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1.
Methods for simulating air pollution due to road traffic and the associated effects on stormwater runoff quality in an urban environment are examined with particular emphasis on the integration of the various simulation models into a consistent modelling chain. To that end, the models for traffic, pollutant emissions, atmospheric dispersion and deposition, and stormwater contamination are reviewed. The present study focuses on the implementation of a modelling chain for an actual urban case study, which is the contamination of water runoff by cadmium (Cd), lead (Pb), and zinc (Zn) in the Grigny urban catchment near Paris, France. First, traffic emissions are calculated with traffic inputs using the COPERT4 methodology. Next, the atmospheric dispersion of pollutants is simulated with the Polyphemus line source model and pollutant deposition fluxes in different subcatchment areas are calculated. Finally, the SWMM water quantity and quality model is used to estimate the concentrations of pollutants in stormwater runoff. The simulation results are compared to mass flow rates and concentrations of Cd, Pb and Zn measured at the catchment outlet. The contribution of local traffic to stormwater contamination is estimated to be significant for Pb and, to a lesser extent, for Zn and Cd; however, Pb is most likely overestimated due to outdated emissions factors. The results demonstrate the importance of treating distributed traffic emissions from major roadways explicitly since the impact of these sources on concentrations in the catchment outlet is underestimated when those traffic emissions are spatially averaged over the catchment area.  相似文献   

2.
Transit traffic through the Austrian Alps is of major concern in government policy. Pollutant burdens resulting from such traffic are discussed widely in Austrian politics and have already led to measures to restrict traffic on transit routes. In the course of an environmental assessment study, comprehensive measurements were performed. These included air quality observations using passive samplers, a differential optical absorption spectroscopy system, a mobile and a fixed air quality monitoring station, and meteorological observations. As was evident from several previous studies, dispersion modeling in such areas of complex terrain and, moreover, with frequent calm wind conditions, is difficult to handle. Further, in the case presented here, different pollutant sources had to be treated simultaneously (e.g., road networks, exhaust chimneys from road tunnels, and road tunnel portals). No appropriate system for modeling all these factors has so far appeared in the literature. A prognostic wind field model coupled with a Lagrangian dispersion model is thus presented here and is designed to treat all these factors. A comparison of the modeling system with results from passive samplers and from a fixed air quality monitoring station proved the ability of the model to provide reasonable figures for concentration distributions along the A10.  相似文献   

3.
We used a dispersion model to analyze measurements made during a field study conducted by the U.S. EPA in July–August 2006, to estimate the impact of traffic emissions on air quality at distances of tens of meters from an eight-lane highway located in Raleigh, NC. The air quality measurements consisted of long path optical measurements of NO at distances of 7 and 17 m from the edge of the highway. Sonic anemometers were used to measure wind speed and turbulent velocities at 6 and 20 m from the highway. Traffic flow rates were monitored using traffic surveillance cameras. The dispersion model [Venkatram, A., 2004. On estimating emissions through horizontal fluxes. Atmospheric Environment 38, 2439–2446] explained over 60% of the variance of the observed path averaged NO concentrations, and over 90% of the observed concentrations were within a factor of two of the model estimates.Sensitivity tests conducted with the model indicated that the traffic flow rate made the largest contribution to the variance of the observed NO concentrations. The meteorological variable that had the largest impact on the near road NO concentrations was the standard deviation of the vertical velocity fluctuations, σw. Wind speed had a relatively minor effect on concentrations. Furthermore, as long as the wind direction was within ±45° from the normal to the road, wind direction had little impact on near road concentrations. The measurements did not allow us to draw conclusions on the impact of traffic-induced turbulence on dispersion. The analysis of air quality and meteorological observations resulted in plausible estimates of on-road emission factors for NO.  相似文献   

4.
Abstract

Transit traffic through the Austrian Alps is of major concern in government policy. Pollutant burdens resulting from such traffic are discussed widely in Austrian politics and have already led to measures to restrict traffic on transit routes. In the course of an environmental assessment study, comprehensive measurements were performed. These included air quality observations using passive samplers, a differential optical absorption spectroscopy system, a mobile and a fixed air quality monitoring station, and meteorological observations. As was evident from several previous studies, dispersion modeling in such areas of complex terrain and, moreover, with frequent calm wind conditions, is difficult to handle. Further, in the case presented here, different pollutant sources had to be treated simultaneously (e.g., road networks, exhaust chimneys from road tunnels, and road tunnel portals). No appropriate system for modeling all these factors has so far appeared in the literature. A prognostic wind field model coupled with a Lagrangian dispersion model is thus presented here and is designed to treat all these factors. A comparison of the modeling system with results from passive samplers and from a fixed air quality monitoring station proved the ability of the model to provide reasonable figures for concentration distributions along the A10.  相似文献   

5.
Abstract

Understanding motor vehicle emissions, near-roadway pollutant dispersion, and their potential impact to near-roadway populations is an area of growing environmental interest. As part of ongoing U.S. Environmental Protection Agency research in this area, a field study was conducted near Interstate 440 (I-440) in Raleigh, NC, in July and August of 2006. This paper presents a subset of measurements from the study focusing on nitric oxide (NO) concentrations near the roadway. Measurements of NO in this study were facilitated by the use of a novel path-integrated optical remote sensing technique called deep ultraviolet differential optical absorption spectroscopy (DUV-DOAS). This paper reviews the development and application of this measurement system. Time-resolved near-road NO concentrations are analyzed in conjunction with wind and traffic data to provide a picture of emissions and near-road dispersion for the study. Results show peak NO concentrations in the 150 ppb range during weekday morning rush hours with winds from the road accompanied by significantly lower afternoon and weekend concentrations. Traffic volume and wind direction are shown to be primary determinants of NO concentrations with turbulent diffusion and meandering accounting for significant near-road concentrations in off-wind conditions. The enhanced source capture performance of the open-path configuration allowed for robust comparisons of measured concentrations with a composite variable of traffic intensity coupled with wind transport (R2 = 0.84) as well as investigations on the influence of wind direction on NO dilution near the roadway. The benefits of path-integrated measurements for assessing line source impacts and evaluating models is presented. The advantages of NO as a tracer compound, compared with nitrogen dioxide, for investigations of mobile source emissions and initial dispersion under crosswind conditions are also discussed.  相似文献   

6.
Abstract

A growing number of epidemiological studies conducted worldwide suggest an increase in the occurrence of adverse health effects in populations living, working, or going to school near major roadways. A study was designed to assess traffic emissions impacts on air quality and particle toxicity near a heavily traveled highway. In an attempt to describe the complex mixture of pollutants and atmospheric transport mechanisms affecting pollutant dispersion in this near-highway environment, several real-time and time-integrated sampling devices measured air quality concentrations at multiple distances and heights from the road. Pollutants analyzed included U.S. Environmental Protection Agency (EPA)-regulated gases, particulate matter (coarse, fine, and ultrafine), and air toxics. Pollutant measurements were synchronized with real-time traffic and meteorological monitoring devices to provide continuous and integrated assessments of the variation of near-road air pollutant concentrations and particle toxicity with changing traffic and environmental conditions, as well as distance from the road. Measurement results demonstrated the temporal and spatial impact of traffic emissions on near-road air quality. The distribution of mobile source emitted gas and particulate pollutants under all wind and traffic conditions indicated a higher proportion of elevated concentrations near the road, suggesting elevated exposures for populations spending significant amounts of time in this microenvironment. Diurnal variations in pollutant concentrations also demonstrated the impact of traffic activity and meteorology on near-road air quality. Time-resolved measurements of multiple pollutants demonstrated that traffic emissions produced a complex mixture of criteria and air toxic pollutants in this microenvironment. These results provide a foundation for future assessments of these data to identify the relationship of traffic activity and meteorology on air quality concentrations and population exposures.  相似文献   

7.
A growing number of epidemiological studies conducted worldwide suggest an increase in the occurrence of adverse health effects in populations living, working, or going to school near major roadways. A study was designed to assess traffic emissions impacts on air quality and particle toxicity near a heavily traveled highway. In an attempt to describe the complex mixture of pollutants and atmospheric transport mechanisms affecting pollutant dispersion in this near-highway environment, several real-time and time-integrated sampling devices measured air quality concentrations at multiple distances and heights from the road. Pollutants analyzed included U.S. Environmental Protection Agency (EPA)-regulated gases, particulate matter (coarse, fine, and ultrafine), and air toxics. Pollutant measurements were synchronized with real-time traffic and meteorological monitoring devices to provide continuous and integrated assessments of the variation of near-road air pollutant concentrations and particle toxicity with changing traffic and environmental conditions, as well as distance from the road. Measurement results demonstrated the temporal and spatial impact of traffic emissions on near-road air quality. The distribution of mobile source emitted gas and particulate pollutants under all wind and traffic conditions indicated a higher proportion of elevated concentrations near the road, suggesting elevated exposures for populations spending significant amounts of time in this microenvironment. Diurnal variations in pollutant concentrations also demonstrated the impact of traffic activity and meteorology on near-road air quality. Time-resolved measurements of multiple pollutants demonstrated that traffic emissions produced a complex mixture of criteria and air toxic pollutants in this microenvironment. These results provide a foundation for future assessments of these data to identify the relationship of traffic activity and meteorology on air quality concentrations and population exposures.  相似文献   

8.
Understanding local-scale transport and dispersion of pollutants emitted from traffic sources is important for urban planning and air quality assessments. Predicting pollutant concentration patterns in complex environments depends on accurate representations of local features (e.g., noise barriers, trees, buildings) affecting near-field air flows. This study examined the effects of roadside barriers on the flow patterns and dispersion of pollutants from a high-traffic highway in Raleigh, North Carolina, USA. The effects of the structures were analyzed using the Quick Urban & Industrial Complex (QUIC) model, an empirically based diagnostic tool which simulates fine-scale wind field and dispersion patterns around obstacles. Model simulations were compared with the spatial distributions of ultrafine particles (UFP) from vehicular emissions measured using a passenger van equipped with a Differential Mobility Analyzer/Condensation Particle Counter. The field site allowed for an evaluation of pollutant concentrations in open terrain, with a noise barrier present near the road, and with a noise barrier and vegetation present near the road.Results indicated that air pollutant concentrations near the road were generally higher in open terrain situations with no barriers present; however, concentrations for this case decreased faster with distance than when roadside barriers were present. The presence of a noise barrier and vegetation resulted in the lowest downwind pollutant concentrations, indicating that the plume under this condition was relatively uniform and vertically well-mixed. Comparison of the QUIC model with the mobile UFP measurements indicated that QUIC reasonably represented pollutant transport and dispersion for each of the study configurations.  相似文献   

9.
Understanding motor vehicle emissions, near-roadway pollutant dispersion, and their potential impact to near-roadway populations is an area of growing environmental interest. As part of ongoing U.S. Environmental Protection Agency research in this area, a field study was conducted near Interstate 440 (I-440) in Raleigh, NC, in July and August of 2006. This paper presents a subset of measurements from the study focusing on nitric oxide (NO) concentrations near the roadway. Measurements of NO in this study were facilitated by the use of a novel path-integrated optical remote sensing technique called deep ultraviolet differential optical absorption spectroscopy (DUV-DOAS). This paper reviews the development and application of this measurement system. Time-resolved near-road NO concentrations are analyzed in conjunction with wind and traffic data to provide a picture of emissions and near-road dispersion for the study. Results show peak NO concentrations in the 150 ppb range during weekday morning rush hours with winds from the road accompanied by significantly lower afternoon and weekend concentrations. Traffic volume and wind direction are shown to be primary determinants of NO concentrations with turbulent diffusion and meandering accounting for significant near-road concentrations in off-wind conditions. The enhanced source capture performance of the open-path configuration allowed for robust comparisons of measured concentrations with a composite variable of traffic intensity coupled with wind transport (R2 = 0.84) as well as investigations on the influence of wind direction on NO dilution near the roadway. The benefits of path-integrated measurements for assessing line source impacts and evaluating models is presented. The advantages of NO as a tracer compound, compared with nitrogen dioxide, for investigations of mobile source emissions and initial dispersion under crosswind conditions are also discussed.  相似文献   

10.
The assessment of air quality impacts from roadways is a major concern to urban planners. In order to assess future road and building configurations, a number of techniques have been developed, including mathematical models, which simulate traffic emissions and atmospheric dispersion through a series of mathematical relationships and physical models. The latter models simulate emissions and dispersion through scaling of these processes in a wind tunnel. Two roadway mathematical models, HIWAY-2 and CALINE-4, were applied to a proposed development in a large urban area. Physical modelling procedures developed by Rowan Williams Davies & Irwin Inc. (RWDI) in the form of line source simulators were also applied, and the resulting carbon monoxide concentrations were compared. The results indicated a factor of two agreement between the mathematical and physical models. The physical model, however, reacted to changes in building massing and configuration. The mathematical models did not, since no provision for such changes was included in the mathematical models. In general, the RWDI model resulted in higher concentrations than either HIWAY-2 or CALINE-4. Where there was underprediction, it was often due to shielding of the receptor by surrounding buildings. Comparison of these three models with the CALTRANS Tracer Dispersion Experiment showed good results although concentrations were consistently underpredicted.  相似文献   

11.
The wind flow field around urban street-building configurations has an important influence on the microscale pollutant dispersion from road traffic, affecting overall dilution and creating localised spatial variations of pollutant concentration. As a result, the “representativeness” of air quality measurements made at different urban monitoring sites can be strongly dependent on the interaction of the local wind flow field with the street-building geometry surrounding the monitor. The present study is an initial attempt to develop a method for appraising the significance of air quality measurements from urban monitoring sites, using a general application computational fluid dynamics (CFD) code to simulate small-scale flow and dispersion patterns around real urban building configurations. The main focus of the work was to evaluate routine CO monitoring data collected by Westminster City Council at an intersection of street canyons at Marylebone Road, Central London. Many monitors in the UK are purposely situated at urban canyon intersections, which are thought to be local “hot spots” of pollutant emissions, however very limited information exists in the literature on the flow and dispersion patterns associated with them. With the use of simple CFD simulations and the analysis of available monitoring data, it was possible to gain insights into the effect of wind direction on the small-scale dispersion patterns at the chosen intersection, and how that can influence the data captured by a monitor. It was found that a change in wind direction could result in an increase or decrease of monitored CO concentration of up to 80%, for a given level of traffic emissions and meteorological conditions. Understanding and de-coupling the local effect of wind direction from monitoring data using the methods presented in this work could prove a useful new tool for urban monitoring data interpretation.  相似文献   

12.
ABSTRACT

A series of twelve intensively monitored 1-hr CO dispersion studies were conducted near Davis, CA, in winter 1996. The experimental equipment included twelve CO sampling ports at elevations up to 50 m, three sonic anemometers, a tethersonde station, aircraft measurements of wind and temperature profile aloft, and a variety of conventional meteorological equipment. The study was designed to explore the role of vehicular exhaust buoyancy during worst-case meteorological conditions, such as low winds oriented in near-parallel alignment with the road during a surface-based nocturnal inversion. From the study, field estimates of the CO emission factor (EF) from a California vehicle fleet were computed using two different methods. The analysis suggests that the CT-EMFAC/ EMFAC (EMission FACtor) models currently used to conduct federal conformity modeling significantly overpredict CO emissions for high-speed, free-flowing traffic on California highways.  相似文献   

13.
Low wind scenarios are associated with the worst air pollution episodes in urban street canyons. Under these conditions, operational dispersion models often over-predict pollutant concentration. Traffic-producing turbulence (TPT) becomes dominant in mixing and diluting traffic-related pollutants under low wind speed conditions. Determining the TPT effect on the flow and dispersion patterns within urban street canyons is crucial for the development of detailed operational dispersion models for assessing urban air quality. Several spatially averaged TPT formulations have been recently proposed in the literature. However, only a few attempts have been made so far to incorporate different TPT schemes into operational dispersion models and evaluate their performance using measurements.In this paper, several TPT schemes presented in literature were evaluated. Two TPT schemes were implemented in the well-validated Windows version of the Danish Operational Street Pollution Model (WinOSPM). Both formulations were evaluated using six independent datasets of roadside CO concentrations collected in European cities. Statistical and sensitivity analyses were undertaken to test the performance of the different formulations. The results showed that the overall model performance was significantly sensitive to the TPT schemes adopted. The model performance improved when a detailed characterisation of the TPT, depending on the density of road traffic, was used.  相似文献   

14.
It is difficult to estimate vehicular emission factors at traffic junctions for use in dispersion modelling studies. Firstly, because the vehicles are in various modes of operation and secondly, it is difficult to delineate the effects of other contributing sources, mainly the effects of road dust and deposited constituents, which are very prominent at traffic junctions in India. Factor analysis-multiple regression (FA-MR), a receptor modelling technique has been used in this study for apportioning the contributing sources. The measurement data consist of one year's temporal variation of suspended particulate matter (SPM), analysed for its trace metal constituents, and two gaseous components NO2 and SO2 at two traffic junctions in Mumbai (India). FA-MR apportioned 40% of the observed SPM to road dust and 15% to vehicular sources. Of the total Pb observed in the SPM, FA-MR apportioned 60% to vehicular sources and 20% to road dust. The field-observed vehicular counts, meteorological parameters and road geometry were used in California line source dispersion model to estimate the effective vehicular emission factor for Pb at one traffic junction. This derived emission factor was used to predict the Pb concentration at second (independent observation) traffic junction. The result was found to be more satisfactory than using default emission factors obtained from literature. Similarly, effective vehicular emission factor for NO2 was also evaluated for one site and tested for predicting concentrations at the other site.  相似文献   

15.
The dispersion formulation incorporated in the U.S. Environmental Protection Agency's AERMOD regulatory dispersion model is used to estimate the contribution of traffic-generated emissions of select VOCs – benzene, 1,3-butadiene, toluene – to ambient air concentrations at downwind receptors ranging from 10-m to 100-m from the edge of a major highway in Raleigh, North Carolina. The contributions are computed using the following steps: 1) Evaluate dispersion model estimates with 10-min averaged NO data measured at 7 m and 17 m from the edge of the road during a field study conducted in August, 2006; this step determines the uncertainty in model estimates. 2) Use dispersion model estimates and their uncertainties, determined in step 1, to construct pseudo-observations. 3) Fit pseudo-observations to actual observations of VOC concentrations measured during five periods of the field study. This provides estimates of the contributions of traffic emissions to the VOC concentrations at the receptors located from 10 m to 100 m from the road. In addition, it provides estimates of emission factors and background concentrations of the VOCs, which are supported by independent estimates from motor vehicle emissions models and regional air quality measurements. The results presented in the paper demonstrate the suitability of the formulation in AERMOD for estimating concentrations associated with mobile source emissions near roadways. This paper also presents an evaluation of the key emissions and dispersion modeling inputs necessary for conducting assessments of local-scale impacts from traffic emissions.  相似文献   

16.
Vertical snow sampling and moss bag transplants were used to estimate the local inorganic and organic pollutant load deposited from traffic along a major highway in Finland. The pH and concentrations of Cl(-), NO(3)(-), SO(4)(2-), Ca(2+), Na(+) and polyaromatic hydrocarbons (PAHs) were determined from snow samples collected in winter at different sites along the highway. In summer, moss bags containing 20 g of fresh red-stemmed feather moss (Pleurozium schreberi) were transplanted at the same sites. The moss bag transplants remained exposed to roadside traffic for a period of one month following which the samples were collected and the PAH profiles and concentrations were analysed. The deposition of inorganic and organic pollutants from road traffic was observed up to 60 m from the road. The prevailing winds had a significant effect on the dispersion of pollutants. Snow appears to be a good collector of inorganic pollutants from the atmosphere and can be used to monitor local airborne pollution from road traffic. Snow packs can also be used as passive collectors of organic pollutant loads from road traffic on a local scale. To monitor organic PAH deposition from the road traffic, moss bags appeared to be better indicators compared to snow sampling. The efficiency of moss bags in accumulating PAH compounds indicate that vegetation may be an important sink for traffic pollution.  相似文献   

17.
The BTX levels are significantly high compared to the EU directive for benzene in European cities with population around or higher one million. Since there are hundreds of towns in Europe with smaller population, it is important to know the levels of aromatics in these areas.This work presents the results of a benzene, toluene and xylene (BTX) measurement campaign that took place in Ioannina, a medium-sized Greek city. As a result of traffic situation and the local meteorological conditions, pollution levels in Ioannina are unusually high, at least for a city of that size. BTX levels were measured using passive samplers placed at several points around the city, as well as across a selected street canyon using both passive and active samplers, combined with simultaneous measurements of traffic flow and wind speed. The measurement procedure was repeated in an exact manner for all four seasons and the results suggest that benzene levels, at all sampling points, exceed the limit set by EU Directive 2000/69. Benzene levels appear correlated to traffic density, while benzene/toluene/xylene ratios present a seasonal variation linked to meteorological conditions.  相似文献   

18.
A field measurement campaign was conducted near a major road in southern Finland from September 15 to October 30, 1995. The concentrations of NO, NO2 and O3 were measured simultaneously at three locations, at three heights (3.5, 6 and 10 m) on both sides of the road. Traffic densities and relevant meteorological parameters were also measured on-site. We have compared measured concentration data with the predictions of the road network dispersion model CAR-FMI, used in combination with a meteorological pre-processing model MPP-FMI. In comparison with corresponding results presented previously in the literature, the agreement of measured and predicted datasets was good, as measured using various statistical parameters. For all data (N=587), the index of agreement (IA) was 0.83, 0.82 and 0.89 for the measurements of NOx, NO2 and O3, respectively. The IA is a statistical measure of the correlation of the predicted and measured time series of concentrations. However, the modelling system overpredicts NOx concentrations with a fractional bias FB=+13%, and O3 concentrations with FB=+8%, while for NO2 concentrations FB=−2%. We also analyzed the difference between model predictions and measured data in terms of meteorological parameters. Model performance clearly deteriorated as the wind direction approached a direction parallel to the road, and for the lowest wind speeds. The range of variability concerning atmospheric stability, ambient temperature and the amount of solar radiation was modest during the measurement campaign. As expected, no clear dependencies of model performance were therefore detected in terms of these parameters. The experimental dataset is available for the evaluation of other roadside dispersion models.  相似文献   

19.
Quantifying the emissions and concentrations of heavy metals in urban air is a prerequisite for assessing their health effects. In this paper a combination of measurements and modelling is used to assess the contribution from road traffic emissions. Concentrations of particulate heavy metals in air were measured simultaneously during 1 year at a densely trafficked street and at an urban background site in Stockholm, Sweden. Annual mean concentrations of cadmium were 50 times lower than the EU directive and for nickel and arsenic concentrations were 10 and six times lower, respectively. More than a factor of two higher concentrations was in general observed at the street in comparison to roof levels indicating the strong influence from local road traffic emissions. The only compound with a significantly decreasing trend in the urban background was Pb with 9.1 ng m?3 in 1995/96 compared to 3.4 ng m?3 2003/04. This is likely due to decreased emissions from wear of brake linings and reduced emissions due to oil and coal combustion in central Europe.Total road traffic emission factors for heavy metals were estimated using parallel measurements of NOx concentrations and knowledge of NOx emission factors. In general, the emission factors for the street were higher than reported in road tunnel measurements. This could partly be due to different driving conditions, since especially for metals which are mainly emitted from brake wear, more stop and go driving in the street compared to in road tunnels is likely to increase emissions. Total emissions were compared with exhaust emissions, obtained from the COPERT model and brake wear emissions based on an earlier study in Stockholm. For Cu, Ni and Zn the sum of brake wear and exhaust emissions agreed very well with estimated total emission factors in this study. More than 90% of the road traffic emissions of Cu were due to brake wear. For Ni more than 80% is estimated to be due to exhaust emissions and for Zn around 40% of road traffic emissions are estimated to be due to exhaust emissions. Pb is also mainly due to exhaust emissions (90%); a fuel Pb content of only 0.5 mg L?1 would give similar emission factor as that based on the concentration increment at the street. This is the first study using simultaneous measurements of heavy metals at street and roof enabling calculations of emission factors using a tracer technique.  相似文献   

20.
Transport is an essential sector in modern societies. It connects economic sectors and industries. Next to its contribution to economic development and social interconnection, it also causes adverse impacts on the environment and results in health hazards. Transport is a major source of ground air pollution, especially in urban areas, and therefore contributes to the health problems, such as cardiovascular and respiratory diseases, cancer and physical injuries. This paper presents the results of a health risk assessment that quantifies the mortality and the diseases associated with particulate matter pollution resulting from urban road transport in Haiphong City, Vietnam. The focus is on the integration of modelling and geographic information system approaches in the exposure analysis to increase the accuracy of the assessment and to produce timely and consistent assessment results. The modelling was done to estimate traffic conditions and concentrations of particulate matters based on geo-referenced data. The study shows that health burdens due to particulate matter in Haiphong include 1,200 extra deaths for the situation in 2007. This figure can double by 2020 as the result of the fast economic development the city pursues. In addition, 51,000 extra hospital admissions and more than 850,000 restricted activity days are expected by 2020.  相似文献   

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