Human immuno-deficiency virus and infant feeding in complex humanitarian emergencies: priorities and policy considerations

Issues surrounding mother-to-child transmission of HIV/AIDS pose considerable challenges in complex humanitarian emergencies. The risk of vertical transmission through breastfeeding is well recognised, but safe alternatives are limited by the social, economic and environmental conditions of emergency situations. In 2000, the World Health Organisation published a technical report on behalf of the UNFPA/UNICEF/WHO/UNAIDS Inter-agency Task Team on Mother-to-child Transmission of HIV which outlined revised recommendations for infant feeding by HIV-positive women. This paper outlines reasons why these recommendations may be insufficient during the initial stages of complex humanitarian emergencies and proposes recommendations for establishing infant-feeding policy. Methods of mother-to-child transmission of HIV are reviewed and recent research findings are discussed. Rationale for modifying the 2000 UNFPA/UNICEF/WHO/UNAIDS infant-feeding recommendations in complex emergency situations is explored from the perspective of the infant, the mother and humanitarian field staff. Ethical limitations and future priorities are considered. The paper concludes with recommendations and a policy decision-making framework for consideration during the initial stages of humanitarian crises.     

国家《大气污染防治行动计划》健康效益评估

为了提高空气质量改善进程,2013 年国家发布了《大气污染防治行动计划》。本文基于空气污染与健康效益评估模型(BenMAP),对人口分布资料、大气污染与人体健康影响的暴露反应关系等进行了本土化修正,采用“支付意愿法”与“疾病成本法”相结合的方法,系统评估了《大气污染防治行动计划》实施后,PM_2.5 污染变化引起的环境健康效益。研究结果表明,《大气污染防治行动计划》的实施将在一定程度上降低PM_2.5 环境浓度,改善环境空气质量。如果《大气污染防治行动计划》空气质量目标全面实现,可以避免城镇8.9 万居民的过早死亡,减少12 万人次住院治疗以及941 万人次的门诊和急诊病例,实现的全国健康效益约为867 亿元/ 年,说明了《大气污染防治行动计划》实施的健康有益性。本文对政府部门开展污染损失评估及制定环境健康政策具有重要的参考价值。     

上、下悬窗阻风能力对比研究

环境风会改变排烟窗附近的烟气流向和速度,影响建筑内烟气流动,进而导致建筑自然排烟效率受到影响。采用数值模拟方法,对比研究了排烟窗开启角度和环境风对上、下悬窗阻风能力的影响,分析了不同开窗角度下,悬窗进风量和进风区域随开窗角度和风速的变化规律。结果表明:上、下悬窗相对进风量与开窗角度均成指数关系,但上悬窗阻风能力弱于下悬窗,上悬窗开窗角度大于45°后即失去阻风能力,而下悬窗开窗角度大于75°后才逐渐失去阻风能力,且开窗角度小于30°时,下悬窗至少能比上悬窗多减少50%空气进入室内。上悬窗开窗角度小于56°时,主要进风区域为近窗下侧水平区域;下悬窗开窗角度小于30°时,主要进风区域为窗体两侧及远窗下侧竖直区域,随着开窗角度增大,上、下悬窗主要进风区域均过渡到远窗下侧竖直区域。窗体用于日常通风时建议优选上悬窗。若要用于排烟,则应首选下悬窗,开窗角度15°即可满足阻风要求,若选用上悬窗,开窗角度不宜大于45°。     

环境污染事故应急监测装备的配置思路

分析了应急监测装备的配置形势,提出了应急监测装备的配置思想和配置原则,剖析了配置的关键点在于实现快速响应功能,准确、快速监测数据获取功能,快速解析、准确判断污染趋势功能,图像和声讯实时双向传输功能,以及安全保障和防护功能.     

典型养殖型湖泊中的重金属含量及健康风险特征——以宿鸭湖为例

为评估典型水产养殖型湖泊中的重金属含量水平及其人体健康风险特征,系统采集并测定了宿鸭湖湖水、周边地下水、沉积物及鱼体中的重金属含量.在此基础上计算了不同重金属在不同介质间(湖水-鱼体、湖水-沉积物及沉积物-鱼体)的转移因子,并通过健康风险指数计算定量分析了宿鸭湖水生态系统中重金属对人体的健康影响,以及不同暴露途径的风险贡献率.结果表明:Zn、Ba和Sr在不同介质体内含量均较高,而Sn和Cd的含量均比较低.Cr和Zn在鱼体中的均值含量超过WHO鱼类产品中重金属的含量限值,具有潜在毒性;湖水和地下水中的所有重金属浓度均低于饮用水标准中的相关限值;部分沉积物样品中Cr、Ni、Cu、Zn、Cd和Pb含量超出环境保护部《土壤环境质量标准》(GB15618—2008)自然背景值,但低于美国华盛顿州沉积物化学标准(WAC 172-204-320)中的含量限值,已构成轻微污染.不同介质间的转化因子分析表明,鱼体对湖水中的Zn、Sr、Ba、Cu、Cr、Ni、Co、Sn和Cd均存在富集作用;但除Zn以外,鱼体对沉积物中的其他重金属无明显的富集作用;宿鸭湖水生态系统中的重金属Cr对人体的HRI值为1.6,其健康危害效应不可忽视;食用鱼类是导致Cr人体健康危害的主要途径,贡献率高达94%;最后,与非养殖型湖泊相比,宿鸭湖水库中鱼体内Pb和Cr的含量明显偏高,且重金属从湖水到沉积物的转移因子明显偏高,而从湖水到鱼的生物浓缩因子相对较低.     

Hydrochemistry of drinking water sources and water purifiers in relation to epidemiological study in Hisar,North-West India

The concern related to the drinking of reverse osmosis (RO) water containing low levels of minerals is growing day by day. This study involves the analysis of water samples from various drinking water sources in a rural site, Mirchpur village, an Indus Valley civilization site (grid location: 29° 18′ 42.3″ N, 76° 10′ 33.0″ E) of Hisar, India, along with the health survey of human subjects. The hydrochemistry of water collected from hand pumps, river canals, tube wells, submersibles, and the RO systems installed in various homes was explored for pH, EC, TH, TDS, turbidity, cations (Na⁺, Ca²⁺, Mg²⁺), anions (CO₃²⁻, HCO₃⁻, Cl⁻, SO₄²⁻, NO₃⁻, F⁻), and elements (Fe, Pb, Se) employing the ion chromatography, flame photometry, and ICP-AES techniques. Lead (Pb) and Selenium (Se) were detected in trace amounts (0.30–2.6 μg L⁻¹; 0.10–4.1 μg L⁻¹, respectively) in all the samples, including the samples collected from RO purifiers, but Iron (Fe) was not detected in RO samples even in trace amounts. The F-levels in hand pump water (HPW) and submersible water (SW) (1.9  and 1.7 mg L⁻¹, respectively) and TDS levels in SW (3048 mg L⁻¹) were found to be above WHO and BIS safe limits. TDS levels in the river canal (900 mg L⁻¹), tube well (1104 mg L⁻¹), hand pump (1170 mg L⁻¹), and submersible samples (3048 mg L⁻¹) were found significantly higher as compared to the RO personal water (ROPW; 216 mg L⁻¹) and RO supply water (ROSW; 90 mg L⁻¹). The collected epidemiological data reveals that 21%, 19%, 13%, and 12% of natives reported skin, kidney, hair fall, liver, and stomach issues, respectively, suspecting the crucial role of high TDS and fluoride levels in the area. This study also provides a comparison between the quality of RO and the direct supply water, along with correlation matrices for different parameters, which gives a rationale for the limitations of drinking direct supply water without any purification and RO water containing low mineral content.     

Five-wheel framework for system-based monitoring of heavy metal pollution in rivers

Sectorial approach for monitoring heavy metal pollution in rivers has failed to report realistic pollution status and associated ecological and human health risks. The increasing spread of heavy metals from different sources and emerging risks to human and environmental health call for reexamining heavy metal pollution monitoring frameworks. Also, the sources, spread, and load of heavy metals in the environment have changed significantly over time, requiring consequent modification in the monitoring frameworks. Therefore, studies on heavy metal monitoring in rivers conducted in the last decade were evaluated for experimental designs, research frameworks, and data presentations. Most studies (∼99%) (i) lacked inclusiveness of all environmental compartments; (ii) focused on “one pollutant – one/two compartment” or sometimes “one pollutant – one compartment – one effect” approach; and (iii) remained “data-rich but information poor.” An ecological approach with integrative system thinking is proposed to develop a holistic approach for monitoring river pollution. It is visualized that heavy metal monitoring, risk analyses, and water management must incorporate tracking pollutants in different environmental compartments of a river (water, sediment, and floodplain/bank soil) and consider correlating it with riverbank land use. The systems-based pollution monitoring and assessment studies will reveal the critical factors that drive heavy metals pollutant movement in ecosystems and associated potential risks to the environment, wildlife, and humans. Also, water quality and pollution indexing tools would help better communicate complex pollution data and associated risks among all stakeholders. Therefore, integrating systems approaches in scientific- and policy-based tools would help sustainably manage the health of rivers, wildlife, and humans.     

昭通市农田土壤和蔬菜重金属污染评价及相关性分析

以昭通市农田区域为研究对象,采用点对点协同采样的方法对昭通市农田土壤和蔬菜进行采集,测定了As、Pb、Cu、Zn、Cd和Cr 这6种重金属含量.使用地累积指数和潜在生态风险指数对土壤重金属污染进行评价,利用健康风险模型评估蔬菜对人体产生的风险情况.结果表明,研究区土壤存在Cu、Zn、Pb、Cd和Cr污染,相较于农用地风险筛选值,超标率分别为34.35%、6.87%、2.29%、80.15%和6.11%;蔬菜存在Pb、Cd和Cr污染,相较于食品中污染物限量,超标率分别为6.87%、15.27%和36.64%.土壤污染评价表明,土壤重金属Cd存在强生态风险,其余重金属存在轻微生态风险.人体健康风险评估模型显示,非致癌风险及致癌风险均超过可接受范围,且对儿童的影响更大.相关性分析表明,土壤中的As对蔬菜吸收Cu和Zn具有拮抗作用,而土壤中Cr对蔬菜吸收Cu和Zn具有促进作用.     

金属矿区周边农田土壤与农作物重金属健康风险评估

为探明金属矿区周边农田土壤与农作物重金属污染特征与人体健康风险,通过对矿区周边农田土壤和农作物进行样品采集并分析测定其Cd、Pb和As等重金属含量,采用地累积指数法、富集系数法和综合潜在生态风险指数法,研究土壤和农作物重金属的污染特征与综合潜在生态风险,采用蒙特卡罗模拟法进行土壤和农作物重金属的健康风险评估.结果表明,凉桥村土壤重金属污染主要是Cd、As和Pb,分别有100%、100%和75%以上土壤样品超过农田土壤筛选值（GB 15618-2018）,农作物中Cd、Pb、As、Cr和Ni这5种重金属的含量,均超标《食品安全国家标准食品中污染物限量》（GB 2762-2017）严重;地累积指数和富集系数表明Cd和As污染严重,综合潜在生态风险指数（RI）普遍高于600,具有极高生态风险,其中Cd、As和Pb贡献最大,贡献率分别为77.8%、14.4%和3.1%.健康风险评估表明,凉桥村居民通过摄入农作物以及误食土壤造成较高的致癌风险（致癌风险>10-6）以及非致癌健康风险（危害商值>1）;蒙特卡罗模拟人群健康风险分析显示,凉桥村土壤重金属污染暴露途径下具有较高致癌与非致癌风...     

绥化市城市生态系统健康状况研究

针对当前城市生态系统健康问题,从自然、经济、社会三个子系统出发,运用数学模型对绥化市城市生态系统的健康水平进行了评价。结果表明,2000年-2004年绥化市生态系统综合健康处于亚健康状态,但有逐年好转的趋势。其中自然子系统的健康水平最好,对综合健康指数贡献值最大,经济和社会子系统健康水平相对较低,对综合健康指数的贡献值相对较小。提高经济和社会子系统的健康水平,使经济、社会和自然三大子系统健康协调发展是提高绥化市城市生态系统健康水平的关键。