Hoppenbrouwers T
LAC/USC Medical Center, Department of Pediatrics.
Lung. 1990;168 Suppl:335-46. doi: 10.1007/BF02718150.
Correlations between ambient pollutants and health effects, such as observed in SIDS, may in reality be to a larger extent the result of indoor sources. These distinctions between indoor and outdoor sources, while important, do not detract from the overall conclusion that pollution affects the airway in children directly and indirectly. Much still needs to be learned about the permanence of these effects, the mechanism by which the effect is mediated, and the conditions under which some of these effects are maximal. Two approaches seem particularly suited to shed further light on these issues. First, identification of biological markers for exposure to pollutants will yield both more accurate measures of exposure to pollutants and information about health consequences. Second, newer modeling techniques promise to predict health outcomes under a variety of environmental conditions. Shumway et al., for instance, describe a promising model predicting an increase in mortality due to ambient pollutants in the Los Angeles Basin with higher levels under extremes of temperature, especially during cold spells. Time series and factor analyses may further our knowledge as well. In the near future, large cohort studies should begin to reveal the cumulative effects of air pollution on the respiratory system, especially in relation to active smoking. Finally, studies in Black children are virtually unavailable. Given their high risk for respiratory illnesses, such studies are sorely needed.
环境污染物与健康影响之间的相关性，比如在婴儿猝死综合征中观察到的情况，实际上在很大程度上可能是室内污染源导致的。室内和室外污染源之间的这些差异虽然很重要，但并不影响污染直接或间接影响儿童气道这一总体结论。关于这些影响的持久性、影响介导的机制以及某些影响达到最大值的条件，仍有很多需要了解。两种方法似乎特别适合进一步阐明这些问题。首先，识别污染物暴露的生物标志物将既能提供更准确的污染物暴露测量值，又能提供有关健康后果的信息。其次，更新的建模技术有望预测各种环境条件下的健康结果。例如，舒姆韦等人描述了一个很有前景的模型，该模型预测洛杉矶盆地因环境污染物导致的死亡率会随着极端温度水平升高而增加，尤其是在寒潮期间。时间序列分析和因素分析也可能增进我们的认识。在不久的将来，大型队列研究应该开始揭示空气污染对呼吸系统的累积影响，尤其是与主动吸烟相关的影响。最后，针对黑人儿童的研究几乎没有。鉴于他们患呼吸道疾病的风险很高，这类研究非常必要。
