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对于空气污染对寿命的影响,这是大家都关注的问题,我也不是反对控制空气污染的努力。我只是希望工作做得更踏实点,因为这个世界哗众取宠的东西太多了。我更不希望看到有人利用这个问题,特别是这篇文章这么快的发表,这么快的被美国媒体宣传,这么广泛的在国内传播,对此我是有一点疑问的。
老虎说健康经济学的历史有很多年了,是的,不过我觉得这样的课题,需要公卫学院卫生经济学专家来研究或者参与研究,这样可以避免很多问题。
再说,公卫确实有人在做这方面的工作,我就看到这样一篇(我先声明,对这样的文章我同样看不懂,我介绍不意味我同意该篇作者的观点。但是了解他们为什么选择这样的角度也许会有价值):
Res Rep Health Eff Inst. 2010 Nov;(154):17-78.
Part 1. A time-series study of ambient air pollution and daily mortality in Shanghai, China.
Kan H, Chen B, Zhao N, London SJ, Song G, Chen G, Zhang Y, Jiang L; HEI Health Review Committee.
Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China.
Abstract
Although the relation between outdoor air pollution and daily mortality has been examined in several Chinese cities, there are still a number of key scientific issues to be addressed concerning the health effects of air pollution in China. Given the changes over the past decade in concentrations and sources of air pollution (e.g., the change from one predominant source [coal combustion], which was typical of the twentieth century, to a mix of sources [coal combustion and motor-vehicle emissions]) and transition in China, it is worthwhile to investigate the acute effects of outdoor air pollution on mortality outcomes in the country. We conducted a time-series study to investigate the relation between outdoor air pollution and daily mortality in Shanghai using four years of daily data (2001-2004). This study is a part of the Public Health and Air Pollution in Asia (PAPA) program supported by the Health Effects Institute (HEI). We collected data on daily mortality, air pollution, and weather from the Shanghai Municipal Center of Disease Control and Prevention (SMCDCP), Shanghai Environmental Monitoring Center, and Shanghai Meteorologic Bureau. An independent auditing team assigned by HEI validated all the data. Our statistical analysis followed the Common Protocol of the PAPA program (found at the end of this volume). Briefly, a natural-spline model was used to analyze the mortality, air pollution, and covariate data. We first constructed the basic models for various mortality outcomes excluding variables for air pollution, and used the partial autocorrelation function of the residuals to guide the selection of degrees of freedom for time trend and lag days for the autoregression terms. Thereafter, we introduced the pollutant variables and analyzed their effects on mortality outcomes, including both mortality due to all natural (nonaccidental) causes and cause-specific mortality. We fitted single- and multipollutant models to assess the stability of the effects of the pollutants. For mortality due to all natural causes, we also examined the associations stratified by sex and age. Stratified analyses by education level, used as a measure of socioeconomic status, were conducted as well. In addition to an analysis of the entire study period, the effects of air pollution in just the warm season (from April to September) and cool season (from October to March) were analyzed. We also examined the effects of alternative model specifications--such as lag effects of pollutants and temperature, degrees of freedom for time trend and weather conditions, statistical approaches, and averaging methods for pollutant concentrations-on the estimated effects of air pollution. We found significant associations between the air pollutants--particulate matter 10 pm or less in aerodynamic diameter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), and ozone (O3) -and daily mortality from all natural causes and from cardiopulmonary diseases. The increased mortality risks found in the data from Shanghai were generally similar in magnitude, per concentration of pollutant, to the risks found in research from other parts of the world. An increase of 10 microg/m3 in 2-day moving average concentrations of PM10, SO2, NO2, and O3 corresponded to 0.26% (95% confidence interval [CI], 0.14-0.37), 0.95% (95% CI, 0.62-1.28), 0.97% (95% CI, 0.66-1.27), and 0.31% (95% CI, 0.04-0.58) increases, respectively, in mortality due to all natural causes. Sensitivity analyses suggested that our findings were generally insensitive to alternative model specifications. We found significant effects of the gaseous pollutants SO2 and NO2 on daily mortality after adjustment for PM10. Our analysis also provided preliminary, but not conclusive, evidence that women, older people, and people with a low level of education might be more vulnerable to air pollution than men, younger people, and people with a high level of education. In addition, the associations between air pollution and daily mortality appeared to be more pronounced in the cool season than in the warm. We concluded that short-term exposure to outdoor air pollution (PM10, SO2, NO2, and O3) was associated with daily mortality in Shanghai and that gaseous pollutants might have independent health effects in the city. Overall, the results of the study appeared largely consistent with those reported in other locations worldwide. Further research will be needed to disentangle the effects of the various pollutants and to gain more conclusive insights into the influence of various sociodemographic characteristics (e.g., sex, age, and socioeconomic status) and of season on the associations between air pollution and daily mortality.
我觉得,这样重大的问题,不妨请经济学家和公卫专家坐下来讨论讨论,也许会有更好的思路。 |
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