Children's Health and Environment Program, Queensland Children's Medical Research Institute, The University of Queensland, Brisbane, Australia.
Institute for Health and the Environment, University at Albany, Rensselaer, NY.
Ann Glob Health. 2016 Jan-Feb;82(1):3-9. doi: 10.1016/j.aogh.2016.01.004.
The 2010 Global Burden of Disease estimates indicate a trend toward increasing years lived with disability from chronic noncommunicable diseases (NCDs). Risk factors examined included smoking, diet, alcohol, drug abuse, and physical inactivity. By contrast, little consideration was given to accumulating evidence that exposures to environmental chemicals, psychosocial stress, and malnutrition during fetal development and across the life span also increase risk of NCDs. To address this gap, we undertook a narrative review of early-life environmental contributions to disease. We documented numerous etiologic associations. We propose that future GBD estimates use an expanded approach for assessing etiologic contributions of environmental exposures to recognized disease risk factors. We argue that broadening the definition of environmental disease, together with improved methods of assessing early life exposures and their health outcomes across the life span, will allow better understanding of causal associations and provide the incentives required to support strategies to control avoidable exposures and reduce disease risk.
2010 年全球疾病负担估计表明，残疾调整生命年（DALY）因慢性非传染性疾病（NCD）而增加的趋势。所检查的风险因素包括吸烟、饮食、酒精、药物滥用和缺乏身体活动。相比之下，对于越来越多的证据，即胎儿期和整个生命周期中接触环境化学物质、心理社会压力和营养不良也会增加 NCD 风险，几乎没有给予考虑。为了解决这一差距，我们对生命早期环境对疾病的贡献进行了叙述性综述。我们记录了许多病因关联。我们建议，未来的全球疾病负担估计使用一种扩展的方法来评估环境暴露对公认疾病风险因素的病因贡献。我们认为，扩大环境疾病的定义，以及改善评估整个生命周期中早期生活暴露及其健康结果的方法，将有助于更好地了解因果关系，并提供支持控制可避免暴露和降低疾病风险的策略所需的激励措施。
