Residence location as a measure of environmental exposure: a review of air pollution epidemiology studies
Residence location as a measure of environmental exposure: a review of air pollution epidemiology studies
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DOI：
10.1038/sj.jea.7500074
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发表时间：
2000-01-01
期刊：
影响因子：
--
通讯作者：
Batterman, S
中科院分区：
文献类型：
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作者：
Huang, YL;Batterman, S
长期以来，居住地点一直被用于指示许多流行病学研究中的环境暴露。这一指标易于确定，所需接触或监测数据很少，可能适用于许多类型的调查。然而，居住地点作为暴露指标的有效性、准确性和实用性受到了当前对多种暴露途径、持久性和有毒污染物以及来自非点源、移动的源和点源的累积暴露的关注的挑战。本文回顾了45项流行病学研究，这些研究使用居住地点来确定研究人群并估计空气污染暴露。13项研究（29%）根据"邻近"措施确定环境暴露，通常是受试者住所到污染源的距离。其他研究使用假定具有相同污染水平的"区域"。一些研究结合了区域和邻近方法。在27项（60%）研究中使用监测数据对暴露量进行了量化，在2项（4%）研究中使用了离散度模型。16项（36%）研究没有使用任何环境数据来量化暴露。共有31项（69%）研究报告了健康终点与居住地点所代表的污染物暴露之间的显著关联。一般而言，没有采用全面和系统的方法来确定和估计人口接触情况，因此认为接触估计数可能具有很大的不确定性。除非核实各组之间的接触水平，否则无法确定接触与健康终点之间的非显著关联是否表明缺乏可测量的健康影响，或者仅仅是接触分类错误的结果。需要进行针对具体地点的定量接触评估，以便更好地量化和确认此类研究中的接触情况，并允许对各项研究进行解释和比较。
Residence location has long been used to indicate environmental exposure in many epidemiological studies. This indicator is easy to establish, requires little exposure or monitoring data, and is potentially applicable to many types of investigations. The validity, accuracy and utility of residence location as an exposure indicator, however, is challenged by current concerns regarding multiple exposure pathways, persistent and toxic contaminants, and cumulative exposures from non-point, mobile and point sources. This paper reviews 45 epidemiological studies that use residence location to identify study populations and estimate air pollution exposures. Thirteen (29%) of the studies determined environmental exposures based on "proximity" measures, usually the distance from a subject's residence to a pollutant source. Other studies used "zones" presumed to have equal pollutant levels. Several studies combined zone and proximity approaches. Exposures were quantified using monitoring data in 27 (60%) studies and dispersion modeling in two (4%) studies. Sixteen (36%) studies did not use any environmental data to quantify exposure. A total of 31 (69%) of the studies reported significant associations between health endpoints and the pollutant exposures represented by residence location. In general, comprehensive and systematic approaches to identify and estimate population exposures were not used, and the exposure estimates were therefore deemed likely to have great uncertainty. Unless exposure levels among groups are verified, it cannot be determined whether nonsignificant associations between exposures and health endpoints indicate a lack of measurable health effects, or are merely a result of exposure misclassification. Site-specific and quantitative exposure assessments are needed to better quantify and confirm exposures within such studies, as well as to permit interpretations and comparisons across studies.