Wardlaw A J
Department of Respiratory Medicine, Glenfield Hospital NHS Trust, Leicester, U.K.
Clin Exp Allergy. 1995 Nov;25 Suppl 3:6-8.
Asthma and other types of allergic disease such as allergic rhinitis are increasing in prevalence throughout the western world. This report has reviewed the available world literature to examine the evidence that this increase is related to air pollution and to identify areas of uncertainty which need further research. We have restricted our review to aspects which are of direct relevance to allergic disease. In particular we have not addressed links between air pollution and increased cardio-respiratory mortality. There is good evidence that a number of air pollutants including sulphur dioxide, nitrogen dioxide, ozone and particulates, if present at sufficiently high concentrations, can exacerbate existing allergic disease, particularly asthma. Such concentrations are not infrequently found in the U.K. during episodes of poor air quality. The evidence that air pollutants cause problems at concentrations below internationally accepted guidelines (which are not, however, comprehensive) is not conclusive, although there is no room for complacency. In view of the frequency with which guidelines are breached and the risk to health this poses, the working group regard reducing air pollution in the U.K. as an important priority. The evidence that air pollutants, either from 'old style' fossil fuel burning, or from automobiles has contributed to the increase in the prevalence of asthma and allergy, other than through unmasking occult disease, is inconclusive although definitive studies are lacking. Similarly evidence to support the hypothesis that air pollutants act as adjuvants to increase the risk of becoming atopic is weak. The working party recommends detailed and comprehensive monitoring of air pollution concentrations across the U.K., development of techniques to measure individual exposure, research into the interaction between air pollutants and allergens and a major research effort into the effects of particulates. We would also welcome large, long-term, cohort studies to answer as definitively as possible whether exposure to increased air pollution increases the risk of becoming allergic.
在整个西方世界，哮喘和其他类型的过敏性疾病（如过敏性鼻炎）的患病率正在上升。本报告回顾了现有的全球文献，以研究这种上升与空气污染相关的证据，并确定需要进一步研究的不确定性领域。我们将综述限制在与过敏性疾病直接相关的方面。特别是，我们没有涉及空气污染与心肺死亡率增加之间的联系。有充分的证据表明，包括二氧化硫、二氧化氮、臭氧和颗粒物在内的一些空气污染物，如果浓度足够高，会加剧现有的过敏性疾病，尤其是哮喘。在英国空气质量差的时期，这种浓度并不罕见。虽然不能掉以轻心，但空气污染物在低于国际公认准则（然而这些准则并不全面）的浓度下是否会引发问题，证据并不确凿。鉴于违反准则的频率以及这对健康构成的风险，工作组认为减少英国的空气污染是一项重要的优先事项。除了通过揭示潜在疾病外，来自“老式”化石燃料燃烧或汽车排放的空气污染物是否导致了哮喘和过敏患病率的上升，证据并不确凿，尽管缺乏确定性研究。同样，支持空气污染物作为佐剂增加患特应性风险这一假设的证据也很薄弱。工作组建议对英国各地的空气污染浓度进行详细而全面的监测，开发测量个人暴露的技术，研究空气污染物与过敏原之间的相互作用，并对颗粒物的影响进行重大研究。我们也欢迎开展大型、长期的队列研究，以尽可能明确地回答接触增加的空气污染是否会增加患过敏症的风险。
