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Providing Context for Ambient Particulate Matter and Estimates of Attributable Mortality

机译：为周围的颗粒物和可归因的死亡率估算提供上下文

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Four papers on fine particulate matter (PM2.5) by Anenberg et al., Fann et al., Shin et al., and Smith contribute to a growing body of literature on estimated epidemiological associations between ambient PM2.5 concentrations and increases in health responses relative to baseline notes. This article provides context for the four articles, including a historical review of provisions of the U.S. Clean Air Act as amended in 1970, requiring the setting of National Ambient Air Quality Standards (NAAQS) for criteria pollutants such as particulate matter (PM). The substantial improvements in both air quality for PM and population health as measured by decreased mortality rates are illustrated. The most recent revision of the NAAQS for PM2.5 in 2013 by the Environmental Protection Agency distinguished between (1) uncertainties in characterizing PM2.5 as having a causal association with various health endpoints, and as all-cause mortality, and (2) uncertainties in concentration-excess health response relationships at low ambient PM2.5 concentrations below the majority of annual concentrations studied in the United States in the past. In future reviews, and potential revisions, of the NAAQS for PM2.5, it will be even more important to distinguish between uncertainties in (1) characterizing the causal associations between ambient PM2.5 concentrations and specific health outcomes, such as all-source mortality, irrespective of the concentrations, (2) characterizing the potency of major constituents of PM2.5, and (3) uncertainties in the association between ambient PM2.5 concentrations and specific health outcomes at various ambient PM2.5 concentrations. The latter uncertainties are of special concern as ambient PM2.5 concentrations and health morbidity and mortality rates approach background or baseline rates.
机译：Anenberg等人，Fann等人，Shin等人和Smith撰写的四篇有关细颗粒物（PM2.5）的论文为有关环境PM2.5浓度与健康状况增加之间的流行病学关联性的研究提供了越来越多的文献相对于基准音符的响应。本文提供了这四篇文章的内容，包括对1970年修订的《美国清洁空气法》条款的历史回顾，要求为诸如颗粒物（PM）等污染物的标准制定国家环境空气质量标准（NAAQS）。通过降低死亡率可以说明，PM和居民健康的空气质量均得到了显着改善。环境保护局在2013年对PM2.5的NAAQS进行了最新修订，区分了（1）在将PM2.5表征为与各种健康终点之间存在因果关系以及全因死亡率方面的不确定性，以及（2）在低于过去美国研究的大多数年度浓度的低PM2.5浓度下，浓度-过量健康反应关系的不确定性。在将来对PM2.5的NAAQS的审查和可能的修订中，区分（1）表征环境PM2.5浓度与特定健康结果（如全源）之间因果关系的不确定性将变得更加重要。死亡率，与浓度无关，（2）表征PM2.5主要成分的效力，（3）在不同的PM2.5浓度下，PM2.5浓度与特定健康结果之间的关联不确定。由于环境中PM2.5的浓度以及健康发病率和死亡率接近背景或基线水平，后一种不确定性尤其值得关注。

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