In health management, although individuals are the first responsible person, it is difficult to control the impact of the external environment. Air pollution is a type of carcinogen. Data shows that about 7 million people die prematurely due to air pollution every year, of which more than 4 million people die from PM2.5. Overall, air pollution is susceptible to populations, and it contributes more than 20% to premature deaths in the affected population. Specifically, 40% of premature deaths of COPD, 20% of neonatal deaths and 20% of diabetes deaths are all caused by air pollution.
Healthy China proposes that China's average life expectancy will be extended from the current 77.8 years to 79 years in 2030. Some scholars estimate that if China's PM2.5 value drops to The latest guidance value of of the World Health Organization is 5 micrograms/cubic meter, the average life expectancy in my country can increase by 1.2 to 1.4 years. This shows that from the perspective of air pollution control alone, the goal of 79 years of life expectancy in 2030 can be achieved, of course, this is just the result of risk assessment.
air pollutant PM2.5 is complex in composition. It is not a separate chemical, but a mixture of multiple compounds and has different particle sizes. After PM2.5 enters the human body, it may be deposited into alveolar , penetrating the cardiovascular barrier, or even the blood-brain barrier, affecting the human nerves. In addition, people of different diseases, genders and ages also have different susceptibility to PM2.5.
Epidemiological studies usually assume that the situation in all individuals is the same, but in fact there are great differences between individuals. Therefore, focusing on individual and population susceptibility will help individuals take corresponding preventive measures to better adapt to the environment, and on the other hand, it can promote the introduction of targeted public protection policies for susceptible populations.
Patients under different disease states also respond differently when exposed to air pollution. For example, diabetes is a metabolic disorder syndrome, and the patient's body is in a long-term chronic inflammatory state, while air pollution often affects various organs of the human body through inflammation. In order to determine the correlation between the two, we conducted a research design of epidemiology - a fixed group study.
In addition to obtaining the conclusion of a large number of environmental exposures, this study can also explain its mechanism of occurrence in combination with multiomics studies. The study found that ultrafine particulate matter had a very robust association with respiratory inflammation in the diabetic population in Shanghai, but since the study only targeted diabetic population, it was impossible to prove that they must be more susceptible than healthy populations. In later study designs, we added case controls to conduct a more in-depth and systematic analysis of susceptibility.
Through a series of studies, we found that prediabetes people are more susceptible to air pollution; blood sugar metabolism disorders will aggravate the damage to phthalmodynamic function of PM2.5, resulting in reduced vascular elasticity and endothelial dysfunction; we also found that respiratory inflammation of COPD is more susceptible to air pollution, and people with poor lung function are more susceptible to systemic inflammation caused by PM2.5; we also obtained evidence that sphingolipids affect the mediating effect of atherosclerosis in PM2.5.
In the study, we increasingly use multi-omics to combine exposure to transcriptomics , proteomics and metabolomics to further explain the mechanism by which air pollution exposure leads to differences in susceptibility to individual health effects. Through mechanism research, we can further demonstrate the causal relationship of individual susceptibility to air pollution, which is of great significance to preventing diseases and protecting health.
So far, our team has conducted a lot of research on 10 groups and has also obtained some related results. When conducting research on pre-diabetic populations, the population we selected was a large number of people participating in annual physical examinations, and the physical examination itself played a very important role in individual health management.
The significance of studying the susceptibility of environmental pollution on human health is that if the impact of environmental pollution on the health of each individual or subpopulation can be identified, the public will be able to obtain more scientific and effective health management guidance suggestions after physical examinations, and enhance their awareness of taking personal protection measures for environmental pollution. More importantly, at the national and social level, it helps to take susceptibility as a specific environmental quality standard, thereby protecting human health to a greater extent and enhancing environmental equity.
《Journal of Medical Sciences》 (2022-09-23 Edition 5 Cover)
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