Office of Research and Development, US EPA, RTP, NC, USA.
Office of Research and Development, US EPA, RTP, NC, USA.
Environ Res. 2018 Feb;161:144-152. doi: 10.1016/j.envres.2017.11.008. Epub 2017 Nov 13.
The current single-pollutant approach to regulating ambient air pollutants is effective at protecting public health, but efficiencies may be gained by addressing issues in a multipollutant context since multiple pollutants often have common sources and individuals are exposed to more than one pollutant at a time.
We performed a cross-disciplinary review of the effects of multipollutant exposures on cardiovascular effects.
A broad literature search for references including at least two criteria air pollutants (particulate matter [PM], ozone [O], oxides of nitrogen, sulfur oxides, carbon monoxide) was conducted. References were culled based on scientific discipline then searched for terms related to cardiovascular disease. Most multipollutant epidemiologic and experimental (i.e., controlled human exposure, animal toxicology) studies examined PM and O together.
Epidemiologic and experimental studies provide some evidence for O concentration modifying the effect of PM, although PM did not modify O risk estimates. Experimental studies of combined exposure to PM and O provided evidence for additivity, synergism, and/or antagonism depending on the specific health endpoint. Evidence for other pollutant pairs was more limited.
Overall, the evidence for multipollutant effects was often heterogeneous, and the limited number of studies inhibited making a conclusion about the nature of the relationship between pollutant combinations and cardiovascular disease.
目前,针对环境空气污染物的单一污染物监管方法在保护公众健康方面是有效的,但在多污染物背景下解决问题可能会提高效率,因为多种污染物通常具有共同的来源,而且个体一次会接触到多种污染物。
我们对多污染物暴露对心血管影响的作用进行了跨学科综述。
我们广泛搜索了至少包含两种标准空气污染物(颗粒物[PM]、臭氧[O]、氮氧化物、硫氧化物、一氧化碳)的参考文献。参考文献根据科学学科进行筛选,然后搜索与心血管疾病相关的术语。大多数多污染物流行病学和实验(即受控人体暴露、动物毒理学)研究同时研究了 PM 和 O。
流行病学和实验研究为 O 浓度调节 PM 影响提供了一些证据,尽管 PM 并没有改变 O 风险估计。PM 和 O 联合暴露的实验研究提供了加性、协同作用和/或拮抗作用的证据,具体取决于特定的健康终点。其他污染物对的证据则更为有限。
总体而言,多污染物效应的证据往往存在异质性,而且研究数量有限,无法就污染物组合与心血管疾病之间关系的性质得出结论。