McDonnell W F
Clinical Research Branch, U.S. Environmental Protection Agency, Research Triangle Park, NC 27711.
Environ Health Perspect. 1993 Dec;101 Suppl 4(Suppl 4):199-203. doi: 10.1289/ehp.93101s4199.
The study of health effects induced by exposure to mixtures of pollutants is a complex task. The purpose of this paper is to identify areas of research in which the conduct of human controlled exposure (clinical) studies may contribute to better understanding health effects of exposure to indoor air and other mixtures. The strengths and weaknesses of clinical studies in general are reviewed, as well as examples from the literature of approaches that have been used. Human chamber studies play an important role alongside epidemiologic and animal toxicologic studies in such research. Human chamber studies are limited with regard to assessing chronic effects, rare effects, or effects from long-duration exposures but are powerful in assessing acute, reversible effects from short-duration exposures in humans. The areas in which human chamber studies are most likely to contribute include identification of effects or markers of effects for exposure to a given pollutant or mix of pollutants; direct dose-response assessment of effects for individual compounds and mixtures of set composition; identification of individual compounds responsible for the effects of a mixture; study of the joint effects of a binary mixture; development of markers of acute exposure for particular compounds; development of outcome measurements to be used in the field; and identification, characterization, and testing of sensitive subpopulations.
研究接触污染物混合物所引发的健康影响是一项复杂的任务。本文旨在确定一些研究领域，在这些领域中开展人体对照暴露（临床）研究可能有助于更好地理解接触室内空气及其他混合物对健康的影响。本文综述了一般临床研究的优缺点，并列举了文献中所采用方法的实例。在这类研究中，人体舱室研究与流行病学和动物毒理学研究同样发挥着重要作用。人体舱室研究在评估慢性影响、罕见影响或长期暴露的影响方面存在局限性，但在评估人体短期暴露产生的急性、可逆影响方面却很有效。人体舱室研究最有可能做出贡献的领域包括：识别接触特定污染物或污染物混合物的影响或影响标志物；对特定化合物和特定组成混合物的影响进行直接剂量反应评估；识别造成混合物影响的单个化合物；研究二元混合物的联合作用；开发特定化合物急性暴露的标志物；开发将在现场使用的结果测量方法；以及识别、表征和测试敏感亚人群。
