Health Effects Institute, Boston, MA, United States.
Health Effects Institute, Boston, MA, United States.
Environ Int. 2022 Jun;164:107262. doi: 10.1016/j.envint.2022.107262. Epub 2022 Apr 25.
The health effects of traffic-related air pollution (TRAP) continue to be of important public health interest. Following its well-cited 2010 critical review, the Health Effects Institute (HEI) appointed a new expert Panel to systematically evaluate the epidemiological evidence regarding the associations between long-term exposure to TRAP and selected adverse health outcomes. Health outcomes were selected based on evidence of causality for general air pollution (broader than TRAP) cited in authoritative reviews, relevance for public health and policy, and resources available. The Panel used a systematic approach to search the literature, select studies for inclusion in the review, assess study quality, summarize results, and reach conclusions about the confidence in the evidence. An extensive search was conducted of literature published between January 1980 and July 2019 on selected health outcomes. A new exposure framework was developed to determine whether a study was sufficiently specific to TRAP. In total, 353 studies were included in the review. Respiratory effects in children (118 studies) and birth outcomes (86 studies) were the most commonly studied outcomes. Fewer studies investigated cardiometabolic effects (57 studies), respiratory effects in adults (50 studies), and mortality (48 studies). The findings from the systematic review, meta-analyses, and evaluation of the quality of the studies and potential biases provided an overall high or moderate-to-high level of confidence in an association between long-term exposure to TRAP and the adverse health outcomes all-cause, circulatory, ischemic heart disease and lung cancer mortality, asthma onsetin chilldren and adults, and acute lower respiratory infections in children. The evidence was considered moderate, low or very low for the other selected outcomes. In light of the large number of people exposed to TRAP - both in and beyond the near-road environment - the Panel concluded that the overall high or moderate-to-high confidence in the evidence for an association between long-term exposure to TRAP and several adverse health outcomes indicates that exposures to TRAP remain an important public health concern and deserve greater attention from the public and from policymakers.
交通相关空气污染（TRAP）对健康的影响仍然是重要的公共卫生关注点。在其 2010 年备受关注的评论之后，健康影响研究所（HEI）任命了一个新的专家小组，对长期接触 TRAP 与选定不良健康结果之间的关联进行系统评估。健康结果是基于权威综述中提到的与一般空气污染（比 TRAP 更广）相关的因果关系证据、对公共卫生和政策的相关性以及现有资源选择的。该小组采用系统方法搜索文献，选择纳入综述的研究，评估研究质量，总结结果，并就证据的可信度得出结论。对 1980 年 1 月至 2019 年 7 月期间选定健康结果的文献进行了广泛搜索。制定了一个新的暴露框架来确定研究是否对 TRAP 足够具体。该综述共纳入 353 项研究。儿童呼吸系统影响（118 项研究）和出生结果（86 项研究）是最常研究的结果。较少的研究调查了心血管代谢影响（57 项研究）、成人呼吸系统影响（50 项研究）和死亡率（48 项研究）。系统评价、荟萃分析以及对研究质量和潜在偏差的评估的结果提供了对长期接触 TRAP 与全因、循环、缺血性心脏病和肺癌死亡率、儿童哮喘发作和成人哮喘发作以及儿童急性下呼吸道感染等不良健康结果之间关联的整体高或中至高置信度。对于其他选定的结果，证据被认为是中度、低度或非常低。鉴于大量的人接触 TRAP - 无论是在道路附近环境中还是之外 - 专家小组得出结论，对长期接触 TRAP 与几种不良健康结果之间的关联的整体高或中至高置信度表明，接触 TRAP 仍然是一个重要的公共卫生关注点，值得公众和政策制定者给予更多关注。
