ORISE, National Exposure Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA, Fax: +919-541-0905.
National Exposure Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA.
Rev Environ Health. 2018 Dec 19;33(4):349-381. doi: 10.1515/reveh-2018-0034.
Children's exposures to chemical and non-chemical stressors from their everyday environment affects their overall health and well-being. American-Indian/Alaska-Native (AI/AN) children may have a disproportionate burden of stressors from their built and natural environments when compared to children from other races/ethnicities. Our objectives were to identify chemical and non-chemical stressors from AI/AN children's built and natural environments and evaluate their linkages with health and well-being outcomes from the peer reviewed literature. Library databases (e.g. PubMed) were searched to identify studies focused on these stressors. References were excluded if they: did not discuss AI/AN children or they were not the primary cohort; discussed tribes outside the United States (U.S.); were reviews or intervention studies; or did not discuss stressors from the built/natural environments. Out of 2539 references, 35 remained. Sample populations were predominantly (70%) in New York (NY) and Alaska (AK); 14 studies reported on the same cohort. Studies with matching stressors and outcomes were few, ruling out a quantitative review. Respiratory and developmental outcomes were the main outcomes evaluated. Primary non-chemical stressors were residential proximity to polluted landscapes, lack of indoor plumbing, and indoor use of wood for heating or cooking. The main chemical stressors were volatile organic compounds (VOCs), particulate matter (PM2.5), polychlorinated biphenyls (PCBs), p,p'-DDE, hexachlorobenzene (HCB), lead, and mercury. Our qualitative review was suggestive of a potential increase in respiratory illness from indoor wood use or no plumbing, which can be used as a guide to promote healthy environments for AI/AN children. We identified limited studies (<40), demonstrating this population as understudied. Future studies need to consider: sample populations from other tribes in the U.S., stressors outside the household, other elements of the natural environment, and an evaluation of stressors from AI/AN children's total environment (built, natural, and social).
儿童在日常生活环境中接触到的化学和非化学应激源会影响他们的整体健康和福祉。与其他种族/族裔的儿童相比，美洲印第安人/阿拉斯加原住民 (AI/AN) 儿童可能会承受来自建筑和自然环境的不成比例的压力源。我们的目标是从 AI/AN 儿童的建筑和自然环境中识别化学和非化学应激源，并从同行评议文献中评估它们与健康和福祉结果的联系。图书馆数据库（例如 PubMed）被搜索以识别专注于这些应激源的研究。如果参考文献：不讨论 AI/AN 儿童或不是主要队列；讨论美国以外的部落；是评论或干预研究；或不讨论建筑/自然环境中的应激源，则将其排除在外。在 2539 篇参考文献中，有 35 篇保留下来。样本人群主要（70%）来自纽约州（NY）和阿拉斯加（AK）；14 项研究报告了同一队列。具有匹配应激源和结果的研究很少，排除了定量综述。呼吸道和发育结果是评估的主要结果。主要的非化学应激源是居住环境靠近受污染的景观、缺乏室内管道以及室内使用木材取暖或烹饪。主要的化学应激源是挥发性有机化合物 (VOC)、颗粒物 (PM2.5)、多氯联苯 (PCBs)、p,p'-DDE、六氯苯 (HCB)、铅和汞。我们的定性综述表明，室内使用木材或没有管道可能会增加呼吸道疾病，这可以作为促进 AI/AN 儿童健康环境的指南。我们确定了<40 项研究，表明该人群研究不足。未来的研究需要考虑：来自美国其他部落的样本人群、家庭以外的应激源、自然环境的其他元素，以及对 AI/AN 儿童总环境（建筑、自然和社会）中应激源的评估。
