Background

The current single-pollutant approach to regulating ambient air pollutants is effective at protecting public health, but efficiencies may be gained by addressing issues in a multipollutant context since multiple pollutants often have common sources and individuals are exposed to more than one pollutant at a time.

Objective

We performed a cross-disciplinary review of the effects of multipollutant exposures on cardiovascular effects.

Methods

A broad literature search for references including at least two criteria air pollutants (particulate matter [PM], ozone [O₃], oxides of nitrogen, sulfur oxides, carbon monoxide) was conducted. References were culled based on scientific discipline then searched for terms related to cardiovascular disease. Most multipollutant epidemiologic and experimental (i.e., controlled human exposure, animal toxicology) studies examined PM and O₃ together.

Discussion

Epidemiologic and experimental studies provide some evidence for O₃ concentration modifying the effect of PM, although PM did not modify O₃ risk estimates. Experimental studies of combined exposure to PM and O₃ provided evidence for additivity, synergism, and/or antagonism depending on the specific health endpoint. Evidence for other pollutant pairs was more limited.

Conclusions

Overall, the evidence for multipollutant effects was often heterogeneous, and the limited number of studies inhibited making a conclusion about the nature of the relationship between pollutant combinations and cardiovascular disease.

中文翻译：

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对心血管疾病多污染物影响的证据进行跨学科评估

背景

当前用于调节环境空气污染物的单一污染物方法可有效保护公众健康，但是通过在多种污染物的情况下解决问题可能会提高效率，因为多种污染物通常具有共同的来源，并且个人一次暴露于一种以上的污染物。

客观的

我们对多种污染物对心血管的影响进行了跨学科的综述。

方法

进行了广泛的文献检索，以寻找包括至少两种标准空气污染物（颗粒物[PM]，臭氧[O ₃ ]，氮氧化物，硫氧化物，一氧化碳）的参考文献。根据科学学科对参考文献进行筛选，然后搜索与心血管疾病相关的术语。大多数多污染物的流行病学和实验研究（即，受控的人体暴露，动物毒理学）研究同时检查了PM和O ₃。

讨论

流行病学和实验研究为O ₃浓度改变了PM的影响提供了一些证据，尽管PM并没有改变O _3的风险估计。联合暴露于PM和O _3的实验研究提供了根据特定的健康终点而实现的加性，协同作用和/或拮抗作用的证据。其他污染物对的证据更为有限。

结论

总体而言，多种污染物作用的证据通常是异质的，并且有限的研究数量受到限制，无法得出有关污染物组合与心血管疾病之间关系的性质的结论。