Burden of Disease from Toxic Waste Sites in India, Indonesia, and the Philippines in 2010
Burden of Disease from Toxic Waste Sites in India, Indonesia, and the Philippines in 2010
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DOI：
10.1289/ehp.1206127
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发表时间：
2013-07-01
影响因子：
10.4
通讯作者：
Fuller, Richard
中科院分区：
文献类型：
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作者：
Chatham-Stephens, Kevin;Caravanos, Jack;Fuller, Richard
背景技术背景：以前的计算有毒暴露的疾病负担没有包括估计的负担，从有毒废物网站由于没有暴露data.OBJECTIVE：我们开发了一个残疾调整生命年（DALY）为基础的估计，可归因于有毒废物网站的疾病负担。我们集中在三个低收入和中等收入国家（LMICs）：印度，印度尼西亚和Philippine.METHODS：通过铁匠研究所的有毒场地识别计划，全球努力，以确定在LMICs的废物场地的网站。在每个地点的环境介质中至少对八种有毒化学品中的一种进行了取样，并估计了处于危险中的人口。通过将这些暴露的疾病发病率估计值与人口数据相结合，我们计算了每个地点可归因于暴露的DADs。我们估计，2010年，在这三个国家的373个有毒废物场地，有8，629，750人面临着暴露于工业污染物的风险，这些暴露导致828，722个DIFFERS，范围为814，934- 1，557，121个DINES，取决于所使用的加权因子。这一疾病负担与这些国家的室外空气污染（1，448，612迪拉姆）和疟疾（725，000迪拉姆）的估计负担相当。铅和六价铬共同占99.2%的总DALYS的化学品evaluated.CONCLUSIONS：有毒废物的网站是负责一个显着的疾病负担中LMICs。尽管某些因素（例如未识别和未筛查的地点）可能导致我们的估计低估了实际疾病负担，但其他因素（例如将环境采样外推至整个暴露人群）可能导致高估了归因于这些地点的疾病负担。有毒废物场是一个重大的，迄今尚未得到充分认识的全球健康问题。
BACKGROUND: Prior calculations of the burden of disease from toxic exposures have not included estimates of the burden from toxic waste sites due to the absence of exposure data.OBJECTIVE: We developed a disability-adjusted life year (DALY)-based estimate of the disease burden attributable to toxic waste sites. We focused on three low-and middle-income countries (LMICs): India, Indonesia, and the Philippines.METHODS: Sites were identified through the Blacksmith Institute's Toxic Sites Identification Program, a global effort to identify waste sites in LMICs. At least one of eight toxic chemicals was sampled in environmental media at each site, and the population at risk estimated. By combining estimates of disease incidence from these exposures with population data, we calculated the DALYs attributable to exposures at each site.RESULTS: We estimated that in 2010, 8,629,750 persons were at risk of exposure to industrial pollutants at 373 toxic waste sites in the three countries, and that these exposures resulted in 828,722 DALYs, with a range of 814,934-1,557,121 DALYs, depending on the weighting factor used. This disease burden is comparable to estimated burdens for outdoor air pollution (1,448,612 DALYs) and malaria (725,000 DALYs) in these countries. Lead and hexavalent chromium collectively accounted for 99.2% of the total DALYs for the chemicals evaluated.CONCLUSIONS: Toxic waste sites are responsible for a significant burden of disease in LMICs. Although some factors, such as unidentified and unscreened sites, may cause our estimate to be an underestimate of the actual burden of disease, other factors, such as extrapolation of environmental sampling to the entire exposed population, may result in an overestimate of the burden of disease attributable to these sites. Toxic waste sites are a major, and heretofore underrecognized, global health problem.