CHNG 13: CC KHA CNH A CHT CA SC KHE MI TRNG (THE HEALTH) 13.

1 Gii thiu v sc khe mi trng Nh mt phn t ca cng ng sinh vt, loi ngi to nn mi trng sng trong sinh quyn mt mi trng sng thuc cao hn vo mi quan h phc tp (phc h) gia sinh quyn, kh quyn, thy quyn v thch quyn. Nhng chng ta ch mi bt u tm hiu v thu nhn mt s hiu bit c bn v tng th phm vi ca cc nhn t mi trng lm nh hng n sc khe v an sinh ca chng ta. Khi chng ta tip tc nghin cu v chu trnh a cht t 1 lng nh cc thnh phn trong t, v nc n cc m hnh vng kh hu, a cht v a th - chng ta ang thc hin nhng khm ph quan trng v cch m cc nhn t ny c th nh hng n t l t vong v t l mc phi bnh tt no . Ch ring M, t l ngi cht bin thin ng k t vng ny n vng khc, v mt s thay i l kt qu ca mi trng a phng, vt l, sinh hc v ha hc ni m chng ta sng. Bnh tt c miu t nh l mt s thiu cn bng do s iu chnh km gia mt c th v mi trng. Bnh tt t khi ch c 1 nguyn nhn. ng gp ca nh a cht cho ta hiu bit v cc nguyn nhn gy ra bnh nhm gip m rng cc kha cnh ca a cht mi trng c th nh hng n phm vi tc ng ca bnh tt. Cng vic phc tp ny cn phi c k thut vng chc kt hp vi nhiu ngnh nghin cu cng vi cc GEOLOGIC ASPECTS OF ENVIRONMENTAL

bc s v cc nh khoa hc khc. Mc d s vic by gi kh m h, kh nng mang li ca lnh vc nng lng ca a cht y hc ang c kch thch v c th cui cng mang li mt vai tr quan trng trong sc khe mi trng. nghin cu cc kha cnh a cht ca sc khe mi trng, cng cn phi xem xt cc yu t vn ha v kh hu kt hp vi cc s t l mc bnh v t vong. a. Bnh tt lan truyn trong mi trng (Environmentally

Transmitted Infectious Diseases) Mi trng ly truyn bnh, lan truyn t s tng tc gia cc c th vi thc n, ngun nc, khng kh hoc t, l 1 trong nhng vn sc khe c nht m loi ngi phi i mt. Cc bnh c th c iu chnh bng cch kim sot mi trng, nh l ci thin h thng v sinh v x l nc, c phn loi nh cc vn sc khe mi trng lin quan. Mc d c lin quan ln n cc c t v cc cht gy ung th m chng ta ang to ra trong x hi cng nghip ngy nay, bnh truyn nhim ang c pht trong mi trng to nn t l t vong ln nhng t nc ang pht trin. M tnh ly nhim trong mi trng truyn bnh d nhin khng c loi tr, v mi nm c hng ngn trng hp bnh ly truyn qua nc ung v ng c thc n. Chng c th truyn nhim bi: cn trng nh mui hoc b cht; tip xc lm h hng thc n, nc, hoc t; hoc pht tn qua h thng thng gi ca mt ta nh cao tng. Nhng v d c bit v truyn bnh trong mi trng bao gm bnh vim phi do vi khun, nhim trng rut (tiu chy kinh nin), nhim

khun salmonella (nhim c thc n), st rt, dch, st xut huyt, nhim khun do ve, v bnh truyn nhim (ly lan gia ngi v gia sc). b. Nhn t vn ha (Cultural Factors) Kha cnh vn ha ca mt x hi phn nh ton b nhng nhn thc v k thut m con ngi trong x hi pht trin tip tc tn ti trong mi trng ca h. Nhng kha cnh ny bao gm nhng s xut hin ca bnh tt bng cch to ra cc mt xch hoc ro cn gia con ngi vi nguyn nhn gy ra bnh . Bn cht v mc ca cc mt xch ph thuc vo cc nhn t nh phong tc a phng v mc cng nghip ha. Nhng ngi nng thn tip xc trc tip vi nc v t d ny sinh cc vn v sc khe hn l th. X hi cng nghip gn nh loi tr cc bnh tt nh dch t, thng hn, giun mc v kit l, nhng d mc cc bnh nh ung th phi v nhng bnh khc c lin quan n nhim khng kh, t v nc. Mt v d v mi lin h gia vn ha v bnh tt, xem xt v thi quen xy dng gn y M. Chng ta thng xy nh trn nhng tm ximng, loi vt liu c th gia tng cc t gy, v cch ly cc ngi nh xp cht ch bo ton nng lng. Nhng thi quen ny lm cho cc ngi nh d b nh hng hn bi nhim khng kh bn ngoi, nh kh radon, l con ng dn n ung th phi. Mt v d khc l v ung th d dy vi t l cao Nht. Ngi Nht thch n cm dng bt; chng may, trong bt li cha khong a-mi-ang nh l 1 tp cht. A-mi-ang, mt loi khong dng si, cng l cht gy ung th hoc ng vai tr th ng nh l 1 cht mang lng nh kim loi gy ung th.

Phm vi nh hng ca c t ch cng gi n mt nn vn ha, chnh tr, v kinh t lm nh hng n cc kiu bnh tt. nh hng ca c t ch c th bao gm bnh thiu mu, chm pht trin tr tu, v chng t lit. Ch c tm ra trong mt s ru whiskey lu v a n kt qu l c t ch nm trong ngi ln v thm ch l tr cha sinh ra, hoc tr s sinh ang iu dng m nhng ngi m ung n. Mt vi nh nghin cu a ra gi thuyt rng c t ch lan rng l mt trong s cc l do gy ra s sp ca ch La M. c tnh rng ngi La M sn xut khong 55 tn ch mi nm trong 400 nm. Ch c dng lm bnh ng si-r t nc p nho, lm ly cho ngi La M ung ru vang, v c trong m phm v dc phm. Giai cp thng tr cng s dng ng dn nc vo nh l nhng ng ch. Cc s gia bin lun rng dn dn c t ch c trong giai cp t sn dn n kt cuc sau cng ca h l lan rng nhng ci cht yu, nhng d dng, v ph hy no. Hm lng ch cao c pht hin trong hi ct ca ngi La M c i thm phn ng h gi thuyt ny. ng h hn na n t mt nghin cu v li bng sng bng Greenland , nhng li ny ch ra rng trong thi k t 500 nm trc Cng nguyn n 300 nm sau Cng nguyn, ch tp trung trong bng cao hn 4 ln bnh thng. iu ny gi ra rng s khai thc v lm tan chy kim loi ch trong thi gian m ch La M gy ra nhim khng kh bn cu Bc. Vic loi tr ch trong xng v sn, ch phng x thnh cng M. Tuy nhin, c t ch tr em vn l 1 vn tim nng nghim trng trong nhng khu ph c bi v tr em tip xc vi ch tch tr trong t v sn ca cc ta nh c. c. Yu t kh hu (Climatic Factors)

Cc yu t kh hu nh nhit , m v lng ma i lc lin quan mt thit ti cc loi bnh. Hai trong s cc bnh lin quan n kh hu ti t nht, bnh sn mng (schistosomiasis/snail fever) v bnh st rt (malaria), c tm thy cc vng nhit i. Cc bnh ny c lin quan n kh hu bi v cc sinh vt truyn bnh nh c sn v mui pht trin theo iu kin kh hu tng ng. Bnh sn mng l nguyn nhn quan trng gy cht trong tr em v lm mt dn nng lng ca hng triu ngi trn khp th gii. nh hng ca n gy ra hu qu kinh t nghim trng, v mt s nh nghin cu coi n nh l 1 cn bnh trm trng nht ca th gii. Gi s c mi tng quan gia nn vn ha hoc kh hu vi cc dch bnh phi c quan st cn thn vi mt s nghi ng bi v him khi c mt cu tr li n gin cho sc khe mi trng. V d, nu bnh sn mng ch b chi phi bi yu t kh hu, th tt c cc vng m c kh hu tng ng, nh l lu vc sng Amazon chng hn th cng c th c dch bnh. Nhng khng phi trng hp no cng ng, v trong mt s trng hp th nguyn nhn l do a cht. iu kin lu vc Amazon th gn nh l tt nht pht trin bnh, nhng n ch xy ra trong 2 vng rt hn ch, trc ht l bi v khng c Canxi trong nc hu ht cc vng cho sn mng k sinh trn c sn. Mt s vng lu vc sng Amazon, tnh acid trong nc c s hin din ca ng (Cu) v cc kim loi nng khc c th l nguyn nhn gy ra s vng mt ca c sn trong mt mi trng ph hp khc cho bnh sn mng. T phn gii thiu v sc khe mi trng ny, chng ta c th nhn ra c mt s tng quan phc tp gia cc kiu bnh v mi trng.

By gi chng ta s tp trung vo kha cnh a cht ca sc khe mi trng. Trong chng ny chng ta s xem xt c th cc nhn t a cht quan trng i vi sc khe, nh hng ca yu t vi lng n sc khe, v s quan trng ca a cht mi trng i vi bnh tim v bnh ung th, l nguyn nhn chnh gy t vong M. Chng c kt thc bng vic bn v s phng x v kh radon, bao gm cc nhn t a cht phc tp v tim nng e da nghim trng i vi sc khe con ngi. 13.2 Mt vi nhn t a cht ca sc khe mi trng: a. S phong ph ca cc nguyn t: Tn ti mi quan h t l nghch gia s lng nguyn t ca mt nguyn t v s phong ph ca n: nguyn t cng nh th c thng gp nhiu hn so vi cc nguyn t nng hn. Cc nguyn t ch yu trong ca v lc a.
Atomic No. 8 14 13 26 20 11 12 19 Total Element O Si Al Fe Ca Na Oxygen Silicon Aluminum Iron Calcium Natrium Weight (%) 46.40 28.15 8.23 5.63 4.15 2.36 2.33 2.09 99.34

Mg Magiesium K Potassium

Cc nguyn t ch yu trong c th sng

Atomic No. 8 6 1 7 20 15 16 19 11 17 12 Total Element O Oxygen C Carbon H Hydrogen N Nitrogen Ca Calcium P Phosphorus S Sulfur K Potassium Na Sodium Cl Chlorine Mg Magnesium Weight (%) 65.00 18.00 10.00 3.00 1.50 1.00 0.25 0.20 0.15 0.15 0.05 99.30

Mt s nguyn t nh Ni, As, Al v Ba tch ly li trong m theo giai on nn c xem l cc nguyn t tui tc (age elements) b. S tp trung v phn tn ca cc cht: b.1 Chu trnh sinh a ha: Cc nguyn t v hp cht di chuyn theo cc con ng khc nhau trong thch quyn, thy quyn, kh quyn v sinh quyn to thnh chu trnh sinh a ha. Cc qu trnh t nhin nh gii phng kh t hot ng ni la hoc s phong ha gc v vn gii phng ra cc vt cht ha hc vo mi trng. Thng thng nng ca cc nguyn t vi lng

tng ln khi chuyn t sang t, t nc vo thc vt v vo trong c th ng vt. Cc nguyn t c gii phng ra bi cc qu trnh t nhin hoc nhn to v cc nguyn t khc tham gia vo cc chu trnh tun hon v c ti ch li bi cc qu trnh sinh a ha v qu trnh thnh to . Cc qu trnh ny c th lm thay i mc tp trung ca cc nguyn t hoc hp cht v th nng ca chng c s khc bit gia ha thnh ( hnh thnh t ni la) v trm tch (c hnh thnh t cc sn phm ca s phong ha ha thnh). Nng ca cc nguyn t hay hp cht ny tng ln hay gim i ph thuc vo cc qu trnh sinh a ha v qu trnh thnh to . Mc d nhng thng tin ny khng chi tit cho lm nhng n vn hu ch bi v n ch ra s s thay i c lin quan n s phong ph ca cc nguyn t c sinh ra bi cc qu trnh thnh to v cc qu trnh sinh hc. V d: Se tng ln gp 10 ln t qu trnh phong ha ha thnh thnh phin st. Ngoi than v khong phosphorite ( giu canxi phosphat), nhng loi trm tch khc cng c s tng nng tng t nh Se. Cc v d cho thy cc qu trnh thnh to v qu trnh sinh a ha nh phong ha, ra la, bi t v lng ng c nh hng nh n nng v s phn tn ca cc nguyn t v cc vt cht khc thng qua mi trng. Cc qu trnh nhn to c nh hng n nng ca cc ha cht v khi cc hot ng ny tng ln cng gy ra cc vn nhim tim n ( xem: Nitrogen and people). A CLOSER LOOK: Nitrogen and People Ci nhn thit thc: Nit v Con ngi

S pht trin kinh khng ca dn s trn Tri t t khong 2 t ngi t nhng nm 1950 n mt mc vt tri l 6 t ngi vo nm 2000 l thnh qu to ln ca dc phm v cc h thng bo v sc khe vi nn nng nghip tp trung cung cp ngun thc phm cho 6 t ngi. Vic sn xut phn bn nit nhn to vi quy m ln trong cng giai on t nhng nm 1950 n cui th k XX cho thy s tng ln trong tiu th cc phn bn t 10 triu tn ln gn 80 triu tn mi nm. Trong thi k , t l pht trin dn s trung bnh khong 2% mi nm trong khi tiu th phn bn nit t t l pht trin gn 5% mi nm. N gi ln rng s pht trin kinh khng ca vic s dng phn bn nit m u mt s bao trm ngoi mun vic th nghim a ha vi nhng ri ro tim tng v hu qu ca mi trng. iu ny xy ra l do ng dng qu mc phn bn nit gy ra cc vn mi trng nghim trng i vi x hi ngy nay, bao gm: nhim nc mt v nc ngm c vng th v nng thn (chng 11). mt s vng c kh nng lng ng cc hp cht nit t khng kh vo trong t m vn thm phn bn vo th khng cn cn thit na. Tuy nhin, vic ny tt nhin khng phi l mt p dng c k hoch, v lng nit qu mc c th gy ra nhng vn mi trng khng ng c. Thc t, nhng vn mi trng lin quan n phn bn nit nhn to khng c lng trc khi chng ta bt u sn xut quy m ln vo gia th k XX. iu ny nhn mnh nguyn l thng nht mi trng (principle of environmental unity) bn khng th lm 1 vic g khi m mi vic u c nh hng n nhng vic khc. Mt vn chnh cn li l: s nhim ca Tri t th ang tng ln gp i trong th k ti, c l vo khong nm 2040. Vn lng thc cho 6 t ngi s i hi s thay i to ln theo cch hoc l

tng lng lng thc, hoc thay i cch s dng. Mc d chng ta thnh cng trong vic hn ch s pht trin dn s trong 1 vi thp k ti, nhng chng ta vn c thm t nht vi t ngi cn lng thc, iu ny i hi s gia tng ng k lng phn nit gia tng nng sut ma v. iu ny gy thm nhim cho nc mt v nc ngm trong nhng vng nng nghip chnh, dn n 1 s gia tng v cc bnh tt c gy ra bi s nhim nit v cc cht c hi. iu ny c th c trnh nh th no? K hoch tm nng lm gim s gia tng trong vic s dng phn bn nit bao gm: Thay i thi quen n ung ca con ngi bng cch

chuyn sang ch n nhiu rau, iu ny s lm gim 1 lng ng k t ai cn thit cung cp thc n cho con ngi bi v trung bnh c khong 3 n 4 n v protein t cy trng th to ra 1 n v protein t tht. Tuy nhin, chng ta c th n gin ha vic s dng t chn nui gia sc trng cy. iu ny l bi v t chn nui, thng l nhng vng c dc ln v lp t mng vi lng ma c hn v tm nng xi mn cao, khng th cung cp c sn lng ma v. Pht trin cc phng php bn phn c hiu qu cho cy

trng hn ch lng d tha. iu ny l s thay th y ha hn nht cho chuyn mn ha nng nghip. Tm li, s gia tng song song gia dn s vi vic s dng phn bn cho thy rng cc hot ng nng nghip chuyn mn ha th lm gia tng s lng con ngi trn Tri t. C v nh chng ta pht trin thi quen s dng v s ph thuc vo ha cht nh nit tng hp cung

cp thc n cho con ngi trn Tri t. Bi v cc vn mi trng c lin quan n vic s dng 1 lng ln nit v nng lng m cn cho vic sn xut (du khng cn nhiu th k XXI so vi th k XX, chng XV). C l chng ta phi u tin cho vic lm gim bt s ph thuc vo cc ha cht ny. iu ny chng t rng rt kh khn nhng hy vng c th thc hin c nhim v ny. b.2 S phong ha (weathering): Phong ha l ph trnh ph hy v mt vt l v ha ca v l qu trnh chnh trong s hnh thnh . Vt liu gc cho t l m hoc vn c vn chuyn v lng ng bi nc, gi hoc bng. S phong ha l mt qu trnh t nhin m gii phng cc nguyn t vi lng c s dng trong cc qua trnh ca s sng. Tc ng nhn to vo qu trnh phong ha l s nhim. V d : Ch c gii phng vo khng kh. Ch c cho vo trong nhin liu v c thi ra qua h thng ng x kh. Thy ngn, Cadimi, Nikel, km v cc kim loi khc cng c thi vo bu kh quyn thng qua cc hot ng cng nghip v khai m. Vic lm gim thiu s nhim ch thnh cng. Ch khng cn c s dng trong nhin liu M v cc nc khc trn th gii. Kt qu l nng ch gim mt cch nhanh chng, hn 90%. iu ny c nh hng n sc khe ca hng triu ngi m chu nh hng khi ch c thi ra t vic t chy nhin liu c cha ch trong xe c. b.3 Ra la (leaching):

Ra la, lng ng, bi t, hot dng sinh hc v cc qu trnh khc c nh hng n mc tp trung hoc phn tn cc nguyn t sau khi chng c gii phng ra t cc qu trnh t nhin v nhn to. Qu trnh ra la ca l s di chuyn t nhin ca vt cht ha tan (trong dung dch) t cc tng t pha trn xung cc tng t pha di. Vt cht ra tri khi t c th i vo h thng nc ngm v c phn tn hoc pha long. Nu cc vt cht c qu nhiu, hoc c tnh c hay c th gy hi th c th gy nhim nc ngm. Ra la thng bt gp vng c kh hu m, m; nhng ni t ngho dinh dng bi v cc cht dinh dng b chuyn vn i ni khc. Hn na cc nguyn t vi lng cn li trong t c th tp trung mc thp hn mong i. b.4 Tch t (accumulation): Thut ng tch t c lin quan n cc qu trnh lm tng s gi li ca cc vt cht trong t. V d: mui c th tch t trn b mt t thng qua bc hi ca cc cht trong t; cc cht ny theo qu trnh ra la di chuyn gia cc tng t ri tch t li tng B. V d: vng bn kh hn CaCO3 tch t trong tng B ca mt vi loi t. b.5 S lng ng (deposition): S lng ng ca vt liu tri t lm gia tng 2 vn quan trng v mi trng: + Mt l: cc kim lai nng v mt vi vt cht khc gy ra s ph v sinh hc khi chng lng ng trong sui, h, i dng. V d: thy ngn c th lng ng vo cc trm tch l lng v trm tch y dn n nng c cao hn ca thy ngn trong mi trng nc. iu ny c

th gy ra s ph v cu trc sinh hc (biological disruption) , bi v cc thc vt bm vo trm tch v ng vt n cc trm tch s tch ly li thy ngn, thng qua chui thc n nng thy ngn tch ly li cng ngy cng cao. Qua trnh ny c gi l biomagnification-s phng i sinh hc v c th dn n cc cht nhim nh thy ngn b ra la gy ra cc vn v sc khe cho con ngi v nhng ng vt khc m n c. + Hai l: s thiu ht cc nguyn t vi lng cn thit mt s vng v cc nguyn t ny khng c lng ng vo cc trm tch m b mang i bi gi, nc v bng. Vn th 2 ny t c bit hn l vn 1, bi v n c lin quan n s tng tc ca nhiu qu trnh khc nhau nh ra la vi s lng ng. S xi mn v lng ng bi gi l s vn chuyn c chn lc. c cho l nguyn nhn gy ra s thiu ht ca cc nguyn t nh Ch, St, ng, cobalt v nhng vt liu khc i ct ca Nebraska. Cc kim loi ny nm trong cc ht nh v khi lng ln hn so vi cc ht thch anh nn khng th b gi mang i to nn i. 13.3 Nguyn t vi lng v sc khe: Mi mt nguyn t c mt ph rng cc nh hng i vi c th thc vt hay ng vt c th. V d, Se l cht c i vi vng c cha nhiu Se, nhng khng c s nh hng no d dng nhn ra hu ht cc khu vc, v n cn l cht c li thc y chn nui ng vt mt s vng. a. iu ph thuc v effective dose) liu hiu dng (dose dependency and

Cch y nhiu nm, ngi ta cng nhn rng tc dng ca cc nguyn t vi lng cc loi sinh vt c th ph thuc vo liu hay nng ca nguyn t. S ph thuc vo liu ny c biu th bng ng cong liu phn ng, c trnh by 13.2a. khi mt nguyn t c nng khc nhau c biu din trong h thng sinh hc c v i vi s tc ng trn sinh vt, c 3 im r rng. Th nht, mc d nng cao c th c, nguy him, hoc thm ch gy cht ngi (13. 2), nhng nhng nguyn t vi lng ny c th c li hay c th ni l vn cn thit cho cuc sng. Th 2, ng cong liu phn ng B-C, l khong nng c li nht cho sinh vt. Th 3, c 2 ngng nng m ti bt u tc dng c hi cho cuc sng sinh vt. l im A v D, nng di A v trn D gy hi. Cc im A, B, C, D, E v F 13.2a l nhng ngng nng quan trng. Tuy nhin E l 2 im ng ng ch c t c dng cho mt s t c c lo i (chng tc ng n con ngi v mt s cc loi khc), v im tht s quan trng ch nh l vi tt c c c lo i nhng khng r. Gi tr c c im c li ti a cho sinh vt ph thuc v o s c n b ng sinh l ri ng ca t ng lo i ng vt. Nhng im khc, ty theo nhng hot ng ca cc giai on khc nhau, m c th c li hay hi, c th khc nhau rt nhiu c v s lng v cht lng i vi cc cht khc nhau, v v vy ch quan st c trong mt iu kin c bit.

Hnh 13.2 a Thut ng c t ch v cc vt liu gy c cho con ngi v cho cc sinh vt sng khc. Ngnh nghin cu v cht c v nh hng ca chng n mi trng, cng nh v mt kinh t v phn lung hp php ca cht c i vi mi trng, gi l c cht hc (the study of toxins and their environmental effects, as well as economic and legal ramifications of toxins in the environment, is known as toxicology). c cht hc thng nghin cu v cch s dng khi nim liu hiu dng (ED) o lng s nh hng ca mt cht trong mt qun th ch khng phi mt sinh vt ring bit. Nh vy vic nghin cu to ra 3 ng th biu din liu phn ng biu din hnh 13.2, ph thuc vo cht c v nhng loi nghin cu. (liu c m 50 . TD-50 l n ng s c th ph n ng li, c triu chng c cht lethal dose-LD). LD-50 l liu m

bit v thm ch b cht. Nu cc c th u cht th liu hiu dng (ED) c gi l liu g 50% s c th b cht.

3 ng hnh 13.2b c th biu th s ngi pht ban tng ln 3 loi c t khc nhau. ng A l mt ng tuyn tnh a ra mt quan h trc tip gia liu c v trm s dn c biu hin , khi nng c cht tng ln gp i th s c th b cht cng tng gp i. ng B l ng phi tuyn tnh, c s gia tng nhanh nht s c th phn ng t 2575%. ng C cng l mt ng phi tuyn tnh biu din ngng tc ng (im T trn ng v). S tng nng trc im T khng c nh hng nhiu n c th, ch khi t ti ngng T v sau th phn trm s c th phn ng li tng ln.

b. C n b ng ngu n t vi lng Tc ng mt cn bng( qu ln hay qu nh) ca nguyn t vi lng tiu biu : F, I, n, v Se. Flo: F l mt nguyn t vi lng quan trng tn ti di dng hp cht florid hay florua. Hp cht calcium fluoride gip ngn nga su rng bng vic tng trng mt lng ln, hay tng tnh khng ca tinh th

apatit trong rng( calcium phosphate). Qu trnh tng t xy ra xng, ni Fluoride h tr trong s pht trin ca cu trc xng hon chnh hn m c kh nng b thoi ha ngi gi. F kh phong ph trong v trong mt s loi t v nc. Hu ht F trong t v nc c ngun gc t m, nhng n cng c to ra bi hng ni la. Hot ng cng nghip v s dng phn bn cng c. Lin quan gia nng Fluoride v ng cong liu ph n ng ca sc khe c ch ra 13.3. nng Florit tt nht ( im B) lm gim su rng khong 1 ppm. Mc flo cao hn 1.5ppm gim khng ng k t l su rng, nhng n lm tng s xut hin v mc nghim trng ca nhng vt m (s i mu ca rng). Nng khong 4- 6 ppm, flo c th gip ngn nga vi ha ca ng mch ch bng v c th lm gim t l long xng, mt cn bnh c trng bi s gim khi lng xng v thoi ha ct sng. im C nm trn ng cong liu phn ng 13.3 c xc nh t s nghin cu li ch ca F trong chng long xng. im E c xc nh t vic nghin cu nng Flo t 8- 20 ppm c lin quan n vic to ra qu nhiu lin kt trong mng xng (dy c, dng hnh si bn ngoi lp xng) v vi ho dy chng m thng thng khng ha vi. V tr cc im A,D v F c bit chnh xc, nhng Flo liu khi lng l thnh phn chnh ca mt vi loi ng vt gm nhm cht c. Iot: bnh v tuyn gip c th l mt v d ni ting nht v mi quan h gia a cht v bnh tt. Vi tuyn gip, c t v tr c ca c yu cu iod m bo cc chc nng bnh thng. S thiu ht I s gy bnh bu c, lin quan n s m rng tuyn gip. Hn na, a tr

c sinh t ngi m thiu iod s c th b n n, c trng bi s ci cc, suy dinh dng v c tnh trng b bnh tm thn. Mt giai on t l n n kh ph bin cc vng Mexico v switzland m c tie l bu c cao. T l bu c lin quan rt r rt vi s thiu ht I, c biu din bng mi quan h gia nhng vng thiu I v s xut hin bu c nc M. S dng mui iod ngy nay rt ph bin nga bnh bu c, v cng pht hin ra tt c cc thanh nin v ngi trng thnh b bnh bu c khi s dng mui iod cng gip gim dn kch c ca khi bu. Ch trong 4 nm( 1924- 1928), s dng mui iod Michigan lm gim t l bu c xung t 38.6- 38.9% . nhng ngi bu c tn ti mt phn ln trn th gii. V d, Sri Lanca, gn 10 triu ngi i k m, t l bnh tt cao khong 44% dn s. m, nguyn nhn chnh l s thiu ht iod, ngoi ra cn c yu t kh hu, bu c tht lng Sri Lanka trng vi mt vng kh hu m nn lm gim ngun iod s n c trong t nhin. T l ngi bu c cao hn so nhng vng xa xi c thu nhp thp. Mt chng trnh cung cp mui iod l cn thit lm gim t l bnh bu c.(18). C rt nhiu s nghin cu ng ch v nhng qu trnh lm tng

hoc thay i nng iod t cc vt liu b mt tri t. Gi thuyt ph bin nht c chp nhn th ni rng iod trong t c to ra t qu trnh phong ha . Mt phn ca ngun iod ny i vo sng v bin, lm cho i dng tr nn cha mt lng ln iod, cha khong 25% tng lng iod trn tri t. Tuy nhin, v hu ht hp cht ca iod tng i d ha tan, nn lng iod cn li khng nhiu trong sau mt qu trnh phong ha di. Mt hc thuyt khc ng tin cy hn l iod trong i

dng vo kh quyn di dng kh v ri xung cc vng t bi ma v tuyt. Km : l nguyn t cn thit cho thc vt, ng vt v con ngi. Km l nguyn t kim loi nng, nu tha mt lng ln s gy bnh, n c vai tr rt ln c bit n u tin t nghin cu v s thiu ht km. S thiu ht km hin ti 32 trng thi, l nguyn nhn dn n nhiu loi bnh ca cy, lm gim nng sut, cht lng ht ging v gy tn tht ma mng. S thiu ht km trong thc vt c lin quan ch yu lin quan n ba tnh trng t: lng km thp, km khng c gi tr trong t, qun l t k m. Km c cng nhn l cn thit i vi tt c cc loi ng vt v con ngi, c bit qua nhng trng thi u ca s pht trin v s sinh trng. Mc d ch yu cu mt lng rt nh, nhng s thiu ht km c th dn ti v sinh, chm lnh vt thng,nguyn nhn ri lon ca xng, khp v da. S thiu ht km trong c th con ngi c th lin quan n bnh ung th, bnh tai bin hay mt s bnh khc nhng ngi thm nin. Km l liu php cha tr, n c bit c tc dng hu hiu vi s hi phc cc t bo v hu ch trong iu tr mt s bnh mn tnh. B sung thm km vo t c th gip ngn chn chng chm pht trin ca cy trng, b sung km cn gip vt nui tng trng, chm sc phi c thc hin km theo vic b sung km. Tuy nhin khng c b sung km qu nhiu, qu nhiu cadmium (mt nguyn t c lien quan n km) c th pht tn ra mi trng. Cadmium c th gy ra cc vn lin quan vi bnh xng, bnh tim v ung th..

Selen: khi tp trung mc cao, selen c th l nguyn t c nht trong mi trng. N l mt v d tt gii thch l do ti sao s quan tm n sc sc khe con ngi ang ngy cng tng ln lin quan n vic kim sot nguyn t vi lng Selen ph thuc vo tng loi ng vt c th tp trung khong 0.04ppm, c li 0,1 ppm, v c hi mc trn 4ppm . Selen c quan tm trong lnh vc sinh hc bi v n rt c hi, mc d nhng thit hi ln trong chn nui hu ht l do thiu ht selen hn l nhim c selen. c ca selen mi y c pht hin San Joaquin Valley trong trung tm Clifornia, ni m n lm e da nn nng nghip ni y. Ngun ch yu sinh ra Selen l t hot ng ca ni la. N c nh gi thng qua lch s hnh thnh tri t, ni la gii phng ra khong 0.1 g selen cho mi cm2 b mt tri t. Selen pht ra t ni la dng ht, tp trung gn ming ni la. y l nhng li gii thch ti sao trung bnh mc tp trung ca selen trong ca v tri t l 0.05ppm, cn Hawaii , ni c nhiu ni la l 6-15ppm. Selen trong cc loi t khc nhau, nng t 0.1ppm trong nhng vng t b thiu ht selen v nhiu nht l 1200ppm nhng vng t b nhim c selen . C nhiu s lo ngi, tuy nhin, c mt lng ln selen tp trung trong thc vt. Vn nan gii l vic tm ra cc nghin cu v li ch ca selen. Trong t axit ( Hawaii) nguyn t selen khng ha tan c trong hp cht v khng th dng c cho thc vt, nhng ngc li trong t kim selen c th b oxi ha trong hn hp v c th ha tan nhiu trong nc v thc vt c th hp th. Trng cy cung cp thc n th cho ng vt

trong t c cha nhiu selen ha tan l rt c, trong khi trng trng trn t c cha selen khng ha tan li gy thiu ht selen. Selen c xu hng tp trung cc c th sng. Mt vi thc vt c gi l loi tch ly nhiu selen, c th tch ly ti 2000ppm selen, trong khi cc loi khc trong cng mt khu vc li ch c th tch ly t hn 10 ppm tng selen. Mc selen trong mu ngi t 0.1-0.34 ppm. N th gp 1000 ln trong nc sng v vi ngn ln trong nc bin. Mt khc c bin tch ly Selen khong 2 ppm, gp nhiu nghn ln so vi trong nc bin. Bi v selen tch t trong cht hu c, n c th c tp trung lp trm tch hu c v t. Do , nhin liu ha thch nh than , c pht trin t vt liu hu c, cng cha selen. c tnh lng Selen c sinh ra t hot ng t chy than v du nc M l khong 4000 tn. Chng ra t c bit v nh hng ca s thiu ht selen v c tnh gy ra bi Selen ngi. Tuy nhin, selen c bit n l c lin quan n chng lon dng c b v cu, v mt nghin cu kt lun rng cng c th l mt yu t gy bnh ny con ngi. Mt vi trng hp ng c selen c cnh bo do thc phm trng t c nhiu khong cha selen hoc nhng ngi ung nc c khong cha nhiu selen cc nc km pht trin. cc nc kinh t pht trin, ni m thc phm c kim nh tiu chun, ng c Selen c th ch l vn nh.. c. Vic s dng ca con ngi v s mt cn b ng nguyn t vi lng:

Nng nghip, cng nghip v hot ng khai thc khong sn l nguyn nhn pht tn cc vt liu c kh nng nguy him v c hi ra mi trng. S mo him ny li ci gi m chng ta phi tr cho li sng ca mnh. V d nh nhng vn pht sinh bt ng t vic chng ta s dng ha cht kim sot su hi v bnh tt. Tr tru thay, chng ta dnh nhiu thi gian, nng lng, v tin bc bn rt cc ngun nguyn liu ca cc chu k a cht, nhng khi lm nh vy chng ta tp trung pht tn s lng ln cc nguyn t vi lng c hi vo mi trng. Mt s kin lch s minh ha cho iu ny l s xut hin ca mt bnh xng nghim trng lin quan n khai thc m km, ch v cadmium Nht. Mt cn bnh mn tnh nghim trng c gi l itai-itai( tc "au au" trong ting nht Ngoi tn thng thn, ngi bnh cn chu cc chng long xng v nhuyn xng ) tc ng rt nhiu n cuc sng ca ngi dn Nht Bn.. Bnh ny lm xng cc k au n, lm long xng v d gy xng. Cn bnh n ra khi chin tranh th gii ln 2 gn kt thc. Khi m cc khu cng nghip Nht Bn b h hng v cc qu trnh thc hnh x l cht thi cng nghip phn ln b b qua Hot ng khai thc m km, ch, cadmium cht thi khai thc vo cc con sng, v nng dn s dng nc b nhim h lu cho cc mc ch sinh hot v nng nghip Nguyn nhn gy ra cn bnh ny khng r, nhng nm 1960 khi kim tra xng v cc m cc ca nn nhn ngi ta pht c cha hm lng ln km, ch v Cadmium

Khi o hm lng kim loi nng trong lu vc sng zintsu cho thy rng cc mu nc ni chung c t hn 1 ppm Cd v 50 ppm km, cc kim loi ny tp trung lp trm tch v thm ch nng cn cao hn trong thc vt ,phn tch kt qu ca 5 mu cho thy trung bnh c 6 ppm Cd trong t nhim.Trong r cy trng, trung bnh tng ln 1250 ppm, v trong go thu hoch l 125 ppm. Cc th nghim tip theo cho thy khi chut c cho n mt ch n ung c cha 100 ppm Cd , th n b mt khong 3 % ca tng s m xng v khi cho chut n mt ch n ung c cha 30 ppm Cd, 300 ppm km. 150 ppm ch v 150 ppm ng th n b mt tng ng 30% tng s m xng. Mc d cc ph p o nng kim loi nng trong nc, t v thc vt trong lu vc sng zintsu kt qu c thay i mt cht..nhng r rng l cc nh khoa hc kh chc chn rng cc kim loi nng, c bit l Cd c nng vi phn triu trong t v la go sn l nguyn nhn gy bnh itai-itai.. 13.4 Bnh mn t nh v mi trng a ha: Sc khe c nh ngha l trng thi ca c th c iu tit bi c mi trng bn trong v bn ngoi ca chnh sinh vt. Chng ta bit nh hng ca a cht n bnh mn tnh t hn nhng nh hng ca cc mi trng khc nh kh hu. Bi v: + Th nht, gi thuyt v mi quan h gia mi trng a cht v s mc bnh khng chnh xc c kim tra y , nghin cu c s v lnh vc kim nh cn c phi hp tt hn.

+ Th hai, nhiu phng php vn cn kh khn trong vic tm c cc d liu ng tin cy v c th so snh cho cc nghin cu y t a cht. S khc nhau v a l trong t l mc bnh tim M c th lin quan n mi trng a cht, v n c c tnh 2/3 kt qu cc bnh ung th nm bn cu Ty m nguyn nhn 1 phn l do mi trng, mc d yu t di truyn cng rt quan trng. a. Bnh tim v mi trng a ha: Gii hn bnh tim y bao gm bnh tim mch vnh (CVD) v bnh tim mch (CHD). S khc nhau v t l t vong ca bnh tim thng th hin mi quan h th v ca nc ung vi cht ha hc. cng l mt khi nim dung biu th hm lng ca canxi v magi b ha tan trong nc. Nng cc cht ny cng cao to ta cng cng cao, nc vi nng ca cc cht ny thp gi l nc mm. Cc nghin cu ti Nht Bn, Wales, Thy in v M tt c u kt lun rng nhng ngi s dng nc mm nhiu th c t l mc bnh tim cao hn nhng ngi s dng nc cng. S khc nhau v a l ca cn bnh Nht Bn c lin quan n t l sulfate vi bicarbonate trong nc sng. Cc khu vc Nht Bn c t l t vong cao do t qu ni chung tng ng vi khu vc c t l sulfate v bicarbonate l tng i cao. Nhng ion bicarbonate ( HCO3-) l mt phn kt qu ca hin tng phong ha ha hc ca cc loi giu cacbon nh vi, bao gm phn ln ca qung canxit (CaCO3), hoc canxi-magi cacbonat, qung olomit [CaMg(CO3)2]. Do , nc c bicarbonate cao thng cha nng

canxi v/hoc magi cao v tng i cng. Nc cng s c nng bicarbonate cao v mt t l nh sulfate-bicarbonate. Ngc li, nu vi t l cao s l nc mm. S phong ph ca sulfate, c bit l ng Bc ca Nht Bn, bt ngun t ni la giu lu hunh c tm thy . Cc sng trong khu vc c nc tng i mm. Ngc li, cc con sng chy qua trm tch th c lng sulfate thp v bicarbonate cao (nc tng i cng), ging hu ht cc con sng trn th gii. Nc mm c tnh axit v c th, thng qua s n mn ca ng Mt s c im khc ca nc mm c th ng gp trc tip Mt s cht (c th l mt t phn t) ha tan trong nc cng c

ng, gii phng vo trong nc cc nguyn t gy bnh tim n bnh tim. th gip ngn nga bnh tim. Mt nghin cu v t Georgia cho rng cc nguyn t vt c tm thy trong t nh mangan, crom, vanadi, v ng ng vai tr c li trong cng tc phng chng bnh tim mch . Thng tin b sung l cn phi nng cao hiu bit ca chng ta v cch cc nguyn t vi lng nh hng n tim v h tun hon. Cadmium, flo, v selen, mt s khc, cn nghin cu thm. i vi cadmium, chng ta bit rng c nhn nhng ngi cht do cc bin chng cao huyt p thng c nng cadmium cao hn so vi c nhn nhng ngi cht v cc bnh khc. ng ngc nhin, tuy nhin, nhng cng nhn tip xc vi bi cadmium v tch t cc nguyn t trong phi th khng c t l bt thng ca cao huyt p.

b. Ung th v mi trng a ha: Ung th c xu hng lin quan n iu kin mi trng. Ngun gc cht gy ung th: + T t nhin trong vt cht tri t nh t v nc + c gii phng t hot ng ca con ngi. Thng tin gn y cho thy rng nhng cht gy ung th c th c tm thy ngun nc ung ca chng ta. Chc chn nc b nhim do cng nghip v th thi ra c cha nhiu ha cht c hi, mt s cht c th gy ung th ang c thi vo ngun cung cp nc b mt v nc ngm ca chng ta. Khi kt hp vi clo, mt s cht thi cng nghip to ra ha cht gy ung th vi nng thp. Nghin cu ny cho thy mt mi tng quan phc tp gia bnh ung th v mt s yu t mi trng: kh hu, t, thc vt, v thi quen nng nghip Cc mi tng quan cao nht gia t l ung th thc qun v yu t mi trng do nh hng ca loi t . Mc t l cao nht c lin quan ti t mn phn lc a pha ng ca khu vc; cc t l thp nht l trong vnh ai ma phn pha Ty. Lng ma tng t ng sang Ty theo h s 4, v t cng c kh mn. thm thc vt v h thng nng nghip c s thay i t chn th trn cc trang tri tha tht cy chu hn n cc khu rng ti tt v nng tri trng la, tri cy v tr. Song song vi s

thay i ny t ng sang Ty gim bt c t l mc ung th thc qun. 13.5 Phng x v kh radon: a. B n cht ca phng x

Tt c nguyn t ca cng nguyn t c cng s nguyn t (s proton trong ht nhn). ng v l s nguyn t ca nguyn t khc nhau v s notron v do khi lng nguyn t khc nhau(s proton +notron trong ht nhn). V d, 2 ng v cu uranium l 235U92 v 238 U92. Nguyn t ca 2 ng v ny c s nguyn t bng nhau bng 92, nhng tng khi lng tng ng l 235 v 238. ng v ny c th vit uranium-235 v uranium-238 hoc U-235 v U-238. Mt ng v phng x ,t phn r ht nhn,tc l ht nhn thay i trong khi pht ra di 1 hay nhiu hnh thc ca bc x. C 3 loi bc x chnh pht ra trong lc phn r l ht alpha,bete,gamma. Mi ng v phng x u c tnh pht x c trng,mt s ng v ch pht ra 1 loa bc x,mt s pht ra nhiu bc x. Ht alpha gm 2 ht proton v 2 ht notron,nn ln hn nhiu so vi cc ht phng x khc. V phn r alpha(pht ra ht alpha) lm thay i s proton trong ht nhn,ng v thay i to thnh ng v ca nguyn t khc. V d, Ra-222, c 86 proton,phn r ra ht alpha do to ra Po-218 c 84 proton. V khi lng ln, ht alpha di chuyn chm (nng lng thp) pht ra phng x. Chng di chuyn khong rt ngn (t 5-8 cm trong khng kh) v thm nhp vo vt liu di t ngn hn ht beta v gamma.

Ht beta l hot ng ca cc electron v c khi lng nh hn hat alpha. Phn r beta xy ra khi 1 netron trong nhn ca ng v t ng thay i. Ch rng in t pht ra l sn phm ca s thay i, khng c in t trong ht nhn trc khi xy ra phn r beta. Bc x gamma, 1 loi nng lng c gi l tia gamma phn r t ng v, nhng s proton v notron khng thay i. Tia gamma trong ht nhn tng t nh tia X trong y hc. Tia gamma c pht ra bi ht nhn v c nng lng cao, di chuyn nhanh v xuyn qua su hn ht alpha v beta. c trng quan trng ca ng v phng x l chu k bn r,l thi gian cn thit mt na cht phng x phn r. Mi ng v phng x ch c chu k bn r nht nh. V d, Ra-222 c chu k na phn r rt ngn khong 3.8 ngy. C-14, ng v phng x ca carbon, c chu k bn r l 5570y; U-235 c chu k na phn r 700 triu nm v U-237 l 4.5 t nm. Mt t ng v phng x,c bit l nguyn t nng,tri qua 1 lot phn r phng x,cui cng thnh ng v bn(khng phng x). Chui phn r t U-238 to ra Ra-226, radon-222 v Po-218 n ng v bn Pb206. Hai vic quan trng vi mi s thay i l phn loi phn r phng x v thi gian sng trung bnh. Phn r t 1 ng v phng x n gii hn nh ca ngun gc v nguyn t con. V d,ngun gc radon-222, l kh vi chu k bn r l 3.8 ngy, phn r ht alpha to ra ht nh hn, Po-218, cht rn vi thi gian bn r l 187s. b. n v bc x

n v o phng x dng o phng x ph thuc vo vic ta quan tm ti qu trnh phn r phng x hoc trong nh hng ca liu hp th bi sinh vt sng. Trong 2 trng hp,u o nng lng phng x. b.1 o ph n r phng x : n v chung o phng x l curi(Ci) v s knh trng i vi Marie v Pierre Curie,ngi u tin bit s phn r nguyn t,polonium v radium vo nm 1890. Marie Curie t ra thi hn phng x v b ly tn polonium cho qu hng ca mnh,Ba Lan. Tc hi ca bc x khng c bit ti thi im , Marie Curie v con gi ca b lm vic vi cht phng x u cht v bnh bch cu,c coi l do cht phng x gy ra. Curi (Ci) l tng s phng x trong 1g radium-226, tri qua 37 t phn r mi giy. Radium-226 c chu k bn r l 1622 nm,ti thi im cui cng khi lng ban u ca radium gim 0.5g, phn r ht nhn s gim 18.5 t mi giy v tng phn r hin ti bng 0.5Ci. Trong h thng quc t v o lng,n v o phn r phng x l becquerel (Bq) (l tn gio vin vt l ca Marie Curie,Henri Becquerel) ,tng ng vi phn r phng x trn mi giy( 1Ci = 3.7*1010 Bq). Bequerel dng trong kh phng x,cha t nguyn t hn so vi cng cht rn. Nu ta lm vic vi radon-222,v d,chng ta c th bit c trng thi ca phng x trong mi m3 hoc pCi/l. Mi picocuries bng 1012

ca curi,nn pCi/l o bng s phn r mi giy trond lt (1 pCi/l =37

Bq/m3). b.2 o liu phng x: o liu lng phng x pht ra l rad v rem. 1 rad l n v o liu hp th, v rem l n v o liu tng ng,y

l gii thch ngn gn. Cc n v tng ng theo h thng quc t l gray v sievert :1 gray (liu hp th) =100rad v 1sievert (liu tng ng)= 100rem. C 2 h thng n v ny u c s dng. Rad v gray o nng lng cn li bi cc t bo tip xc vi phng x. Tuy nhin,v c nhiu loi bc x xm nhp khc nhau,chng to ra mc nguy him khc nhau cho t bo . Rad v gray c tng ln nhiu ln bi yu t gi l tng i hiu qu sinh hc sn xut liu tng ng(liu hiu qu tng ng), o bng rem hoc sievert. Mrem v mSv bng 1/ngn ca rem hoc Sv-o liu hp th nh. n v o tia X v gamma l R hoc theo h thng quc t l C/kg. c. Ngu c sc khe t bc x phng x.

ng v phng x gy nguy him ti sc khe con ngi ph thuc vo cc yu t: loi phng x pht ra, kiu tip xc (bn trong hay bn ngoi c th), chu k na phn r phng x,trng thi vt l v hot ng ha hc. Radon-222 pht ra nng lng chm v chu k bn phn r ngn nhng nguy him v l cht kh. Nu ta ht vo,vt liu nh pht ra bc x gy nguy him trong c th. c.1 Loi phng x: chng ta ch ti s di chuyn ht alpha t 58cm trong khng kh trc khi dng li va chm vi ht khc trong khng kh. Trong t bo ca con ngi st hn so vi khng kh th n di chuyn chm hn 0.005-0.008cm, lm cho chng nhiu ln gy nguy hi ti t bo v m. Bc x alpha gy hi cho con ngi khi ng v pht x alpha b ht vo hoc b hp th:tt c pht x u b chn li bi cc m ca c th

trong thi gian ngn, v vy c th con ngi hp th ht nng lng nguy hi ny. V nng lng rt cao v s xm nhp su, tia gamma gy hi trong hoc ngoi c th. Tuy nhin, nu pht x l hp th, 1 s bc x ra ngoi c th, gim th nguy hi. Bo v t ngun bn ngoi tia gamma i hi phi c b dy che chn. Bc x beta l trung gian trong nh hng ca n, mc d bc x beta hp th vo c th khi pht x beta c hp th. Ht beta t ngun bn ngoi c th dng khi gp vt chn va phi. c.2 Liu phng x : bc x nn t nhin (l bc x t nhin chng ta ang tip xc trong hoc gn b mt tri t) nhn c gi tr trung bnh khong 1.5mSv/ngi/nm. Trong phm vi no gi tr vo khong 1.0-2.5mSv. Ni chung, mc cao nht ca bc x vng ni v thp nht Florida. S khc bit ny do cao v a hnh. Nhiu tia bc x c nhn cao cao hn v khng kh mng hn v granit thng cha cc khong cht phng x ph bin hn vng ni. Florida vi a cht vi v a hnh thp,c mc bc x nn tng i thp. Tuy nhin, cc vng ca ni xy ra s trm lng photphat, bc x nn thng trn mc trung bnh do tp trung uranium cao trong phosphat. Khng c s tha thun no chung cho cht phng x m chng ta nhn c t ngun nn phng x. Tuy nhin, ngun nn chnh l K-40 v C-14, xut hin vi s lng ln v hu nh pht ra t 0.2-0.25 mSv/ngi/nm. Kali l cht in phn quan rng trong mu v 1 ng v ca k-40 l phng x vi chu k bn r di. Mc d K-40 chim t l nh trong tng s kali tn ti trong c th mi ngi nhng tt c u c 1 t phng x. Do nu bn chia s cuc sng vi ngi khc bn s nhn

c 1 t phng x (mt t nguy him vi ci li trong mi quan h). Tia v tr pht ra khong 0.35-1.5mSv/ngi/nm ty thuc vo cao v cht phng x trong v t bn ra khong 0.35mSv. Tuy nhin, tng lng pht ra t v t c th nhiu hn 1 s khu vc c kh radon r r vo nh. Do tc ng con ngi(con ngi to ra) ti ngun bc c mc thp gm tia X phc v cho mc ch y t v nha khoa,c th cung cp tb t 0.7-0.8mSv/ngi/nm; th nghim v kh ht nhn v nh my ht nhn c th chu khong 0.04mSv v phn r nhin liu ha thch nh than,du kh t nhin c th vi khong 0.03mSv. Cng vic v phong cch sng cng c th nh hng n tng liu ca ngi . Thi gian bn bay trn cao bn c th nhn thm liu. Nu bn lm vic ti nh my ht nhn hoc nh my t than truyn thng hoc 1 s v tr trong nh my bn c th tip xc thm bc x mc thp. Tng bc x nhn c bi ngi lm vic gim st cht ch nh nh my in ht nhn v phng th nghim to ra tia X; ton th cn b cng nhn phi eo ph hiu cho thy tng liu lng bc x nhn c.

Hnh cho thy mt s ngun phng x hay tip xc. iu ch y l tip xc vi kh radon mc cao (c ngha l nh vi nng cao nht ca radon) c th tng ng vi s tip xc m ngi dn di tn Chernobyl trong nm sau tai nn nh my ht nhn ti Nga. Nhng cu hi chnh v vic tip xc vi ht nhn l: khi tip xc v liu ny nguy hi n sc khe con ngi th na? Khng d tr li cu hi ny. Chng ta bit mc tip xc bc x liu cao v con ngi nhng t hn nhiu khi vn tip tc tip xc vi bc x thp. C nhiu thng tin v vic tip xc ca liu cao ca nn nhn bom nguyn t Nht Bn, c nhng ngi tip xc vi nng bc x cao ti m uranium,nhng ngi lm vic vi cht phng x dng cha bnh. Nhng ngi tip xc vi liu bc x cao c t l mc ung th cao hn s ngi cn li. Cc nghin cu cho thy t l t vong chm nht t 10-25 nm trong thi gian tip xc v bt u pht bnh.

Nhng tc ng bt li ca bc x liu cao dc xc nh t cc nghin cu. Liu khong 5000mSv (5Sv) c xem l nguy him khi tip xc. Liu khong 1000-2000mSv c th gy ra vn nh nn ma, mt mi, tng t l sy thai trong thi gian t hn 2 thng v tm thi v sinh nam gii v ti 500 mSv vn sinh l thit hi c gi li. Liu bc x cho php mi nm vi cng nhn l 50 mSv, khong 30 ln so vi lng bc x tb m 1 ngi nhn c t ngun nn t nhin. Liu ti a cho php hng nm i vi cng dn Hoa K l 5 mSv, khong 3 ln mc tb hng nm ca liu nn t nhin. Mc d hu ht nh khoa hc ng rng bc x gy ung th, l cuc tranh lun v mi lin h gia liu bc x thp v t l t vong do ung th. Mt s nh khoa hc tin rng mi quan h ny tuyn tnh, v vy bt k s gia tng no ca bc x u to ra mi nguy him b sung. Nhng ngi khc tin rng c th c kh nng t x l v phc hi t liu phng x thp vi biu hin sc khe bt u xut hin ngoi mt s liu ngng. D lun vn ang quan tm v vn ny,nhng c v nh thn trng bo v quan im ny v chp nhn rng c mi quan h tuyn tnh, c ngha l bt k s gia tng no ca bc x u lm tng tnh nh hng ti con ngi. d. Kh Radon Radon c pht hin vo nm 1900 bi nh ha hc ngi c Ernest Dorn. Kh Radon l mt cht kh phng x t nhin khng mu, khng mi v khng v. Phn r phng x ca uranium-238 to ra radium226, c phn r chuyn sang radon-222 (xem hnh 183.10). do , loi

 cha uranium l ngun gc ca kh radon gy nhim ng k nh hng n nhiu ngi nh ti Hoa K Radon c hnh thnh nh mt phn ca bnh thng phng x phn r dy chuyn ca uranium. Uranium c khong t tri t c hnh thnh v ca ng v ph bin nht c chu k bn r di (4,5 t nm). Uranium, radium , v do radon, s tip tc xy ra trong hng triu nm khong nng ging nh h by gi. [1] Radon c trch nhim phn ln cc tip xc cng chng bc x ion ha . N thng l ng gp ln nht duy nht mt c nhn nn bc x liu, v l bin nht t v tr n v tr. Radon kh t cc ngun thin nhin c th tch ly trong cc ta nh, c bit l trong khu vc kn chng hn nh gc x p, v tng hm. N cng c th c tm thy mt s nc sui v sui nc nng. [2] bng chng dch t hc cho thy mt lin kt r rng gia hi th nng radon cao v t l mc ung th phi . Nh vy, radon c xem l mt cht gy nhim ng k nh hng n cht lng khng kh trong nh trn ton th gii. Theo Hoa K C quan Bo v mi trng, kh radon l hu ht cc nguyn nhn thng gp th hai ca ung th phi, sau khi ht thuc l, gy ra 21.000 ca t vong ung th phi mi nm Hoa K ) d.1 Ti sao kh radon gy nguy him? Lm con ngi lo lng v khi tip xc kh radon vi nng cao lm tng nguy c ung th phi, c bit l i vi ngi ht thuc. Nguy c ung th phi pht trin do s chiu x ca Radon tu thuc vo lng kh Radon m chng ta ht phi. Cng c nhiu Radon trong khng kh, nguy

c cng ln. Tng t, khong thi gian chng ta ht th trong khng kh cha Radon cng di th nguy c cng ln. Trong nhng nm gn y c khong 140.000 trng hp ung th phi t vong xy ra mi nm Hoa K. Ht thuc l cn lm nguy c mc bnh ung th phi tng ln cao hn nhng ngi c nguy c mc cn bnh ny do tip xc vi kh radon, EPA c tnh c 7.000 n 30.000 trng hp t vong v nguyn nhn ny, v th khi tip xc vi c thuc l v kh radon th nguy c b ung th gp 10 ln khi tip xc vi tng nguyn nhn ny Trong khng kh, radon v thoron dng nguyn t t do, sau khi thot ra t cc vt liu xy dng, t v nhng khong vt khc, chng phn r phng x thnh chui cc ng v phng x con m nguy him nht l polonium-218. Polonium phn r alpha vi chu k bn hu 3,05 pht, cho mt vi chu trnh th trong h thng h hp ca ngi. Polonium-218 bay cng cc ht bi c kch thc c nanomt v micromt to thnh cc ht sol kh phng x. Cc sol kh phng x ny c kch thc c vi chc micromt nn c th c ht vo qua ng th v tai hi hn, chng c th b lu gi ti ph nang. Ti ph nang, polonium-218 phn r alpha pht ra cc ht nhn hli ht alpha (c in tch +2e; khi lng nguyn t l 4). Cc ht alpha c nng lng rt cao s bn ph nhn t bo ph nang, gy ra cc sai hng nhim sc th t c ng tiu cc n c ch phn chia t bo. Mt phn nng lng phn r ht nhn truyn cho ht

nhn phn r, lm cc ht nhn ny b git li. Nng lng git li ca cc ht nhn radon c th ph v cc phn t protein trong t bo ph nang. Kt qu l xc sut gy ung th do radon rt cao. Trong nhng nghin cu gn y ng rng radon nh l mt nguyn nhn ca khi u c tnh trong thn, v ung th ca tr con. Theo c tnh mt cch tng i ca EPA (Environmental protection Agency) th tai bin do ng th c th so sch vi ci cht ca ca tai nn xe c v cao hn hng trm ln so vi nhim nc v nhim khng kh. S nhim do mi trng bn ngoi th thp khong 0.001 hoc 1/105 so vi s nhim bn trong nh cc c quan ha hc th c xem xt 0.1%. Theo Lut mi trng ca M, mc cho php kh radon trong nh l < 4 pCi/l/nm, tng ng 0,148 Bq/l/nm, hay 148 Bq/m3/nm. Theo tiu chun an ton bc x ca C quan Nng lng Nguyn t Quc t (IAEA), nng kh radon trong nh ca dn chng khng c vt qu di t 200 n 600 Bq/m3/nm, ngha l t 0,6 n 1,7 Bq/m3/ngy. V nguy c ngm, radon vi nng ln gy nguy hi nhng ch vi nng nh th v hi. cc EPA thit lp 4,0 pCi/l l mc phng x nu vt qu th kh radon c coi l nguy him. Nng ngoi tri trung bnh ca kh radon l c khong 0,2 pCi / l, v mc trung bnh trong nh khong 1,0 pCi / l. Mc phng x ca 4,0 pCi / l ch l mt c tnh ca mt mc tiu tp trung m cc cp trong nh nn c gim xung. Nu bn cha bao gi ht thuc, nguy c c th so snh 4,0 pCi / l l gn nh nhau, nu bn l mt ngi ht thuc, nguy c l khong 100 ln nguy c t vong trong mt tai nn my bay .

Nu ri ro t kh radon l ngay c gn vi c tnh ca EPA, sau gy nguy him l tng ng vi t vong do tai nn t v hng trm ln so vi nhng ri ro do nhim ngoi tri c th hin din trong nc v khng kh. Cc cht nhim trong mi trng ngoi tri thng theo quy nh lm gim nguy c t vong v bnh tt n di 0,001 phn trm, hoc 1 trong 100.000. Phn cng nguy c t cc cht nhim trong nh nh ha cht hu c cho thy mt nguy c ung th khong 0,1 phn trm. y l nh so vi cc ri ro lin quan radon. V d, nhng ngi sng trong nh trong khong 20 nm vi mt nng radon trung bnh trong khong 25pCi mt l / mt c hi 2-3 phn trm ung th phi (42). d2. c t nh a cht ca kh radon Bao gm loi v cu trc a cht rt quan trng trong vic xc nh bao nhiu radon c th t c b mt tri t.. Uranium-238 cha ng trong v t c th bin i. Mt vi loi , chng hn nh ct kt, ni chung cha ng di 1ppm (1/1.000.000) U-238; cc loi khc, nh l phin s t en v mt s granite, c th cha hn 3 ppm U-238. Mt lng ln radon trong thc t c lin h n s c mt ca uranium trong t v . Mt vi vng ca nc M c mt nn mng m hm lng uranium vt qu mc trung bnh trong t nhin. Cc vng t Pennsylvania, New Jersey, v New York ni ting v hm lng cao v kh radon. Nhng vng t ny c rt nhiu ngi nh vi s tp trung cao ca radon. Tng t, hai vng t Florida c xc nh l c mt s tp trung cao ca uranium v kali phng x trong cc giu photphat. mt s trng thi khc, bao gm c Illinois, New Mexico, South Dakota, North

Dakota, v Washington, l ni c hm lng radon trong nh cao. phin s t en c Santa Baabara, California, l ni c xem l ngun sn sinh nhiu kh radon. Cc cu trc a cht, chng hn nh c c khe nt v c c on g th thng c s lm giu thm uranium v c th dng sinh kh radon trong t . Mt nguyn cu ti pha nam Virginia cho thy rng cc i trt trong granite th c s tp trung radon cao. Hn na mc cao nht trong nh c xc nhn l th trn Boyer, Pennysyvania, M. Santa Barbara, California, s tp trung cao ca kh radon trong nh. l do cc vt nt trong a tng gii phng kh radon. Mt lng ln kh radon m thot ra khi nn gc v mt t t t th chu nh hng ln bi dung lng ca nc. m cao c lin quan n vic cho php kh radon di chuyn vo trong vng khng gian gia t v nt t gy trong : nc nhiu lm gim bt khong thi gian m radon c th bin i nh l kt qu ca hot ng phn r phng x t nhng dng vt cht ban u nh l radium-226. Mt mi lin h nh vi m lm cho kh radon di chuyn d dng t cc np t gy trong v cc l rng trong t. l, qu trnh khuch tn ca kh radon th nhiu hn trong cht cha bo ha. Nh vy, m nh hng n lng kh radon m c th ti b mt tri t theo hai cch sau: 1. m cao lm tng s di chuyn kh radon i vo v tr ng trong cc l hng trong nt t gy trong hoc gia cc ht t. 2. m cao cn gi cho radon khng di chuyn xuyn qua cc l hng trong v t.

Kt qu, l mt lng nc ti u s lm cho mt lng ln nht kh radon tht s i ti b mt tri t. Trong mt s loi t th m ti u l khong t 20-30%. d3. Kh Radon vo nh b ng nhng cch no? Kh Radon vo nh bng 3 cch chnh: Kh di chuyn t t v vo tng hm v cc phn khc ca ngi nh Nc ngm c bm t ging Vt liu c xy dng nh gch c lm t vt liu pht ra kh radon

Hu ht nhng vn quan tm gn y v kh radon th lin quan n vic s dng vt liu xy dng cha nng radon cao. Vd,gia nhng nm 1929 v 1975, cht liu c s dng sn xut b tong Thy in cha nng radium cao. Tng t, nhng thp nin 1960 M,pht hin ra nhiu nh Grand Junction, thuc Colorado- c xy dng vi vt liu nhim cht thi ngun Uranium. Mt vi ngi nh Florida b pht hin l c nng radon cao. Cui cng, nhiu ngi nh

New Jersey c xy dng khu vc bi rc- ni m cht thi t qu trnh to ra radi lng ng. Thng 12/1984, cc nh khoa hc pht ra kh radon t ngun thin nhin c th vo trong nh gy nn mi nguy hi i vi sc khe. cu chuyn ca Stranley Watras c k i k li nhiu ln. Stranley Watras Pennsylvania l 1 c vn k thut trm nng lng ht nhn Limerick. li vo khu vc, my d tm phng x m bo rng khng c mt cht phng x no pht ra d dng. L phn ng trm nng lng khng c bt ln khi Watras i vo. Kim tra qun o ca anh y th s nhim cht phng x khng bt ngun t khu vc m bt gun t nh anh y sng.vn phng cng ty nng lng kim tra nh anh y th kinh ngc khi tm thy mc phng x ca khng kh trong nh l 3200pCi/l, cao hn 800 ln so vi 4pCi/l- ngng cho php ca chi nhnh bo v mi trng ca M. cc nh khoa hc rt ngc nhin bi v h khng tin radon thm t nhin vo nh c th gy nguy him. nh cua Watras th c theo di v ghi li cho n cui nhng nm 1980, khi m 1 ngi nh Whispering Hills, New Jersey, c pht hin mc phng x l 3500pCi/l. S c kh radon trong nh lin quan n mt s tht l kh radon c th di chuyn qua cc khe h nh trong t v . Radon di chuyn v thm qua sn v nn nh lm bng b tong,ng di sn, vt nt nh tng. gi cng l mt nhn t bi v khi n gia tng khng kh thi vo v thi ra cc ta nh. Radon cng c th vo nh thng qua ngun cung cp nc, c bit nu nh no c ging, mc d s ng

gp ny khng nhiu bng kh thm qua nn nh. Radon v cc sn phm ca n c thot bt ra ngoi khi nc s dng cho sinh hot hng ngy nh tm ra, ra chn, gic . Nc bm t nc ngm cung cp cho thnh ph cng c th cha kh Radon. Tuy nhin, bi v hu ht nc c cha trong khong vi ngy v c x l sch, c khong thi gian gia lc bm ln v x l sch, khong thi gian ny radon c thot ra. Kt qu l nc c nng radon thp. d4. o lng kh radon trong nh. o nng kh radon trong nh vn c nhiu kh khn. xc nh mc radon, cn phi o c radon bng cc thit b chuyn dng. Nng radon trong khng kh c hin th theo n v pCi/l hoc Bq/m3.Nng Radon c th cc k d thay i trong nh , ph thuc vo ma trong nm v radon pht ra t hi t. nhiu khu vc ca nhiu nc, nng kh radon vo ma ng cao hn ma h, v ca s c m ra cho thng gi. S pht x radon c th thay i ph thuc vo p sut, hm lng nc v nhng thay i khc kh m xc nh. Nhn t khc v vic phng x trong nh l trong khi c nh c nng cao,cc nh khc trong vng ln cn mc thp hn. Mc d ngnh a cht mc thng thng c th s dng nhng cng c chn on xc nh nhng vng c nng radi cao, ch c kim tra trong nh mi xc nh c iu ny. d5. Nhn thc v vn ny:

K t nm 1985, s nhn thc v vn kh radon M tng ln. Tuy nhin con ngi c mt vn kh khn l chng ta khng th ngi, nghe, thy hay chm vo. Cc ch nh c v nh quan tm ngi tr ti sn hn l mi nguy hi v sc khe. C mt s thiu st ng k gia nhn thc ca con ngi v vn radon v ngha tim n ca chnh n. y l s tht trong nhng bang nh New Jersey- ni m vn c bit n trong nhng nm. Mt cuc kho st cc ch nh, kt qu l ch 5% trong s c k hoch kim tra radon, 10% tin rng radon c th l mt vn ,khong 30% mong ch c mt vn radon. Khng c mt nh gi c th no v cc nh M c th gia tng nng kh radon. Nhn vo cuc kho st va qua, ch khong 1 nh trong 12 nh kho st c mc radon trong nh trn 4pCi/l. Nu y l t l trung bnh, khong 7 triu nh M c nng ln, v hng triu ngi nh cn c kim tra. Mc khc nhiu cuc kim tra c thc hin nhng ni m nghi ng. cuc kim tra gn y hn 100 trng,EPA pht hin hn 1 na c nng radon trn mc 4pCi/l, v 1 trng Tennessee l 136pCi/l. thng ny quan trng v cc nh vn phng tin rng tr em d b nh hng hn ngi ln bi v phi tr em nh hn v s tht l n ang pht trin. d6 Gi m n ng kh radon trong nh: 1 chng trnh thnh cng lm gim hoc gii hn cc nguy c tim n v kh radon trong nh da vo 3 chin lc sau: Cc khe h cho radon i qua c xc nh v bt kn

 Ci thin s thng hi ca ngi nh bng cch m ca s v s dng qut H thng thng gi c lp t Phng php n gin nht l gia tng s thng gi ca ngi nh. Bt kn cc vt nt nn nh c th gim radon i qua. My d tm c th gip con ngi xc nh v tr, nhng phng php ny khng gii quyt vn v cc vt nt mi c th hnh thnh. C nhiu kin xy dng khc nhau, bao gm h thng thng gi tng hm v pha trn trn nh (crawl space).nu ngi nh c xy dng lt bng phin, ri h thng thng gi subslab c lp t. C nhng tin tt v nhng tin xu. tin xu l c nhiu ni trn nc M v cc nc khc trn th gii l s pht ra kh radon cao t t v , v s pht x ang l mi nguy him trong nh. Tin tt l hu ht cac vn c th c nh mt cch d dng. Thm ch l h thng thng gi c lp dt ch tn c vi ngn $ 13.6 nh gi ri ro trong c hc nh gi ri ro l qu trnh xc nh tim nng nh hng sc khe bt li v mi trng sau khi tip xc vi mt vt liu c hi, d l mt kim loi nng trong t nhin hoc nhn to ha cht hu c. Cc bc trong vic nh gi ri ro l: X c nh mi nguy him. Bc ny quyt nh tip xc vi mt vt liu c bit c th gy ra vn sc khe mi trng. N c th bao gm iu tra dn s vi nhng ngi tip xc. V d, trong vic xc nh cc mi nguy him lin kt vi kh radon, cc nh iu tra nghin

cu tip xc vi kh radon i vi khai thc uranium cng nh tip xc trong nh. Mt cch tip cn xc nh nguy c c th c tin hnh th nghim cp phn t xc nh mt vt liu c th tng tc vi t bo sng. nh gi ph n ng liu. Mc ch ca bc ny l xc nh cc mi quan h gia liu lng ca mt vt liu c hi v tc ng bt li v mi trng sc khe ca n. iu ny thng l mt vn gy tranh ci bi v cc cu tr li d on liu thp thng c ngoi suy t cc hiu ng c bit n liu cao hn, hoc ngc li. Cng c th c cuc tho lun lin quan n ngng c hoc khng c hay vng mt. Cui cng, vic nh gi phn ng liu thng da vo phn tch thng k cc d liu thu c t quan st v do c th c li th nghim hoc o lng. nh gi phi nhim. Mc tiu ca nh gi phi nhim l c lng thi gian, tn s v cng tip xc vi mt cht c no . Ngi ta cho rng cc mi nguy him lin quan n tip xc trc tip t l vi dn s l thc s tip xc cng nh thi gian, cng , hoc tn s ca tip xc. nh gi phi nhim cng l mt qu trnh gy tranh ci bi v o phi nhimv nng cc cht c hi nng rt nh (phn triu hoc phn t) l kh khn Mc ri ro. y l bc cui cng trong qu trnh nh gi ri ro. N bao gm c xem x t n mi nguy him c xc nh, nh gi phn ng liu, v nhng nh gi tip xc nh nu trn.nh gi ri ro t vic tip

xc vi cht c trong mi trng cho php k hoch chng ta pht trin hnh ng gim thiu ri ro. y l qu trnh qun l ri ro, trong tch hp nh gi ri ro vi cc php lut, x hi, chnh tr, kinh t, cc vn k thut lin quan n k hoch hnh ng. C hai k hochnh gi ri ro v qun l ri ro yu cu lm cho bn n khoa hc bng m thanh da trn thng tin ca tt c hin ti. PHN B SUNG : AMING Amiang l mnh khong sn nh, ko di gi l dy , c bit l nhng mnh v ca cc khong cht silic st t c bit n nh amphibole hoc ca serpentine. c s dng nhiu trong cng nghip ca aming, ch yu lin quan n phng chy v nung nng vt liu. Aming c s dng trong lp lt phanh, nh l mt s cch in cho nhiu mc ch khc nhau. Nhc im ca vic s dng aming l cc lin h rng ri vi mt s loi aming i vi cng nhn trong ngnh cng nghip dn n trng hp bnh v phi, c cho l do ht phi cc si. S quan tm cng gia tng khi nu ra rng vic tip xc vi aming c th gy ra ung th phi. Vic di chuyn gim s hin din ca aming hoc cm n hon ton dn trong nhng nm gn y vic loi b cc aming t nhng kin trc c (c bit l cc trng hc v cc ta nh cng cng khc) ti Hoa K. Aming khng ch l khong sn m cn sn xut nghin bt c loi no nh sn xut mt s cc mnh khong sn nh ko di. Phng th nghim lm th nghim, trong ng vt c tip xc vi nhiu loi dy kim loi m dy kim loi nhng vo m phi cho thy cc khi u c th pht trin nh l mt kt qu ca s tip xc.

Nhng th nghim ny b ph bnh bi v chng lin quan n liu lng cao ca cc si c t trc tip trn cc m phi, nim mc. p dng cc kt qu ca nhng th nghim ny vi con ngi i hi phi ngoi suy cc mc thp hn nhiu phi nhim m ngi dn phi i mt. Nghin cu v bnh ung th c ch nh thch anh nh mt vt liu gy ung th c th xy ra i vi con ngi, nh l kt qu, bt c vt liu t nhin Hoa K vi hn mt phn mi phn trm ca silicat t do (bao gm thch anh) phi hin th du hiu cnh bo nguy him. Nh vy, xe ti vn chuyn nghin nt v mt l thuyt cn phi thc hin cnh bo, v mt chic xe ti Delaware vn chuyn nghin c thc t pht hnh mt s vi phm khng hin th cc du hiu nh vy! Cc tc gi bo co v vic thc hin cc cu lnh (khi hai) l nhng bi bin ct bao gm cc silicat c th to ra nguy c sc khe cng ng, v vy s cnh bo phi c ng. Nhiu s hiu lm, theo quan im ca tc gi, kt qu t ngha cng nh cc n lc ng ngha ngoi suy t nhng nghin cu c tnh i vi mi trng vi s hiu bit c im ph bin trong t nhin ca cc khong cht. Ct thch anh gm nhng phn cng v trn ht, khng x bi. Tr li vi cuc tho lun ca chng ti v aming, tt c cc loi aming c c hi khng bng nhau. Khong sn chrysotile c bit n nh aming trng v l loi ph bin nht c s dng ti Hoa K. N c c tnh c khong 95 phn trm ca aming by gi ni trong nc M l aming trng. Nghin cu sc khe mi trng ca th m Canada, ni m hu ht cc aming n t y, ngh rng phi nng amiang trng khng gy hi. Trong thc t, khng c nghin cu no noi l dn n bnh phi khi khng tip xc vi aming trng. Mt

khc, aming xanh, m xut pht t cc khong Crocidolite, c bit l gy ra bnh phi. S dng aming trong cc ta nh ti Hoa K tr thnh mt vn sc khe. Mt s lng ln ca s s hi c lin quan n tip xc vi khng chim ch aming, c bit l tip xc ca tr em, v s tin rt ln c s dng ty tr amiang trng ca cc trng, cc ta nh cng cng, v nh ca. C v nh t cc cuc tho lun ca chng ta v aming trng nguy c c phng i v rng c rt nhiu vic loi b cc aming trng c th b khng cn thit. Tuy nhin, nghin cu b sung nn c dnh tm tr nh gi ri ro sc khe lin quan vi cc loi aming v sn xut nh, mng, mnh x