首页 > 资讯 > 医疗卫生人员对气候变化的健康风险认知和适应策略研究进展

医疗卫生人员对气候变化的健康风险认知和适应策略研究进展

泰然健康网
2024-12-09 00:08

摘要:

全球气候变化已经并将持续对人类健康造成广泛而严重的影响。世界卫生组织呼吁，医疗卫生专业人员须在应对气候变化和保护公众健康方面发挥重要作用，尤其应当在气候敏感性疾病监测、脆弱人群识别与照护、健康共益效应促进、风险沟通和环保倡导等方面采取积极行动。本研究系统回顾了国内外医疗卫生人员对气候变化的健康风险认知和适应策略研究进展，发现大多数人员基本认识到气候变化的健康威胁，并采取了高温热浪和气候敏感性传染病早期预警等有限的应对措施，但仍面临突出的挑战和障碍，需要更多的健康风险评估信息、风险管理专业知识以及充足的专业技术人员和资金支持。未来研究应加强评估气候变化健康风险认知程度与实际适应行动的关联性，并开展优先适应策略甄别、干预措施效果和成本效益的分析，以帮助政府决策部门和医疗卫生人员积极应对。

Abstract:

Global climate change has widespread and serious impacts on human health and is expected to be worse in the future. The World Health Organization has called for health professionals to play an important role in addressing climate change and protecting public health, especially in climate-sensitive disease surveillance, vulnerable population identification and care, health co-benefit promotion, risk communication, and environmental advocacy. We systematically reviewed international research advances of health care professionals' perceptions and adaptation strategies on climate change-related health risks. We found that most health professionals basically recognized the health threats of climate change and adopted a few early warning strategies in coping with heat waves and climate-sensitive infectious diseases. However, they still faced significant challenges and obstacles, and needed more health risk assessment information, risk management expertise, and adequate health workforce and financial support. Future research should strengthen the assessment on the relationship between climate changerelated health risk perceptions and actual adaptation actions, and the evaluation on priority adaptation strategies, and the effectiveness and cost-benefit analysis of interventions, aiming to help government decision-making departments and health professionals respond to climate change positively.

[1]

EBI K L, OGDEN N H, SEMENZA J C, et al. Detecting and attributing health burdens to climate change[J]. Environ Health Perspect, 2017, 125(8):85004. doi: 10.1289/EHP1509

[2] 童世庐.气候变化与人群健康[J].中华预防医学杂志, 2018, 52(4):344-347. doi: 10.3760/cma.j.issn.0253-9624.2018.04.003 [3]

WATTS N, AMANN M, AYEB-KARLSSON S, et al. The Lancet Countdown on health and climate change:from 25 years of inaction to a global transformation for public health[J]. Lancet, 2018, 391(10120):581-630. doi: 10.1016/S0140-6736(17)32464-9

[4]

WOODWARD A, SMITH K R, CAMPBELL-LENDRUM D, et al. Climate change and health:on the latest IPCC report[J]. Lancet, 2014, 383(9924):1185-1189. doi: 10.1016/S0140-6736(14)60576-6

[5] 钟爽, 黄存瑞.气候变化的健康风险与卫生应对[J].科学通报, 2019, 64(19):2002-2010. http://kns.cnki.net/KCMS/detail/detail.aspx?dbcode=CJFD&filename=KXTB201919005 [6]

MAIBACH EW, SARFATY M, MITCHELL M, et al. Limiting global warming to 1.5 to 2.0℃-a unique and necessary role for health professionals[J]. PLoS Med, 2019, 16(5):e1002804. doi: 10.1371/journal.pmed.1002804

[7]

RAMANATHAN V, HAINES A. Healthcare professionals must lead on climate change[J]. BMJ, 2016, 355:i5245. http://cn.bing.com/academic/profile?id=7d4c9fcd6b5d39ae1af8f7ec17a18b84&encoded=0&v=paper_preview&mkt=zh-cn

[8]

World Health Organization. Climate change and health conference document[R]. Geneva: WHO, 2016.

[9]

World Health Organization. Operational framework for building climate resilient health systems[R]. Geneva: WHO, 2015.

[10]

SYAL S S, WILSON R S, CRAWFORD J M, et al. Climate change and human health-what influences the adoption of adaptation programming in the United States public health system?[J]. Mitig Adapt Strateg Glob Chang, 2011, 16(8):911-924. doi: 10.1007/s11027-011-9302-1

[11]

MAIBACH E W, CHADWICK A, MCBRIDE D, et al. Climate change and local public health in the United States:preparedness, programs and perceptions of local public health department directors[J]. PLoS One, 2008, 3(7):e2838. doi: 10.1371/journal.pone.0002838

[12]

ROSER-RENOUF C, MAIBACH E W, LI J. Adapting to the changing climate:an assessment of local health department preparations for climate change-related health threats, 2008-2012[J]. PLoS One, 2016, 11(3):e0151558. doi: 10.1371/journal.pone.0151558

[13]

BEDSWORTH L. Preparing for climate change:a perspective from local public health officers in California[J]. Environ Health Perspect, 2009, 117(4):617-623. doi: 10.1289/ehp.0800114

[14]

CARR J L, SHEFFIELD P E, KINNEY P L. Preparedness for climate change among local health department officials in New York state:a comparison with national survey results[J]. J Public Health Manag Pract, 2012, 18(2):E24-E32. doi: 10.1097/PHH.0b013e31823dea74

[15]

SARFATY M, MITCHELL M, BLOODHART B, et al. A survey of African American physicians on the health effects of climate change[J]. Int J Environ Res Public Health, 2014, 11(12):12473-12485. doi: 10.3390/ijerph111212473

[16]

SARFATY M, BLOODHART B, EWART G, et al. American Thoracic Society member survey on climate change and health[J]. Ann Am Thorac Soc, 2015, 12(2):274-278. doi: 10.1513/AnnalsATS.201410-460BC

[17]

SARFATY M, KRESLAKE J M, CASALE T B, et al. Views of AAAAI members on climate change and health[J]. J Allergy Clin Immunol Pract, 2016, 4(2):333-335.e26. doi: 10.1016/j.jaip.2015.09.018

[18]

POLIVKA B J, CHAUDRY R V, MAC CRAWFORD J. Public health nurses' knowledge and attitudes regarding climate change[J]. Environ Health Perspect, 2012, 120(3):321-325. doi: 10.1289/ehp.1104025

[19]

PATERSON J A, FORD J D, FORD L B, et al. Adaptation to climate change in the Ontario public health sector[J]. BMC Public Health, 2012, 12:452. doi: 10.1186/1471-2458-12-452

[20]

SEMENZA J C, SUK J E, ESTEVEZ V, et al. Mapping climate change vulnerabilities to infectious diseases in Europe[J]. Environ Health Perspect, 2012, 120(3):385-392. doi: 10.1289/ehp.1103805

[21]

MCIVER L J, CHAN V S, BOWEN K J, et al. Review of climate change and water-related diseases in Cambodia and findings from stakeholder knowledge assessments[J]. Asia Pac J Public Health, 2016, 28(S2):49S-58S. http://cn.bing.com/academic/profile?id=59c33f66102f4ed7af76878d9d46263a&encoded=0&v=paper_preview&mkt=zh-cn

[22]

NIGATU A S, ASAMOAH B O, KLOOS H. Knowledge and perceptions about the health impact of climate change among health sciences students in Ethiopia:a crosssectional study[J]. BMC Public Health, 2014, 14:587. doi: 10.1186/1471-2458-14-587

[23]

MAJRA J P, ACHARYA D. Protecting health from climate change:preparedness of medical interns[J]. Indian J Community Med, 2009, 34(4):317-320. doi: 10.4103/0970-0218.58390

[24]

TONG M X, HANSEN A, HANSON-EASEY S, et al. Health professionals' perceptions of hemorrhagic fever with renal syndrome and climate change in China[J]. Glob Planet Change, 2017, 152:12-18. doi: 10.1016/j.gloplacha.2017.02.007

[25] 高菡璐, 杨超, 兰莉, 等.哈尔滨市卫生专业人员应对气候变化风险的认知调查[J].环境与职业医学, 2017, 34(12):1067-1071. doi: 10.13213/j.cnki.jeom.2017.17562 [26]

TONG M X, HANSEN A, HANSON-EASEY S, et al. China's capacity of hospitals to deal with infectious diseases in the context of climate change[J]. Soc Sci Med, 2018, 206:60-66. doi: 10.1016/j.socscimed.2018.04.021

[27]

WEI J, HANSEN A, ZHANG Y, et al. Perception, attitude and behavior in relation to climate change:a survey among CDC health professionals in Shanxi province, China[J]. Environ Res, 2014, 134:301-308. doi: 10.1016/j.envres.2014.08.006

[28]

WEI J, HANSEN A, ZHANG Y, et al. The impact of climate change on infectious disease transmission:perceptions of CDC health professionals in Shanxi Province, China[J]. PLoS One, 2014, 9(10):e109476. doi: 10.1371/journal.pone.0109476

[29] 汪庆庆, 陈晓东, 周连, 等.医疗卫生人员对气候变化的关注、认知及其影响因素调查[J].江苏预防医学, 2012, 23(4):26-28. doi: 10.3969/j.issn.1006-9070.2012.04.010 [30]

TONG M X, HANSEN A, HANSON-EASEY S, et al. Perceptions of capacity for infectious disease control and prevention to meet the challenges of dengue fever in the face of climate change:a survey among CDC staff in Guangdong Province, China[J]. Environ Res, 2016, 148:295-302. doi: 10.1016/j.envres.2016.03.043

[31] 苏丽琴, 程义斌, 辛鹏举, 等.三城市公共卫生人员对气候变化健康影响的知识、态度、行为调查[J].环境卫生学杂志, 2013, 3(6):507-509, 514. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=gwyx-wsx201306007 [32]

XIAO J, FAN W, DENG Y, et al. Nurses' knowledge and attitudes regarding potential impacts of climate change on public health in central of China[J]. Int J Nurs Sci, 2016, 3(2):158-161. http://cn.bing.com/academic/profile?id=01ce865d39265aaa764fb4c51c532a69&encoded=0&v=paper_preview&mkt=zh-cn

[33]

YANG L, LIAO W, LIU C, et al. Associations between knowledge of the causes and perceived impacts of climate change:a cross-sectional survey of medical, public health and nursing students in universities in China[J]. Int J Environ Res Public Health, 2018, 15(12):2650. doi: 10.3390/ijerph15122650

[34]

LIAO W, YANG L, ZHONG S, et al. Preparing the next generation of health professionals to tackle climate change:are China's medical students ready?[J]. Environ Res, 2019, 168:270-277. doi: 10.1016/j.envres.2018.10.006

[35]

HATHAWAY J, MAIBACH E W. Health implications of climate change:a review of the literature about the perception of the public and health professionals[J]. Curr Environ Health Rep, 2018, 5(1):197-204. doi: 10.1007/s40572-018-0190-3

[36]

GILL M, STOTT R. Health professionals must act to tackle climate change[J]. Lancet, 2009, 374(9706):1953-1955. doi: 10.1016/S0140-6736(09)61830-4

[37]

SHIN G Y, MANUEL R J. Healthcare professionals must "think globally, act locally" on climate change[J]. BMJ, 2016, 355:i5686. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=HighWire000006579479

[38]

MOSER A M, STIGLER F L, HADITSCH B. Physicians' responsibility for planetary health[J]. Lancet Planet Health, 2017, 1(2):e56. doi: 10.1016/S2542-5196(17)30023-2

[39]

JOHNSON G A. Role of GPs in communicating lifestyle messages that are good for health and the climate[J]. BMJ, 2013, 347:f6480. doi: 10.1136/bmj.f6480

[40]

WANG S, JIANG J, ZHOU Y, et al. Climate-change information, health-risk perception and residents' environmental complaint behavior:an empirical study in China[J]. Environ Geochem Health, 2019(1):10.1007/s10653-018-0235-4. http://cn.bing.com/academic/profile?id=fc6d1506a68630df6545bd77abf6a56b&encoded=0&v=paper_preview&mkt=zh-cn

[41]

COSTELLO A, MONTGOMERY H, WATTS N. Climate change:the challenge for healthcare professionals[J]. BMJ, 2013, 347:f6060. doi: 10.1136/bmj.f6060

[42]

XIE E, DE BARROS E F, ABELSOHN A, et al. Challenges and opportunities in planetary health for primary care providers[J]. Lancet Planet Health, 2018, 2(5):e185-e187. doi: 10.1016/S2542-5196(18)30055-X

[43]

BLASHKI G, ABELSOHN A, WOOLLARD R, et al. General Practitioners' responses to global climate change-lessons from clinical experience and the clinical method[J]. Asia Pac Fam Med, 2012, 11(1):6. doi: 10.1186/1447-056X-11-6

[44] BLASHKI G, ABELSOHN A, WOOLLARD R, 等.应对全球气候变化: 全科医生的临床经验和方法[J].邵钧, 译.中国全科医学, 2013, 16(10): 1079-1084. [45]

PURCELL R, MCGIRR J. Preparing rural general practitioners and health services for climate change and extreme weather[J]. Aust J Rural Health, 2014, 22(1):8-14. doi: 10.1111/ajr.12075

[46]

PATRICK R, SMITH J A. Core health promotion competencies in Australia:are they compatible with climate change action?[J]. Health Promot J Austr, 2011, 22(4):28-33. doi: 10.1071/HE11428

[47]

DASGUPTA P, EBI K, SACHDEVA I. Health sector preparedness for adaptation planning in India[J]. Climatic Change, 2016, 138(3/4):551-566. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=7e740c1061e71e74cd1233269ba10125

[48]

LOWE D, EBI K L, FORSBERG B. Heatwave early warning systems and adaptation advice to reduce human health consequences of heatwaves[J]. Int J Environ Res Public Health, 2011, 8(12):4623-4648. doi: 10.3390/ijerph8124623

[49]

NITSCHKE M, TUCKER G, HANSEN A, et al. Evaluation of a heat warning system in Adelaide, South Australia, using case-series analysis[J]. BMJ Open, 2016, 6(7):e12125. http://cn.bing.com/academic/profile?id=6b535865fbc4037f6e3efee4f15eeeb8&encoded=0&v=paper_preview&mkt=zh-cn

[50]

BENMARHNIA T, BAILEY Z, KAISER D, et al. A differencein-differences approach to assess the effect of a heat action plan on heat-related mortality, and differences in effectiveness according to sex, age, and socioeconomic status(Montreal, Quebec)[J]. Environ Health Perspect, 2016, 124(11):1694-1699. doi: 10.1289/EHP203

[51]

BENMARHNIA T, ZHAO X, WANG J, et al. Evaluating the potential public health impacts of the Toronto cold weather program[J]. Environ Int, 2019, 127:381-386. doi: 10.1016/j.envint.2019.03.042

[52] 毕鹏.气候变化对弱势群体健康影响的社区干预[J].中华预防医学杂志, 2018, 52(4):348-351. doi: 10.3760/cma.j.issn.0253-9624.2018.04.004 [53]

TONG M X, HANSEN A, HANSON-EASEY S, et al. Perceptions of malaria control and prevention in an era of climate change:a cross-sectional survey among CDC staff in China[J]. Malar J, 2017, 16(1):136. doi: 10.1186/s12936-017-1790-3