工业化学品造成的室外空气污染导致新发哮喘或慢性阻塞性肺疾病：一项系统评价方案
Outdoor air pollution from industrial chemicals causing new onset of asthma or COPD: a systematic review protocol.
作者信息
Lux Harald, Baur Xaver, Budnik Lygia Therese, Heutelbeck Astrid, Teixeira João Paulo, Neumann Emeri, Adliene Diana, Puišo Judita, Lucas David, Löndahl Jakob, Damialis Athanasios, Goksel Ozlem, Orru Hans
机构信息
Occupational, Social and Environmental Medicine, University Hospital Jena - Friedrich Schiller University Jena, Erlanger Allee 103, 07747, Jena, Germany.
Department of Psychiatry and Psychotherapy, Ruppiner Kliniken, Neuruppin, Germany.
出版信息
J Occup Med Toxicol. 2020 Dec 28;15(1):38. doi: 10.1186/s12995-020-00289-6.
BACKGROUND
Until today, industrial sources contribute to the multifaceted contamination of environmental air. Exposure to air pollutants has the potential to initiate and promote asthma and chronic obstructive pulmonary disease (COPD). At global scale, both entities cause the majority of about 4 million annual deaths by respiratory disease. However, we identified industrial contamination as a subgroup of air pollution that may be associated with this burden and is underinvestigated in research. Therefore, the aim of this study is to investigate associations between substances industrially released into environmental air and the occurrence of asthma and COPD in the human population. Here we present the protocol for our systematic review of the current evidence.
METHODS
The following determinations will be applied during the systematic review process and are specified in the protocol that complies with the PRISMA-P statement. Populations of children and adults, as well as outdoor workers, exposed to industrially released air pollutants are of interest. Eligible studies may include subjects as controls who are non- or less exposed to the investigated air pollutants. The outcomes new-onset asthma and/or COPD investigated with risk ratio, odds ratio, hazard ratio, incidence rate ratio, cumulative incidence, and incidence rate are eligible. We will search the electronic literature databases EMBASE, MEDLINE, and Web of Science for peer-reviewed reports of incidence studies and incidence case-control studies. After systematic sorting of initial records, included studies will be subjected to quality assessment. Data will be synthesized qualitatively and, if appropriate, quantitatively for risk ratio and odds ratio. We will maintain and provide a PRISMA report.
DISCUSSION
Results of this systematic review may indicate alterations of incidence and risk of asthma and/or COPD in populations within industrial exposure radiuses including outdoor workplaces. Specific causal substances and compositions will be identified, but results will depend on the exposure assessment of the eligible studies. Our approach covers effects of industrial contributions to overall air pollution if studies reportedly attribute investigated emissions to industry. Results of this study may raise the question wether the available higher-level evidence sufficiently covers the current scale of industrial exposure scenarios and their potential harm to respiratory health.
TRIAL REGISTRATION
This protocol was registered in PROSPERO, registration number CRD42020151573 .
背景
直至今日，工业源仍是环境空气污染多方面污染的成因之一。接触空气污染物有可能引发并加重哮喘和慢性阻塞性肺疾病（COPD）。在全球范围内，这两种疾病导致每年约400万人死于呼吸道疾病。然而，我们发现工业污染作为空气污染的一个子类别，可能与这一负担相关，但在研究中却未得到充分调查。因此，本研究旨在探究工业排放到环境空气中的物质与人群中哮喘和COPD发生之间的关联。在此，我们展示了对现有证据进行系统综述的方案。
方法
在系统综述过程中将采用以下判定方法，并在符合PRISMA-P声明的方案中予以明确规定。我们关注的人群包括接触工业排放空气污染物的儿童、成人以及户外工作者。符合条件的研究可能包括将未接触或较少接触所研究空气污染物的对象作为对照。以风险比、比值比、风险率、发病率比、累积发病率和发病率来研究新发哮喘和/或COPD的结果是符合条件的。我们将在电子文献数据库EMBASE、MEDLINE和科学网中搜索关于发病率研究和发病率病例对照研究的同行评审报告。在对初始记录进行系统分类后，纳入的研究将接受质量评估。数据将进行定性综合分析，若合适，还将对风险比和比值比进行定量分析。我们将维护并提供一份PRISMA报告。
讨论
本次系统综述的结果可能表明，在包括户外工作场所在内的工业暴露半径范围内的人群中，哮喘和/或COPD的发病率和风险发生了变化。将确定具体的致病物质和成分，但结果将取决于符合条件的研究中的暴露评估。如果研究报告将所调查的排放归因于工业，我们的方法涵盖了工业对总体空气污染的影响。本研究结果可能会引发这样一个问题，即现有的高级别证据是否充分涵盖了当前工业暴露场景的规模及其对呼吸健康的潜在危害。
试验注册
本方案已在PROSPERO注册，注册号为CRD42020151573 。
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