环境因子对人群健康影响的测量与评估方法  

Effects of Environmental Factors on Population Health:Measurement and Assessment

作　　者：陶庄[1] 杨功焕[1] 

机构地区：[1]中国疾病预防控制中心公共卫生监测与信息服务中心,北京102206

出　　处：《环境与健康杂志》2010年第4期342-346,共5页Journal of Environment and Health

基　　金："十一五"国家科技支撑计划课题(2006BAI19B03)

摘　　要：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 for assessing the effects of environmental factors on human health. Methods Based on the environment part of the frame for comparative risk assessment （CRA） of WHO, the frame and index system for environmental contamination risk assessment which accorded with the situation in China was developed. With the prevalence of different exposure level, RR and the choice of counterfactual scenario, the potential impact fraction （PIF） was estimated. Then an example on the study of liver cancer related with water pollution was used to show the new frame. In this example, the contaminated water was regarded as the environmental factor, incidence of liver cancer was regarded as variable of health, and the analysis was performed with spatial interpolation, counterfactual analysis and CRA theory. Results The quantity of COD of river water in this area was estimated with ordinary Kriging interpolation, and the accumulated exposure of COD was calculated with the trend of annual COD, and the number of population exposed to COD was estimated at same time. In accordance with the different level of pollution and the RR relate to liver cancer, the trend with monotonically increasing showed. At same time, the values of PIF illuminated that 75.72% in male and 66.39% in female would avoid death for liver cancer if the level of contaminated water could be reduced to the level of the control areas. Conclusion The frame includes CRA, spatial analysis and counterfaetual analysis is a good approach to assess the health effects of environmental factors.

关 键 词：环境污染 环境因子 可比较风险评估 潜在影响因子 累积暴露 空间插值 反事实分析 

分 类 号：R181.3[医药卫生—流行病学]