Coronary heart disease and household air pollution from use of solid fuel: a systematic review.
Coronary heart disease and household air pollution from use of solid fuel: a systematic review.
复制标题
DOI：
10.1093/bmb/ldw015
复制
发表时间：
2016-06
影响因子：
6.7
通讯作者：
Coggon D
中科院分区：
文献类型：
--
作者：
Fatmi Z;Coggon D
越来越多的证据表明，使用固体燃料做饭和取暖造成的室内空气污染(IAP)可能是冠心病(CHD)的一个重要风险因素。我们检索了截至2015年6月12日的Ovid Medline、Embase Classic、Embase和Web of Science数据库，以确定有关CHD与固体燃料引起的IAP的关系、任何风险增加的可能幅度以及潜在致病机制的初步流行病学研究报告。目前流行病学证据的平衡表明，由于使用固体燃料，特别是生物质燃料做饭和取暖，IAP引发CHD的风险增加。长期风险敞口的相对风险可能是两到四倍。证据基础仍然有限，尽管来自固体燃料的这种IAP与冠心病的联系与吸烟、环境烟草烟雾和环境空气污染的已知危害一致，并得到了对炎症过程、动脉粥样硬化和血压影响的证据的支持，但它需要更大规模和更有力的研究来证实。完成了两项关于使用生物质燃料引起的CHD和IAP的相对较小的病例对照研究，证明了这种研究的可行性，并鼓励使用类似方法进行更大规模的进一步研究。这类研究的必要性尤其迫切，因为发展中国家的CHD发病率正在上升，而IAP可能与推动这种增长的风险因素产生协同作用。此外，有相对便宜的方法可以减少使用固体燃料引起的IAP，而且干预研究表明，这些方法可能对CHD以及由这种污染引起的其他疾病产生有益影响。
Evidence is emerging that indoor air pollution (IAP) from use of solid fuels for cooking and heating may be an important risk factor for coronary heart disease (CHD). We searched the Ovid Medline, Embase Classic, Embase and Web of Science databases through to 12 June 2015 to identify reports of primary epidemiological research concerning the relationship of CHD to IAP from solid fuel, the likely magnitude of any increase in risk, and potential pathogenic mechanisms. The current balance of epidemiological evidence points to an increased risk of CHD from IAP as a consequence of using solid, and especially biomass, fuels for cooking and heating. Relative risks from long-term exposure could be two- to fourfold. The evidence base is still limited, and although an association of CHD with such IAP from solid fuel is consistent with the known hazards from smoking, environmental tobacco smoke and ambient air pollution, and supported by evidence of effects on inflammatory processes, atherosclerosis and blood pressure, it requires confirmation by larger and more robust studies. The completion of two relatively small case-control studies on CHD and IAP from use of biomass fuel demonstrates the feasibility of such research, and is an encouragement to further, larger studies using similar methods. The need for such research is particularly pressing because the incidence of CHD in developing countries is rising, and IAP may interact synergistically with the risk factors that are driving that increase. Furthermore, relatively cheap methods are available to reduce IAP from use of solid fuels, and there are indications from intervention studies that these may impact beneficially on CHD as well as other diseases caused by such pollution.