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哮喘患者如何被纳入紧急规划和响应指南值的推导中?

How are asthmatics included in the derivation of guideline values for emergency planning and response?

机构信息

Karolinska Institutet, Institute of Environmental Medicine, Unit of Work Environment Toxicology, Stockholm, Sweden.

出版信息

Regul Toxicol Pharmacol. 2012 Aug;63(3):461-70. doi: 10.1016/j.yrtph.2012.05.010. Epub 2012 Jun 7.

Abstract

Guideline values for emergency planning and response are aimed to protect the general public, including asthmatics and other susceptible groups, during sudden airborne releases of chemicals. A precondition of asthma may increase the individual susceptibility to acute exposures. This paper studies to what extent experimental data on asthmatics are included in the rationale and derivation of guideline values. An analysis of the Technical Support Documents (TSDs) of the Acute Exposure Guideline Levels (AEGLs) shows that only 23 of the 176 TSDs include references to experimental studies on asthmatics, 30 include a statement on asthmatics but no reference to experimental data, and 123 lack any explicit statement on asthmatics. The TSDs were further compared with the support documents of nine other programs for acute or occupational short-term values. All programs were incomplete with respect to experimental data on asthmatics. Omission of asthmatics may interfere with trustful and efficient health protective actions. We suggest that the availability of data on asthmatics should be carefully examined in the development of guideline values, and that the lack of such data should be explicitly noted. In the latter case, available data for other irritants may be used to justify an appropriate assessment factor.

摘要

紧急规划和响应指南值旨在保护公众,包括哮喘患者和其他易感人群,防止化学品突然 airborne 释放。哮喘的前期条件可能会增加个体对急性暴露的敏感性。本文研究了在指南值的基本原理和推导中纳入哮喘患者实验数据的程度。对急性暴露指导水平(AEGL)的技术支持文件(TSD)的分析表明,在 176 份 TSD 中,只有 23 份提到了哮喘患者的实验研究,30 份提到了哮喘患者但没有提到实验数据,而 123 份 TSD 没有明确提到哮喘患者。进一步将 TSD 与其他九个急性或职业短期值计划的支持文件进行比较。所有计划在哮喘患者的实验数据方面都不完整。省略哮喘患者可能会干扰值得信赖和有效的健康保护措施。我们建议在制定指南值时应仔细检查有关哮喘患者的数据可用性,并明确指出缺乏此类数据。在后一种情况下,可以使用其他刺激性物质的数据来证明适当的评估因素是合理的。

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