摘要：How living near environmental hazards contributes to poorer health and disproportionate health outcomes is an ongoing concern. We conducted a substantive review and critique of the literature regarding residential proximity to environmental hazards and adverse pregnancy outcomes, childhood cancer, cardiovascular and respiratory illnesses, end-stage renal disease, and diabetes. Several studies have found that living near hazardous wastes sites, industrial sites, cropland with pesticide applications, highly trafficked roads, nuclear power plants, and gas stations or repair shops is related to an increased risk of adverse health outcomes. Government agencies should consider these findings in establishing rules and permitting and enforcement procedures to reduce pollution from environmentally burdensome facilities and land uses. Concerns about health and environmental hazards transcend the academic, scientific, and regulatory worlds; they are also of compelling interest to the public, who often recognizes a relationship between environmental hazards and health. In a 1999 national telephone survey among US voters, 1 74% of respondents thought that environmental factors had an important impact on childhood cancer, and 73% thought these factors had an impact on birth defects. More than 50% of respondents felt that air pollution, contaminated drinking water, and toxic waste had a great deal of impact on a person's health. These concerns often resulted in public perceptions of disease clusters near hazardous waste sites, industrial facilities, and other potential sources of chemical releases. With the advent of geographic information systems, environmental scientists and public health researchers have been able to address these concerns more comprehensively and objectively with the use of various proximity analyses. We undertook a systematic review of 94 studies that examined residential proximity to environmental hazards in relation to adverse reproductive outcomes, childhood cancer, respiratory and cardiovascular conditions, or other adverse health outcomes. In our review, unlike in previously published reviews, we focused on a wide range of health outcomes in relation to residential proximity to multiple environmental hazards and identified each study's limitations. If the evidence indicates that residential proximity is associated with poorer health outcomes, regulatory agencies may need to factor in nearby populations when siting industrial facilities, municipal waste sites, incinerators, and other potential sources of emissions.
