臭氧消耗对人类健康的影响及其与气候变化的相互作用。
The human health effects of ozone depletion and interactions with climate change.
机构信息
Biomedical Sciences, University of Edinburgh Medical School, Edinburgh, EH8 9AG, Scotland.
出版信息
Photochem Photobiol Sci. 2011 Feb;10(2):199-225. doi: 10.1039/c0pp90044c. Epub 2011 Jan 20.
Depletion of the stratospheric ozone layer has led to increased solar UV-B radiation (280-315 nm) at the surface of the Earth. This change is likely to have had an impact on human exposure to UV-B radiation with consequential detrimental and beneficial effects on health, although behavioural changes in society over the past 60 years or so with regard to sun exposure are of considerable importance. The present report concentrates on information published since our previous report in 2007. The adverse effects of UV radiation are primarily on the eye and the skin. While solar UV radiation is a recognised risk factor for some types of cataract and for pterygium, the evidence is less strong, although increasing, for ocular melanoma, and is equivocal at present for age-related macular degeneration. For the skin, the most common harmful outcome is skin cancer, including melanoma and the non-melanoma skin cancers, basal cell carcinoma and squamous cell carcinoma. The incidence of all three of these tumours has risen significantly over the past five decades, particularly in people with fair skin, and is projected to continue to increase, thus posing a significant world-wide health burden. Overexposure to the sun is the major identified environmental risk factor in skin cancer, in association with various genetic risk factors and immune effects. Suppression of some aspects of immunity follows exposure to UV radiation and the consequences of this modulation for the immune control of infectious diseases, for vaccination and for tumours, are additional concerns. In a common sun allergy (polymorphic light eruption), there is an imbalance in the immune response to UV radiation, resulting in a sun-evoked rash. The major health benefit of exposure to solar UV-B radiation is the production of vitamin D. Vitamin D plays a crucial role in bone metabolism and is also implicated in protection against a wide range of diseases. Although there is some evidence supporting protective effects for a range of internal cancers, this is not yet conclusive, but strongest for colorectal cancer, at present. A role for vitamin D in protection against several autoimmune diseases has been studied, with the most convincing results to date for multiple sclerosis. Vitamin D is starting to be assessed for its protective properties against several infectious and coronary diseases. Current methods for protecting the eye and the skin from the adverse effects of solar UV radiation are evaluated, including seeking shade, wearing protective clothing and sunglasses, and using sunscreens. Newer possibilities are considered such as creams that repair UV-induced DNA damage, and substances applied topically to the skin or eaten in the diet that protect against some of the detrimental effects of sun exposure. It is difficult to provide easily understandable public health messages regarding "safe" sun exposure, so that the positive effects of vitamin D production are balanced against the negative effects of excessive exposure. The international response to ozone depletion has included the development and deployment of replacement technologies and chemicals. To date, limited evidence suggests that substitutes for the ozone-depleting substances do not have significant effects on human health. In addition to stratospheric ozone depletion, climate change is predicted to affect human health, and potential interactions between these two parameters are considered. These include altering the risk of developing skin tumours, infectious diseases and various skin diseases, in addition to altering the efficiency by which pathogenic microorganisms are inactivated in the environment.
平流层臭氧消耗导致地球表面太阳紫外线-B 辐射(280-315nm)增加。这种变化可能已经对人类接触紫外线-B 辐射产生了影响,对健康产生了相应的有害和有益影响,尽管过去 60 年来,社会在暴露于阳光下的行为方面发生了相当大的变化。本报告集中于自 2007 年我们上次报告以来公布的信息。紫外线辐射的不利影响主要在眼睛和皮肤上。虽然太阳紫外线辐射是某些类型白内障和翼状胬肉的已知风险因素,但证据虽然越来越多,但对于眼部黑色素瘤的证据却较弱,目前对于与年龄相关的黄斑变性的证据尚无定论。对于皮肤来说,最常见的有害后果是皮肤癌,包括黑色素瘤和非黑色素瘤皮肤癌、基底细胞癌和鳞状细胞癌。这三种肿瘤的发病率在过去五十年中显著上升,尤其是在皮肤白皙的人群中,预计还会继续上升,因此给全球健康带来了重大负担。过度暴露于阳光下是皮肤癌的主要已确定环境风险因素,与各种遗传风险因素和免疫效应有关。暴露于紫外线后,免疫系统的某些方面受到抑制,其对传染病的免疫控制、疫苗接种和肿瘤的免疫控制的后果是另外的关注点。在一种常见的太阳过敏症(多形性光疹)中,对紫外线辐射的免疫反应失衡,导致日晒后出现皮疹。暴露于太阳紫外线-B 辐射的主要健康益处是产生维生素 D。维生素 D 在骨骼代谢中起着至关重要的作用,并且还与广泛的疾病的保护有关。尽管有一些证据支持一系列内部癌症的保护作用,但目前还没有定论,但对结直肠癌的保护作用最强。已经研究了维生素 D 在预防多种自身免疫性疾病中的作用,迄今为止,最令人信服的结果是多发性硬化症。维生素 D 正在开始被评估用于预防多种感染性和冠心病的保护特性。评估了保护眼睛和皮肤免受太阳紫外线辐射不利影响的当前方法,包括寻找阴凉处、穿防护服和太阳镜,以及使用防晒霜。还考虑了一些新的可能性,例如修复紫外线诱导的 DNA 损伤的乳膏,以及局部应用于皮肤或食用的饮食中的物质,以预防阳光照射的一些有害影响。很难提供关于“安全”日晒的容易理解的公共卫生信息,因此维生素 D 产生的积极影响与过度暴露的负面影响相平衡。国际社会对臭氧层消耗的反应包括开发和部署替代技术和化学品。到目前为止,有限的证据表明,臭氧消耗物质的替代品对人类健康没有重大影响。除了平流层臭氧消耗外,气候变化预计还会影响人类健康,并考虑到这两个参数之间的潜在相互作用。除了改变皮肤肿瘤、传染病和各种皮肤病的发病风险外,这些变化还包括改变环境中致病微生物失活的效率。