Hänninen Otto, Knol Anne B, Jantunen Matti, Lim Tek-Ang, Conrad André, Rappolder Marianne, Carrer Paolo, Fanetti Anna-Clara, Kim Rokho, Buekers Jurgen, Torfs Rudi, Iavarone Ivano, Classen Thomas, Hornberg Claudia, Mekel Odile C L
National Institute for Health and Welfare (THL), Department of Environmental Health, Helsinki, Finland.
Environ Health Perspect. 2014 May;122(5):439-46. doi: 10.1289/ehp.1206154. Epub 2014 Feb 28.
Environmental health effects vary considerably with regard to their severity, type of disease, and duration. Integrated measures of population health, such as environmental burden of disease (EBD), are useful for setting priorities in environmental health policies and research. This review is a summary of the full Environmental Burden of Disease in European countries (EBoDE) project report.
The EBoDE project was set up to provide assessments for nine environmental risk factors relevant in selected European countries (Belgium, Finland, France, Germany, Italy, and the Netherlands).
Disability-adjusted life years (DALYs) were estimated for benzene, dioxins, secondhand smoke, formaldehyde, lead, traffic noise, ozone, particulate matter (PM2.5), and radon, using primarily World Health Organization data on burden of disease, (inter)national exposure data, and epidemiological or toxicological risk estimates. Results are presented here without discounting or age-weighting.
About 3-7% of the annual burden of disease in the participating countries is associated with the included environmental risk factors. Airborne particulate matter (diameter ≤ 2.5 μm; PM2.5) is the leading risk factor associated with 6,000-10,000 DALYs/year and 1 million people. Secondhand smoke, traffic noise (including road, rail, and air traffic noise), and radon had overlapping estimate ranges (600-1,200 DALYs/million people). Some of the EBD estimates, especially for dioxins and formaldehyde, contain substantial uncertainties that could be only partly quantified. However, overall ranking of the estimates seems relatively robust.
With current methods and data, environmental burden of disease estimates support meaningful policy evaluation and resource allocation, including identification of susceptible groups and targets for efficient exposure reduction. International exposure monitoring standards would enhance data quality and improve comparability.
环境健康影响在严重程度、疾病类型和持续时间方面差异很大。人口健康的综合衡量指标，如疾病环境负担（EBD），有助于确定环境健康政策和研究的优先事项。本综述是欧洲国家疾病环境负担（EBoDE）项目完整报告的总结。
EBoDE项目旨在对选定欧洲国家（比利时、芬兰、法国、德国、意大利和荷兰）相关的九种环境风险因素进行评估。
主要使用世界卫生组织的疾病负担数据、（国际）暴露数据以及流行病学或毒理学风险估计值，对苯、二恶英、二手烟、甲醛、铅、交通噪音、臭氧、细颗粒物（PM2.5）和氡的伤残调整生命年（DALYs）进行了估计。此处呈现的结果未进行贴现或年龄加权。
参与国每年约3%-7%的疾病负担与所纳入的环境风险因素有关。空气中的细颗粒物（直径≤2.5μm；PM2.5）是主要风险因素，每年导致6000-10000个伤残调整生命年，涉及100万人。二手烟、交通噪音（包括道路、铁路和空中交通噪音）和氡的估计范围有重叠（600-1200个伤残调整生命年/百万人）。一些疾病环境负担估计值，特别是二恶英和甲醛的估计值，包含很大的不确定性，只能部分量化。然而，估计值的总体排名似乎相对可靠。
采用当前的方法和数据，疾病环境负担估计有助于进行有意义的政策评估和资源分配，包括识别易感人群和有效降低暴露的目标。国际暴露监测标准将提高数据质量并改善可比性。
