A framework for examining social stress and susceptibility to air pollution in respiratory health.
A framework for examining social stress and susceptibility to air pollution in respiratory health.
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DOI：
10.1289/ehp.0900612
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发表时间：
2009-09
影响因子：
10.4
通讯作者：
Kubzansky LD
中科院分区：
文献类型：
--
作者：
Clougherty JE;Kubzansky LD
人们越来越有兴趣解开空间聚集的社会和物理环境暴露对健康的影响，并探索它们之间的潜在协同作用，特别关注心理社会压力和空气污染的综合影响。在低收入城市社区，这两种暴露可能会增加，并且有人假设，可以影响免疫功能和易感性的压力可能会加强空气污染对呼吸道疾病发作和恶化的影响。本文试图综合社会和环境流行病学、毒理学、免疫学和暴露评估等方面的相关研究，为环境健康研究者提供一个有用的框架，旨在研究环境污染与社会或心理因素相结合对健康的影响。我们回顾了现有的流行病学和毒理学证据的压力和污染的协同效应，然后描述压力的生理效应和测量和评估压力的关键问题，因为它涉及到物理环境暴露和易感性。最后，当我们努力解开聚集性社会和身体暴露对健康的影响并准确描述这些暴露之间的相互作用时，我们确定了未来的一些主要方法学挑战。要了解压力和污染对健康的综合和潜在的协同作用，还有大量的工作要做。随着这项研究的进行，我们建议仔细关注压力和污染暴露的相对时间性，其独立和综合效应的非线性，流行病学方法未阐明的生理途径，以及在多个地理尺度上社会和物理暴露的相对空间分布。
There is growing interest in disentangling the health effects of spatially clustered social and physical environmental exposures and in exploring potential synergies among them, with particular attention directed to the combined effects of psychosocial stress and air pollution. Both exposures may be elevated in lower-income urban communities, and it has been hypothesized that stress, which can influence immune function and susceptibility, may potentiate the effects of air pollution in respiratory disease onset and exacerbation. In this paper, we attempt to synthesize the relevant research from social and environmental epidemiology, toxicology, immunology, and exposure assessment to provide a useful framework for environmental health researchers aiming to investigate the health effects of environmental pollution in combination with social or psychological factors. We review the existing epidemiologic and toxicologic evidence on synergistic effects of stress and pollution, and then describe the physiologic effects of stress and key issues related to measuring and evaluating stress as it relates to physical environmental exposures and susceptibility. Finally, we identify some of the major methodologic challenges ahead as we work toward disentangling the health effects of clustered social and physical exposures and accurately describing the interplay among these exposures. There is still tremendous work to be done toward understanding the combined and potentially synergistic health effects of stress and pollution. As this research proceeds, we recommend careful attention to the relative temporalities of stress and pollution exposures, to nonlinearities in their independent and combined effects, to physiologic pathways not elucidated by epidemiologic methods, and to the relative spatial distributions of social and physical exposures at multiple geographic scales.
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影响因子：
5
作者：
COHEN, S;KAMARCK, T;MERMELSTEIN, R
通讯作者：
MERMELSTEIN, R
影响因子：
10.4
作者：
DeFur PL;Evans GW;Cohen Hubal EA;Kyle AD;Morello-Frosch RA;Williams DR
通讯作者：
Williams DR
影响因子：
10.4
作者：
Clougherty JE;Levy JI;Kubzansky LD;Ryan PB;Suglia SF;Canner MJ;Wright RJ
通讯作者：
Wright RJ
影响因子：
10.4
作者：
Cory-Slechta DA;Virgolini MB;Thiruchelvam M;Weston DD;Bauter MR
通讯作者：
Bauter MR
影响因子：
11.8
作者：
Belojevic, Goran;Jakovjevic, Branko;Ilic, Jelena
通讯作者：
Ilic, Jelena