空氣汙染與心血管健康

Air Pollution and Cardiovascular Health

蘇大成(Ta-Chen Su)

《台灣醫學》 20卷4期 (2016/07) Pp. 377-386

https://doi.org/10.6320/FJM.2016.20(4).5

摘要

越來越多的證據指出空氣污染是心臟血管疾病的危險因子，2010年美國心臟學會的共識會議報告，以及台灣過去的研究，在致病機轉上都支持都市的空氣污染與心臟血管疾病的相關性，短期及長期空氣污染暴露，皆會影響到心臟血管健康。面對日益惡化的空氣品質，對於有甚麼好的自然環境可以幫助人類，我們渴求甚殷。台大森林醫學研究團隊研究發現森林環境對心血管疾病、身體免疫系統、和健康相關生活品質，皆有正面的健康效應。亞洲地區的空氣品質在過去二、三十年明顯地惡化，主要來自於快速的經濟發展所帶來的都市化、工業化、與自動車化。如何面對處理都市的空氣污染問題，是具有挑戰性的課題，我們要設法尋求解決方案。

關鍵字

空氣汙染 ； 心臟血管疾病 ； 室內空氣汙染 ； 森林與健康

並列摘要

More and more evidence indicates environmental pollutions are important risk factors affecting cardiovascular diseases (CVDs). Among these, urban air pollution shares the greatest contribution on human health, which is not only confined to illness but also involved in a higher impact on CVDs morbidity and mortality. The mechanisms linking air pollution to cardiovascular diseases are proposed in the scientific statement by the American Heart Association, and our previous studies also added support to these mechanisms. Short-term urban air pollution has been associated with inflammation, oxidative stress, blood coagulation, and autonomic dysfunction in young adults, and cardiac and vasomotor dysfunctions in middle-aged adults. Moreover, in middle-aged adults, the carotid intima-media thickness and blood leukocyte and monocyte are associated with the individual’s long-term exposure to air pollution of PM_(2.5) absorbent, PM_(10), NO_(2), and NO_(x) estimated by land-use regression models of the European Study of Cohorts for Air Pollution Effects. These studies provided supporting evidence to the increased risk of CVDs following short-term and long-term air pollution exposure. In search of which kind of natural environments may benefit our health, the Forest and Health Cooperative Study Team of National Taiwan University have demonstrated the potential favorable health effects on subclinical atherosclerosis in terms of carotid intima-media thickness and subjective health-related quality of life in workers living in forest environment compared to those of living in Taipei. Further studies also demonstrated either short-term or long-term exposures to forest environments may positively impact NK cells and NK cell activity in human. Air quality in Asia has deteriorated significantly in recent decades because of rapid industrialization, urbanization, and motorization. How to cope with this critical condition and searching for possible solutions are anticipated.

並列關鍵字

air pollution ； cardiovascular disease ； indoor air pollution ； forest and health

參考文獻

Lim SS, Vos T, Flaxman AD, et al: Acomparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012;380:2224-60."

Lelieveld J, Evans JS, Fnais M, et al: The contribution of outdoor air pollution sources to premature mortality on a global scale. Nature 2015;525:367-84."

Raaschou-Nielsen O, Andersen ZJ, Beelen R, et al: Air pollution and lung cancer incidence in 17 European cohorts: prospective analyses from the European Study of Cohorts for Air Pollution Effects (ESCAPE). Lancet Oncol 2013;14: 813-22."

Peters A, Dockery DW, Muller JE, et al: Increased particulate air pollution and the triggering of myocardial infarction. Circulation 2001;103:2810-5."

Peters A, von Klot S, Heier M, et al: Exposure to traffic and the onset of myocardial infarction. N Engl J Med 2004;351:1721-30."