Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland.
Department of Pulmonary Diseases, Heart and Lung Center, Helsinki University Hospital and University of Helsinki, 00029 Helsinki, Finland.
Int J Environ Res Public Health. 2022 Mar 25;19(7):3945. doi: 10.3390/ijerph19073945.
Chronic obstructive pulmonary disease (COPD) is a slowly developing non-communicable disease (NCD), causing non-reversible obstruction and leading to marked morbidity and mortality. Besides traditional risk factors such as smoking, some environmental substances can augment the risk of COPD. The European Human Biomonitoring Initiative (HBM4EU) is a program evaluating citizens' exposure to various environmental substances and their possible health impacts. Within the HBM4EU, eighteen priority substances or substance groups were chosen. In this scoping review, seven of these substances or substance groups are reported to have an association or a possible association with COPD. Main exposure routes, vulnerable and high-exposure risk groups, and matrices where these substances are measured are described. Pesticides in general and especially organophosphate and carbamate insecticides, and some herbicides, lead (Pb), and polycyclic aromatic hydrocarbons (PAHs) showed an association, and cadmium (Cd), chromium (Cr and CrVI), arsenic (As), and diisocyanates, a possible association with COPD and/or decreased lung function. Due to long latency in COPD's disease process, the role of chemical exposure as a risk factor for COPD is probably underestimated. More research is needed to support evidence-based conclusions. Generally, chemical exposure is a growing issue of concern, and prompt action is needed to safeguard public health.
慢性阻塞性肺疾病（COPD）是一种缓慢发展的非传染性疾病（NCD），导致不可逆转的阻塞，并导致显著的发病率和死亡率。除了吸烟等传统危险因素外，一些环境物质也会增加 COPD 的风险。欧洲人类生物监测倡议（HBM4EU）是一个评估公民接触各种环境物质及其可能对健康产生的影响的计划。在 HBM4EU 中，选择了十八种优先物质或物质组。在本次范围界定综述中，报告了其中七种物质或物质组与 COPD 有关或可能有关。描述了主要的暴露途径、脆弱和高暴露风险群体以及测量这些物质的基质。一般来说，农药特别是有机磷和氨基甲酸酯类杀虫剂以及一些除草剂、铅（Pb）和多环芳烃（PAHs）与 COPD 和/或肺功能下降有关，而镉（Cd）、铬（Cr 和 CrVI）、砷（As）和二异氰酸酯与 COPD 和/或肺功能下降可能有关。由于 COPD 疾病过程潜伏期长，化学暴露作为 COPD 危险因素的作用可能被低估。需要更多的研究来支持基于证据的结论。总的来说，化学暴露是一个日益受到关注的问题，需要采取迅速行动来维护公众健康。
