Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China.
Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China.
Environ Int. 2019 Oct;131:105041. doi: 10.1016/j.envint.2019.105041. Epub 2019 Aug 1.
PM-bound toxic metals (TMs) are derived from various sources, and they can cause many adverse health effects on the human body. To effectively reduce the disease burden of TMs by controlling the relative sources, an integrated approach of quality-adjusted life years (QALYs) and source-apportionment (positive matrix factorization, PMF) was proposed and applied to some typical diseases induced by TMs in 2017 in Beijing. The estimation included two parts; first, the number of potentially affected people was calculated based on the source mass contribution from PMF and the inhalation unit risk of TMs; second, the QALYs lost per affected person was calculated based on the disease duration, expected years of life lost (EYLL) and quality of life (QoL) for both affected people and the general population. The results showed that QALYs lost per person for renal cancer (17.3 QALYs), pneumonia (14.4 QALYs), lung cancer (14.2 QALYs), skin cancer (12.7 QALYs) and diabetes mellitus (12.6 QALYs) were higher than those for other diseases. Combined with PMF, the source contributions to the overall burden of typical diseases from the TMs followed the order of coal combustion (50.2%) > vehicle emissions (24.4%) > fuel oil combustion (11.4%) > Cr-related industry (10.9%) > resuspended dust (3.0%). The rank was further compared with that assessed for noncancer and cancer risks, and we verified the reasonability of the QALYs method. For seasonal contributions to coal combustion, winter and spring had the highest contributions, which coincided with the fact that coal was the main fuel for heating in Beijing. The QALYs lost attributed to TMs for coal combustion decreased by 49.1% from 2016 to 2017, which may indicate an effective policy associated with coal control. Overall, the integrated approach was successfully employed for estimating the disease burden induced by TMs from each source and was an effective solution to identify the control rank of sources for TM reduction.
受人为源影响的有毒金属（TMs）来自于不同的污染源，它们可能会对人体健康造成多种不利影响。为了通过控制相关污染源来有效降低 TMs 的疾病负担，本研究提出并应用质量调整生命年（QALYs）和源解析（正定矩阵因子分解，PMF）的综合方法，对 2017 年北京由 TMs 引起的一些典型疾病进行了评估。该评估包括两部分：首先，根据 PMF 解析的污染源质量贡献和 TMs 的吸入单位风险，计算潜在受影响人群的数量；其次，根据疾病持续时间、预期寿命损失（EYLL）和受影响人群以及一般人群的生活质量（QoL），计算每个受影响人群的 QALYs 损失量。结果表明，与其他疾病相比，肾细胞癌（17.3 QALYs）、肺炎（14.4 QALYs）、肺癌（14.2 QALYs）、皮肤癌（12.7 QALYs）和糖尿病（12.6 QALYs）的人均 QALYs 损失更高。结合 PMF，TMs 对典型疾病总负担的来源贡献顺序为：煤炭燃烧（50.2%）＞机动车排放（24.4%）＞燃料油燃烧（11.4%）＞Cr 相关工业（10.9%）＞再悬浮颗粒物（3.0%）。进一步与非癌症和癌症风险评估的排序进行比较，验证了 QALYs 方法的合理性。对于煤炭燃烧的季节性贡献，冬季和春季的贡献最高，这与北京冬季以煤炭为主要取暖燃料的事实相符。2016 年至 2017 年，由于煤炭燃烧导致的 TMs 损失的 QALYs 减少了 49.1%，这可能表明与煤炭控制相关的有效政策。总的来说，该综合方法成功地用于评估每个污染源 TMs 引起的疾病负担，是识别 TMs 减排的污染源控制优先级的有效方法。
