Samet J M, Utell M J
Department of Medicine, University of New Mexico, Albuquerque.
JAMA. 1991 Aug 7;266(5):670-5.
The focus of public health concern and research in regard to environmental lung diseases has changed across the century. Illustrative agents include radon, indoor asbestos, environmental tobacco smoke, acidic aerosols, and oxidant gases. Tremendous progress has been made in understanding and preventing environmental lung diseases. However, we remain concerned about adverse consequences of breathing polluted outdoor and indoor air. In the persistent concerns about adverse effects of polluted air on the lung, a new emphasis is pervasive; the focus has shifted from avoiding clinical disease among highly exposed individuals to protecting the population from an unacceptable burden of risk. The technique of quantitative risk assessment has become increasingly important for characterizing the safety of environmental agents. The resulting emphasis on the final risk projection and attendant uncertainties may overly emphasize gaps in our knowledge.
在整个世纪里，关于环境性肺病的公共卫生关注焦点和研究重点都发生了变化。具有代表性的致病因素包括氡、室内石棉、环境烟草烟雾、酸性气溶胶和氧化性气体。在理解和预防环境性肺病方面已经取得了巨大进展。然而，我们仍然担忧吸入受污染的室外和室内空气所带来的不良后果。在对污染空气对肺部不良影响的持续关注中，一种新的侧重点普遍存在；关注点已从避免高暴露个体出现临床疾病，转向保护人群免受不可接受的风险负担。定量风险评估技术对于描述环境因素的安全性变得越来越重要。由此对最终风险预测及伴随的不确定性的强调，可能会过度突出我们知识上的差距。
