论文部分内容阅读
目的建立评价环境因子对人群健康影响的一种新方法。方法按照WHO的可比较风险评估(comparative risk assessment,CRA)框架中对环境因素的评估部分,发展符合我国实际的环境污染物风险评估的框架和指标,通过对各个暴露水平的覆盖率和各暴露水平相应的RR的估计以及对理想场景的选取估算潜在影响分值(potential impact fraction,PIF);并将该方法应用于我国某地区水污染对肝癌发生的风险测量和估计,以受污染的水为环境因子,以肝癌死亡为健康指标,使用空间插值、反事实分析理论以及可比较风险评估(CRA)理论进行分析。结果使用普通Kriging插值法估计了该地区的COD水平,并且根据历年河流中COD水平的变化趋势估计了累积COD暴露水平,计算相应的暴露人口;根据不同的污染等级和相应的肝癌标化死亡率计算RR值,结果显示RR值随累积COD暴露水平的增加而呈单调上升趋势;PIF值显示,如果水污染程度降至对照区水平,将有75.72%的男性和66.39%的女性避免死于肝癌。结论综合使用可比较风险评估(CRA)、反事实理论、空间分析等技术可以较好地评估环境因子对人群健康的影响。
Objective To establish a new method to evaluate the impact of environmental factors on human health. Methods According to the assessment of environmental factors in the comparative risk assessment (CRA) framework of WHO, we developed a framework and indicators that are in line with the actual risk assessment of environmental pollutants in our country. Through the coverage of each level of exposure and exposure Level corresponding RR estimation and the selection of the ideal scenario to estimate the potential impact fraction (PIF). The method is applied to the risk measurement and estimation of liver cancer in a certain area in our country. As environmental factors, mortality of liver cancer as a health indicator, using spatial interpolation, counterfactual analysis theory and comparative risk assessment (CRA) theory analysis. Results Ordinary Kriging interpolation method was used to estimate the COD level in this area. Based on the trend of COD level in the rivers over the years, the cumulative COD exposure level was estimated and the corresponding exposed population was calculated. According to the different pollution levels and corresponding liver cancer standardized mortality The RR value was calculated and the results showed that the RR value increased monotonously with the increase of accumulated COD exposure. The PIF value showed that 75.72% of males and 66.39% of females died of liver cancer if the water pollution dropped to the level of control area . Conclusion Comprehensive use of comparative risk assessment (CRA), counterfactual theory, spatial analysis and other techniques can better assess the environmental factors on the health effects of the population.