Buffler P A, Crane M, Key M M
Environ Health Perspect. 1985 Oct;62:423-56. doi: 10.1289/ehp.8562423.
Factors affecting the design of an epidemiologic study assessing possible health effects from chemical waste disposal sites are reviewed. Such epidemiologic studies will most likely be prompted either by a known release of chemicals into the environment around the site, or by an unusual disease cluster in a population near the site. In the latter situation, a method for evaluating the health effects is needed, and one possible approach is discussed. In the former situation, it may not be obvious what health outcomes are relevant. Reported associations between health effects and chemicals in humans were reviewed. Studies from the occupational and environmental literature were classified by chemical and target organ affected and presented in tabular form. No attempt was made to critically evaluate the quality of evidence for each health effect, although bibliographic documentation was provided where possible. Episodes of chemical contamination of food, drinking water and other media were also reviewed and presented in a separate table. The organ sites likely to be affected by toxic chemicals from waste disposal sites depend heavily on the route of exposure and the dose that is received. Ingestion is the most frequently reported route of exposure in episodes of environmental contamination. These have affected the hepatic, renal, hematopoietic, reproductive, and central nervous systems. The type and severity of effects were dose-dependent. Direct skin contact is important in the occupational environment where dermal and central nervous system effects have been reported but seems less likely as a route of exposure for populations around waste disposal sites. Inhalation, unless at relative high concentrations or as a result of fire, is unlikely to be important, although hematopoietic, reproductive, and central nervous system effects have been reported in occupational studies.
本文综述了影响评估化学废物处理场地可能产生的健康影响的流行病学研究设计的因素。此类流行病学研究很可能是由场地周围环境中已知的化学物质泄漏，或场地附近人群中出现的异常疾病聚集现象所引发。在后一种情况下，需要一种评估健康影响的方法，本文讨论了一种可能的方法。在前一种情况下，哪些健康结果具有相关性可能并不明显。本文回顾了已报道的人类健康影响与化学物质之间的关联。职业和环境文献中的研究按所涉及的化学物质和受影响的靶器官进行分类，并以表格形式呈现。尽管尽可能提供了文献记录，但并未对每种健康影响的证据质量进行严格评估。还对食品、饮用水和其他介质的化学污染事件进行了回顾，并单独列成表格呈现。废物处理场地产生的有毒化学物质可能影响的器官部位在很大程度上取决于接触途径和所接受的剂量。在环境污染事件中，摄入是最常报告的接触途径。这些污染事件已影响到肝脏、肾脏、造血系统、生殖系统和中枢神经系统。影响的类型和严重程度取决于剂量。在职业环境中，直接皮肤接触很重要，已有报道称其会对皮肤和中枢神经系统产生影响，但对于废物处理场地周围的人群来说，这种接触途径似乎不太可能。吸入，除非浓度相对较高或因火灾导致，否则不太可能是重要的接触途径，尽管职业研究中已报道其会对造血系统、生殖系统和中枢神经系统产生影响。
