environmental exposure

环境暴露
  • 文章类型: Journal Article
    首次测量颗粒物(PM2.5、PM10和TSP)以及气态污染物(CO,NO2和SO2)于2019年6月至2020年4月在费萨拉巴德进行,Metropolitan,巴基斯坦,评估它们的季节性变化;2019年夏季、2019年秋季、2019-2020年冬季和2020年春季。污染物测量是在从费萨拉巴德地区的Sitara化学工业到Bhianwala的30个地点进行的,网格距离为3公里,Sargodha路,TehsilLarian,Chiniot区。ArcGIS10.8用于使用反距离加权方法对污染物浓度进行插值。PM2.5、PM10和TSP浓度在夏季最高,秋季或冬季最低。CO,NO2和SO2浓度在夏季或春季最高,在冬季最低。季节平均NO2和SO2浓度超过世卫组织年度空气质量指导值。对于所有四个季节,一些地方的空气质量比其他地方好。即使在这些较清洁的地点,空气质量指数(AQI)对敏感群体也不健康,较差的地点显示出非常关键的AQI(>500)。粉尘中的碳和硫含量在春季(64mgg-1)和夏季(1.17mgg-1)较高,在秋季(55mgg-1)和冬季(1.08mgg-1)较低。对20个人的静脉血液分析显示,镉和铅的浓度高于WHO允许的限值。那些由于职业而长期暴露于路边直接污染的人往往表现出更高的Pb和Cd血液浓度。结论是,路边的空气质量极差,可能会损害裸露工人的健康。
    First-ever measurements of particulate matter (PM2.5, PM10, and TSP) along with gaseous pollutants (CO, NO2, and SO2) were performed from June 2019 to April 2020 in Faisalabad, Metropolitan, Pakistan, to assess their seasonal variations; Summer 2019, Autumn 2019, Winter 2019-2020, and Spring 2020. Pollutant measurements were carried out at 30 locations with a 3-km grid distance from the Sitara Chemical Industry in District Faisalabad to Bhianwala, Sargodha Road, Tehsil Lalian, District Chiniot. ArcGIS 10.8 was used to interpolate pollutant concentrations using the inverse distance weightage method. PM2.5, PM10, and TSP concentrations were highest in summer, and lowest in autumn or winter. CO, NO2, and SO2 concentrations were highest in summer or spring and lowest in winter. Seasonal average NO2 and SO2 concentrations exceeded WHO annual air quality guide values. For all 4 seasons, some sites had better air quality than others. Even in these cleaner sites air quality index (AQI) was unhealthy for sensitive groups and the less good sites showed Very critical AQI (> 500). Dust-bound carbon and sulfur contents were higher in spring (64 mg g-1) and summer (1.17 mg g-1) and lower in autumn (55 mg g-1) and winter (1.08 mg g-1). Venous blood analysis of 20 individuals showed cadmium and lead concentrations higher than WHO permissible limits. Those individuals exposed to direct roadside pollution for longer periods because of their occupation tended to show higher Pb and Cd blood concentrations. It is concluded that air quality along the roadside is extremely poor and potentially damaging to the health of exposed workers.
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  • 文章类型: Journal Article
    本研究旨在估计在9个主要拉丁美洲城市中,遵守世界卫生组织(WHO)空气质量准则(AQGs)PM10和PM2.5限值的短期可预防死亡率和相关经济成本。
    我们使用时间序列回归模型估计了特定城市的PM-死亡率关联,并计算了归因死亡率分数。接下来,我们使用统计寿命值计算符合WHOAQGs限值的经济效益.
    在大多数城市,PM浓度超过WHOAQGs极限值的90%以上。发现PM10与浓度高于WHOAQGs极限值的1.88%的平均超额死亡率相关,而PM2.5为1.05%。相关的年度经济成本差异很大,PM10在1950万美元至33869万美元之间,PM2.5在1.963亿美元至22.096亿美元之间。
    我们的研究结果表明,决策者迫切需要制定干预措施,以实现拉丁美洲可持续的空气质量改善。符合世卫组织AQGs对拉丁美洲城市PM10和PM2.5的限值将大大有利于城市人口。
    UNASSIGNED: This study aims to estimate the short-term preventable mortality and associated economic costs of complying with the World Health Organization (WHO) air quality guidelines (AQGs) limit values for PM10 and PM2.5 in nine major Latin American cities.
    UNASSIGNED: We estimated city-specific PM-mortality associations using time-series regression models and calculated the attributable mortality fraction. Next, we used the value of statistical life to calculate the economic benefits of complying with the WHO AQGs limit values.
    UNASSIGNED: In most cities, PM concentrations exceeded the WHO AQGs limit values more than 90% of the days. PM10 was found to be associated with an average excess mortality of 1.88% with concentrations above WHO AQGs limit values, while for PM2.5 it was 1.05%. The associated annual economic costs varied widely, between US$ 19.5 million to 3,386.9 million for PM10, and US$ 196.3 million to 2,209.6 million for PM2.5.
    UNASSIGNED: Our findings suggest that there is an urgent need for policymakers to develop interventions to achieve sustainable air quality improvements in Latin America. Complying with the WHO AQGs limit values for PM10 and PM2.5 in Latin American cities would substantially benefits for urban populations.
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  • 文章类型: Journal Article
    尽管近年来空气质量逐渐改善,如PM2.5浓度下降所示,环境臭氧上升的问题变得越来越严重。为了减少臭氧暴露对人类健康和环境福利的危害,科学家和政府监管机构已经制定了臭氧准则和标准。这些回答了哪些暴露水平对人类健康和环境有害的问题,以及如何保证环境臭氧暴露,分别。那么臭氧准则和标准的制定依据是什么呢?本文详细回顾了世界卫生组织(WHO)和美国环境保护局(EPA)对臭氧准则和标准的修订过程。本研究试图探索和分析更新指南和标准的科学依据和经验方法,以指导未来的修订过程,并为进一步的科学研究提供方向。我们发现许多流行病学和毒理学研究以及暴露-反应关系为制定和修订臭氧指南提供了强有力的支持。在制定标准时,臭氧暴露已得到有效考虑,和经济成本,健康,并合理估计了符合标准的间接经济效益。因此,流行病学和毒理学研究以及建立暴露-反应关系,以及应加强对遵守标准的暴露和风险评估以及效益成本估计,以进一步更新准则和标准。此外,随着臭氧和PM2.5共同导致的空气污染日益突出,应开展更多与臭氧准则和标准有关的联合暴露科学研究。
    Although air quality has gradually improved in recent years, as shown by the decrease in PM2.5 concentration, the problem of rising ambient ozone has become increasingly serious. To reduce hazards to human health and environmental welfare exposure to ozone, scientists and government regulators have developed ozone guidelines and standards. These answer the questions of which levels of exposure are hazardous to human health and the environment, and how can ambient ozone exposure be guaranteed, respectively. So what are the basis for the ozone guidelines and standards? This paper reviews in detail the process of revising ozone guidelines and standards by the World Health Organization (WHO) and the United States Environmental Protection Agency (EPA). The present study attempts to explore and analyze the scientific basis and empirical methods for updating guidelines and standards, in a view to guide the future revision process and provide directions for further scientific research. We found many epidemiological and toxicological studies and exposure-response relationships provided strong support for developing and revising the ozone guidelines. When setting standards, ozone exposure has been effectively considered, and the economic costs, health, and indirect economic benefits of standard compliance were reasonably estimated. Accordingly, epidemiological and toxicological studies and the establishment of exposure-response relationships, as well as exposure and risk assessment and benefit-cost estimates of standards compliance should be strengthened for the further update of guidelines and standards. In addition, with the increasing prominence of combined air pollution led by ozone and PM2.5, more joint exposure scientific research related to ozone guidelines and standards should be undertaken.
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  • 文章类型: Journal Article
    本文对人类暴露于射频电磁场(RF-EMF)的现有限制进行了全球概述和分析。这些参考级别是由不同的国家甚至地区政府建立的,可以基于国际非电离辐射防护委员会(ICNIRP)建议提供的准则,电气和电子工程师协会(IEEE)的国际电磁安全委员会,甚至在美国联邦通信委员会(FCC),还有,基于所谓的预防原则。明确提及国家或地区采用的接触限值,比如加拿大,意大利,波兰,瑞士,中国,俄罗斯,法国,和比利时地区(布鲁塞尔,佛兰德斯,Wallonia),限制远远低于国际标准。将极限与选定的一组原位测量进行比较。这清楚地表明,与国际标准相比,测量值通常很小,但与降低的极限相比可能更高。基于这种观察和合理的假设,即人们对电磁场(EMF)的敏感性在任何地方(全身)都是相同的,我们提出了为公众建立全球参考限制的想法,因此适用于所有国家,如果ICNIRP认为合适的话。研究必须继续产生测量数据,证明我们真正接触的暴露水平,有了这个,向制定准则的组织提供论据,尤其是ICNIRP,来评估电流限制是否太多。高,可以在考虑相关时进行修改。据我们所知,任何时候都没有超过公众的参考水平。
    A worldwide overview and analysis for the existing limits of human exposure to Radiofrequency Electromagnetic Fields (RF-EMF) is given in this paper. These reference levels have been established by different national and even regional governments, which can be based on the guidelines provided by the recommendations of the International Commission on Non-Ionizing Radiation Protection (ICNIRP), the International Committee on Electromagnetic Safety of the Institute of Electrical and Electronics Engineers (IEEE), and even in the United States of the Federal Communications Commission (FCC), as well as, are based on the so-called precautionary principle. Explicit reference is made to the exposure limits adopted in countries or regions, such as Canada, Italy, Poland, Switzerland, China, Russia, France, and regions of Belgium (Brussels, Flanders, Wallonia), where the limits are much lower than the international standards. The limits are compared to a selected set of in-situ measurements. This clearly shows that the measured values are typically very small compared to the international standards but could be somewhat higher compared to the reduced limits. Based on this observation and the reasonable assumption that the sensitivity of people to Electromagnetic Fields (EMF) is the same everywhere (whole-body), we propose the idea to establish a worldwide reference limit for the general public, thus applicable in all countries, if the ICNIRP considers it appropriate. Research must continue to generate measurement data that demonstrate the levels of exposure to which we are really exposed, and with this, provide arguments to the organizations that established the guidelines, especially the ICNIRP, to evaluate whether the current limits are too much. High and can be modified when considered pertinent. To the best of our knowledge, at no time has the reference level for the general public been exceeded.
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  • 文章类型: Journal Article
    本文讨论了评论论文中的争论,即5G新无线电(5GNR)和其他蜂窝系统生成的布里渊前体可能是比载波频率的功率穿透深度更深层组织损伤的原因。来自脉冲射频信号(RF-EMF)的布里渊前体的原始理论以及对其可能的健康影响的推测可以追溯到1990年代,并且基于对非常短(纳秒)超宽带宽RF脉冲传播的研究通过水。由于蜂窝电话信号的窄带宽,这种假设对于蜂窝电话信号是不正确的。评论过的论文没有提供替代的基本原理,说明为什么布里渊效应会导致蜂窝和其他通信系统的RF-EMF辐射造成组织损伤。本文还指出了有关组织对RF-EMF的热响应的其他不准确性。
    This article discusses the contention in the commented-upon paper that Brillouin precursors generated by 5G New Radio (5G NR) and other cellular systems are a possible cause of tissue damage at deeper layers of tissue than the power penetration depth of the carrier frequency. The original theory for Brillouin precursors from pulsed radiofrequency signals (RF-EMF) and speculation about their possible health effects dates back to the 1990\'s and was based on studies of the propagation of very short (nanosecond) ultrawide-bandwidth RF pulses through water. This assumption is not correct for cellular telephone signals due to their narrow bandwidth. The commented-on paper provides no alternative rationale as to why Brillouin effects should cause tissue damage from RF-EMF radiation from cellular and other communications systems. Other inaccuracies in this paper concerning thermal responses of tissue to RF-EMF are also noted.
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  • 文章类型: Journal Article
    邻苯二甲酸酯和双酚A(BPA)是在塑料生产中广泛用作原料的化合物,让它们在我们的日常生活中无处不在。这导致广泛的人类暴露和人类健康危害。尽管已经在世界各地的不同地区努力评估这些化合物的风险,数据分散可能会掩盖重要趋势,这些趋势可能有助于更新当前的指南和法规。这项研究提供了对人类接触这些化学物质水平的全面全球评估,考虑到饮食和非饮食摄入,并评估相关风险。总的来说,全球报告的邻苯二甲酸盐和双酚A的每日暴露摄入量(EDI)值分别为1.11×10-7至3700µgkgbw-1d-1和3.00×10-5至6.56µgkgbw-1d-1。然而,研究表明,邻苯二甲酸盐的剂量-累加效应可使EDI增加至5100µgkgbw-1d-1,在非致癌(HQ)和致癌(CR)效应方面具有较高的风险.邻苯二甲酸酯和双酚A的全球HQ值分别为2.25×10-7至3.66和2.74×10-7至9.72×10-2。同时,大量研究显示了邻苯二甲酸苄丁酯(BBP)和邻苯二甲酸二(2-乙基己基)酯(DEHP)的高CR值。此外,在许多研究中,DEHP显示了人类最高的最大平均CR值,比BBP高179倍。尽管有越来越多的证据表明这些化学物质在低剂量暴露时对动物和人类有有害影响,大多数法规尚未更新。因此,本文强调需要更新指南和公共政策,考虑到低剂量暴露的不利影响的令人信服的证据,它警告不要使用替代增塑剂作为邻苯二甲酸酯和BPA的替代品,因为它们的安全性存在显著差距。
    Phthalates and bisphenol A (BPA) are compounds widely used as raw materials in the production of plastics, making them ubiquitous in our daily lives. This results in widespread human exposure and human health hazards. Although efforts have been conducted to evaluate the risk of these compounds in diverse regions around the world, data scattering may mask important trends that could be useful for updating current guidelines and regulations. This study offers a comprehensive global assessment of human exposure levels to these chemicals, considering dietary and nondietary ingestion, and evaluates the associated risk. Overall, the exposure daily intake (EDI) values of phthalates and BPA reported worldwide ranged from 1.11 × 10-7 to 3 700 µg kg bw-1 d-1 and from 3.00 × 10-5 to 6.56 µg kg bw-1 d-1, respectively. Nevertheless, the dose-additive effect of phthalates has been shown to increase the EDI up to 5 100 µg kg bw-1 d-1, representing a high risk in terms of noncarcinogenic (HQ) and carcinogenic (CR) effects. The worldwide HQ values of phthalates and BPA ranged from 2.25 × 10-7 to 3.66 and from 2.74 × 10-7 to 9.72 × 10-2, respectively. Meanwhile, a significant number of studies exhibit high CR values for benzyl butyl phthalate (BBP) and di(2-ethylhexyl) phthalate (DEHP). Moreover, DEHP has shown the highest maximum mean CR values for humans in numerous studies, up to 179-fold higher than BBP. Despite mounting evidence of the harmful effects of these chemicals at low-dose exposure on animals and humans, most regulations have not been updated. Thus, this article emphasizes the need for updating guidelines and public policies considering compelling evidence for the adverse effects of low-dose exposure, and it cautions against the use of alternative plasticizers as substitutes for phthalates and BPA because of the significant gaps in their safety.
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  • 文章类型: Review
    锰(Mn)的毒物动力学通过稳态来控制,因为Mn是必需元素。然而,在高剂量下,锰也有神经毒性,与呼吸有关,生殖,和发展效应。虽然已经为慢性吸入暴露于环境锰制定了基于健康的标准,还需要短期(24小时)环境暴露指南。我们回顾了美国州,联邦,和基于健康的国际吸入毒性标准,并对最近的出版物进行了文献检索。认为最适合得出24小时指南的研究在猴子中暴露90小时后,炎性气道变化和大脑中氧化应激的生化指标的LOAEL为1500μg/m3。我们对这个出发点应用了300的累积不确定性因子,导致5μg/m3的24小时指南。为了解决潜在神经毒性的不确定性,我们使用先前发表的基于生理的Mn药代动力学模型来预测大脑靶组织中Mn的水平(即,苍白球),用于两种短期人类暴露情况下5μg/m3的暴露。PBPK模型预测支持5μg/m3的短期指南,可保护呼吸效应和神经毒性。包括婴儿和儿童的暴露。
    The toxicokinetics of manganese (Mn) are controlled through homeostasis because Mn is an essential element. However, at elevated doses, Mn is also neurotoxic and has been associated with respiratory, reproductive, and developmental effects. While health-based criteria have been developed for chronic inhalation exposure to ambient Mn, guidelines for short-term (24-h) environmental exposure are also needed. We reviewed US state, federal, and international health-based inhalation toxicity criteria, and conducted a literature search of recent publications. The studies deemed most appropriate to derive a 24-h guideline have a LOAEL of 1500 μg/m3 for inflammatory airway changes and biochemical measures of oxidative stress in the brain following 90 total hours of exposure in monkeys. We applied a cumulative uncertainty factor of 300 to this point of departure, resulting in a 24-h guideline of 5 μg/m3. To address uncertainty regarding potential neurotoxicity, we used a previously published physiologically based pharmacokinetic model for Mn to predict levels of Mn in the brain target tissue (i.e., globus pallidus) for exposure at 5 μg/m3 for two short-term human exposure scenarios. The PBPK model predictions support a short-term guideline of 5 μg/m3 as protective of both respiratory effects and neurotoxicity, including exposures of infants and children.
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  • 文章类型: Practice Guideline
    目的:“2023年AHA/ACC/ACCP/ASPC/NLA/PCNA慢性冠心病患者管理指南”提供了更新并巩固了自“2012年ACCF/AHA/ACP/AATS/PCNA/SCAI/STS《稳定性缺血性心脏病患者诊断和管理指南》”和相应的“2014年ACCF/ASCNA《ACCF/ACP/ACATHA稳定性心脏病
    方法:从2021年9月至2022年5月进行了全面的文献检索。临床研究,系统评价和荟萃分析,以及对人类参与者进行的其他证据被确定为从MEDLINE(通过PubMed)以英文发表,EMBASE,Cochrane图书馆,医疗保健研究和质量机构,以及与本指南相关的其他选定数据库。
    本指南为慢性冠心病患者的管理提供了以证据为基础和以患者为中心的方法。考虑健康的社会决定因素,并纳入共同决策和基于团队的护理原则。相关主题包括治疗决策的一般方法,指南指导的管理和治疗,以减少症状和未来的心血管事件,关于慢性冠心病患者血运重建的决策,特殊人群的管理建议,患者随访和监测,证据缺口,以及未来需要研究的领域。如果适用,基于成本效益数据的可用性,还为临床医生提供了成本价值建议.以前发布的指南中的许多建议已经更新了新的证据,并且在发布的数据支持下创建了新的建议。
    The \"2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease\" provides an update to and consolidates new evidence since the \"2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease\" and the corresponding \"2014 ACC/AHA/AATS/PCNA/SCAI/STS Focused Update of the Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease.\"
    A comprehensive literature search was conducted from September 2021 to May 2022. Clinical studies, systematic reviews and meta-analyses, and other evidence conducted on human participants were identified that were published in English from MEDLINE (through PubMed), EMBASE, the Cochrane Library, Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline.
    This guideline provides an evidenced-based and patient-centered approach to management of patients with chronic coronary disease, considering social determinants of health and incorporating the principles of shared decision-making and team-based care. Relevant topics include general approaches to treatment decisions, guideline-directed management and therapy to reduce symptoms and future cardiovascular events, decision-making pertaining to revascularization in patients with chronic coronary disease, recommendations for management in special populations, patient follow-up and monitoring, evidence gaps, and areas in need of future research. Where applicable, and based on availability of cost-effectiveness data, cost-value recommendations are also provided for clinicians. Many recommendations from previously published guidelines have been updated with new evidence, and new recommendations have been created when supported by published data.
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  • 文章类型: Journal Article
    目的“2023年AHA/ACC/ACCP/ASPC/NLA/PCNA慢性冠心病患者管理指南”提供了更新并巩固了自“2012年ACCF/AHA/ACP/AATS/PCNA/SCAI/STS稳定性缺血性心脏病患者诊断和管理指南”和相应的“2014年ACC/AHA/ASCATNA稳定性心脏病/Focus诊断指南”以来的新证据。方法2021年9月至2022年5月进行了全面的文献检索。临床研究,系统评价和荟萃分析,以及对人类参与者进行的其他证据被确定为从MEDLINE(通过PubMed)以英文发表,EMBASE,Cochrane图书馆,医疗保健研究和质量机构,以及与本指南相关的其他选定数据库。本指南为慢性冠心病患者的管理提供了基于证据和以患者为中心的方法。考虑健康的社会决定因素,并纳入共同决策和基于团队的护理原则。相关主题包括治疗决策的一般方法,指南指导的管理和治疗,以减少症状和未来的心血管事件,关于慢性冠心病患者血运重建的决策,特殊人群的管理建议,患者随访和监测,证据缺口,以及未来需要研究的领域。如果适用,基于成本效益数据的可用性,还为临床医生提供了成本价值建议.以前发布的指南中的许多建议已经更新了新的证据,并且在发布的数据支持下创建了新的建议。
    The \"2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease\" provides an update to and consolidates new evidence since the \"2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease\" and the corresponding \"2014 ACC/AHA/AATS/PCNA/SCAI/STS Focused Update of the Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease.\"
    A comprehensive literature search was conducted from September 2021 to May 2022. Clinical studies, systematic reviews and meta-analyses, and other evidence conducted on human participants were identified that were published in English from MEDLINE (through PubMed), EMBASE, the Cochrane Library, Agency for Healthcare Research and Quality, and other selected databases relevant to this guideline.
    This guideline provides an evidenced-based and patient-centered approach to management of patients with chronic coronary disease, considering social determinants of health and incorporating the principles of shared decision-making and team-based care. Relevant topics include general approaches to treatment decisions, guideline-directed management and therapy to reduce symptoms and future cardiovascular events, decision-making pertaining to revascularization in patients with chronic coronary disease, recommendations for management in special populations, patient follow-up and monitoring, evidence gaps, and areas in need of future research. Where applicable, and based on availability of cost-effectiveness data, cost-value recommendations are also provided for clinicians. Many recommendations from previously published guidelines have been updated with new evidence, and new recommendations have been created when supported by published data.
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  • 文章类型: Journal Article
    我们应用AirQ+模型分析了我们研究期间(2020年12月15日至2022年6月17日)的2021年数据,以定量估计通过采用新的世界卫生组织空气质量指南(WHOAQG)可以避免的长期和短期暴露于大气污染物的特定健康结果的数量。巴西东南部。基于时间变化,在采样期间,PM2.5,PM10,NO2和O3超过了2021年WHOAQG的54.4%,主要在冬季(2021年6月至9月)。降低圣保罗的PM2.5值,根据世界卫生组织的建议,每年可以预防113和24例肺癌(LC)和慢性阻塞性肺疾病(COPD)死亡,分别。此外,它可以避免因PM2.5暴露而导致的呼吸系统疾病(RD)和心血管疾病(CVD)导致的258和163例住院。由于O3导致的RD和CVD的超额死亡结果分别为443和228,90例由于NO2导致RD住院。因此,AirQ+是一个有用的工具,可以进一步制定和实施空气污染控制策略,以减少和防止住院,死亡率,以及圣保罗暴露于PM2.5、O3和NO2的经济成本。
    We applied the AirQ+ model to analyze the 2021 data within our study period (15 December 2020 to 17 June 2022) to quantitatively estimate the number of specific health outcomes from long- and short-term exposure to atmospheric pollutants that could be avoided by adopting the new World Health Organization Air Quality Guidelines (WHO AQGs) in São Paulo, Southeastern Brazil. Based on temporal variations, PM2.5, PM10, NO2, and O3 exceeded the 2021 WHO AQGs on up to 54.4% of the days during sampling, mainly in wintertime (June to September 2021). Reducing PM2.5 values in São Paulo, as recommended by the WHO, could prevent 113 and 24 deaths from lung cancer (LC) and chronic obstructive pulmonary disease (COPD) annually, respectively. Moreover, it could avoid 258 and 163 hospitalizations caused by respiratory (RD) and cardiovascular diseases (CVD) due to PM2.5 exposure. The results for excess deaths by RD and CVD due to O3 were 443 and 228, respectively, and 90 RD hospitalizations due to NO2. Therefore, AirQ+ is a useful tool that enables further elaboration and implementation of air pollution control strategies to reduce and prevent hospital admissions, mortality, and economic costs due to exposure to PM2.5, O3, and NO2 in São Paulo.
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