Boston College, US.
Woods Hole Center for Oceans and Human Health, Woods Hole Oceanographic Institution, US.
Ann Glob Health. 2020 Dec 3;86(1):151. doi: 10.5334/aogh.2831.
Pollution - unwanted waste released to air, water, and land by human activity - is the largest environmental cause of disease in the world today. It is responsible for an estimated nine million premature deaths per year, enormous economic losses, erosion of human capital, and degradation of ecosystems. Ocean pollution is an important, but insufficiently recognized and inadequately controlled component of global pollution. It poses serious threats to human health and well-being. The nature and magnitude of these impacts are only beginning to be understood.
(1) Broadly examine the known and potential impacts of ocean pollution on human health. (2) Inform policy makers, government leaders, international organizations, civil society, and the global public of these threats. (3) Propose priorities for interventions to control and prevent pollution of the seas and safeguard human health.
Topic-focused reviews that examine the effects of ocean pollution on human health, identify gaps in knowledge, project future trends, and offer evidence-based guidance for effective intervention.
Pollution of the oceans is widespread, worsening, and in most countries poorly controlled. It is a complex mixture of toxic metals, plastics, manufactured chemicals, petroleum, urban and industrial wastes, pesticides, fertilizers, pharmaceutical chemicals, agricultural runoff, and sewage. More than 80% arises from land-based sources. It reaches the oceans through rivers, runoff, atmospheric deposition and direct discharges. It is often heaviest near the coasts and most highly concentrated along the coasts of low- and middle-income countries. Plastic is a rapidly increasing and highly visible component of ocean pollution, and an estimated 10 million metric tons of plastic waste enter the seas each year. Mercury is the metal pollutant of greatest concern in the oceans; it is released from two main sources - coal combustion and small-scale gold mining. Global spread of industrialized agriculture with increasing use of chemical fertilizer leads to extension of Harmful Algal Blooms (HABs) to previously unaffected regions. Chemical pollutants are ubiquitous and contaminate seas and marine organisms from the high Arctic to the abyssal depths.
Ocean pollution has multiple negative impacts on marine ecosystems, and these impacts are exacerbated by global climate change. Petroleum-based pollutants reduce photosynthesis in marine microorganisms that generate oxygen. Increasing absorption of carbon dioxide into the seas causes ocean acidification, which destroys coral reefs, impairs shellfish development, dissolves calcium-containing microorganisms at the base of the marine food web, and increases the toxicity of some pollutants. Plastic pollution threatens marine mammals, fish, and seabirds and accumulates in large mid-ocean gyres. It breaks down into microplastic and nanoplastic particles containing multiple manufactured chemicals that can enter the tissues of marine organisms, including species consumed by humans. Industrial releases, runoff, and sewage increase frequency and severity of HABs, bacterial pollution, and anti-microbial resistance. Pollution and sea surface warming are triggering poleward migration of dangerous pathogens such as the species. Industrial discharges, pharmaceutical wastes, pesticides, and sewage contribute to global declines in fish stocks.
Methylmercury and PCBs are the ocean pollutants whose human health effects are best understood. Exposures of infants to these pollutants through maternal consumption of contaminated seafood can damage developing brains, reduce IQ and increase children's risks for autism, ADHD and learning disorders. Adult exposures to methylmercury increase risks for cardiovascular disease and dementia. Manufactured chemicals - phthalates, bisphenol A, flame retardants, and perfluorinated chemicals, many of them released into the seas from plastic waste - can disrupt endocrine signaling, reduce male fertility, damage the nervous system, and increase risk of cancer. HABs produce potent toxins that accumulate in fish and shellfish. When ingested, these toxins can cause severe neurological impairment and rapid death. HAB toxins can also become airborne and cause respiratory disease. Pathogenic marine bacteria cause gastrointestinal diseases and deep wound infections. With climate change and increasing pollution, risk is high that infections, including cholera, will increase in frequency and extend to new areas. All of the health impacts of ocean pollution fall disproportionately on vulnerable populations in the Global South - environmental injustice on a planetary scale.
Ocean pollution is a global problem. It arises from multiple sources and crosses national boundaries. It is the consequence of reckless, shortsighted, and unsustainable exploitation of the earth's resources. It endangers marine ecosystems. It impedes the production of atmospheric oxygen. Its threats to human health are great and growing, but still incompletely understood. Its economic costs are only beginning to be counted.Ocean pollution can be prevented. Like all forms of pollution, ocean pollution can be controlled by deploying data-driven strategies based on law, policy, technology, and enforcement that target priority pollution sources. Many countries have used these tools to control air and water pollution and are now applying them to ocean pollution. Successes achieved to date demonstrate that broader control is feasible. Heavily polluted harbors have been cleaned, estuaries rejuvenated, and coral reefs restored.Prevention of ocean pollution creates many benefits. It boosts economies, increases tourism, helps restore fisheries, and improves human health and well-being. It advances the Sustainable Development Goals (SDG). These benefits will last for centuries.
World leaders who recognize the gravity of ocean pollution, acknowledge its growing dangers, engage civil society and the global public, and take bold, evidence-based action to stop pollution at source will be critical to preventing ocean pollution and safeguarding human health.Prevention of pollution from land-based sources is key. Eliminating coal combustion and banning all uses of mercury will reduce mercury pollution. Bans on single-use plastic and better management of plastic waste reduce plastic pollution. Bans on persistent organic pollutants (POPs) have reduced pollution by PCBs and DDT. Control of industrial discharges, treatment of sewage, and reduced applications of fertilizers have mitigated coastal pollution and are reducing frequency of HABs. National, regional and international marine pollution control programs that are adequately funded and backed by strong enforcement have been shown to be effective. Robust monitoring is essential to track progress.Further interventions that hold great promise include wide-scale transition to renewable fuels; transition to a circular economy that creates little waste and focuses on equity rather than on endless growth; embracing the principles of green chemistry; and building scientific capacity in all countries.Designation of Marine Protected Areas (MPAs) will safeguard critical ecosystems, protect vulnerable fish stocks, and enhance human health and well-being. Creation of MPAs is an important manifestation of national and international commitment to protecting the health of the seas.
污染——人类活动向空气、水和土地排放的不需要的废物——是当今世界最大的环境致病因素。据估计,每年有 900 万人因此过早死亡,造成巨大的经济损失、人力资本流失和生态系统退化。海洋污染是全球污染的一个重要但未被充分认识和控制不足的组成部分。它对人类健康和福祉构成严重威胁。这些影响的性质和程度才刚刚开始被理解。
(1) 广泛研究海洋污染对人类健康的已知和潜在影响。(2) 告知政策制定者、政府领导人、国际组织、民间社会和全球公众这些威胁。(3) 提出控制和防止海洋污染和维护人类健康的干预措施的优先事项。
重点审查海洋污染对人类健康影响的专题审查,确定知识空白,预测未来趋势,并为有效的干预措施提供循证指导。
海洋污染广泛存在且日益严重,而且在大多数国家都未得到有效控制。它是有毒金属、塑料、人造化学品、石油、城市和工业废物、农药、化肥、制药化学品、农业径流和污水的复杂混合物。其中超过 80% 来自陆源。它通过河流、径流、大气沉降和直接排放进入海洋。它通常在沿海地区最严重,在中低收入国家的沿海地区浓度最高。塑料是海洋污染中增长最快、最明显的组成部分,据估计,每年有 1000 万吨塑料废物进入海洋。汞是海洋中最受关注的金属污染物;它主要来自两个来源——煤炭燃烧和小规模采金。全球工业化农业的扩展导致化肥使用的增加,从而使有害藻类大量繁殖(HABs)扩展到以前未受影响的地区。化学污染物无处不在,从北极到深海,污染了海洋和海洋生物。
海洋污染对海洋生态系统造成多种负面影响,而全球气候变化加剧了这些影响。石油基污染物减少了产生氧气的海洋微生物的光合作用。海洋吸收二氧化碳的增加导致海洋酸化,破坏珊瑚礁,损害贝类发育,溶解海洋食物网底部含钙微生物,并增加一些污染物的毒性。塑料污染威胁着海洋哺乳动物、鱼类和海鸟,并在大洋环流中积聚。它分解成含有多种人造化学品的微塑料和纳米塑料颗粒,这些颗粒可以进入包括人类食用的海洋生物的组织。工业排放物、径流和污水增加了赤潮、细菌污染和抗微生物耐药性的频率和严重程度。污染和海水变暖正在引发危险病原体如的北移,如。工业排放物、医药废物、农药和污水导致鱼类资源全球减少。
甲基汞和多氯联苯是人类健康影响最清楚的海洋污染物。通过食用受污染海鲜,婴儿暴露于这些污染物会损害正在发育的大脑,降低智商,并增加儿童患自闭症、注意力缺陷多动障碍和学习障碍的风险。成年人暴露于甲基汞会增加心血管疾病和痴呆的风险。制造化学品——邻苯二甲酸酯、双酚 A、阻燃剂和全氟化学品,其中许多从塑料废物中释放到海洋中——会破坏内分泌信号,降低男性生育能力,损害神经系统,并增加癌症风险。HABs 产生的强效毒素在鱼类和贝类中积累。摄入这些毒素会导致严重的神经损伤和快速死亡。HAB 毒素也可以成为空气传播物,导致呼吸道疾病。海洋致病性细菌引起胃肠道疾病和深部伤口感染。随着气候变化和污染的增加,霍乱等感染的频率增加并扩展到新的地区的风险很高。海洋污染对全球南方弱势群体——地球规模的环境不公正——造成的所有健康影响都不成比例。
海洋污染是一个全球性问题。它来自多个来源,并跨越国界。这是对地球资源鲁莽、短视和不可持续利用的结果。它危及海洋生态系统。它阻碍了大气中氧气的产生。它对人类健康的威胁越来越大,但仍不完全了解。其经济成本才刚刚开始计算。海洋污染是可以预防的。与所有形式的污染一样,海洋污染可以通过部署基于法律、政策、技术和执法的数据驱动战略来控制,这些战略针对优先污染来源。许多国家已经利用这些工具来控制空气和水污染,现在正在将其应用于海洋污染。迄今为止取得的成功表明,更广泛的控制是可行的。污染严重的港口已经得到清理,河口得到了恢复,珊瑚礁得到了修复。海洋污染的预防带来了许多好处。它促进了经济增长,增加了旅游业,有助于恢复渔业,并改善了人类健康和福祉。它推进了可持续发展目标(SDG)。这些好处将持续几个世纪。
认识到海洋污染严重性、承认其日益严重的危险、让民间社会和全球公众参与并采取基于证据的大胆行动以从源头阻止污染的世界领导人将是防止海洋污染和保护人类健康的关键。预防陆源污染是关键。消除煤炭燃烧和禁止所有汞的使用将减少汞污染。禁止一次性塑料和更好地管理塑料废物可减少塑料污染。持久性有机污染物(POPs)禁令减少了多氯联苯和滴滴涕的污染。工业排放物的控制、污水的处理以及化肥使用的减少减轻了沿海污染,降低了赤潮的频率。得到充分资金支持并得到强有力执法支持的国家、区域和国际海洋污染控制方案已被证明是有效的。强有力的监测对于跟踪进展至关重要。进一步具有很大潜力的干预措施包括广泛向可再生燃料过渡;向以创造很少废物为重点、关注公平而不是无休止增长的循环经济过渡;采用绿色化学原则;以及在所有国家建立科学能力。海洋保护区(MPAs)的指定将保护关键生态系统、保护脆弱的鱼类种群,并增进人类健康和福祉。海洋保护区的建立是保护海洋健康的国家和国际承诺的重要体现。