The effects of 3 environmental risks on mortality disparities across Mexican communities
The effects of 3 environmental risks on mortality disparities across Mexican communities
复制标题
3 种环境风险对墨西哥社区死亡率差异的影响
DOI：
10.1073/pnas.0808927105
复制
发表时间：
2008
期刊：
影响因子：
--
通讯作者：
M. Ezzati
中科院分区：
文献类型：
--
作者：
Gretchen A. Stevens;Rodrigo H. Dias;M. Ezzati
环境风险造成的不良健康负担的差异，除了对总体人口的影响之外，还应是一个重要的考虑因素。我们使用比较风险评估方法来计算墨西哥不安全饮用水和卫生设施、家庭固体燃料使用造成的室内空气污染和城市环境颗粒物污染对死亡率的影响。我们还估计了每个风险因素在不同居住城市（县）和不同城市社会经济地位（SES）之间造成的死亡率差异。分析的数据来源是全国人口普查、具有人口代表性的健康调查和风险因素暴露的空气质量监测；风险因素影响的流行病学研究的系统综述和荟萃分析；以及特定疾病死亡率的重要统计数据。2001-2005年期间，不安全的水和卫生设施、家庭固体燃料使用和城市颗粒物污染分别造成每年3 000人、3 600人和7 600人死亡。在没有这些环境暴露的情况下，儿童年死亡率将分别降低每1 000名儿童0.2、0.1和0.1个，预期寿命将分别增加1.0、1.2和2.4个月。在社会经济地位最低的社区，这些风险因素加在一起造成了10.6%的儿童死亡（每1 000名儿童死亡0.9人），但在社会经济地位最高的社区，这一比例仅为4.0%（每1 000名儿童死亡0.1人）。在50个受影响最严重的城市，这三种接触造成每1 000名儿童3.2人死亡，预期寿命减少10个月。这三种环境风险对死亡率影响的巨大差异应该成为干预和环境监测计划的基础。
The disparities in the burden of ill health caused by environmental risks should be an important consideration beyond their aggregate population effects. We used comparative risk assessment methods to calculate the mortality effects of unsafe water and sanitation, indoor air pollution from household solid fuel use, and ambient urban particulate matter pollution in Mexico. We also estimated the disparities in mortality caused by each risk factor, across municipios (counties) of residence and by municipio socioeconomic status (SES). Data sources for the analysis were the national census, population-representative health surveys, and air quality monitoring for risk factor exposure; systematic reviews and meta-analyses of epidemiological studies for risk factor effects; and vital statistics for disease-specific mortality. During 2001–2005, unsafe water and sanitation, household solid fuel use, and urban particulate matter pollution were responsible for 3,000, 3,600, and 7,600 annual deaths, respectively. Annual child mortality rates would decrease by 0.2, 0.1, and 0.1 per 1,000 children, and life expectancy would increase by 1.0, 1.2, and 2.4 months, respectively, in the absence of these environmental exposures. Together, these risk factors caused 10.6% of child deaths in the lowest-SES communities (0.9 deaths per 1,000 children), but only 4.0% in communities in the highest-SES ones (0.1 per 1,000). In the 50 most-affected municipios, these 3 exposures were responsible for 3.2 deaths per 1,000 children and a 10-month loss of life expectancy. The large disparities in the mortality effects of these 3 environmental risks should form the basis of interventions and environmental monitoring programs.
影响因子：
10.4
作者：
O'Neill MS;Jerrett M;Kawachi I;Levy JI;Cohen AJ;Gouveia N;Wilkinson P;Fletcher T;Cifuentes L;Schwartz J;Workshop on Air Pollution and Socioeconomic Conditions
通讯作者：
Workshop on Air Pollution and Socioeconomic Conditions
影响因子：
120.7
作者：
Pope, CA;Burnett, RT;Thurston, GD
通讯作者：
Thurston, GD
DOI：
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发表时间：
--
期刊：
--
影响因子：
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作者：
G. Jones;R. Steketee;G. Jones;R. Steketee;R. Black;Z. Bhutta;S. Morris;Bellagio Child;Survival Study Group
通讯作者：
G. Jones;R. Steketee;G. Jones;R. Steketee;R. Black;Z. Bhutta;S. Morris;Bellagio Child;Survival Study Group