Sydbom A, Blomberg A, Parnia S, Stenfors N, Sandström T, Dahlén S E
Unit for Experimental Asthma & Allergy Research, The National Institute of Environmental Medicine, Karolinska Institutet, Stockhlom, Sweden.
Eur Respir J. 2001 Apr;17(4):733-46. doi: 10.1183/09031936.01.17407330.
Epidemiological studies have demonstrated an association between different levels of air pollution and various health outcomes including mortality, exacerbation of asthma, chronic bronchitis, respiratory tract infections, ischaemic heart disease and stroke. Of the motor vehicle generated air pollutants, diesel exhaust particles account for a highly significant percentage of the particles emitted in many towns and cities. This review is therefore focused on the health effects of diesel exhaust, and especially the particular matter components. Acute effects of diesel exhaust exposure include irritation of the nose and eyes, lung function changes, respiratory changes, headache, fatigue and nausea. Chronic exposures are associated with cough, sputum production and lung function decrements. In addition to symptoms, exposure studies in healthy humans have documented a number of profound inflammatory changes in the airways, notably, before changes in pulmonary function can be detected. It is likely that such effects may be even more detrimental in asthmatics and other subjects with compromised pulmonary function. There are also observations supporting the hypothesis that diesel exhaust is one important factor contributing to the allergy pandemic. For example, in many experimental systems, diesel exhaust particles can be shown to act as adjuvants to allergen and hence increase the sensitization response. Much of the research on adverse effects of diesel exhaust, both in vivo and in vitro, has however been conducted in animals. Questions remain concerning the relevance of exposure levels and whether findings in such models can be extrapolated into humans. It is therefore imperative to further assess acute and chronic effects of diesel exhaust in mechanistic studies with careful consideration of exposure levels. Whenever possible and ethically justified, studies should be carried out in humans.
流行病学研究表明，不同程度的空气污染与各种健康结果之间存在关联，这些健康结果包括死亡率、哮喘加重、慢性支气管炎、呼吸道感染、缺血性心脏病和中风。在机动车产生的空气污染物中，柴油废气颗粒在许多城镇排放的颗粒物中占比极高。因此，本综述聚焦于柴油废气的健康影响，尤其是其颗粒物成分。接触柴油废气的急性影响包括鼻和眼的刺激、肺功能变化、呼吸变化、头痛、疲劳和恶心。长期接触与咳嗽、咳痰和肺功能下降有关。除了这些症状，对健康人的接触研究还记录了气道中一些严重的炎症变化，尤其是在检测到肺功能变化之前。在哮喘患者和其他肺功能受损的受试者中，这种影响可能更具危害性。也有观察结果支持柴油废气是导致过敏大流行的一个重要因素这一假说。例如，在许多实验系统中，柴油废气颗粒可被证明可作为过敏原的佐剂，从而增强致敏反应。然而，许多关于柴油废气不良影响的体内和体外研究都是在动物身上进行的。关于接触水平的相关性以及此类模型中的研究结果是否能外推至人类，仍存在疑问。因此，在机制研究中进一步评估柴油废气的急性和慢性影响，并仔细考虑接触水平势在必行。只要有可能且符合伦理道德，就应在人体中开展研究。
