控制大气污染水平.     

城市大气污染健康危险度评价的方法——第三讲 大气污染物暴露与人群健康效应的暴露一反应关系分析（续二）

暴露-反应关系分析把大气质量的变化和人群健康效应终点的变化相关联，是定量评价大气污染健康危害的关键之一。在确定各项大气污染相关健康结局暴露-反应关系的基础上，结合暴露评价，就可以定量估计大气污染对居民健康危害。目前，应用于大气污染健康危险度评价的暴露-反应关系，主要来源于人群流     

大气污染与居民死亡的相关性研究

本文就近年来在大气污染物和居民死亡方面研究取得的一些成果和进展进行了汇总和讨论。文章主要涉及大气主要污染物的定义、来源及危害,大气主要污染物对人群死亡影响的流行病学研究方法,大气主要污染物对人群死亡影响的流行病学研究结果等方面。大气污染物对居民死亡的流行病学研究类型多为时间序列分析等生态学研究,主要通过Poisson回归模型、广义相加模型等方法,定量评估大气污染对人群健康不良影响的程度。     

城市大气污染健康危险度评价的方法第三讲大气污染物暴露与人群健康效应的暴露-反应关系分析(续二)

暴露-反应关系分析把大气质量的变化和人群健康效应终点的变化相关联,是定量评价大气污染健康危害的关键之一.在确定各项大气污染相关健康结局暴露-反应关系的基础上,结合暴露评价,就可以定量估计大气污染对居民健康危害.目前,应用于大气污染健康危险度评价的暴露-反应关系,主要来源于人群流行病学研究,而非志愿者暴露实验和动物毒理学实验.     

郑州市十年来大气污染分析

在郑州市１０年来大气污染物监测基础上,对大气主要污染物进行分析和评价。结果表明郑州市大气污染严重,但大气综合污染水平呈下降趋势。并指出了大气污染的危害和今后的治理对策。     

城市二氧化氮、悬浮颗粒物、二氧化硫健康危险度评价

越来越多的证据表明,城市大气污染物与各个年龄组的急慢性疾病有关。许多国家在制定降低污染物浓度决策时考虑的基本依据就是污染物对健康的影响,因此,监测各种大气污染物的环境浓度以及吸入剂量非常重要。污染物剂量只有和健康效应联系起来才能最终进行健康危险度评估。在早期的研究中对印度德里市悬浮颗粒物、二氧化氮、二氧化硫3种污染物进行了健康危险度评价。为了评价和分析的需要,研究者划分出3个地区,即居民区、工业区和商业区,将城市总人群划分为3个年龄组(婴幼儿、儿童和成人),不同年龄组体重和呼吸频率不同。在研究中计算3个年龄组呼吸频率、体重以及在不同地区的停留因子。研究结果显示,德里市儿童组受空气污染影响最大。在所有的年龄组中,二氧化硫的平均健康危险度最低。因此,研究将二氧化硫平均健康危险度作为参考对照,以评价悬浮颗粒物和二氧化氮对健康的危害。在不同地区的所有年龄人群中,二氧化氮的平均健康危险度是二氧化硫的22.11倍,悬浮颗粒物是二氧化硫的16.13倍。     

环境卫生与监测

032 8 92　上海市城区大气二氧化硫污染对健康影响的定量评价 /陈秉衡…∥环境与健康杂志 2 0 0 2 ,19( 1) 11～ 13综合定量评价上海市城区大气SO2 污染的健康危害。以国际上近年来通用的危险度评价方法为基础 ,结合大气污染物每增高一单位所产生的健康损失。结果 ,1990、1998年上海城区大气SO2 污染造成可避免死亡数分别为 4 50～ 2 4 0 0人、30～ 170人 ,慢性支气管炎可避免患病数 54 6 0 0、4 0 0 0人 ,内科门诊人次 51580 0、32 2 0 0 ,儿科门诊人次 15750 0、70 0 0 ,急诊人次 10 190 0～ 334 6 0 0 ,6 6 0 0～ 2 32 0 0 ,咳嗽症…     

我国大气颗粒物暴露与人群健康效应的关系

目的；综合分析我国大气颗粒物暴露与人群健康效应的流行病学资料，以获取我国颗粒物－健康效应的暴露－反应关系。方法：在联机检索文献的基础上，确定各健康效应终点的定量暴露－反应关系，多篇文献的综合评价采用Meta分析的方法进行。结果：建立了从发病到死亡各个健康效应终点上，大气颗粒物浓度每升高一定单位，人群不良健康效应发生的相对危险度，结论：该文建立的暴露－反应关系，可用于我国大气颗粒物污染的健康危险度评价工作。     

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。     

Ambient air quality programmes for health impact assessment in the WHO European region

An important aim of air quality assessment is to provide information about population exposure and health impact assessment. Numerous epidemiological studies have already shown that exposure to excessive levels of ambient air pollutants are associated with either acute or chronic health effects. Until recently, the adequacy of monitoring population exposure in relation to quantitative assessment of health effects of air pollution was rarely considered in ambient air monitoring strategies. This made the formulation of health-related recommendations to risk management difficult and weakens preventive and other measures to reduce adverse health effects of air pollution. To improve local and national capacities for health impact assessment, the European Centre for Environment and Health of the World Health Organization has prepared methodology guidelines concerning selected aspects of air monitoring. The WHO Collaborating Centre for Air Quality Management and Air Pollution Control support efforts in line with international programmes on quality assurance and control for Europe.     

Single pollutant versus surrogate measure approaches: do single pollutant risk assessments underestimate the impact of air pollution on lung cancer risk?

Cancer risk as a result of air pollution may be quantified by different approaches. We compared the sum of unit risk based effects of single pollutants with an epidemiology-based method by using PM(10) as a surrogate of the total air pollution. The excess rate for lung cancer cases attributable to an increase of 10 microg/m3 in average PM(10) exposure was estimated from available cohort studies. Applying the epidemiology-based risk method to the air pollution situation in the Basel area (Switzerland) resulted in 13.3 (95% CI = 6.9-19.8) excess lung cancer cases per 100,000 person years. This estimate was considerably higher than the unit risk-based estimate yielding 1.1 (range, 0.45-2.8) cancer cases per 100,000 person years. We discuss these discrepancies in light of inherent differences between approaches in toxicology and epidemiology.     

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.     

Road-traffic pollution and asthma - using modelled exposure assessment for routine public health surveillance

Asthma is a common disease and appears to be increasing in prevalence. There is evidence linking air pollution, including that from road-traffic, with asthma. Road traffic is also on the increase. Routine surveillance of the impact of road-traffic pollution on asthma, and other diseases, would be useful in informing local and national government policy in terms of managing the environmental health risk.Several methods for exposure assessment have been used in studies examining the association between asthma and road traffic pollution. These include comparing asthma prevalence in areas designated as high and low pollution areas, using distance from main roads as a proxy for exposure to road traffic pollution, using traffic counts to estimate exposure, using vehicular miles travelled and using modelling techniques. Although there are limitations to all these methods, the modelling approach has the advantage of incorporating several variables and may be used for prospective health impact assessment.The modelling approach is already in routine use in the United Kingdom in support of the government's strategy for air quality management. Combining information from such models with routinely collected health data would form the basis of a routine public health surveillance system. Such a system would facilitate prospective health impact assessment, enabling policy decisions concerned with road-traffic to be made with knowledge of the potential implications. It would also allow systematic monitoring of the health impacts when the policy decisions and plans have been implemented.     

The short-term effect of 24-h average and peak air pollution on mortality in Oslo, Norway

Numerous epidemiological studies have shown associations between increases in outdoor air pollution and all-cause mortality as well as cardiovascular and respiratory related mortality. The majority of studies has used the routine monitoring network and thus has not been able to characterize the small-scale variation in daily averages and peak concentrations within urban settings. To address possible short term impact on mortally by air pollution we used a time-stratified case-crossover design to estimate associations of traffic-related air pollution and wood burning and daily mortality during a period of 10?years among residents above 50?years of age in Oslo, Norway. A dispersion model was used to assess short-term air pollution for daily (24-h) averages and peak concentrations of nitrogen dioxide (NO₂) from exhaust and particulate matter with a diameter of 2.5?μm or less (PM_2.5) from exhaust and wood-burning at residential neighbourhood level for each individual. We found an overall increased risk from exposure at the lag of 0–5?days before the day of death for both pollutants. The excess risk was highest for PM_2.5 with a 2.8?% (95?% confidence interval: 1.2–4.4) increase per 10?μg per cubic meter change in daily exposure. Short-term traffic-related air pollution was associated with increased risk for mortality among individuals above 50?years of age, especially for circulatory outcomes.     

Practical advancement of multipollutant scientific and risk assessment approaches for ambient air pollution

Objectives: The U.S. Environmental Protection Agency is working toward gaining a better understanding of the human health impacts of exposure to complex air pollutant mixtures and the key features that drive the toxicity of these mixtures, which can then be used for future scientific and risk assessments.Data sources: A public workshop was held in Chapel Hill, North Carolina, 22-24 February 2011, to discuss scientific issues and data gaps related to adopting multipollutant science and risk assessment approaches, with a particular focus on the criteria air pollutants. Expert panelists in the fields of epidemiology, toxicology, and atmospheric and exposure sciences led open discussions to encourage workshop participants to think broadly about available and emerging scientific evidence related to multipollutant approaches to evaluating the health effects of air pollution.Synthesis: Although there is clearly a need for novel research and analytical approaches to better characterize the health effects of multipollutant exposures, much progress can be made by using existing scientific information and statistical methods to evaluate the effects of single pollutants in a multipollutant context. This work will have a direct impact on the development of a multipollutant science assessment and a conceptual framework for conducting multipollutant risk assessments.Conclusions: Transitioning to a multipollutant paradigm can be aided through the adoption of a framework for multipollutant science and risk assessment that encompasses well-studied and ubiquitous air pollutants. Successfully advancing methods for conducting these assessments will require collaborative and parallel efforts between the scientific and environmental regulatory and policy communities.     

中国煤烟型大气污染对人群健康危害的定量研究

采用环境流行病学、环境化学、污染气象学相结合的研究方法 ,通过建立暴露浓度数学模型和大气颗粒物源解析确定燃煤污染物暴露水平 ,并定量研究其对人群健康危害程度的技术方法 ,获得了大气环境常规监测资料不能得到的燃煤大气污染物PM1 0 、PM2 5、B(a)P等的人群历史暴露水平、燃煤对大气污染物的贡献率及煤烟型大气污染物的现状污染水平 ;确定了燃煤污染物对人群健康危害的影响程度。结果表明 ,重度污染区成人发生呼吸系统症状和阻塞性肺部疾病的危险性分别是相对清洁区的 1 7倍和 1 5倍 ;Ln(PM1 0 )每升高一个单位 ,小学生呼吸系统大、小气道通气量分别降低 1 94ml和 1 72ml;Ln(SO2 )升高一个单位 ,小学生呼吸系统大、小气道通气量分别降低 69ml和 1 1 9ml;重度污染区小学生非特异免疫指标和体液免疫指标均明显低于相对清洁区     

Health exposure assessment and policy analysis

Many of the existing models in regard to health, environment and development answer very few questions of concern to health planners. The models need to be precise and specific. Potential impacts of environmental pollutants on human health are evaluated on the basis of quantitative health risk assessment (QHRA). Distribution and transport of pollutants; human exposure to the pollutant; and toxicology and pharmacokinetics of a pollutant in human beings are the elements involved in health modelling.

In the present paper, age‐specific human exposures to air pollutants (suspended particulate matter, sulphur dioxide and nitrogen dioxide) have been analysed and estimated for two cities, Delhi and Nagpur, in India. The analysis, which is based on age‐specific breathing rates, body weights and occupancy factors for residential, commercial and industrial zones, highlights the exposure‐risks due to suspended particulate matter (SPM), SO₂ and NO₂. Amongst several interesting inferences which the analysis brings out is the fact that children suffer most from air pollution induced health‐risks. Interfacing the present model with toxicokinetic and pharmaco‐dynamic models will facilitate more precise quantification and assessment of health‐risks.     

Systematic review and metaanalysis of air pollution exposure and risk of diabetes

The present systematic review and metaanalysis of published observational studies was conducted to assess the health effects of exposure to air pollution on diabetes risk. Online databases were searched through January 2013, and the reference lists of pertinent articles reporting observational studies in humans were examined. Pooled relative risks and 95 % confidence intervals were calculated with a random-effects model. Exposure to air pollution was associated with slight increase in risk of diabetes and susceptibility of people with diabetes to air pollution. These results were consistent between time-series, case-crossover and cohort studies and between studies conducted in North America and Europe. The association between exposure to air pollution and diabetes was stronger for gaseous pollutants than for particulate matter. Our metaanalysis suggests that exposure to air pollution may be a risk factor for diabetes and increase susceptibility of people with diabetes to air pollution.