我國霧霾問題已有多年，對人民的健康產生了哪些實際影響？

11-26

希望有權威論證支持，謝謝。

肺癌
你可以查看每年的《北京市衛生與人群健康狀況報告》

　2012年，北京市腫瘤防治研究辦公室監測數據顯示，2010年肺癌位居北京市戶籍人口男性惡性腫瘤發病的第一位，在女性中居第二
位，僅次於乳腺癌。2001至2010年，北京市肺癌發病率增長了56%。全市新發癌症患者中有五分之一為肺癌患者。2010年，北京市戶籍居民肺癌死亡
率達48.9/10萬，亦居「眾癌之首」。不僅如此，35歲以上人群的肺癌發病率上升加速；且男性發病率高於女性，北京的肺癌患者男女比例為172比
100。

2013年，北京市市戶籍人口死因前三位仍然是惡性腫瘤、心臟病和腦血管病，佔總死亡的74.0%，其中惡性腫瘤已連續七年成為北京市的首位死因。居民惡性腫瘤發病率為313.02/10萬，比上一年增長3.22%，仍在緩慢地持續上升。

其中男性惡性腫瘤新發病例中肺癌居第一位，其次為結直腸癌、肝癌、胃癌和前列腺癌。女性乳腺癌居第一位，其次為肺癌、結直腸癌、甲狀腺癌和子宮體癌。甲狀腺癌發病率為15.74/10萬，比2003年（3.19/10萬）上升393.42%，年齡標化後，年平均增長16.92%，說明甲狀腺癌已成為北京市增長最快的惡性腫瘤。

沒有數據，但是我知道因為環境污染，重疾保險的保費都漲了。

你沒發現現在咽炎鼻炎那麼多，這種病往前30年，哪有這麼多。

讓數據給我們一些信息。在google scholar上搜索"air quality and diseases china"可以找到不少文獻。摘抄其中幾篇的abstract。按發表時間排列，比較近年的靠前排。中文翻譯是我基於google translator的基礎上做的。歡迎指正，補充資料。

1. Association of Particulate Air Pollution With Daily Mortality
The China Air Pollution and Health Effects Study
空氣微粒污染與日死亡率的相關性
中國的空氣污染與健康影響研究

中國是世界上顆粒物水平最高的少數幾個國家之一。然而，關於顆粒物質對健康的研究在中國做的很少。這個研究的目的是考察直徑小於10微米的顆粒物PM10和中國16個城市在1996年至2008年間每日死亡率的關係。…
16個中國城市的日平均PM10濃度範圍從52微克/立方米至156微克/立方米。16城市綜合分析顯示PM10和死亡率顯著相關： 2天的移動平均10微克/立方米PM10增加與0.35％（95％後的時間間隔（PI）：0.18，0.52）總死亡率增加相關，與0.44％（95％的PI：0.23，0.64）心血管死亡率的增加相關，以及0.56％（95％的PI：0.31，0.81）的呼吸疾病死亡率增加相關。女性，老年人，以及與教育程度較低的居民更容易受PM10危害。總結，這項關於中國顆粒物空氣污染的大規模流行病學研究表明，短期暴露於PM10與死亡風險增加相關。
Renjie Chen, Haidong Kan*, Bingheng Chen, Wei Huang, Zhipeng Bai, Guixiang Song and Guowei Pan, on Behalf of the CAPES Collaborative Group
American Journal of Epidemiology, 2012 Apr 17:kwr425.

Association of Particulate Air Pollution With Daily Mortality
Abstract

China is one of the few countries with some of the highest particulate matter levels in the world. However, only a small number of particulate matter health studies have been conducted in China. The study objective was to examine the association of particulate matter with an aerodynamic diameter of less than 10 μm (PM10) with daily mortality in 16 Chinese cities between 1996 and 2008. Two-stage Bayesian hierarchical models were applied to obtain city-specific and national average estimates. Poisson regression models incorporating natural spline smoothing functions were used to adjust for long-term and seasonal trends of mortality, as well as other time-varying covariates. The averaged daily concentrations of PM10 in the 16 Chinese cities ranged from 52 μg/m3 to 156 μg/m3. The 16-city combined analysis showed significant associations of PM10 with mortality: A 10-μg/m3 increase in 2-day moving-average PM10 was associated with a 0.35% (95% posterior interval (PI): 0.18, 0.52) increase of total mortality, 0.44% (95% PI: 0.23, 0.64) increase of cardiovascular mortality, and 0.56% (95% PI: 0.31, 0.81) increase of respiratory mortality. Females, older people, and residents with low educational attainment appeared to be more vulnerable to PM10 exposure. Conclusively, this largest epidemiologic study of particulate air pollution in China suggests that short-term exposure to PM10 is associated with increased mortality risk.

2. The association between fine particulate air pollution and hospital emergency room visits for cardiovascular diseases in Beijing, China
在中國北京，細微顆粒的空氣污染和因為心血管疾病去醫院急診室就診之間的關聯
這些結果表明，環境空氣中污染物的水平升高與因為心血管疾病去醫院急診室就診的增加相關。數據是中國北京的。
Yuming Guo, Yuping Jia, Xiaochuan Panm Liqun Liu, H.-Erich Wichmann
Science of The Total Environment
Volume 407, Issue 17, 15 August 2009, Pages 4826–4830
The association between fine particulate air pollution and hospital emergency room visits for cardiovascular diseases in Beijing, China
Results

8377 hospital ER visits of CVD were collected in our study. After adjusting the temperature and the relative humidity, the associations for 10 μg/m3 increases in levels of PM2.5, SO2, or NO2 and hospital ER visits for cardiovascular diseases were statistically significant with odds ratios (ORs) of 1.005{95% confidence interval (CI): 1.001–1.009}, 1.014(95% CI: 1.004–1.024), and 1.016(95% CI: 1.003–1.029), respectively.

Conclusion

These findings suggest that elevated levels of ambient air pollutants are associated with the increase in hospital ER visits for CVD in Beijing, China.

3. Visibility, air quality and daily mortality in Shanghai, China
可見度，空氣質量與每日死亡率，在中國上海的情況
在各種污染物中，PM2.5和能見度的相關性最強。... 能見度降低，和各種原因的死亡率，以及因心血管疾病的死亡率的升高相關。
Wei Huang, Jianguo Tan, Haidong Kan, Ni Zhao, Weimin Song, Guixiang Song, Guohai Chen, Lili Jiang, Cheng Jiang, Renjie Chen, Bingheng Chen
Science of The Total Environment
Volume 407, Issue 10, 1 May 2009, Pages 3295–3300
Visibility, air quality and daily mortality in Shanghai, China
Abstract

This study was designed to assess the association between visibility and air quality, and to determine whether the variations in daily mortality were associated with fluctuations in visibility levels in Shanghai, China. Mortality data were extracted from the death certificates, provided by Shanghai Municipal Center of Disease Control and Prevention, and visibility data were obtained from Shanghai Municipal Bureau of Meteorology. Air quality data (PM10, PM2.5, PM10–2.5, SO2, NO2 and O3) were obtained from Shanghai Environmental Monitoring Center. Generalized additive model (GAM) with penalized splines was used to analyze the mortality, visibility, air pollution, and covariate data. Among various pollutants, PM2.5 showed strongest correlation with visibility. Visibility, together with humidity, was found appropriate in predicting PM2.5 (R-squared: 0.64) and PM10 (R-squared: 0.62). Decreased visibility was significantly associated with elevated death rates from all causes and from cardiovascular disease in Shanghai; one inter-quartile range (8 km) decrease in visibility corresponded to 2.17% (95%CI: 0.46%, 3.85%), 3.36% (95%CI: 0.96%, 5.70%), and 3.02% (95%CI: ? 1.32%, 7.17%) increase of total, cardiovascular and respiratory mortality, respectively. The effect estimates using predicted PM2.5 and PM10 concentrations were similar to those assessed using actual concentrations. This is the first study in Mainland China assessing the association between visibility and adverse health outcomes. Our findings suggest the possibility of using visibility as a surrogate of air quality in health research in developing countries where air pollution data might be scarce and not routinely monitored.

4. Household Air Pollution from Coal and Biomass Fuels in China: Measurements, Health Impacts, and Interventions
觀察到的健康影響包括呼吸道疾病，肺癌，慢性阻塞性肺疾病，免疫系統減弱，並肺功能減弱。砷中毒和使用「毒」煤產生的FL uorosis在中國某些地區被觀察到。
Household Air Pollution from Coal and Biomass Fuels in China: Measurements, Health Impacts, and Interventions on JSTOR
Junfeng(Jim) Zhang and Kirk R. Smith
Environmental Health Perspectives
Vol. 115, No. 6 (Jun., 2007), pp. 848-855
DATA SOURCES: We reviewed approximately 200 publications in both Chinese- and English-
language journals that reported health effects, exposure characteristics, and fuel/stove intervention options.
CONCLUSIONS: Observed health effects include respiratory illnesses, lung cancer, chronic obstructive pulmonary disease, weakening of the immune system, and reduction in lung function. Arsenic poisoning and ?uorosis resulting from the use of 「poisonous」 coal have been observed in certain regions of China. Although attempts have been made in a few studies to identify specific coal smoke constituents responsible for speci?c adverse health effects, the majority of indoor air measurements include those of only particulate matter, carbon monoxide, sulfur dioxide, and/or nitrogen dioxide. These measurements indicate that pollution levels in households using solid fuel
generally exceed China』s indoor air quality standards. Intervention technologies ranging from sim
ply adding a chimney to the more complex modernized bioenergy program are available, but they
can be viable only with coordinated support from the government and the commercial sector.

5. Associations between daily mortalities from respiratory and cardiovascular diseases and air pollution in Hong Kong, China
-- Wong et al. 59 (1): 30 -- Occupational and Environmental Medicine
香港的研究。一句話概括，呼吸系統疾病和缺血性心臟疾病（IHD）的死亡率，和污染物的濃度，顯著相關。
Occupational Environmental Medicine 2002;59:30-35 doi:10.1136/oem.59.1.30
Associations between daily mortalities from respiratory and cardiovascular diseases and air pollution in Hong Kong, China
T W Wong, W S Tam, T S Yu, A H S Wong
Abstract
Objective: To investigate the association between ambient concentrations of air pollutants and respiratory and cardiovascular mortalities in Hong Kong.
Methods: Retrospective ecological study. A Poisson regression of concentrations of daily air pollutants on daily mortalities for respiratory and cardiovascular diseases in Hong Kong from 1995 to the end of 1998 was performed using the air pollution and health: the European approach (APHEA) protocol. The effects of time trend, seasonal variations, temperature, and humidity were adjusted. Autocorrelation and overdispersion were corrected. Daily concentrations of nitrogen dioxide (NO2), sulphur dioxide (SO2), ozone (O3), and particulate matter &<10 μm in aerodynamic diameter (PM10) were averaged from eight monitoring stations in Hong Kong. Relative risks (RRs) of respiratory and cardiovascular mortalities (per 10 μg/m3 increase in air pollutant concentration) were calculated.
Results: Significant associations were found between mortalities for all respiratory diseases and ischaemic heart diseases (IHD) and the concentrations of all pollutants when analysed singly. The RRs for all respiratory mortalities (for a 10 μg/m3 increase in the concentration of a pollutant) ranged from 1.008 (for PM10) to 1.015 (for SO2) and were higher for chronic obstructive pulmonary diseases (COPD) with all pollutants except SO2, ranging from 1.017 (for PM10) to 1.034 (for O3). RRs for IHD ranged from 1.009 (for O3) to 1.028 (for SO2). In a multipollutant model, O3 and SO2 were significantly associated with all respiratory mortalities, whereas NO2 was associated with mortality from IHD. No interactions were detected between any of the pollutants or with the winter season. A dose-response effect was evident for all air pollutants. Harvesting was not found in the short term.
Conclusions: Mortality risks were detected at current ambient concentrations of air pollutants. The associations with the particulates and some gaseous pollutants when analysed singly were consistent with many reported in temperate countries. PM10 was not associated with respiratory or cardiovascular mortalities in multipollutant analyses.

個人的感覺是:
咽喉長期間歇性不舒服
跟感冒時候的咽喉感覺差不多
但是完全沒有感冒

------
但是看了很多資料,
其實危害最大的應該是肺.
霧霾不是直接殺死你,
但是會危害健康讓你早死.

霾星人知識百科：PM2.5與肺癌

PM，英文全稱為particulatematter(顆粒物)。PM2.5是指大氣中直徑小於或等於2.5微米的顆粒物，也稱為可入肺顆粒物。它的直徑還不到人頭髮絲粗細的1/30。雖然PM2.5隻是地球大氣成分中含量很少的組分，但它對空氣質量和能見度等有重要的影響。而且PM2.5還有粒徑小，表面可以攜帶大量的有毒、有害物質的特點，其在大氣中的停留時間長、輸送距離遠，因而對人體健康和大氣環境質量的影響更大。

肺癌，是對人群健康和生命威脅最大的惡性腫瘤之一。目前肺癌已成為我國首位惡性腫瘤死亡原因，佔全部惡性腫瘤死亡的22.7%，且發病率和死亡率仍在繼續迅速上升。而且，我國肺癌發病率在以每年26.9%的速度在增長。儘管肺癌的最主要的致病因素是吸煙，但很多流行病學研究已證明，大氣污染的日益嚴重增加了肺癌的患病幾率，這其中與肺癌發病率增加有直接關係的物質就是PM2.5。

下面是維基百科上寫的:

顆粒物的大小決定了它們最終在呼吸道中的位置。較大的顆粒物往往會被纖毛和黏液過濾，無法通過鼻子和咽喉。然而，小於10微米的顆粒物即可吸入顆粒物（PM10），可以穿透這些屏障達到支氣管和肺泡。而小於2.5微米的顆粒物，細顆粒物（PM2.5），比表面積大於PM10，更易吸附有毒害的物質。如重金屬（在城市中以重金屬元素最為嚴重，較突出的有Zn、Pb、As、Cd等，而不同地區也有著各自的特點）、有毒微生物等。由於體積更小，PM2.5具有更強的穿透力，可能抵達細支氣管壁，並干擾肺內的氣體交換。更小的微粒（直徑小於等於100納米）會通過肺部傳遞影響其他器官。

其中，發表於《美國醫學會雜誌》的一項研究表明，PM2.5會導致動脈斑塊沉積，引發血管炎症和動脈粥樣硬化，最終導致心臟病或其他心血管問題。這項始於1982年的研究證實，當空氣中PM2.5的濃度長期高於10 μg/m3，就會帶來死亡風險的上升。濃度每增加10 μg/m3，總的死亡風險會上升4%，心肺疾病帶來的死亡風險上升6%，肺癌帶來的死亡風險上升8%。此外，PM2.5極易吸附多環芳烴等有機污染物和重金屬，使致癌、致畸、致突變的機率明顯升高。中國科學院陳竺院士等研究者，於《柳葉刀》雜誌上發表的文章中估計中國每年因室外空氣污染導致的早死人數在35萬-50萬人之間。

最小的顆粒物（直徑小於等於100納米，合0.1微米）帶來的危害更為嚴重。有證據表明這些顆粒物可以傳過細胞膜到達其他器官，包括大腦。有研究指出，這些微粒可能引發腦損傷（包括老年痴呆症）。值得注意的是，柴油發動機產生的微粒直徑通常在 100 納米（合0.1微米）左右。

我覺得車禍也算一個……受害者飄過……

我感覺比較明顯的是對生活質量的影響吧。
原來在成都念書的時候，晚上沒事兒去逛個夜市，吃個宵夜，唱個小歌什麼的，各種愜意～
後來來了北京念研究生。
約好的聚會，霧霾太大，cancel.
出去吃個飯，霧霾太大，還是點外賣吧。
室外活動，打個籃球羽毛球，或者溜達溜達散個步也被迫取消。
一年三百六十五天，沒幾天是適合出行的。久而久之，形成了每天坐在實驗室，或者呆在宿舍的生活習慣，有時候，一宅就是一個星期，一整天坐在電腦前，望望窗外都不知道現在是幾點。心裡那個感覺，真是感覺生活都沒啥樂趣了。
到處灰濛濛的，唯一能見到的好風景如圖：

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另外，不是我憤青，這些問題給北京人民帶來的損失，沒見有關部門跳出來要求什麼，倒是地鐵便宜了點，有關部門就坐不住了。真是呵呵

民眾直接感受：可怕的事情，間接反應：經常生病恢復慢，潛在反應：身體變差。

在外留學一年回國第二天就狂流鼻涕，喉嚨疼痛不已...

來京多年，鼻毛長勢喜人……哭……

首先，不太可能有權威論證
因為只要是權威的，就想要開脫責任，要麼是為政府開脫（監管不力），要麼是為民眾開脫（明火取暖、吸煙、鞭炮和燒柴巴拉巴拉）
其次，不開脫責任的有是另一番權威。就是把所有因素都考慮到了。它給你的答案就是不能光想到霧霾，有這麼一群作死的人。不死於肺癌也會死於其他。簡單說就是這種權威不僅僅考慮霧霾，還包括植被、濕地、高碳等等

還要權威論證？你不知道這是guojia jimi嗎？

之前回北京的第一天就感覺鼻咽喉都不舒服每天狂喝水兩周後直接發燒了另外最近幾年肺癌的人越來越多了吧