Joubert Bonnie R, Mantooth Stacey N, McAllister Kimberly A
National Institute of Environmental Health Sciences, National Institutes of Health, Durham, NC, United States.
VISTA Technology Services, Durham, NC, United States.
Front Genet. 2020 Jan 16;10:1166. doi: 10.3389/fgene.2019.01166. eCollection 2019.
The World Health Organization in 2016 estimated that over 20% of the global disease burden and deaths were attributed to modifiable environmental factors. However, data clearly characterizing the impact of environmental exposures and health endpoints in African populations is limited. To describe recent progress and identify important research gaps, we reviewed literature on environmental health research in African populations over the last decade, as well as research incorporating both genomic and environmental factors. We queried PubMed for peer-reviewed research articles, reviews, or books examining environmental exposures and health outcomes in human populations in Africa. Searches utilized medical subheading (MeSH) terms for environmental exposure categories listed in the March 2018 US National Report on Human Exposure to Environmental Chemicals, which includes chemicals with worldwide distributions. Our search strategy retrieved 540 relevant publications, with studies evaluating health impacts of ambient air pollution (n=105), indoor air pollution (n = 166), heavy metals (n = 130), pesticides (n = 95), dietary mold (n = 61), indoor mold (n = 9), per- and polyfluoroalkyl substances (PFASs, n = 0), electronic waste (n = 9), environmental phenols (n = 4), flame retardants (n = 8), and phthalates (n = 3), where publications could belong to more than one exposure category. Only 23 publications characterized both environmental and genomic risk factors. Cardiovascular and respiratory health endpoints impacted by air pollution were comparable to observations in other countries. Air pollution exposures unique to Africa and some other resource limited settings were dust and specific occupational exposures. Literature describing harmful health effects of metals, pesticides, and dietary mold represented a context unique to Africa. Studies of exposures to phthalates, PFASs, phenols, and flame retardants were very limited. These results underscore the need for further focus on current and emerging environmental and chemical health risks as well as better integration of genomic and environmental factors in African research studies. Environmental exposures with distinct routes of exposure, unique co-exposures and co-morbidities, combined with the extensive genomic diversity in Africa may lead to the identification of novel mechanisms underlying complex disease and promising potential for translation to global public health.
世界卫生组织在2016年估计，超过20%的全球疾病负担和死亡归因于可改变的环境因素。然而，能够清晰描述环境暴露对非洲人群的影响以及健康终点的数据有限。为了描述近期进展并找出重要的研究空白，我们回顾了过去十年间有关非洲人群环境卫生研究的文献，以及纳入基因组和环境因素的研究。我们在PubMed上查询了经同行评审的研究文章、综述或书籍，这些文献探讨了非洲人群的环境暴露与健康结果。搜索使用了2018年3月美国国家人类接触环境化学品报告中列出的环境暴露类别的医学主题词（MeSH），其中包括全球分布的化学品。我们的搜索策略检索到540篇相关出版物，这些研究评估了环境空气污染（n = 105）、室内空气污染（n = 166）、重金属（n = 130）、农药（n = 95）、膳食霉菌（n = 61）、室内霉菌（n = 9）、全氟和多氟烷基物质（PFASs，n = 0）、电子废物（n = 9）、环境酚类（n = 4）、阻燃剂（n = 8）和邻苯二甲酸盐（n = 3）对健康的影响，其中出版物可能属于多个暴露类别。只有23篇出版物同时描述了环境和基因组风险因素。空气污染对心血管和呼吸系统健康终点的影响与其他国家的观察结果相当。非洲和其他一些资源有限地区特有的空气污染暴露是沙尘和特定职业暴露。描述金属、农药和膳食霉菌对健康有害影响的文献代表了非洲特有的情况。关于邻苯二甲酸盐、PFASs、酚类和阻燃剂暴露的研究非常有限。这些结果强调了需要进一步关注当前和新出现的环境和化学健康风险，以及在非洲研究中更好地整合基因组和环境因素。具有独特暴露途径、独特共暴露和共病情况的环境暴露，再加上非洲广泛的基因组多样性，可能会导致发现复杂疾病背后的新机制，并有望转化为全球公共卫生的潜力。
