Chepfu yemutobvu isingaperi injodzi huru yechirwere chemoyo muvanhu vakuru uye kusaziva zvakanaka muvana, uye inogona kukonzera kukuvadza kunyangwe pamwero wemutobvu waimboonekwa sewakachengeteka. Muna 2019, kuratidzwa kwemutobvu kwakakonzera kufa kwemamiriyoni mashanu neshanu kubva kuchirwere chemoyo pasi rese uye kurasikirwa kwakazara kwe765 miriyoni IQ mapoinzi muvana gore rega.
Kuratidzwa kwemutobvu kunenge kwese kwese, kusanganisira mupendi ine lead, peturu ine lead, dzimwe pombi dzemvura, ceramics, cosmetics, zvinonhuhwirira, pamwe nekunyungudutsa, kugadzirwa kwebhatiri nemamwe maindasitiri, saka nzira dzehuwandu hwehuwandu hwakakosha kubvisa chepfu yemutobvu.
Chepfu yemutobvu chirwere chekare. Dioscorides, chiremba wechiGiriki uye nyanzvi yemishonga muRoma yekare, akanyora De
Materia Medica, iro basa rakakosha pamishonga yemishonga kwemakumi emakore, rakatsanangura zviratidzo zvehupfu hwemutobvu hwakanyanya makore anoda kusvika 2 000 apfuura. Vanhu vane muchetura wakajeka wemutobvu vanonzwa kuneta, kutemwa nemusoro, kushatirwa, dumbu rakasimba, uye kuvimbiswa. Kana huwandu hwemutobvu weropa hunodarika 800 μg/L, chepfu yemutobvu yakaoma inogona kukonzera kugwinha, encephalopathy, uye kufa.
Chepfu yemutobvu isingaperi yakazivikanwa makore anopfuura zana apfuura sechikonzero cheatherosclerosis uye "lead chepfu" gout. Pakuongorora chitunha, 69 vevarwere 107 vane gout inokonzerwa nomutobvu vakanga “vakaoma madziro etsinga nekuchinja kweatheromatous.” Muna 1912, William Osler (William Osler)
"Doro, mutungamiri, uye gout zvinotamba mabasa anokosha mupathogenesis ye arteriosclerosis, kunyange zvazvo nzira chaidzo dzekuita dzisinganzwisisike," Osler akanyora. Mutsetse wokutungamirira (mutsetse webhuruu wakanaka welead sulfide kumucheto kwemazino) chiratidzo chechepfu yomutobvu isingaperi muvakuru.
Muna 1924, New Jersey, Philadelphia neNew York City yakarambidza kutengeswa kwepeturu ine lead mushure mekunge 80 muzana yevashandi vaigadzira tetraethyl lead paStandard Oil muNew Jersey vakawanikwa vaine chepfu yemutobvu, vamwe vacho vakafa. Musi waChivabvu 20, 1925, Hugh Cumming, chiremba wekuvhiya mukuru weUnited States, akaunganidza masayendisiti nevamiriri veindasitiri kuti vaone kana zvaive zvisina njodzi kuwedzera tetraethyl lead mupeturu. Yandell Henderson, nyanzvi yokushanda kwomuviri uye nyanzvi muhondo yemakemikari, akanyevera kuti “kuwedzera kwomutobvu wetetraethyl kuchafumura zvishoma nezvishoma chiverengero chavagari vemo chikuru kuchepfu yomutobvu nokuoma kwetsinga”. Robert Kehoe, mukuru wezvekurapa weEthyl Corporation, anotenda kuti masangano ehurumende haafanire kurambidza tetraethyl lead kubva mumotokari kusvika yaratidza kuti ine chepfu. “Mubvunzo hausi wokuti mutobvu une ngozi here, asi kuti kumwe kuungana kwomutobvu kune ngozi,” akadaro Kehoe.
Kunyange zvazvo migodhi yemutobvu yave ichienderera mberi kwemakore 6,000, kushandiswa kwemutobvu kwakawedzera zvinoshamisa muzana remakore rechi20. Mutobvu isimbi inoumbika, inogara yakasimba inoshandiswa kudzivirira mafuta kuti asatsva nekukasira, kuderedza “kugogodzwa kweinjini” mumotokari, kutakura mvura yekunwa, magaba echikafu anotengeswa, kuita kuti pendi ipenye kwenguva refu nekuuraya zvipembenene. Sezvineiwo, mitobvu mizhinji inoshandiswa kuita izvi zvinangwa inoguma yava mumiviri yevanhu. Pachikuru chedenda rechepfu yomutobvu muUnited States, mazana avana aipinzwa muchipatara zhizha riri rose nokuda kweecephalopathy yomutobvu, uye chikamu chimwe muzvina chavo chaifa.
Parizvino vanhu vari kuoneswa mutobvu pamatanho ari pamusoro pemasikirwo echisikigo. Muma1960, geochemist Clair Patterson, akashandisa lead isotopes kufungidzira zera rePasi pamakore 4.5 bhiriyoni.
Patterson akawana kuti migodhi, kunyungudutswa uye kuburitswa kwemotokari kwakakonzera kuti mutobvu wemuchadenga uise zvakapetwa ka1,000 kupfuura mwero wemusikirwo wekumashure mumasamples echando chechando. Patterson akawanawo kuti kuwanda kwemutobvu mumapfupa evanhu vari munyika dzakabudirira kwakapetwa ka1,000 kupfuura kuya kwevanhu vairarama munguva dzisati dzave nemaindasitiri.
Kuratidzwa kwemutungamiri kwakaderera neanopfuura 95% kubva kuma1970, asi chizvarwa chemazuva ano chichiri kutakura 10-100 nguva yakawanda kupfuura vanhu vanogara munguva dzepre-industrial.
Nezvisizvo zvishomanene, zvakadai somutobvu mumafuta emuchadenga uye zvombo uye mabhatiri elead-asidhi emotokari, mutobvu hauchashandiswi muUnited States neEurope. Vanachiremba vakawanda vanodavira kuti chinetso chechepfu yomutobvu chinhu chekare. Zvisinei, pendi yomutobvu mudzimba dzechikuru, peturu ine lead yakaiswa muvhu, mutobvu unobvisirwa mupombi dzemvura, uye utsi unobva kumafesitiri ezvemaindasitiri nezvimba zvinopisa zvose zvinoparira kufumurwa kwomutobvu. Munyika zhinji, mutobvu unoburitswa mukunyungudutswa, kugadzirwa kwebhatiri uye marara e-e-marara, uye kazhinji inowanikwa mupendi, ceramics, cosmetics uye zvinonhuwira. Tsvagiridzo inosimbisa kuti chepfu ye lead isingaperi injodzi yehosha yemwoyo muvanhu vakuru uye kusaziva zvakanaka muvana, kunyangwe pamwero waimbonzi wakachengeteka kana usingakuvadzi. Ichi chinyorwa chichapfupisa mhedzisiro yekusingaperi-yepamusoro-level chepfu yekutungamirira
Exposure, kutorwa uye mutoro wemukati
Kupinzwa nemuromo nekufemesa ndidzo nzira huru dzekufumurwa nemutobvu. Vacheche vane kukurumidza kukura uye kukura vanogona kutora mutobvu nyore nyore, uye kushomeka kwesimbi kana kushomeka kwecalcium kunogona kukurudzira kunwa kwe lead. Lead inotevedzera calcium, iron, uye zinc inopinda musero kuburikidza nemachani ecalcium uye zvinotakura simbi senge divalent metal transporter 1[DMT1]. Vanhu vane genetic polymorphisms inokurudzira iron kana calcium absorption, zvakadai seaya anokonzera hemochromatosis, akawedzera kutora kwemutobvu.
Kana yangobatwa, 95% yemutobvu yasara mumuviri wemunhu mukuru inochengetwa mumapfupa; 70% yemutobvu yasara mumuviri wemwana inochengetwa mumapfupa. Inenge 1% yehuwandu hwemutobvu mumuviri wemunhu inotenderera muropa. 99% yemutobvu muropa iri mumasero matsvuku eropa. Yese yeropa lead concentration (ichangobva kunyudzwa lead uye remobilized lead kubva mubhonzo) ndiyo inonyanya kushandiswa biomarker ye exposure level. Zvinhu zvinoshandura bhonzo metabolism, senge menopause uye hyperthyroidism, zvinogona kuburitsa mutobvu wakavharirwa mumapfupa, zvichiita kuti mazinga eropa awedzere.
Muna 1975, apo lead yakanga ichiri kuwedzerwa kupeturu, Pat Barry akaita ongororo yeautopsy yevanhu 129 vekuBritain uye akaverengera mutoro wavo wose. Avhareji yese mutoro mumuviri wemurume i165 mg, yakaenzana nehuremu hwepepa clip. Muviri wevarume vane chepfu yemutobvu waive 566 mg, katatu chete avhareji yemutoro wesample yese yechirume. Mukuenzanisa, chiyero chemutoro wese mumuviri wemukadzi i104 mg. Mune vese varume nevakadzi, huwandu hwepamusoro hwemutobvu munyama yakapfava hwakanga huri mutsinga, nepo muvarume huwandu hwacho hwaive hwakanyanya muatherosclerotic plaques.
Vamwe vanhu vari panjodzi yakawedzera yechepfu yemutobvu zvichienzaniswa nehuwandu hwevanhu. Vacheche nevana vadiki ndivo vari panjodzi huru yekumwa mutobvu nekuda kwekusadya kwavo nemuromo, uye vanogona kutora mutobvu kupfuura vana vakura nevakuru. Vana vaduku vanogara mudzimba dzisina kuchengetwa zvakanaka dzakavakwa pamberi pa 1960 vari mungozi yechepfu yomutobvu ichibva mukunwa machipisi ependi neguruva reimba rine mutobvu. Vanhu vanonwa mvura yomupombi yemupombi dzine mutobvu kana kuti vanogara pedyo nenhandare dzendege kana kuti dzimwe nzvimbo dzine mutobvu dzine mutobvu vari pangozi yakawedzerwa yokuva nomuchetura wakaderera womutobvu. MuUnited States, mitoo yakawanda mumhepo yakakwira zvakanyanya munharaunda dzakapatsanurwa kupfuura munharaunda dzakabatanidzwa. Vashandi vari mumaindasitiri anonyungudutsa, ekugadziridzazve mabhatiri uye ekuvaka, pamwe chete nevaya vanoshandisa pfuti kana kuti vane zvimedu zvemabara mumiviri yavo, variwo panjodzi yakawedzerwa yechepfu yemutobvu.
Lead ndiyo kemikari yekutanga ine chepfu yakayerwa muNational Health and Nutrition Examination Survey (NHANES). Pakutanga kwechikamu chekubuda kwepeturu ine lead, mwero weropa wakadzika kubva pa150 μg/L muna 1976 kusvika pa90 muna 1980.
μg/L, nhamba yekufananidzira. Mwero wemutobvu weropa unofungidzirwa kuti ungakuvadza wakaderedzwa kakawanda. Muna 2012, Centers for Disease Control and Prevention (CDC) yakazivisa kuti mutobvu wakachengeteka muropa revana hausati wazivikanwa. CDC yakaderedza chiyero chehuwandu hwehuwandu hwehuwandu hweropa muvana - kazhinji hunoshandiswa kuratidza kuti chiito chinofanira kutorwa kuderedza kuratidzwa kwemutobvu - kubva ku100 μg / L kusvika ku50 μg / L muna 2012, uye kusvika ku35 μg / L muna 2021. yakashandiswa μg/dL, iyo inoratidza humbowo hwakawanda hwehuturu hwemutobvu pamazinga akaderera.
Rufu, kurwara nekuremara
"Mutobvu unogona kukuvadza chero kupi zvako, uye mutungamiri uri kwose kwose," akanyora kudaro Paul Mushak naAnnemarie F. Crocetti, vose vari nhengo dzeNational Board of Air Quality yakagadzwa naPresident Jimmy Carter, mumushumo kuCongress muna 1988. Kukwanisa kuyera mazinga emutobvu muropa, mazino uye mapfupa kunoratidza huwandu hwezvinetso zvehutano zvinosanganiswa nekusingaperi-level low lead poisoning pamazinga anowanzowanikwa mumuviri womunhu. Mwero yakaderera yehuturu hwemutobvu chinhu chengozi yekuzvarwa kusati kwasvika, pamwe chete nekukanganisika kwekuziva uye kutadza kwekutarisa hyperactivity disorder (ADHD), kuwedzera kweropa uye kuderedzwa kwekuchinja kwemoyo muvana. Muvanhu vakuru, mwero wakaderera wechepfu yomutobvu ndiyo inokonzera kukanganisa itsvo kusingaperi, hypertension uye chirwere chemwoyo
Kukura uye neurodevelopment
Pahuwandu hwemutobvu unowanzowanikwa muvakadzi vane pamuviri, kuratidzwa kwemutobvu chinhu chengozi yekuberekwa kusati kwasvika. Mune anotarisirwa kuberekwa kweboka rekuzvarwa kweCanada, kuwedzera kwe10 μg/L mumazinga ekutungamira kweropa raamai kwakabatana ne70% yengozi yakawedzera yekuzvarwa kusati kwasvika. Kune vakadzi vane pamuviri vane serum vitamin D mazinga ari pasi pe50 mmol / L uye mazinga ekutungamirira kweropa akawedzera ne 10 μg / L, njodzi yekuzvarwa kwekanguva isati yasvika yakawedzera kusvika katatu.
Muchidzidzo chekutanga chevana vane zviratidzo zvekiriniki zvechepfu yemutobvu, Needleman et al. vakawana kuti vana vane mwero wakakwirira wemutobvu vangangotanga kushaikwa kweurouropsychological pane vana vane mwero wakaderera wemutobvu, Uye vangangonzi varombo nevadzidzisi munzvimbo dzakadai sekuvhiringidza, hunyanzvi hwesangano, kumhanyisa uye humwe hunhu. Makore gumi gare gare, vana vaiva muboka rine mazinga akakwirira edentin lead vaiva neka5,8 mukana wokuva nedyslexia uye ka7.4 mukana wokurega chikoro kupfuura vana vari muboka rine mwero wakaderera womutobvu.
Reshiyo yekuderera kwekuziva kuwedzera mutobvu yaive yakakura muvana vane mwero wakaderera wemutobvu. Mukuongorora kwakabatanidzwa kwevanomwe vanotarisirwa kubatanidzwa, kuwedzera kweropa rinotungamirira mazinga kubva ku10 μg/L kusvika 300 μg/L kwakabatanidzwa ne9-point kuderera muIQ yevana, asi kuderera kukuru (kuderera kwe6-point) kwakaitika apo mazinga ekutungamira kweropa akatanga kuwedzera ne100 μg/L. Dose-response curves yaive yakafanana nekudzikira kwekuziva kwakabatana neyakayerwa lead level mubhonzo uye plasma.
Kuratidzwa kwemutungamiri chinhu chengozi yekusagadzikana kwehunhu senge ADHD. Muongororo yeUS inomiririra nyika yevana vane makore 8 kusvika ku15, vana vane mwero weropa wemutobvu wakakura kudarika 13 μg/L vaive nemukana wakapetwa kaviri wekuve neADHD pane avo vane mazinga emutobvu weropa mune yakaderera quintile. Muvana ava, angangoita 1 mu5 zviitiko zveADHD zvinogona kuverengerwa kune kutungamira kuratidzwa.
Kuratidzwa kwekutungamira kwehudiki chinhu chengozi yehunhu hwekusashamwaridzana, kusanganisira maitiro ane chekuita nekusagadzikana kwehunhu, hutsotsi, uye hunhu hwematsotsi. Mune meta-ongororo yezvidzidzo gumi nematanhatu, mazinga ekutungamira eropa akakwira aigara achibatanidzwa nekusazvibata kwevana. Mune zvidzidzo zviviri zvinotarisirwa zveboka, hutungamiri hwepamusoro hweropa kana kuti dentin lead muhudiki hwakabatana nehuwandu hwehutsotsi uye kusungwa mukukura kwechidiki.
Kuratidzwa kwemutobvu wepamusoro muhuduku kwaibatanidzwa nekuderedzwa kwehuropi hwehuropi (zvichida nekuda kwekuderedzwa kweukuru hwemauron uye dendrite branching), uye kuderedzwa kwehuropi hwacho hwakaramba huchikura. Muchidzidzo chaisanganisira vanhu vakuru, ropa repamusoro kana bhonzo rekutungamira mazinga angangove akabatana nekukasira kuderera kwekuziva, kunyanya kune avo vakatakura APOE4 allele. Kuratidzwa kwehutungamiri hwehuduku hudiki hunogona kunge huri mungozi yekukudziridza kunonoka-kutanga kwechirwere cheAlzheimer, asi humbowo hahuna kujeka.
Nephropathy
Kuratidzwa kwemutobvu chinhu chine njodzi yekuvandudza chirwere cheitsvo chisingaperi. Iyo nephrotoxic mhedzisiro yemutobvu inoratidzwa mune intranuclear inosanganisirwa miviri yeproximal renal tubules, tubule interstitial fibrosis uye chisingaperi renal kutadza. Pakati peavo vakapinda muongororo yeNHANES pakati pe1999 na2006, vanhu vakuru vane mazinga emutobvu weropa pamusoro pe24 μg/L vaive ne56% mukana wekuve nekuderedzwa kweglomerular filtration rate (<60 mL/[min·1.73 m2]) pane avo vane ropa rinotungamira mazinga ari pasi pe11 μg/L. Muchidzidzo chinotarisirwa cheboka, vanhu vane mazinga emutobvu weropa ari pamusoro pe33 μg/L vaive ne49 muzana yengozi yekuva nechirwere cheitsvo chisingaperi pane avo vane mwero wakaderera weropa.
Chirwere chemwoyo
Lead induced cellular shanduko hunhu hwekukwira kweropa uye atherosclerosis. Muzvidzidzo zvemurabhoritari, mazinga akaderera emutobvu anowedzera kushushikana kweoxidative, kuderedza mazinga ebioactive nitric oxide, uye kukonzeresa vasoconstriction nekuita kuti protein kinase C ishande, zvichiita kuti BP irambe iripo. Mutobvu kuratidzwa kunokanganisa nitric oxide, kunowedzera hydrogen peroxide kuumbwa, inhibits endothelial kugadziriswa, kunokanganisa angiogenesis, kunokurudzira thrombosis, uye kunotungamirira kune atherosclerosis (Mufananidzo 2).
Ongororo ye in vitro yakaratidza kuti endothelial masero akasimwa munzvimbo ine lead yakawandisa ye0.14 kusvika 8.2 μg/L kwemaawa 72 yakakonzera kukuvara kwesero membrane (misodzi diki kana perforations inocherechedzwa nekuongorora electron microscopy). Ichi chidzidzo chinopa humbowo hwekupedzisira hwekuti mutobvu uchangobva kunyudzwa kana mutobvu uchipindazve muropa kubva mubhonzo unogona kukonzera kusashanda kwe endothelial, inova shanduko yepakutanga inooneka munhoroondo yechisikigo yeatherosclerotic maronda. Mukuongororwa kwechikamu chemumiriri wemumiriri wevakuru vane avhareji yeropa inotungamira ye27 μg/L uye pasina nhoroondo yechirwere chemoyo, kutungamirira kweropa kwakawedzera ne10%.
Pa μg, the odd reshiyo yeyakakomba coronary artery calcification (kureva, Agatston mamakisi> 400 ine zvibodzwa zve0[0 zvichiratidza kusaverengerwa] uye zvibodzwa zvepamusoro zvichiratidza yakakura calcification renji) yaive 1.24 (95% nguva yekuvimba 1.01 kusvika 1.53).
Kuratidzwa kwemutobvu chinhu chikuru chenjodzi yerufu kubva kuchirwere chemoyo. Pakati pa1988 na1994, vakuru veAmerica 14 000 vakatora chikamu muongororo yeNHANES uye vakateverwa kwemakore 19, avo 4,422 vakafa. Mumwe muvanhu vashanu vanofa nehosha yemwoyo. Mushure mekugadzirisa kune zvimwe zvinokonzera njodzi, kuwedzera kwehuwandu hwehutungamiri hweropa kubva ku10th percentile kusvika ku90th percentile yakabatanidzwa nekupetwa kwekaviri kwengozi yekufa kubva kuhosha yemwoyo. Ngozi yehutano hwemwoyo uye chirwere chemoyo rufu chinokwira zvakanyanya kana nhanho dzekutungamira dziri pasi pe50 μg / L, pasina chikumbaridzo chakajeka (Mifananidzo 3B uye 3C). Vatsvakurudzi vanodavira kuti chikamu chimwe muzvina chemirioni chinofa nguva isati yakwana yemwoyo netsinga gore rimwe nerimwe imhaka yechepfu yomutobvu isingaperi. Pane ivava, 185 000 vakafa nehosha yemwoyo.
Kuratidzirwa kwomutobvu kungava chimwe chezvikonzero nei rufu rwechirwere chemwoyo rwakatanga kukwira ndokuzodonha muzana ramakore rapfuura. MuUnited States, mwero worufu rwehosha yemwoyo yakakwira zvakakomba muhafu yokutanga yezana ramakore rechi20, ichikwira zvikuru muna 1968, uye ipapo ichiderera zvishoma nezvishoma. Ikozvino yave 70 muzana pazasi kwayo 1968 peak. Kutungamira kuratidzwa peturu inotungamirwa yakabatana nekuderera kwekufa kubva kuchirwere chemoyo checoronary (Mufananidzo 4). Pakati peavo vakapinda muongororo yeNHANES, iyo yakateverwa kusvika kumakore masere pakati pe1988-1994 na1999-2004, 25% yekuderedzwa kwese kwechiitiko chechirwere chemoyo chaive nekuda kwekuderedzwa kweropa rekutungamira.
Mumakore apakuvamba okubvisa peturu ine mutobvu, kuwanda kweBP muUnited States kwakaderera zvikuru. Pakati pa1976 na1980, 32 muzana yevakuru vokuAmerica vaiva neBP. Muna 1988-1992, chikamu chaingova 20%. Izvo zvinowanzoitika (kusvuta, mishonga yeropa, kufutisa, uye hukuru hukuru hwecuff inoshandiswa kuyera BP muvanhu vakafutisa) hazvitsananguri kudonha kweBP. Nekudaro, iyo yepakati ropa lead level muUnited States yakadzikira kubva ku130 μg/L muna 1976 kusvika 30 μg/L muna 1994, zvichiratidza kuti kuderera kwemutobvu kuratidzwa ndicho chimwe chikonzero chekudonha kweropa. MuChidzidzo Chakasimba CheMhuri Yemhuri, iyo yaisanganisira American Indian cohort, kutungamirira kweropa kwakaderera ne ≥9 μg / L uye systolic blood pressure yakaderera neavhareji ye7.1 mm Hg (yakagadziriswa kukosha).
Mibvunzo yakawanda inoramba isina kupindurwa pamusoro pemigumisiro yekuratidzwa kwemutobvu pahosha yemwoyo. Nguva yekuratidzwa inodiwa kukonzera hypertension kana chirwere chemoyo hainyatsonzwisiswi, asi kwenguva yakareba kuwedzera kuratidzwa kwekutungamira kwakayerwa mubhonzo kunoratidzika kunge kune simba rekufungidzira rakasimba kupfuura kuratidzwa kwenguva pfupi kuyerwa muropa. Zvisinei, kuderedza kuratidzirwa kwomutobvu kunoratidzika kuva kunoderedza BP uye ngozi yokufa nehosha yemwoyo mukati megore rimwe kusvikira ku2. Kwapera gore mushure mekurambidza mafuta anotungamira kubva mujaho reNASCAR, nharaunda dziri pedyo nenjanji dzakave nemazinga akaderera ekufa kwechirwere chemoyo kana zvichienzaniswa nenharaunda dzakawanda. Chekupedzisira, pane kudikanwa kwekudzidza kwenguva yakareba mhedzisiro yemoyo muvanhu vakafumurwa kumazinga emutobvu ari pasi pe10 μg/L.
Kuderedza kuratidzirwa kune mamwe makemikari ane chepfu kwakakonzerawo kuderera kwechirwere chemwoyo. Kubvisa peturu inotungamirwa kubva muna 1980 kusvika muna 2000 kwakaderedza zvinhu mumaguta makumi mashanu nerimwe, zvichikonzera kuwedzera kwegumi neshanu muzana mukurarama. Vanhu vashoma vari kusvuta. Muna 1970, inenge 37 muzana yavakuru vokuAmerica vaisvuta; Pakasvika 1990, 25 muzana bedzi yavaAmerica vaisvuta. Vanosvuta vane mwero wemutobvu weropa wakakwira zvakanyanya pane vasiri kuputa. Zvakaoma kuseka nhoroondo uye zvazvino zvinokonzeresa kusvibiswa kwemhepo, utsi hwefodya uye kutungamira pachirwere chemoyo.
Chirwere checoronary heart ndicho chikonzero chikuru chekufa pasi rose. Ongororo dzinopfuura gumi nembiri dzakaratidza kuti kuratidzirwa kwemutobvu chinhu chikuru uye chinowanzofuratirwa chengozi yerufu kubva kuhosha yemwoyo. Mune meta-analysis, Chowdhury et al vakawana kuti kukwirira kweropa kutungamirira mazinga chinhu chakakosha chengozi yechirwere chemoyo. Muzvidzidzo zvisere zvinotarisirwa (nehuwandu hwevatori vechikamu 91,779), vanhu vane huwandu hwemutobvu weropa muchikamu chepamusoro-soro vaive ne85% yenjodzi yepamusoro yekutadza kuuraya myocardial infarction, kuvhiyiwa kwebypass, kana kufa nehosha yemoyo pane avo vari pasi-pasi quintile. Muna 2013, iyo Environmental Protection Agency (EPA)
The Protection Agency yakagumisa kuti kutungamirira kuratidzwa kune ngozi kune chirwere chemwoyo; Makore gumi gare gare, American Heart Association yakatsigira mhedziso iyoyo.
Nguva yekutumira: Nov-02-2024