人群暴露环境镉污染与健康危害的流行病学研究进展

Advances of Epidemiological Study on Population Exposure and Health Hazard of Environmental Cadmium Pollution

镉是环境中常见的毒性很强的重金属污染物,非职业接触主要通过吸烟及食物链途径进入体内,持续低剂量的镉暴露往往会在(40~50)岁后才表现出明显症状的机体损害,可对人体多个系统产生损伤,表现为以肾脏和骨骼为主的特异性靶器官损伤以及对人群慢性疾病和死亡的潜在非特异性影响,且多数的健康危害效应以人群慢性疾病谱和发(患)病率的变化来体现,常常难以观察到,因此更需要重视环境镉污染所致的潜在人群健康危害。环境镉污染的人群健康危害评估包括摄入量评估、暴露人群健康损害效应评价、暴露与损害效应的剂量反应关系,以及结合以上内容对人群健康风险进行评估。本文主要针对环境镉污染人群调查研究进行梳理,从人群镉暴露、早期肾损伤、骨损伤、生殖和生长发育影响、心血管功能影响以及环境镉与癌症及死亡的队列研究等方面总结了以往研究,并就我国环境镉污染流行病学研究方向提供建议。

Cadmium( Cd) is a common and highly toxic heavy metal in the environment. The non-occupational exposure is mainly through smoking and food chain pathways. Continuous low dose Cd exposure usually demonstrates symptomatic body damage after 40 to 50 years old,causing damages to many systems in the human body,which is characterized not only by specific target organ damages mainly in kidney and bone,but also by potential non-specific effects on population chronic disease and death. Most of the health hazardous effects are reflected in the change of population chronic disease spectrum and morbidity,so they are usually difficult to be observed. Therefore,it is necessary pay attention to the potential population health hazards caused by environmental Cd pollution.The study on the population health hazards of environmental cadmium pollution includes intake evaluation,health damage effect assessment of exposed population,and the dose-response relationship between exposure and damage effect,and it combines levels above to evaluate the population health risk. This paper is mainly focused on investigation studies of population exposed in environmental cadmium pollution. It also summarized previous research from perspectives of population Cd exposure,early kidney damage,bone injury,reproductive and growth effects,cardiovascular function effects,and cohort studiesof cancer and death. At last,a brief proposal is presented about the direction of epidemiological research on environmental cadmium pollution in China.