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风险评估与儿童健康。

Risk assessment and child health.

作者信息

Samet Jonathan M

机构信息

Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205, USA.

出版信息

Pediatrics. 2004 Apr;113(4 Suppl):952-6.

Abstract

Risk assessment, an approach for organizing information about hazards to health, safety, and the environment, provides a framework for gauging the threat to child health from environmental pollutants. A qualitative risk assessment has 4 components: hazard identification, dose-response assessment, exposure assessment, and risk characterization. In a risk assessment, consideration can be given to a population group that potentially has increased susceptibility, whether arising from having a high level of exposure or from increased susceptibility to the agent of concern on a biological basis. Children have been proposed as being at increased risk from some environmental agents, and there has long been concern and debate that the current approach of determining acceptable exposure levels or intake for a person may not yield safe intake limits for infants and children, who may be placed at greater risk than adults because of exposure patterns and inherent susceptibility. The persistence of debate on this critical public health issue reflects, in part, the difficulty of developing sufficiently sensitive and validated animal bioassays for critical outcomes. Epidemiologic studies can play only a limited role, given the complexity of establishing cohorts and tracking exposures from conception forward to assess risks across the lifespan. Meeting society's call for healthy environments for children poses an extraordinary challenge to researchers and to the policy makers who seek to develop evidence-based policies to protect children.

摘要

风险评估是一种整理有关健康、安全和环境危害信息的方法,为衡量环境污染物对儿童健康的威胁提供了一个框架。定性风险评估有4个组成部分:危害识别、剂量反应评估、暴露评估和风险特征描述。在风险评估中,可以考虑一个潜在易感性增加的人群组,这可能是由于高暴露水平,也可能是由于在生物学基础上对相关因素的易感性增加。有人提出儿童受某些环境因素影响的风险增加,长期以来人们一直担心并争论,目前确定一个人可接受暴露水平或摄入量的方法可能无法得出婴儿和儿童的安全摄入限值,由于暴露模式和内在易感性,他们可能比成年人面临更大风险。关于这个关键公共卫生问题的争论持续存在,部分反映了为关键结果开发足够敏感和经过验证的动物生物测定法的困难。鉴于建立队列以及追踪从受孕开始直至评估整个生命周期风险的暴露情况非常复杂,流行病学研究只能发挥有限的作用。满足社会对儿童健康环境的要求,对研究人员以及寻求制定基于证据的政策来保护儿童的政策制定者构成了巨大挑战。

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