Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, United States.
Front Public Health. 2021 Jan 8;8:611693. doi: 10.3389/fpubh.2020.611693. eCollection 2020.
Peak exposures are of concern because they can potentially overwhelm normal defense mechanisms and induce adverse health effects. Metrics of peak exposure have been used in epidemiologic and exposure studies, but consensus is lacking on its definition. The relevant characteristics of peak exposure are dependent upon exposure patterns, biokinetics of exposure, and disease mechanisms. The objective of this review was to summarize the use of peak metrics in epidemiologic and exposure studies. A comprehensive search of Medline, Embase, Web of Science, and NIOSHTIC-2 databases was conducted using keywords related to peak exposures. The retrieved references were reviewed and selected for indexing if they included a peak metric and met additional criteria. Information on health outcomes and peak exposure metrics was extracted from each reference. A total of 1,215 epidemiologic or exposure references were identified, of which 182 were indexed and summarized. For the 72 epidemiologic studies, the health outcomes most frequently evaluated were: chronic respiratory effects, cancer and acute respiratory symptoms. Exposures were frequently assessed using task-based and full-shift time-integrated methods, qualitative methods, and real-time instruments. Peak exposure summary metrics included the presence or absence of a peak event, highest exposure intensity and frequency greater than a target. Peak metrics in the 110 exposure studies most frequently included highest exposure intensity, average short-duration intensity, and graphical presentation of the real-time data (plots). This review provides a framework for considering biologically relevant peak exposure metrics for epidemiologic and exposure studies to help inform risk assessment and exposure mitigation.
峰值暴露令人担忧，因为它们可能会超过正常的防御机制，引发不良健康影响。峰值暴露的指标已被用于流行病学和暴露研究，但对其定义尚未达成共识。峰值暴露的相关特征取决于暴露模式、暴露的生物动力学和疾病机制。本综述的目的是总结峰值指标在流行病学和暴露研究中的应用。使用与峰值暴露相关的关键词，对 Medline、Embase、Web of Science 和 NIOSHTIC-2 数据库进行了全面检索。检索到的参考文献进行了审查，并根据是否包含峰值指标和满足其他标准进行了索引。从每个参考文献中提取了与健康结果和峰值暴露指标相关的信息。共确定了 1215 篇流行病学或暴露参考资料，其中 182 篇被索引并进行了总结。对于 72 项流行病学研究，评估的健康结果最常包括：慢性呼吸道影响、癌症和急性呼吸道症状。暴露通常使用基于任务和全班次时间积分的方法、定性方法和实时仪器进行评估。峰值暴露汇总指标包括是否存在峰值事件、最高暴露强度和高于目标的频率。在 110 项暴露研究中，峰值指标最常包括最高暴露强度、平均短时间强度和实时数据的图形表示（图表）。本综述为考虑流行病学和暴露研究中具有生物学意义的峰值暴露指标提供了一个框架，以帮助为风险评估和暴露缓解提供信息。
