Abstract：
Chronic respiratory diseases are a dealing cause of death and disability worldwide. Their prevalence is steadily increasing and the exposure to environmental contaminants, including Flame Retardants (FRs), is being considered as a possible risk factor. Despite the widespread and continuous exposure to FRs, the role of these contaminants in chronic respiratory diseases is yet not clear. This study aims to systematically review the association between the exposure to FRs and chronic respiratory diseases. Searches were performed using the Cochrane Library, MEDLINE, EMBASE, PUBMED, SCOPUS, ISI Web of Science (Science and Social Science Index), WHO Global Health Library and CINAHL EBSCO. Among the initial 353 articles found, only 9 fulfilled the inclusion criteria and were included. No statistically significant increase in the risk for chronic respiratory diseases with exposure to FRs was found and therefore there is not enough evidence to support that FRs pose a significantly higher risk for the development or worsening of respiratory diseases. However, a non-significant trend for potential hazard was found for asthma and rhinitis/rhinoconjunctivitis, particularly considering urinary organophosphate esters (OPEs) including TNBP, TPHP, TCEP and TCIPP congeners/compounds. Most studies showed a predominance of moderate risk of bias, therefore the global strength of the evidence is low. The limitations of the studies here reviewed, and the potential hazardous effects herein identified highlights the need for good quality large-scale cohort studies in which biomarkers of exposure should be quantified in biological samples.
摘要：
慢性呼吸系统疾病是全世界死亡和残疾的主要原因。它们的患病率稳步上升，暴露于环境污染物，包括阻燃剂（FR），被认为是一个可能的风险因素。尽管广泛而持续地接触FR，这些污染物在慢性呼吸道疾病中的作用尚不清楚。本研究旨在系统评价FRs暴露与慢性呼吸系统疾病之间的关系。使用Cochrane图书馆进行搜索，MEDLINE,EMBASE,pubmed,Scopus,ISIWebofScience（科学和社会科学索引），世卫组织全球卫生图书馆和CINAHLEBSCO。在最初找到的353篇文章中，只有9人符合纳入标准并被纳入.没有发现暴露于FR的慢性呼吸系统疾病的风险在统计学上显着增加，因此没有足够的证据支持FR对呼吸系统疾病的发展或恶化构成明显更高的风险。然而,发现哮喘和鼻炎/鼻结膜炎的潜在危害趋势不明显，特别是考虑尿有机磷酸酯（OPEs），包括TNBP，TPHP,TCEP和TCIPP同源物/化合物。大多数研究表明，中等偏倚风险占主导地位，因此，证据的全球强度很低。这里回顾了研究的局限性，本文确定的潜在危险效应凸显了对高质量大规模队列研究的需求，在这些研究中，应在生物样本中对暴露的生物标志物进行定量。
