摘要
一些流行病学研究表明,大气污染在一定程度上影响胎儿生长发育。近年来,有关孕期大气污染物暴露对妊娠不良结局的影响越来越引起重视,污染物与先天性心脏病的关系是其中重要的研究课题之一。目前一些研究初步证实了母亲孕期污染物暴露与先天性心脏病有关,但研究证据不足,且关于某一种污染物暴露对某一种先天性心脏病的影响尚无定论,相关的评估框架亟待总结和梳理。本文从大气污染对先天性心脏病发生风险的完整评估框架(暴露评估、暴露指标、量化方法、剂量-反应关系)的4个环节入手,系统评述了大气污染与先天性心脏病关系的国内外研究进展。针对目前在污染物暴露评估方法、剂量-反应量化方法和先天性心脏病风险的量化指标选取等方面研究的不足进行了总结剖析。旨在通过建立统一、精准的污染物暴露评估方法,选择确切的污染物暴露剂量和合理的暴露风险评估值,完善传统的量化方法,最终客观、真实地揭示大气污染物暴露与先天性心脏病之间的剂量-反应关系。最后,提出目前该研究领域所面临的诸多问题以及未来发展的趋势。以期为今后大气污染对先天性心脏病的影响评价指明方向,并为预防先天性心脏病、降低儿童死亡率等提供决策依据。
Epidemiological studies show that ambient air pollution may affect the growth of fetus. In recent years, the potential impacts of exposure to air pollutants during pregnancy on adverse outcomes attract increasing attention, among which the relationship between air pollutants and congenital heart disease is an important research topic. Studies have preliminarily proved that exposure to certain pollutants during pregnancy is related to congenital heart disease, but the evidence is limited and there is no definite effect of exposure to specific air pollutant on specific congenital heart disease subtype, thus relevant assessment frameworks are warranted. This paper reviewed research progress on this issue in four aspects--exposure assessment, exposure index, quantitative method, and dose-response relationship, which comprised the framework of risk assessment of exposure to air pollution on congenital heart disease. This paper also analyzed the shortcomings of published studies on pollutant exposure assessment methods, dose-response quantification, and quantitative index selection, aiming to establish a unified and accurate assessment method of pollutant exposure, define pollutant exposure levels and exposure risk estimates, improve traditional quantitative methods, and objectively assess the dose-response relationship between air pollutant exposure and congenital heart disease. Finally, problems in this field and research trends were probed. We look forward to figure out guidelines for assessing the effects of air pollution on congenital heart disease, and provide scientific references to prevent congenital heart disease and reduce child mortality.
出处
《环境与职业医学》
CAS
CSCD
北大核心
2017年第12期1111-1116,1122,共7页
Journal of Environmental and Occupational Medicine
基金
国家自然科学基金项目(编号:41571090
41201539)
关键词
大气污染物暴露
风险评估
剂量-反应关系
先天性心脏病
air pollution exposure
risk assessment
dose-response relationship
congenital heart disease
