Environmental pollution

环境污染
  • 文章类型: Journal Article
    这项研究解决了在理解技术进步如何,特别是工业机器人,影响城市污染排放和公众健康。技术的快速发展和不断变化的工作条件对这些领域产生了重大影响,然而,研究尚未广泛探索这一领域。
    利用2018年中国劳动力动态调查(CLDS)数据集,这项研究探讨了工业机器人对公众健康的影响。采用分析框架来评估采用生态友好型工业机器人与改善工人健康之间的相关性,归因于污染排放的减少。
    研究结果表明,采用工业机器人可以显着提高公众的身心健康。这项研究还确定了工业机器人影响的潜在人口异质性。在年龄较大的无保险体力女工中,这种福利更为明显,教育水平较低,并持有农村户口。这些好处与在宏观和微观层面上改善生产环境质量和减少污染排放密切相关。
    该研究强调了工业机器人对城市健康产生积极影响的巨大潜力,倡导促进更安全发展的战略,更绿色的环境。
    UNASSIGNED: This study addresses a critical gap in understanding how technological advancements, specifically industrial robots, influence urban pollution emissions and public health. The rapid evolution of technology and changing working conditions significantly affect these areas, yet research has not extensively explored this domain.
    UNASSIGNED: Utilizing 2018 China Labor-force Dynamic Survey (CLDS) dataset, this study examines the impact of industrial robots on public health. An analytical framework is employed to assess the correlation between the adoption of eco-friendly industrial robots and improvements in worker health, attributed to the reduction of pollution emissions.
    UNASSIGNED: The findings reveal that the adoption of industrial robots significantly enhance both public physical and mental health. This study also identifies potential demographic heterogeneity in the effects of industrial robots. The benefits are more pronounced among non-insured manual female workers who are older, have lower education levels, and hold rural hukou. These benefits are closely linked to improvements in the quality of the production environment and reductions in pollution emissions at both macro and micro levels.
    UNASSIGNED: The study underscores the significant potential of industrial robots to positively impact urban health, advocating for strategies that promote the development of safer, greener environments.
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  • 文章类型: Journal Article
    人造化学品的不可持续使用对生物多样性和人类健康构成了重大威胁。新出现的证据强调了某些化学物质对代谢健康造成跨代影响的潜力。这里,我们研究了抗雄激素除草剂linuron在非洲爪蛙胰腺中的雄性传播的表观遗传代际效应,以及它们与代谢表型的关联。减少代表性的亚硫酸氢盐测序(RRBS)用于评估祖先暴露于环境相关的linuron水平(44±4.7μg/L)的成年男性F2代胰腺中的全基因组DNA甲基化模式。我们确定了分布在热带X基因组中的1117个差异甲基化区域(DMRs)。揭示潜在的代谢紊乱的调节机制。在对胰腺功能至关重要的基因中鉴定出DMRs,包括钙信号(clstn2,cacna1d和cadps2),与2型糖尿病相关的基因(tcf7l2和adcy5)和胰腺导管腺癌(plec)的生物标志物。相关分析显示,这些基因的DNA甲基化水平与代谢表型之间存在关联,表明葡萄糖代谢的表观遗传调控。此外,与组蛋白修饰相关的基因的差异甲基化表明表观遗传机制发生了改变。这些发现强调了环境污染对胰腺功能的长期影响,并引起了人们对与农药的跨代效应相关的健康风险的担忧。
    The unsustainable use of manmade chemicals poses significant threats to biodiversity and human health. Emerging evidence highlights the potential of certain chemicals to cause transgenerational impacts on metabolic health. Here, we investigate male transmitted epigenetic transgenerational effects of the anti-androgenic herbicide linuron in the pancreas of Xenopus tropicalis frogs, and their association with metabolic phenotypes. Reduced representation bisulfite sequencing (RRBS) was used to assess genome-wide DNA methylation patterns in the pancreas of adult male F2 generation ancestrally exposed to environmentally relevant linuron levels (44 ± 4.7 μg/L). We identified 1117 differentially methylated regions (DMRs) distributed across the X. tropicalis genome, revealing potential regulatory mechanisms underlying metabolic disturbances. DMRs were identified in genes crucial for pancreatic function, including calcium signalling (clstn2, cacna1d and cadps2), genes associated with type 2 diabetes (tcf7l2 and adcy5) and a biomarker for pancreatic ductal adenocarcinoma (plec). Correlation analysis revealed associations between DNA methylation levels in these genes and metabolic phenotypes, indicating epigenetic regulation of glucose metabolism. Moreover, differential methylation in genes related to histone modifications suggests alterations in the epigenetic machinery. These findings underscore the long-term consequences of environmental contamination on pancreatic function and raise concerns about the health risks associated with transgenerational effects of pesticides.
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  • 文章类型: Published Erratum
    [这更正了文章DOI:10.3389/fpubh.2023.1310823。].
    [This corrects the article DOI: 10.3389/fpubh.2023.1310823.].
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  • 文章类型: Journal Article
    煤矸石堆场可能会将重金属(oid)(HM)引入周围的农业土壤中,对附近社区构成潜在的健康风险。这项研究评估了重庆一个废弃煤矿的煤矸石堆附近的农业土壤中的重金属(oid)污染,中国西南地区。HMs的浓度(As,Cd,Cr,Cu,Ni,Pb,和Zn)使用ICP-MS定量,污染状况采用地质累积指数(Igeo)评估,污染因子(CF),污染负荷指数(PLI)和潜在生态风险指数(RI)。在0-30厘米深度的土壤中检测到重金属(oid)污染,在表土层(0-10厘米和10-20厘米深度)中特别明显。在所有检查的深度中,铜作为主要污染物出现,0-10厘米的平均Igeo值为1.20、1.21和1.16,10-20厘米,和20-30厘米的深度,分别,表明中度污染。对于这些深度,Cu的CF分别为3.55、3.55和3.50,将其归类为相当大的污染。PLI值范围为1.61至2.50,平均值为2.12,表明总体污染。生态风险评价表明,各深度土壤生态风险较低。Cd是RI的主要贡献者,占48%,47%,和42%在0-10厘米,10-20厘米,和20-30厘米的深度,分别。健康风险评估显示,儿童具有明显的非致癌风险(平均HI=1.30),成人和儿童具有不可接受的致癌风险(分别为平均TCR=3.26×10-4和1.53×10-3)。这项研究强调了使用多个指标进行全面风险评估的关键需求,以确定HMs的补救工作的优先级。为三峡库区有效的环境管理和公共卫生保护提供科学依据。
    The coal gangue dump may introduce heavy metal(oid)s (HMs) into surrounding agricultural soils, posing potential health risks to nearby communities. This study evaluated heavy metal(oid) pollution in agricultural soils adjacent to a gangue dump at an abandoned coal mine in Chongqing, Southwest China. The concentrations of HMs (As, Cd, Cr, Cu, Ni, Pb, and Zn) were quantified using ICP-MS, and the contamination status was assessed using the Geoaccumulation Index (Igeo), Contamination Factor (CF), Pollution Load Index (PLI), and Potential Ecological Risk Index (RI). Heavy metal(oid) contamination was detected in soils across a depth of 0-30 cm, particularly pronounced in the topsoil layer (0-10 cm and 10-20 cm depths). Cu emerged as the predominant contaminant across all examined depths, with average Igeo values of 1.20, 1.21, and 1.16 for the 0-10 cm, 10-20 cm, and 20-30 cm depths, respectively, indicating moderate contamination. The CF for Cu was 3.55, 3.55, and 3.50 for these respective depths, classifying it as considerable contamination. The PLI values ranged from 1.61 to 2.50, with a mean value of 2.12, indicating overall contamination. The ecological risk assessment indicated that the soil\'s ecological risk was low at all depths. Cd was the major contributor to the RI, accounting for 48%, 47%, and 42% at 0-10 cm, 10-20 cm, and 20-30 cm depths, respectively. Health risk assessments revealed significant non-carcinogenic risks to children (mean HI = 1.30) and unacceptable carcinogenic risks to both adults and children (mean TCR = 3.26 × 10-4 and 1.53 × 10-3, respectively). This study underscores the critical need for comprehensive risk assessments using multiple indicators to prioritize remediation efforts for HMs, providing a scientific basis for effective environmental management and public health protection in the Three Gorges Reservoir Area.
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  • 文章类型: Journal Article
    重金属造成的海洋污染已成为一个重大的环境问题,近年来受到越来越多的关注。海洋生物组织中重金属的积累对海洋生态系统和依赖海产品作为主要食物来源的人类构成了重大威胁。鱼类和甲壳类动物是评估水生环境中重金属污染的有效生物监测器。在这项研究中,我们确定了几种重金属的浓度,包括镉(Cd),铅(Pb),镍(Ni),汞(Hg),和锡(Sn),在四种鱼类中(Mugilcephalus,穆吉尔·卡皮托,L.aurata,和Moronelabrax)和五种甲壳类动物(S.rivulatus,蓝纹皮病,海带起伏,R.decussatus,Callinectessapidus,和MetapenaeusStebbingi)在冬季和夏季都来自Temsah湖。为了评估与食用这些鱼类和甲壳类动物相关的潜在生态和健康风险,我们计算了金属污染指数(MPI),每周摄入量(EWI),目标危险商(THQ),和致癌风险(CR)值。结果表明,与冬季相比,研究样品的夏季金属含量显着增加。此外,该物种肌肉中重金属的浓度通常超过肝脏和g中的浓度。MPI值表明,Moronelabrax在冬季表现出最高的值,而L.aurata在夏季表现出最高的值。Mugilcephalus在两个季节中都表现出最低的MPI值。发现所研究金属的EWI值低于相应的每周容许摄入量(TWI)值。此外,在平均暴露条件下,该地区大多数研究物种的THQ和HI数据普遍低于1。所研究物种中所研究金属的计算CR值表明可接受的致癌风险水平。因此,这表明在Temsah湖中消费研究的物种不会对消费者带来任何潜在的健康危害。
    Marine pollution caused by heavy metals has emerged as a significant environmental concern, garnering increased attention in recent years. The accumulation of heavy metals in the tissues of marine organisms poses substantial threats to both marine ecosystems and human populations that rely on seafood as a primary food source. Fish and crustaceans are effective biomonitors for assessing heavy metal contamination in aquatic environments. In this study, we determined the concentrations of several heavy metals, including cadmium (Cd), lead (Pb), nickel (Ni), mercury (Hg), and tin (Sn), in four fish species (Mugil cephalus, Mugil capito, L. aurata, and Morone labrax) and five crustacean species (S. rivulatus, Cerastoderma glaucum, Paratapes undulatus, R. decussatus, Callinectes sapidus, and Metapenaeus Stebbingi) from Temsah Lake during both winter and summer seasons. To evaluate the potential ecological and health risks associated with consuming these fish and crustacean species, we calculated the metal pollution index (MPI), weekly intake (EWI), target hazard quotient (THQ), and carcinogenic risk (CR) values. The results revealed a noticeable increase in metal levels during the summer compared to winter in the studied samples. Moreover, the concentration of heavy metals in the muscles of the species generally exceeded those in the liver and gills. The MPI values indicated that Morone labrax exhibited the highest values during winter, while L. aurata showed the highest values during summer. Mugil cephalus demonstrated the lowest MPI values in both seasons. The EWI values for the studied metals were found to be lower than the corresponding tolerable weekly intake (TWI) values. Additionally, under average exposure conditions, the THQ and HI data were generally below one for most study species in the area. The calculated CR values for investigated metals in the studied species indicated acceptable carcinogenic risk levels. Therefore, this suggests that consuming studied species within Temsah lake does not present any potential health hazards for consumers.
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  • 文章类型: Journal Article
    全球范围内,环境污染仍然是一个重大的公共卫生问题,根据世界卫生组织的说法,污染导致的死亡占每年死亡人数的23%,如果人们生活在更健康的环境中,这是可以预防的。尽管执行了诸如巴马科之类的多边协定和国际条约,巴塞尔,鹿特丹,Minamata,和斯德哥尔摩公约,联合国可持续发展目标,和国家法律,在低收入国家,有毒污染物仍然是一个严重的环境和公共卫生问题。在Kwekwe市的特定背景下,津巴布韦的一个工业和矿区,与工业相关的环境和污染引起的健康问题已被广泛报道,这项研究是与当地社区密切合作进行的.该研究旨在评估Kwekwe市社区成员对与潜在有毒元素和氰化物污染相关的健康风险的看法。对主要利益相关者和工业居住区居民进行了探索性横断面研究。使用与主要线人的面对面访谈以及与居民和工人的焦点小组讨论来收集数据。在数据分析中采用了主题方法。研究参与者,他在研究过程中发挥了至关重要的作用,认为工业污染主要与氰化物有关,汞和铬构成了重大的环境和健康风险。风险感知评估中的这种参与性方法对于深入了解问题的范围和制定干预策略至关重要。然而,鉴于定性研究结果缺乏普遍性和可重复性,需要进行定量研究,以确定有毒化学污染物的环境水平,作为补充和验证措施。
    Globally, environmental pollution continues to be a significant public health problem, and according to the World Health Organisation, pollution-induced deaths account for 23% of deaths yearly, which could be prevented if people lived in healthier environments. Despite implementing multilateral agreements and international treaties such as the Bamako, Basel, Rotterdam, Minamata, and Stockholm conventions, the United Nations Sustainable Development Goals, and national laws, toxic pollutants remain a serious environmental and public health problem in low-income countries. In the specific context of Kwekwe City, an industrial and mining area in Zimbabwe, where environmental and pollution-induced health problems associated with industries have been widely reported, this study was conducted in close collaboration with the local community. The study aimed to assess community members\' perceptions regarding health risks associated with potentially toxic elements and cyanide pollution in Kwekwe City. An explorative cross-sectional study was conducted with key stakeholders and industrial settlements\' residents. Face-to-face interviews with key informants and focus group discussions with residents and workers were used to gather data. A thematic approach was utilised in data analysis. Study participants, who played a crucial role in the research process, perceived that industrial pollution principally linked to cyanide, mercury and chromium posed significant environmental and health risks. This participatory approach in risk perception assessment is critical in providing insight into the scope of the problem and formulating intervention strategies. However, given that qualitative study results lack generalisability and replicability, quantitative studies need to be undertaken to determine environmental levels of toxic chemical pollutants as a complementary and validative measure.
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  • 文章类型: Journal Article
    在三个相关驱动因素的压力下,环境正在迅速变化:气候变化,污染,生物多样性的丧失。这些环境变化正在以多种方式影响消化系统健康和疾病。极端高温可导致肠和肝功能障碍。获得足够的高营养含量食物和清洁水受到威胁。极端天气与洪水和肠道感染有关,并通过基础设施损失影响护理的提供。空气,水,化学品和塑料造成的土壤污染正在成为各种肠道疾病的危险因素,包括嗜酸性粒细胞性食管炎,代谢功能障碍相关的脂肪肝疾病,消化道癌症,炎症性肠病,和功能性肠病。人口向城市和国家之间的迁移对提供消化系统护理构成了特殊挑战。全球消化卫生界对环境变化威胁的反应正在顺利进行,特别是关于了解和减少内窥镜检查对环境的影响。个人,和同伴社会,变得越来越投入,并在应对挑战中发挥重要作用。
    The environment is changing rapidly under pressure from 3 related drivers: climate change, pollution, and biodiversity loss. These environmental changes are affecting digestive health and disease in multiple ways. Heat extremes can cause intestinal and hepatic dysfunction. Access to adequate amounts of food of high nutritional content and to clean water is under threat. Extreme weather is associated with flooding and enteric infections and affects the delivery of care through infrastructure loss. Air, water, and soil pollution from chemicals and plastics are emerging as risk factors for a variety of intestinal diseases including eosinophilic esophagitis, metabolic dysfunction associated fatty liver disease, digestive tract cancers, inflammatory bowel disease, and functional bowel disease. Migration of populations to cities and between countries poses a special challenge to the delivery of digestive care. The response to the threat of environmental change is well underway in the global digestive health community, especially with regard to understanding and reducing the environmental impact of endoscopy. Individuals, and peer societies, are becoming more engaged, and have an important role to play in meeting the challenge.
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  • 文章类型: Journal Article
    生物聚合物由于其可生物降解的性质而成为石油化学基塑料的非常理想的替代品。生物塑料的生产,如聚羟基链烷酸酯(PHAs),已广泛报道使用各种细菌培养物,其底物范围从纯的到生物废料衍生的糖。然而,大规模生产和经济可行性是主要限制因素。现在,使用藻类生物质进行PHA生产为这些挑战提供了具有显著环境效益的潜在解决方案。藻类,具有利用二氧化碳作为温室气体(GHG)和废水作为生长饲料的独特能力,可以在这个过程中生产增值产品,因此,在促进环境可持续性方面发挥着至关重要的作用。从藻类生物质中回收糖的效率是高度可变的,这取决于预处理程序,这是由于它们的细胞壁之间固有的组成可变性。此外,产量,composition,合成的PHA的性质在来自藻类衍生糖的各种微生物PHA生产者中显著不同。因此,微藻生物质预处理和PHA共聚物的合成仍需要大量的研究以开发有效的商业规模工艺。这篇综述概述了从藻类生物质生产PHA的微生物潜力,并讨论了增强PHA生产及其特性的策略,专注于管理温室气体和促进可持续的未来。
    Biopolymers are highly desirable alternatives to petrochemical-based plastics owing to their biodegradable nature. The production of bioplastics, such as polyhydroxyalkanoates (PHAs), has been widely reported using various bacterial cultures with substrates ranging from pure to biowaste-derived sugars. However, large-scale production and economic feasibility are major limiting factors. Now, using algal biomass for PHA production offers a potential solution to these challenges with a significant environmental benefit. Algae, with their unique ability to utilize carbon dioxide as a greenhouse gas (GHG) and wastewater as feed for growth, can produce value-added products in the process and, thereby, play a crucial role in promoting environmental sustainability. The sugar recovery efficiency from algal biomass is highly variable depending on pretreatment procedures due to inherent compositional variability among their cell walls. Additionally, the yields, composition, and properties of synthesized PHA vary significantly among various microbial PHA producers from algal-derived sugars. Therefore, the microalgal biomass pretreatments and synthesis of PHA copolymers still require considerable investigation to develop an efficient commercial-scale process. This review provides an overview of the microbial potential for PHA production from algal biomass and discusses strategies to enhance PHA production and its properties, focusing on managing GHGs and promoting a sustainable future.
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  • 文章类型: Journal Article
    有毒金属对生态环境造成风险。TypalatifoliaL.是清洁潜在有毒金属污染的水或土壤的良好候选者。然而,有限的研究调查了环境因素的影响(例如,pH值,土壤基质,洪水持续时间)在香花中的金属堆积物上。在这项研究中,香茅在充满不同pH(5、7或9)和不同Cr水平的人工废水的土壤中培养,对Cd和Zn进行了为期四周的研究,以研究环境条件与香茅中金属吸收之间的相互作用。通过电感耦合等离子体-光发射光谱仪测量生物质中的金属含量。
    与Cd和Cr(<1,000mg/kg干生物量)相比,更多的Zn(>10,000mg/kg干生物量)进入植物。大约80%的Zn来自含50mg/LCd的溶液,25mg/LCr,250mg/L的锌被香茅去除。大多数Cd和Cr吸附在土壤上。香花在从初始pH为5、7或9的废水中去除金属方面表现出相对一致的性能。所有溶液的pH在4周后接近中性。需要更多的研究来进一步了解环境条件对植物金属吸收的影响,以提高植物修复效率。
    这是第一个评估在充满不同pH值和不同金属含量的人工废水的土壤中培养的香茅中金属积累的研究。该项目调查了生长条件之间的相互作用(例如,pH值,土壤基质,洪水)和香茅中不同的金属吸收,这在以前的研究中没有进行。
    Toxic metals cause risks to the ecological environment. Typha latifolia L. is a good candidate to clean potentially toxic metals contaminated water or soil. However, limited research investigated the impact of environmental factors (e.g., pH, soil substrate, flood duration) on metal accumulations in cattails. In this study, cattails were cultured in soils flooded with artificial wastewater with varying pH (5, 7 or 9) and different levels of Cr, Cd and Zn for four weeks to investigate the interactions between environmental conditions and metal uptake in cattails. The metal content in biomass were measured by an inductively coupled plasma-optical emission spectrometer.
    More Zn (>10,000 mg/kg dry biomass) entered plants compared to Cd and Cr (<1,000 mg/kg dry biomass). Approximately 80% of Zn from solutions with 50 mg/L Cd, 25 mg/L Cr, 250 mg/L Zn were removed by cattails. Most Cd and Cr were sorbed onto soils. Cattails exhibited relatively consistent performance in removing metals from wastewater with initial pH of 5, 7 or 9. The pH of all the solutions ended close to neutral after 4 weeks. More research is needed to further understand the influence of environmental conditions on metal uptakes in plants to improve phytoremediation efficiency.
    It is the first study to evaluate metal accumulation in cattails cultured in soils flooded with artificial wastewater with varying pH and different levels of metals.This project investigated the interactions between growth conditions (e.g., pH, soil substrate, flooding) and different metal uptake in cattails, which was not conducted in previous research.
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  • 文章类型: Journal Article
    气候变化和环境污染对健康有已知影响。美国政府最近出台的降低通胀法案(IRA)包括遏制气候变化的资助举措,减少环境污染,根据国家自主贡献(NDC)计划(与2005年相比,到2030年温室气体[GHG]排放量减少40-50%)。目前尚不清楚IRA驱动的气候行动对实现NDC目标的预期心血管健康益处。
    我们使用了能源政策模拟器(EPS),一种基于系统动力学建模的模拟算法,估计各种能源政策的影响,模拟到2050年在美国实现NDC目标对健康结果的影响。我们进一步调查了到2050年种族对死亡率(绝对和相对)的影响。我们估计2022年至2050年之间的6种不良健康结果的预计减少:哮喘发作,非致命性心脏病发作,入院,呼吸道症状和支气管炎,丢失的工作日,和死亡。
    到2050年实现NDC目标将导致987,415避免哮喘发作,41,565避免了非致命性心脏病发作,18,993避免了入院,1,493,010避免了呼吸道症状和支气管炎,3,317,250避免了工作日的损失,和32,659人避免了死亡(22,839人在白人中,4993个黑人个体,2801亚洲人,和2026年其他/多种族个体)。到2050年,少数族裔群体在避免死亡方面有更高的相对变化(白人-0.74%,黑色-1.01%,亚洲-1.24%,和其他/多种族-1.75%)。同样,到2050年,与非西班牙裔/拉丁美洲人(-0.7%)相比,西班牙裔/拉丁美洲人的死亡人数相对减少(-1.4%)。
    IRA促进到2050年实现NDC温室气体减排目标将导致大量避免不良健康结果和死亡。预计到2050年,种族和少数民族的死亡人数相对减少幅度最大。本报告强调了无论政治分歧如何,持续进行气候行动投资的重要性。IRA这方面的认识可能对整体健康保护更为重要,除了降低药物成本。
    UNASSIGNED: Climate change and environmental pollution have known health effects. The recently introduced inflation reduction act (IRA) by the United States government includes funding initiatives to curb climate change, and reduce environmental pollution, in line with the nationally determined contribution (NDC) plan (40-50 % reduction in greenhouse gas [GHG] emissions by 2030, as compared with 2005). The projected cardiovascular health benefits of the IRA driven climate actions to achieve the NDC goals are not known.
    UNASSIGNED: We used the Energy Policy Simulator (EPS), a simulation algorithm based on systems dynamics modelling estimating the impact of various energy policies, to model the impact of achieving NDC targets in the United States on health outcomes by 2050. We further investigated race-specific impact on mortality (absolute and relative) by 2050.We estimated the projected reduction in six adverse health outcomes between 2022 and 2050: asthma attacks, non-fatal heart attacks, hospital admissions, respiratory symptoms and bronchitis, lost workdays, and deaths.
    UNASSIGNED: Achievement of NDC targets by 2050 will result in 987,415 avoided asthma attacks, 41,565 avoided nonfatal heart attacks, 18,993 avoided hospital admissions, 1,493,010 avoided respiratory symptoms and bronchitis, 3,317,250 avoided lost workdays, and 32,659 avoided deaths (22,839 among white individuals, 4993 among Black individuals, 2801 among Asian individuals, and 2026 among other/multirace individuals). By 2050, minority racial groups had higher relative change in avoided deaths (white -0.74 %, Black -1.01 %, Asian -1.24 %, and other/multirace -1.75 %). Similarly, Hispanics/latinos higher relative reductions in deaths (-1.4 %) compared with non-Hispanic/Latinos (-0.7 %) by 2050.
    UNASSIGNED: The IRA facilitated achievement of NDC GHG reduction goals by 2050 would result in substantial number of avoided adverse health outcomes and death. Racial and ethnic minorities are expected to have the largest relative reductions in deaths by 2050. The current report underscores the importance of continued climate action investment irrespective of political differences. The appreciation of this aspect of the IRA may be more important to overall preservation of health, beyond the reduction in medication costs.
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