Goldberg Mark S
Division of Clinical Epidemiology, Department of Medicine, McGill University, Montreal, Quebec, Canada.
J Expo Sci Environ Epidemiol. 2007 Dec;17 Suppl 2:S66-70. doi: 10.1038/sj.jes.7500629.
Studies of the effects of ambient air pollution on human health are complicated by the fact that individuals are exposed to a complex mixture of toxic and non-toxic substances that vary in their make-up in space and in time. It is impossible using standard epidemiological designs to uniquely identify any individual component of air pollution as a causal agent of a health effect because of simultaneous exposure to all or a subset of ambient pollutants. Nevertheless, associations observed for a particular pollutant can be interpreted as a marker of toxicity of the mixture, and regulatory action on judiciously selected pollutants can benefit health, as such actions can modify the complex mixture. This paper argues that we may be able to further our understanding of the effects of air pollution on human health by investigating whether particular mixtures are more toxic through (1) conducting and reporting results for all measured components; (2) possibly characterizing the complex mixture by developing synoptic categorizations of daily air pollution, through cluster or latent profile analysis; (3) a careful analysis of differences in the mixtures between locations; and (4) toxicological studies and controlled studies on humans that make use of factorial designs for various components of the air pollution mixture.
环境空气污染对人类健康影响的研究十分复杂，因为个体接触到的是有毒和无毒物质的复杂混合物，其成分随空间和时间而变化。由于个体同时接触到所有或部分环境污染物，因此使用标准的流行病学设计无法唯一确定空气污染的任何单一成分是健康影响的致病因素。然而，针对特定污染物观察到的关联可以解释为混合物毒性的一个指标，对经过审慎选择的污染物采取监管行动可有益于健康，因为此类行动可以改变这种复杂的混合物。本文认为，我们或许能够通过以下方式进一步了解空气污染对人类健康的影响：(1) 对所有测量成分进行检测并报告结果；(2) 通过聚类或潜在剖面分析对每日空气污染进行概要分类，从而可能对这种复杂混合物进行特征描述；(3) 仔细分析不同地点之间混合物的差异；(4) 利用空气污染混合物各成分的析因设计进行毒理学研究和人体对照研究。
